Whipple Effects & Perspectives

I have been working through two separate after-effects of my Whipple procedure in the past few weeks. The Whipple is the surgery that removed my tumor and so, saved my life.

I have always been a little anemic, ever since childhood. Anecdotally, I've been feeling it a little more since my Whipple. I used to give blood and platelets very regularly and only failed for my hemoglobin levels very occasionally. Since being Whippled, I only pass 10-20% of the time. I've also struggled with my running – speed and endurance – since being sick. I reluctantly chalked it up to just getting old. But after waking up exhausted again a full 10 days after doing my first half-marathon in over two years, I knew that something was up. Blood work confirmed my low iron. Scoping my insides since has confirmed that I am not losing blood internally – which is good. It does imply that my iron absorption is extra poor. So I've started weekly iron IV infusions to prop up my counts. Problem experienced, diagnosed and getting remedied – thank God.

I also had a surprise incidence of pancreatitis recently. I went from exceptional to ER in a few hours one Saturday afternoon. Turns out I have a little stone in my pancreatic duct that was causing a back-up in there. An overnight at RWJUH, a CAT scan, 18 hours of IV fluids and time off for my digestive system – and I was fine again. The stone formed because my duct is likely restricted from my tumor having pressing on it. My fine doctors can't get at it because my altered piping increases the risk of a perforation as they snake their way through. Zapping it isn't an option because the pancreas is a soft tissue organ and would cause too much collateral damage. So, I wait for it to pass in its own time. In the meantime, I am forced to avoid the fried and fatty treats (and alcohol) that beckon all around. It was pizza and red wine that irritated my pancreas enough to land me in the ER in the first place. My margin of error is suddenly very slim. Again… problem experienced, diagnosed and getting managed – thank God. Anything short of hearing, "I am sorry Mr. Juricic, there's nothing we can do for you." – I am okay with.

Independent of these health issues (other than having a little bit of horizontal hospital gown time to reconsider life), I have been thinking a lot about perspective lately. It seems to me that perspective is mostly a matter of what we are comparing things to. Satisfaction in life may have more to do with our response to (the nearly-always) when life falls short of some ideal. Because even then, it is nearly-always better than it could have been. [Not to imply that we should strive merely for something better than the worst-case scenario in life.]

A pancreatic stone is far better than any kind of tumor.
My Nona Ana's long and rich 92 years of life and love is far better than most of us will experience.
Running slowly still beats not running at all.

I've noticed some conflicting tendencies amongst us that allow for convenient, and sometimes counter-productive, perspectives. For instance, when we consider our actions – especially in response to the behavior of those around us– our inclination is to compare ourselves to others. "Well…she started it." "He was mean/hit/whatever me." "People cut in all the time." Because this other behaved a certain way (that is wrong in our eyes), we then justify our bad behavior in return. And thus, the situation between the Hatfields and McCoys is perpetuated.

The question is – why do we compare ourselves to the least common denominator in the behavior of others? Why do we allow ourselves to be hurtful back when that person hurts us? We have numerous vey compelling real-life examples of better responses such as Gandhi, MLK, Mother Teresa and, or course the ultimate, Jesus. Why not strive for those bests instead of excusing ourselves to be less than that?

Interestingly, when it comes to how others "should" respond to us, we apply a different
measuring stick. Suddenly we no longer use "others" (or that very person) as a reference point. For the actions that others choose to take towards us, we compare those against what we (claim that we) would have done. Knowing what we need in a given situation, we very readily identify how the other fell short. "I would have…", we think to ourselves. "I would never…", we conclude – conveniently forgetting the times when we are selfish, arrogant or hurtful.

How convenient that we judge ourselves against the worst in others, while others get measured against the best of ourselves. That expedience allows us the maximum latitude, while leaving others minimum room for error. That does not seem like a very loving approach to community with others.

Christianity challenges these errant comparisons. It is not about being Christ-like, exactly. Ours is not so much to try to be Jesus – but, at best, to bring a little bit of Jesus into this world. I can only strive to be the very best Franco that I can be in every situation. That is, obviously, an incredibly tall order. And the best I can do is always better than what I am managing right now. Yet, that is precisely the challenge of Jesus.

