By Lon N. Larson, Ph.D., the Ellis and Nelle Levitt Professor of Pharmacy Administration, Drake University
Thank you. Thank you very much. I really appreciate all of you being here today. I want to thank all those involved in inviting me to make this presentation. I am very honored to be giving this talk.
I apologize for reading the bulk of this presentation. The reasons for doing so are to keep me from wandering off and to increase the likelihood that the word my brain is thinking is the word my mouth is saying. I blame these on chemo-brain (but I suspect both were common even before I had cancer). I will try to read interestingly.
Purpose of the presentation
This presentation is advertised as dealing with the topic: "Choose Your Attitude." I imagine the usual speaker for this topic as being a psychologist, a motivational speaker, a successful coach, or perhaps, a captain of industry. I am none of these. Rather, I am a cancer patient-survivor, and I am the father of a cancer survivor.
Now, you may be thinking this is a presentation on how "attitude can cure cancer" or "the power of the mind in healing." It is not. I do not know if factors like attitude and social support affect the course of the disease.
However, I do believe that attitude and social support affect the patient's quality of life. Please do not desert your friends when they are diagnosed with cancer, even though it can be tough to talk to them; and remember that the cancer patient -- or any patient in chronic pain -- has the right to be depressed and/or angry. Expecting patients to show they are bravely fighting their cancer by always being cheerful and upbeat is unrealistic.
This presentation is simply my story as a cancer patient. I want to share with you some insights -- related to attitude -- that have become especially meaningful to me in coping with uncertainty and adversity. The story deals more with living than dying, and therefore, I hope each of you -- regardless of age or health status -- will hear something that you find thought-provoking and meaningful.
I have some fears regarding this presentation: First, I don't want to denigrate the experiences of other cancer patients. Each cancer patient is unique, and I do not want to portray myself as being stronger or having a better attitude than any other patient. I have received a great deal of publicity about my cancer; I confess it is approaching embarrassing. I am lucky -- not gifted. I claim no "insider knowledge" on how to live life or face death.
Second, I fear that the presentation will come across as a "how-to lecture" and/or as self-praising. Believe me, I do not always practice what I preach. I am struggling with these issues. I am truly a work-in-progress. When it sounds like I am bragging, my intent is to illustrate that ordinary people -- people who are not rich, powerful, famous, or extraordinarily talented -- can make a difference in this world, a big difference.
Finally, I do not want this to be an obituary in which I recite my accomplishments nor an acceptance speech in which I acknowledge all the people who have given so much to me. But I do want to offer a collective "thank you" to all of you who have been part of my life; I owe you everything.
Quick history of medical events
In late October, 2006, I was diagnosed with Mantle Cell Lymphoma -- "nasty stuff" as one oncologist described it -- 50/50 chance of living 2 years; 5-year survival of 10 percent. I began chemotherapy in Des Moines, followed by an autologous stem cell transplant in April, 2007, at the University of Nebraska Medical Center. I was on medical disability during most of the 2006-07 academic year. I returned to full-time class-room teaching in January, 2008.
Our 24-year-old son, Brett, was diagnosed with Ewing's Sarcoma in February of 2008. Believe me, it is far worse being the parent of a cancer patient than it is being a cancer patient. His situation was far more harrowing than I will describe here. His treatment plan called for 14 rounds of chemotherapy -- with surgery in the middle -- at the end of May. A week before his surgery, scans revealed that my lymphoma was in my brain. Brett had surgery at the University of Iowa Hospital and Clinics on the day after Memorial Day.
As the surgeon came to the waiting room to give us a report, I had a seizure and don't remember much of what went on for a couple of weeks afterwards. The good news was that Brett's surgery was a success. He resumed chemotherapy, finishing his last round about two weeks ago with all reports looking good.
Meanwhile, as Brett was resuming his chemo, I was receiving chemotherapy intrathecally. It proved unsuccessful, and I had another seizure in July. I was given 3 to 6 months to live. (That was 4 months ago.) I began general brain radiation therapy, which has been successful in removing visible signs of lymphoma in the brain. I am now receiving systemic chemotherapy for lymphoma in my skin, and it appears to be working. (We hope that the cancer has run out of places to hide.)
I have divided my "emotional coping story" (or attitude story) into five chapters, each based on the wisdom and insights of someone else.
Chapter 1: Lou Gehrig
I want to begin with Lou Gehrig -- one of the greatest baseball players of all time. His hall-of-fame career was abruptly cut short by what became known as Lou Gehrig's disease. At his appreciation day at Yankee Stadium, shortly after his diagnosis, he said (paraphrasing), "Some people say I have been given a bad break. Today, I feel like the luckiest guy in the world." What a surprising statement from someone whose life had just been permanently turned upside-down -- whose quality of life would deteriorate quite rapidly until his death, two years later. And yet, here he was expressing gratitude and hope, not bitterness.
