Archive: Feb 2012

After I posted “Immunity Deficiency Blues,” I was asked to furnish some more background. This essay, which I published in the St. Paul Pioneer Press on 11-17-2010, will provide some context for the reader.

T.S. Eliot thought that April was the cruelest month. I disagree. For me, spring is a time of rebirth and rejuvenation. I would argue that autumn is the most cold-hearted time of year.

Last fall I was afflicted with a mysterious neuropathy that baffled my neurologist. A couple of months later I had hip replacement surgery and a fortuitous x-ray revealed tumors on my lungs. They diagnosed me with stage 3 granular pulmonary lymphoma, a cancer so rare that there are only 500 to 600 cases in the medical literature. Turns out that neuropathy is a symptom of the disease. Who knew?

The prognosis is poor. The median survival from diagnosis is 14 months. More than 60 percent of patients die within five years. I completed chemotherapy in July and the cancer was in remission. However, within a month troubling symptoms appeared. I was increasingly short of breath, gasping after 15-20 paces.  Pulmonary embolisms formed. Most days I took two naps. I had no energy; the smallest tasks were beyond me. Walking became a precarious adventure.

Heart function is one potential victim of chemotherapy. Mine has declined to 20-30 percent. The neuropathy has also worsened. My legs are numb from the knees down and I have minimal feeling in my feet. The outlook is grim. For me, autumn is akin to what Dylan Thomas called “the dying of the light.”

Even as a small boy, I found fall the saddest season. I grew up on an isolated rural homestead and rode the bus to a country school. As the autumn light rapidly diminished, I trudged up our half-mile lane each evening in a darkening and bleak landscape. The few flickering lights in the house and barn were of little consolation. The prairie’s sinister spell of fall twilight lifted once I moved to the city.

Only after I bought a rustic cabin on a river 22 years ago did those distant mood swings return with full force. I remain exuberant until the Summer Solstice. Then the days begin to shorten, only so minutely through July and August. The dying of the light accelerates rapidly from September until the Winter Solstice, and my spirit correspondingly withers. I always close down my cabin on the weekend when Daylight Saving Time ends. As I finish the final tasks, this idyllic setting is awash in dead leaves and darkness. I go into emotional hibernation until the next spring.

This autumn has been particularly difficult. My retired brother flew in from Vancouver Island for two weeks to close down the cabin and winterize our home in the city. While I appreciated his visit and help, it only heightened my sense of helplessness. This must be what the late autumn of life feels like.

I held up remarkably well during chemotherapy. However, the damaging aftereffects of chemo and the doctors’ dim prognosis for recovery have finally broken my spirit. My primary doctor recently gave me a questionnaire for depression: “Little interest or pleasure in doing things;” “Feeling down, depressed or hopeless;” “Feeling tired or having little energy;” Feeling bad about yourself;” “Trouble concentrating on things.”

The results were, frankly, depressing. I have a new stamp on my passport—Prozac Nation. I am now taking an anti-depression drug. When it kicks in, I hope it raises my low spirits. Regardless, no mood-altering drug will change the results of my latest checkup. Autumn just got a bit more cold-hearted.

The cancer is back. It has re-appeared in my lungs and spread to my liver. I feel no urge to “Rage, rage against the dying of the light.” Nevertheless, I am not yet ready for a calm acceptance of the coming darkness. I will rejuvenate soon, in spirit if not body. I look forward to opening my cabin in the spring and watching the Yellow River flow, where one day my ashes will be scattered.


Thanks for all your expressions of concern. I am perpetually mystified by the enigma of the human psyche. I got some eerie messages in the last few days. One person wrote to say she had a dream about me. Three others said that for some reason they had been thinking of me. All of them only later discovered I was in the hospital.

I am back home now. No, the cancer has not returned. No, it was not another heart attack. Something much more pedestrian. I had gotten deathly ill last Monday. On Wednesday I went in and discovered that I had severe neutropenia, a dangerous decline of those white blood cells that fight infection. It is commonly associated with extended chemotherapy and AIDS.

Severe neutropenia leaves you vulnerable to any viral infection that comes along. It has occurred five times in the last 18 months. It is an experience you don’t want to repeat. The infection is like five days of the worst case of flu you have ever experienced. In the first 48 hours, I was awake for about two hours total. Fevers raged to 103 and I took demerol to fight the headaches,chills, tremors, and body ache. Massive antiviral drugs and constant IV fluids finally get it somewhat under control.

I had recently written this for MPR: “I had made my peace with death, when suddenly I was expelled from the land of the dying. It is not easy to return to the land of the living and, once again, play an active role in the human comedy.”  Nevertheless, after 10 months of remission from cancer, I was once again playing an active role with a vengeance. In fact, I had deluded myself into believing that I had won Bergman’s mythic chess match with Death. Once again, this week has been a Memento Mori. He stalks me still. 

“But perhaps that is the point: none of us have anything more than a temporary reprieve from our terminal condition.”