A necessary aspect of that perspective is the knowledge that we will all always fall short. I will for sure – and that's okay. Compared to a lesser me, I can only keep trying to choose my best response. You will disappoint me too – and that's okay. I have to believe that you are doing the best that you can manage too. That is were compassion and forgiveness come in - for ourselves and towards others.

A good perspective can start with the reference point that we are all broken and trying our best. There's lots of rewarding places to go in life from there.

P.S. – Thank you all for the amazing love and prayer support that I have felt throughout this recent health issue and always. I am incredibly blessed!

Letting Go of Life

I have seen, in the last few years, demonstrated instances of individuals seeming to will them selves back to good health (if not back to life). I have also seen sad situations where cancer and other diseases have resisted the strongest will, taking a loved one before they were ready to give back any of their precious time here. I increasingly believe in the possibility that life or death is more than just a chance outcome that happens to us. We may not quite definitively choose but we may have a say. Certainly our influence on the outcome may not be equally balanced – choosing to stay may not "take" as easily as deciding to go. When it comes to the elderly especially, there may come a day when the other side with all of its unknowns becomes more appealing than someone's present state here. My 92-year-old grandmother, Ana, has been circling around that reflection point for a couple of years now. She'll say that she's ready to go, yet keeps fighting on. What an ideal place to be! She surprised me by deciding to have her leg amputated about a year ago and was herself surprised to conclude a few months later that it was worth it. Faced with the loss of her other foot now, she is getting ready to move on. She will be dying on her terms. Though it makes me sad, I see an incredible beauty in that too. What must it be like to have lived such a rich and fulfilling life that one would be content enough to "choose" to check out. Nona Ana fought as so many do – out of necessity, to survive. She taught me the wisdom of knowing when not to fight, and that acceptance can sometimes be the best course. How self-assured to trust in what comes next so much that it overwhelms the fear and apprehension inherent in that uncertainty. How beautiful to have that end come so gradually that it allows for heartfelt goodbyes with those you love. I wish that I might know the day when my work here was so complete that I was prepared to step into the next world in peace. I wish that how I die might reflect how I've lived. In Nona Ana's case, I hope that it can be with all of the stubborn strength, love and dignity she has shown throughout her life. Loving people are visiting her in these last days not because of what she can do for them now but based on the care that she has shown them throughout her life. For me that kindness and hospitality is symbolized by the world's best chicken soup that was waiting for me as my first meal after a long trip every time I visited. She is amazing and teaching me so much right up until this end – including this final lesson on trust. May the saints she's worshipped her whole life bring her safely home. And may there be a bowl of the most delicious soup (as she'd say, kako medezija) waiting for her when she gets there.

Revisiting Fairness

Last month (since these blog entries have slogged to being monthly) I wondered and whined a bit about not deserving my cancer given the not-too-bad care that I had taken of my body, diet, etc. I pondered this within the context of considering faith and acts on outcomes.
While I may have trouble understanding how I deserve the "bad" (cancer) that has come to me – I am equally at a loss to justify how it is that I merit the bounty of wonderful good that I have been blessed with in this life. Our perception of what is just in life is so conveniently twisted.
My 5-year-olds invoke fairness all the time. They probably say "that's not fair!" in various situations more than 10 times a day between them. I don't know if an expectation of fairness is something we instilled in them or is "natural" (i.e., in-born). As it turns out, they don't yet (?) really understand what fair is, they just think that they know injustice when they see it. Come to think of it…maybe they got that from their dad. Or is that too, a universal of sorts – human nature? They misapply the notion as often as not. Even cutting a deck of cards to decide who gets to go first – which is a pretty fair way (in the sense of random, anyway) to make such a decision, I think – ends up deemed unfair by the one that ends up second.
There is a childlike longing for a cosmic justice system in all of us. We want to believe that we get rewards for our goodness, that we "earn" something. It's assuring to think that instant karma works both ways and that it's gonna get you a bonus too. Life repeatedly heaps on the evidence that it doesn't work that way. There was never any assurance that life is fair or causative. What is it in us that refuse to allow us to let go of this scales of justice perspective?
We can try to create that justice as much as we can in a world whose circumstances are mostly beyond our control. Or we might choose to develop the spiritual fortitude to weather the inevitable setbacks and tragedies that inexplicably come our way. In this sometimes gray world, the most fruitful truth may be found in a healthy dose of both – actively creating justice and accepting the inescapable. Like "The Serenity Prayer" says: "God grant me the serenity to accept the things I cannot change; courage to change the things I can; and wisdom to know the difference." Ultimately, the trick is having the courage to bring a little relief and justice whenever we can, and the wisdom to hunker down with your God in the faith of a better day tomorrow when you can't.
In the end, life is not fair – which can, in itself, be a good or bad thing. In the same way that we cannot understand how God can "allow" this or that tragedy to befall anyone, we cannot know what lies behind God's grace either. It makes no sense (to us).
Still, on that plus side, I humbly thank God for the fantastic life that I have been blessed with every day. More good than I could have ever earned. It's a personal heaven right here and now.