I feel much the same way as Gehrig. When I compare my "bad break" to all the good fortune in my life, I feel like I am the luckiest person in the world. My good luck began the day I was born to great parents -- they showed me how to live, and they loved me unconditionally. I received a great education -- my early teachers instilled a love of learning, and my college mentors were great role models of academic professionalism.
Meeting my soul mate, disguised as a schoolmate I had not seen in nearly 20 years, was a miracle that changed my life completely. My children deserved a better father, but they never gave up on me -- and I think I have improved with time. I found an occupation as a university professor that is more a calling than a career. I love fighting "ignorance and close-mindedness." I have gotten to work with intelligent, hard-working students and colleagues at two great universities -- nothing is more stimulating and enjoyable.
Finally, believe it or not, my cancer has also been a source of good fortune. Family relationships have strengthened; friendships have been forged or deepened; I met cancer survivors whose courage and optimism have been inspiring; and I have interacted with very humane and truly caring professionals. Very importantly, it gave me experiences and insights to be a much more helpful and supportive caregiver for my son. Finally, cancer has changed my outlook or attitudes on life, which leads us into the next chapters.
Chapter 2: "This is the day that has been given to us, let us rejoice and be glad in it."
This is paraphrased from the Book of Psalms in the Old Testament of the Bible. It emphasizes the importance of living "in the moment" or "one day at a time" and being grateful for whatever that moment has to offer -- even if it is something unexpected and/or unpleasant. Again, life is what is happening "here and now" -- be it to our liking or not.
"Living in the present" is not easy to do -- even for cancer survivors -- although we have an advantage. A good friend of mine, also a cancer survivor, often points out that everyone is going to die, but cancer patients are more conscious of it -- more aware of it.
When a person is healthy, it is easy to "worry about tomorrow and miss today." After a diagnosis of cancer, we realize that we have a finite number of days available to us. It may be thousands of days or just a few -- but the number is certainly finite. This finitude helps us appreciate each day -- each moment -- more. Also, cancer, after beating us down, makes it easier to give thanks for the moments when the quality of our life is good.
This will sound corny, but I will confess it anyhow. In trying to live in each moment, I have become more observant of people's smiles. I try to look at them intently – without being impolite. I try to make others smile if appropriate. I smile often -- at friends, at strangers -- in hopes they will smile back. There is nothing more beautiful than a human smile. Or stated differently, no person is more beautiful than when he/she is smiling.
Chapter 3: "The barn's burnt down, now I can see the moon."
This was written by a 17th century Japanese poet [Masahide]. It describes beautifully one of the great ironies of life: our emotional [and spiritual] growth spurts occur after failure or adversity -- not after our successes. Two quick stories to illustrate:
A friend was fired by the company where we both worked. I was angry; he was devastated. He had worked hard and was a conscientious manager. His dismissal was not fair. However, within a year, he was saying that this firing was the luckiest thing that had happened to him. He had found a new job that he loved, and he came to realize how much fun work could be. He never would have left our mutual employer voluntarily and, consequently, would not have known the joy of work if he had not been fired. For my friend, being fired was the burnt barn. With it out of the way, he has experienced the moon of rewarding work.
The second story involves me directly. While I lived in Tucson, I attended a church that has been the most transformational experience of my life. The church consisted of a phenomenal preacher and a bunch of people that society -- and many churches -- would label as misfits or undesirables. Many members were gay or lesbian, divorced, fighting addiction of one kind or another, homeless, suffering post-traumatic stress from household abuse or war, seeking employment or a new start. The church was welcoming, compassionate, and nonjudgmental. That is why I was there.
I was one of the misfits; I was going through a divorce. With this divorce, I realized I would never be the father-husband of a family like the one in which I was raised. As I thought back over my childhood, I realized I could not give my children the opportunities to acquire memories like mine. My hopes as a father were shattered. I was devastated. I was a failure; I hurt.
"My barn" -- my marriage and with it, my view of a "good life" -- had burnt down, but this church became the newly visible moon. This church changed my view of God, my view of Godly living, my view of a "good" family, and it made me more compassionate and less judgmental. None of this would have happened if not for my failure in marriage.
A final general comment about the barn and the moon: it does not always work as easily as these stories would indicate. First, the person has to accept that the barn is gone.
As an example, for the cancer patient and our family members, life as we have known it, our hopes and dreams have been altered -- if not shattered. Some people will dwell on their loss, become bitter and angry, and miss the moon entirely. Second, the newly visible moon(s) may not be seen easily or immediately. I began looking for a post-cancer moon when I received this poem shortly after my cancer diagnosis. That was two years ago, and I am still looking. Perhaps today is part of the moon -- we shall see.
In sum, regardless of the adversity we are facing, this wisdom suggests there is opportunity ahead and reasons for optimism. However, it requires acceptance of loss and openness, alertness, and patience to appreciate the newly visible moon.
