One year anniversary

It was on the night of April 3, 2006 that I found a lump in my right testicle. The year that followed that horrible night was one that will mark the rest of my life. It was my own personal 9/11. Damage has been done. But the gash in my groin, four puncture marks in my belly, my ringing ears, my tingling fingers and toes, and my scraggly reflection all remind me less of why they appeared than of a more basic fact: I am alive, god dammit! There is no question that it is because of all of your help and love that this year, with all its horrors, has left as few scars as it has.

The content of yesterday’s meeting with Dr Skinner, the surgeon at USC, came as a complete and total surprise. I had thought that I had driven down to LA in order to hear Skinner’s surgical plan, and if not compare it to the one presented to me at Stanford days before, then at least to evaluate the interest, investment, and preparation of each team, in order to finally make a choice as to who to let slice me up. It was quite shocking, then, when Skinner told me that he did not think that I should have surgery at all. In fact, this famous and experienced surgeon told me that he didn’t want to operate because the only way that he could be confident that he had removed all of the tumor would be to REMOVE my bladder and rectum in the process. And considering that the likelihood is low that there is any live or quiescent tumor still hanging around, the collateral damage would clearly be unacceptable. The option of going in and getting everything that could be removed easily was also deemed a non-starter, since any future surgery would be made much more difficult by the resulting scar tissue. So the plan that he recommended is one of long-term surveillance. There apparently is something like an 80% chance (though nobody really knows) that all that gunk in there is dead anyway, and that any surgery would have been superfluous. There is a very small chance that there is still live tumor which somehow survived the chemo, which will be monitored with frequent blood tests; additionally, there is something like a 20% chance that there is quiescent teratoma hanging out, which could sit there forever, or grow slowly, or undergo “malignant degeneration” and turn nasty again. This will be followed by frequent CTs, and if there is any growth, they would at that point go in and do the surgery that they needed to do to remove the mass. This approach being radically different from Stanford’s, we asked for a referral for a third opinion, and were directed to a team in Indiana, who according to Skinner are the only people with more experience than him at treating testicular cancer. We will be flying out there in a few weeks. In the meantime, though, the thorough explanation I got from Skinner has convinced me not to do the surgery that we had tentatively scheduled for next week at Stanford.

This all seems like bad news, except it isn’t, exactly. After stumbling around in a daze for a while, I realized with the help of some wise friends that even if I went through with the surgery, there would be no guarantee that all of the tumor had actually been removed, and I would still have to be going in for regular screening tests. This way, the only real difference to my daily life is that I don’t have to undergo a gigantic, dangerous, painful, and disfiguring surgery. While the risk of recurrence may be higher because the bulk of the mass didn’t get taken out, that risk is unknowable to begin with, and remains just as vague. The axe hanging over my head will not be any more or less scary.

A long story made short is that things are so ugly in there that… I can just go back to my life?! Huh?! You mean I live in LA again? (Oh, no!) That all of a sudden, I am expected to be an adult again? To collect quarters for laundry, to cook for one, and to wash the lonely dish by hand? I sit in (what apparently is) my apartment, alone, and realize that this last eighteen hours is the longest time that I have spent by myself in a year and a half. What does this mean for the even closer relationship that I have with my parents, and for the many relationships, new and old, that I have with friends in the Bay Area? Who am I, after all of this?

In this empty, quiet apartment, I hope to have the space to find out.