Faith and Acts

Immediately upon being diagnosed with pancreatic cancer 3+ years ago, I wondered "why me?" of course. Not that I was without vices but I considered myself to have a healthy lifestyle. I exercised regularly and ate mostly vegetarian. I was days away from my 6th marathon. I kicked into a classic faith versus acts debate - asking myself why I qualified to have this disease. What had I done to my physical body in this life to start this tumor off? Or, what had I done against God to deserve this bleak fate. In the old days – B.C. – it was believed that people were stricken with maladies because of some sin of their own. My "bad" acts certainly didn't seem to merit this outcome (as if it ever does for anyone).
Similarly, there has been a controversy, in Christianity, for more than 500 years around the relationship between faith and acts. Put another way, is it strong faith that puts us in God's good graces or do we earn it by our actions. What, if anything, do we have to do to earn God's favor? Will only those who live lives of moral merit be saved (i.e., go to heaven)? Some maintain that we are we automatically in by virtue of being God's children. If it's all faith and good acts are not required, then why even bother to be good? How exclusive is this club and just how does one get in?
Different denominations find themselves on various points along the spectrum between (a) believe and you are in and (b) we will all be judged on how we've lived our lives. Regardless of religious affiliation, each of us falls somewhere along this continuum in our personal attitudes. Maybe you believe that we get what we deserve in life; that you have no one to blame but yourself for your situation. We all believe in something. Those morals, beliefs and acts define us. Faith and acts tell us who we are and it's the mix of the two that will determine who we might be.
In life, we can hope for longevity and/or we can work towards it. I took definitive acts, rather than merely counting on my strong gene pool to carry me into my 80s. Then, once my post-diagnosis reality became clear and my future foggy, my faith versus acts balance tipped a bit. Getting what I deserved became less important since I had no clue what that meant anymore. I'd thought that I had been a good enough guy (in terms of acts) to be allowed to live, but I needed more than that now. I began counting on faith as well as acts (and whatever else I could grab on to) to put me into the exclusive 6% club of five-year survivors. I wanted to will myself into seeing my kids grow up by the sheer force of prayer and optimism. Faith could save me. Just to be sure, I cleaned up my physical and mental act further – reconsidering every input into my body, meditating and sleeping more (hopefully not at the same time) and stressing less. If it's acts that can save me – I'm there. But I am not gonna let faith be my weak point either.
I am not saying that I believe that we can earn one fate over another or that I was lacking in faith before. Maybe it helps if faith precedes acts. Maybe you can't get by on just one or the other. Can good fruit spring from a bad tree; good health from a dark place? I don't remotely understand the relationship between faith and acts. I do know that deference to both is working out well for me so far. Thank God.

Get Ready to Rumble!