Chapter 4: "Finding the courage to make our lives a blessing"
This is a line from the Jewish Prayer of Healing.
The English portion of the hymn is:
May the Source of Strength, who blessed the ones before us
Help us find the courage, to make our lives a blessing.
And let us say, 'Amen.'
Bless those in need of healing
Renew our bodies, renew our spirit.
And let us say, 'Amen.'
It is a beautiful hymn, but the phrase "courage to make our lives a blessing" is what most intrigues me. Perhaps naively, I had never thought much about 'making my life a blessing'. What is a life that is a blessing? What does it "look like?" What does it require? For whom is it a blessing? Why does it take courage? And, specific to my case, how does a dying cancer patient make his life a blessing?
We will back up a bit in time: A year before I was diagnosed, my mother died. The newspaper that ran her obituary has a service where readers can send remembrances. A clerk at the Hallmark shop where my mother bought greeting cards wrote (paraphrasing), "Dorothy (my mom) was a wonderful person. I am a better person for having known her." I was stunned when I read this. How was my mother able to influence the life of another person by buying greeting cards from her? My mother would best be described as a sweet, unassuming lady who was always upbeat and quick to smile. But she was not famous. She was far from rich and she had no clout or social prestige -- yet she influenced the life of the clerk.
I was raised believing that we should leave the world a better place than it was upon our arrival and that our contribution is the things that we accomplish. With my mother's obituary, I began to wonder what is really important in making our lives a blessing and leaving a mark on the world: On the one hand, it could be our accomplishments -- what we have done. In academia, we use a curriculum vitae or c.v. as a summary of our professional experiences and accomplishments, awards. It measures what we have done professionally. But does it measure my 'life as a blessing?'
Or as my mother's case suggests: is our life a blessing based on how we live life, how we do what we do? Do we live with honesty, integrity, authenticity, respect, justice, kindness, compassion, and as corny as it sounds, with love? If the important ingredient is how we live, then 'making our lives a blessing' is a matter of attitude, not talent.
As I was trying to make the most of each day, look for moons, and make my life a blessing, something quite unexpected happened. To put it in perspective, we turn to the next chapter.
Chapter 5: George Bailey
George Bailey was the character played by James Stewart in the movie "It's a Wonderful Life." At the beginning of the movie, George did not feel like the luckiest person in the world. He had never been able to leave his two-bit hometown and travel the world as he had dreamt. Now, it looked like he would lose the family business, and perhaps even be charged with criminal conduct.
As he saw it, his life had amounted to nothing; it had been meaningless. He was contemplating suicide, when an angel arrived and showed him what the world would have been like if there had never been a George Bailey. George sees the large number of people he has touched -- unbeknownst to him at the time -- and the positive effect he has had on their lives. He then realizes his life is wonderful -- it has meaning.
After my diagnosis, something quite unexpected and quite memorable occurred. I experienced a "pseudo-George Bailey" moment. An angel did not appear, and I did not get to see what the world would be if I had never been born. However, I did get a glimpse of how others saw me. The response of my colleagues throughout the university (and nation) was heart warming. In a message that touched me deeply, a colleague wrote, "Please hurry back. I miss your smile, your passion, your wisdom."
Even more special was the outpouring of support from students and graduates. It was simply unbelievable. Through conversations, cards, and notes, many expressed their gratitude – not so much for the knowledge that I had taught them -- but for the way I had influenced their lives. These were not just the students that I worked with closely on projects or who were my advisees. The number of students expressing their gratitude and the depth of their feelings toward me were truly overwhelming.
This was not all of my George Bailey experience: As I was receiving my bone marrow transplant, a student group organized a bone marrow transplant registry drive in my honor. (This was front-page news in the Des Moines Register.) Students also organized teams for the Cancer Society's Relay for Life. As a fund-raiser, they sold T-shirts that read:
"In pursuit of survivaL
We wAlk with
And stand foR
And our frieNd
– Dr. Lon Larson"
You can call me George Bailey -- it is a wonderful life.
To conclude: each of us gets to choose our attitudes:
We can worry about a future that may never arrive, or relive the past; OR we can live in this moment and be thankful for it.
We can become bitter over adversity and bad breaks -- our burnt barns; OR we can look for new moons -- new opportunities.
We can seek the courage to make our lives a blessing. We can focus on what we do -- recommend medications, dispense prescriptions, add lines to a c.v., make money, acquire power; OR we can focus on how we do what we do. Do we act with integrity, authenticity, kindness, compassion, patience, justice?
These questions should not be taken lightly. Our answers will affect our joy in living. And they will affect those with whom we interact. Our choice of attitudes influences their lives -- and in turn, the world. The meaningfulness of our lives -- young college student or dying cancer patient -- depends on our choice of attitudes. May we all choose wisely.
Finally, Mr. Gehrig, if I may steal your thunder: Today -- I am the luckiest person in the world.