The thick fog of lives cut short by cancer is stifling the hope-filled sunshine that typically sustains me. My friend Michel's recent passing is the latest unbelievable loss. I am stunned by the suddenness of it even though he'd been battling cancer for some two years. My heart breaks at the pain most assuredly felt by those closest to him which I know dwarfs my own. I am angry with this outcome - though I am not sure who to direct it at. God seems like an appropriate target. Yet, I hesitate (which could probably be the topic of another day).

Besides Michel's tragic end, cancer seems to be all over my world. I just learned of the passing of a pancreatic cancer brother that I had been talking to by phone throughout the first half of 2011. A cousin was diagnosed with colon cancer and a work colleague with pancreatic cancer over the holidays. I am struggling to not drown in the overwhelming sadness, futility and sorrow of these injustices. I am struggling to see God very readily right now. Too little of it is making sense or seems fair to me – as if it ought to. As if there was any such guarantee. ("That's not fair" is one of my kids most used phrases. As if we are born with that expectation.) I feel fooled, like the rug was pulled out, while recognizing that there was never any promise. Life is not just. We can work to make it so with all that which is in our control. And then there's all that we can't. There's a line somewhere.

As usual it is the expectation of something different unrealized that creates the negative emotions. But, how to expect any different? Can we really go through life not expecting to see each person again that we say good-bye to when parting? How do we avoid expecting that we will each live to a ripe, old age, etc? The best we can do may be to sort through these emotions when the unthinkable does happen.
Although it is not quite wrestling with God ala Jacob, it is grappling with tornado events that blow apart our fundamental beliefs and the resultant tattered emotions left in their wake.
The reality is that these natural events do and will happen. Sometimes rarely, sometimes barely, but always eventually. By getting dirty with them in our lives, the struggle itself offers an opportunity to grow. By sorting through our pain and loss we mature emotionally and possibly spiritually too. We do have the option available to stay "clean" – to avoid or ignore the foundational challenges and emotional toll. That may be the path of lesser resistance and work for us for a while. That avoidance is not transferable though – neither interpersonally nor in time. It does not put us in a better position to help a neighbor when a tornado hits their lives. Nor does it better equip us to handle the inevitable next disaster in ours. And don't we want to be in the best possible position to help a loved one during their time of need? Is not our emotional fitness, like our physical, maximized by the very process of tearing down and rebuilding the muscles with which we respond?

In those many instances when I cannot change the external environment, what is happening to me or how someone else is behaving – I sometimes remember that I can always change my own perspective on the situation. Often, that's all we do control.

Yet we have a self-preserving/correcting momentum towards the most stable point. We want life settled, somewhat predictable and complete with an answer key. On a day-to-day basis, that perspective does not recognize that death could come at any moment either for us or someone we love. It would require much more energy to live with that awareness in every now. So, we emotionally conserve – by denying.

I have been reminded lately of the strength that can come out of brokenness. It is broken bread that nourishes us. God can come to us most (pointedly) in our brokenness. It may be that our greatest opportunity comes at that very moment - when we most want to turn away. Let's wrestle.

Milestones Along the River

In a life where every day feels like a blessing, particular milestones have me reconsidering my life's flow. Holidays and anniversaries seem to be zipping by, each offering me perspective. Some are secular, some medical, some both; some personal, some communal, some both. All are poignant prompts.
The tenth anniversary remembrances of 9/11 allowed all of us to look back at all that's happened since everything changed. A turn of events we couldn't have imagined transformed our reality. There is no going back.
The more mundane Halloween has connotations for me beyond the faux fear of costumed children. It is the anniversary of my diagnosis. Has so much time really passed since everything changed? It's been about a thousand days, on top of everything else that God has willed me.
Followed shortly by my 45th birthday – (again) has so much time really passed?! The number matters none when I am feeling this young.
Then…Thanksgiving – newly one of my favorite holidays. A day devoted to gratitude! It's a day where we all pause to celebrate the blessings in our lives. How beautiful is that?!
Dec. 1st was the 3rd anniversary of my rebirth. The 'textbook-case" completion of my Whipple surgery was my own personal resurrection. Since then there's been grieving, letting go, accepting and choosing. The last with a little more clarity and maturity these days (I hope).
These milestones are like a church bell that tolls midnight with a dozen dongs on a crisp November night, slow and meaningful.
There have also been a rash of "remember that time…" mementos lately too - each uniquely and cumulatively good. On a glorious weekend just after my birthday, I helped the Pancreatic Cancer Action Network register the 1,400 walkers and runners that raised $250,000 for the cause of research and awareness. That Sunday evening, I appeared in the WPIX news story about the event. The night before I stretched well beyond my comfort zone in a staged reading of a series of one-act plays performed in our church sanctuary. That stretch is like pulling oneself up on a frayed and knotty rope strung across that river of life. Like milestones, it gives you a new perspective on who you are, where you've been and where you might go.
And where is God in all of this? God is at the center of each of these events because it is God's grace that allows me to experience these time milestones. It is that grace which allows me to hope into the future, to make plans for more and even better things.
Without any merit on my part, God has given me time – to experience, give thanks and contemplate. It's that last part that I am working on most. In my relationship with time, there's a tension between action and reflection. Action often gets the better of the bargain. It's all about finding that balance. Our actions define us but it's the moments in between that provide the fodder. The soul's purpose and direction are found in the pauses. I am learning.
I long to sit on the bank beside the stream more often. And for a little while longer, God willing.

Crossroads and Anvils

A couple of weeks ago, I had two life-changing verdicts arrive within days of one another. I was expecting one outcome to create a big redirection of my career path and earnings forecast. I was anticipating a life-change. The second result was much more important. I needed that info to come back as more of the same, no change – a cancer-free life continuing.
On one Friday, the first decision came back opposite to my expectation. I still have a job - the same job. With this news, life goes on mostly unchanged during my nine to five. It's up to me to get back to the grind and polish that stone into a diamond (or at least something semi-precious).
The next Thursday, I met with my oncologist to review the results of my 6-month CAT scan and blood work. This is the sit-down that really mattered - facing life or death in a well-lit room.
Once again I have been granted more life. Another clean scan! No changes. Thank you God! This trend towards more of the same is much more welcome than the last. What happened work-wise was a distant second to good health news – a side of gravy to the finest meal ever. I am unbelievably relieved. An incredibly good life full of possibilities continues.
Until…just like that, life changes. Within 24 hours of my renewed lease, my sister-in-law Jennifer was injured in a devastating auto accident. She is going to be okay but faces a long and already painful recovery. She has multiple broken bones and fractures – foot, arm, hand, ribs, back and eye. We are counting on the amazing talents of her medical team and her own spirit of perseverance to get her all the way back. The outpouring of love, thoughts and prayers are much appreciated and will certainly help. Thankfully, she and the friend who was driving her car have been improving daily.
Jennifer's accident represents a third direction that one's life can take that confronted me that a week. A life at a major crossroads can (i) continue on largely unaffected, or (ii) take a turn for the better or worse (sometimes we may not know which until the end of that particular road). Or the crossroad (iii) comes suddenly on an otherwise bucolic country road, a broadside out of no where.
Our default perspective is that our own life's "trajectory" is traced out ahead of us – as if there is a path. That ruse is laid bare when life pulls the rug out from under us and the truth falls like an anvil. Just like Wile E. Coyote, we have a hard time incorporating the lesson (of how transitory life can be) into our lives. That trajectory is really just momentum, and the confluence of factors that maintain our day-to-day consistent. Pull out any particular gravitational force and a life can go careening through space. There may be a path, but you'd be a fool to think that you can see much of it in front of you.
Once past the stunned stupor of Jennifer, I am simultaneously questioning and appreciating God. "How could God let this happen?" and thank God that it wasn't worse.
There's no making sense of life, or getting too comfortable in it.
Never forget to say "I love you".
Don't take anything for granted.
Syrupy, I know, but very true too.

PS – My thoughts are very much with three exceptional fighters that cancer took this past week. Wendy - who threw the first ball out with me at the Somerset Patriots Pancreatic Cancer Awareness Day in July. Mary Kay – who mothered all of the Flushing boys. God bless her. And Steve Jobs. Peace to you all and your families.