26. Is It a Gift?

Not exactly the word I would use to describe cancer. But I see her point. 


25. Getting Out

After a scary experience with blood gushing out of my neobladder in early 2012, I had a breakthrough. For the good. I haven't said those words a lot. A couple things began to work in my favor and permanently shape my adjustment to a new lifestyle.

First was talking more with Rhonda, Dr. Schenk's nurse. Rhonda is one of those people you come across when cancer strikes. She's understated, sympathetic and knowledgeable. And she keeps Schenk focused on the immediate task at hand. In turn, Schenk mentors Rhonda on all aspects of medical treatments. For instance, when Shenk performs cystoscopies, after he examines me he has Rhonda take a look through the tubular camera as well. It's easy to think of Rhonda as a kinder, gentler version of Schenk. By this time, Rhonda had become a go-to person for my medical treatment.

Rhonda explained how to manage muscus production in my neobladder. This had been my big enemy in adjusting to a new plumbing system. Namely, the neo would continue to act like the small intestine it formerly was and produce muscus. Lots of muscus inhibits the ability to void a bladder, and can be addressed only with catheters.

Before I had surgery, I didn't really focus on this aspect of the neobladder. Now, I could harly avoid it. Each time I would go to void my bladder, I would take a deep breath and hope that the darn thing would work well -- a feeling that continues to this day. When the neo worked, it became a highlight of my day. When it didn't, I would sigh and wonder whether the extended life God had given me meant a life filled with struggle.

How could I manage my way through all this? Well, different drinks and food groups affect muscus production, Rhonda told me. Dairy products are the worst, with sodas and coffee having a somewhat lesser effect. In other words, many of the things I normally consumed would have to go. Argh. Still, go they did.

And things began to improve. Nowhere near normal, of course. Let's say my condition improved from pure grief to difficult. Not exactly the kinda change that makes you jump for joy. But it was enough progress to free me to do something else: get out more.

My first big outing: a concert featuring the Smithereens, one of my more favorite power-pop bands who were popular in the 1980s and 1990s and now represented one of the best bar bands anywhere. For the past several years, Kate and I had made an annual ritual of going to see the Smithereens at the State Theatre in Falls Church, Va., my hometown. This year, we were able to attend the band's soundcheck before the show. Dennis Diken, a drummer in the mold of Keith Moon, stopped by to chat. When I told him about the importance of this night, he was incredibly warm and supportive.

Before and after the show, I also met others who were either battling cancer or who had lost loved ones to it. It's like cancer is a force that organically connects people with each other. The whole evening, filled with singing, dancing, drinking and conversation, reminded me how wonderful a night out could be. Another step in my recovery.

Next up: nighttime classes at Johns Hopkins University. Again, one aspect of being a cancer survivor is deciding which aspects of your past to bring with you into the future. Before my diagnosis, I had been pursuing a master's degree in American Government at Johns Hopkins. But now, in recovery from cancer, my heart wasn't in it. Kate convinced me otherwise. "Finish what you started," she implored. Indeed, I had only one class remaining, which was intended to complete the full thesis.

Doing so meant getting comfortable with the idea of bringing my bag full of applicances with me. I knew I would have to adjust sooner or later to this new lifestyle. And Hopkins classes seemed like a good way to start. Once in class, my mind began to reengage with subject matter that I hadn't thought about it quite a while. That part of my mind began to wake up, if you will, from a long slumber.

The Hopkins community was incredibly supportive and generous. Professors I had known from pre-diagnosis days, such as Dorothea Wolfson and Tom Stanton, welcomed me back with open arms. We spent time discussing the contruct and merits of my academic arguments, as well as catching up on the events of the past year. With their counsel, I completed my thesis on the future of the U.S. housing finance system.

The faculty was kind enough to give me the award for best thesis in public policy and administration. At the graduation ceremony, Dorothea recounted not just the focus on my thesis, but my illness as well. To top it off, she described how I had submitted a paper soon after I was diagnosed with the plea, "Go easy on grading the guy in chemo." Fellow graduates around me chuckled, with one telling me he wished he had thought of that ploy. A good experience.

Then I began to stretch myself. Before my illness, I had been a season ticket holder to Washington Nationals baseball games. And Kate and I woud occassionally go to Baltimore Orioles games as well. But during my illness, I couldn't attend many games at all. Now, as my body began to piece itself back together, I wanted to change that. In fact, I set a goal to attend more games than ever before.

First, I needed to change my seats. Up until now, we had sat in the cheap seats. But with a neo, I needed access to better-quality restrooms, which meant buying expensive seats on the club level. And these seats came with a minimum of a 42-game plan, more than double my prior plans. Translation: a lot more money. Kate and I discuss any purchase over $500, and this was many, many times that amount. In years past, she would frown on things like this. When I ran it by her, and explained why, she just said, "Do it." Hmm, maybe I can get something extra out of this cancer thing!

Lucky for me, the year I had chosen to attend lots of ballgames came during a season in which the Nationals, a traditional doormat in its division, posted the best record in all of major league baseball and made it to the playoffs for the first time. It was such a sharp reversal that Michael, my usual baseball companion, couldn't bring himself to invest himself emotionally in the Nats because, he feared, they would only return to form and break his heart. By late summer, when the team was cruising in first place, I told him, "Michael, I think you can like these guys now."

He did, and he got to see his first playoff game. I spent the remainder of my time at the park with Kate, creating a post-crisis relationship with her, if you will, as well as many other friends who I hadn't spent much time with since becoming ill.

One of my favorite moments occurred when the Orioles came to Washington to play. Now, Kate is more of an O's fan than a Nats fan, and normally there's no real conflict there. Except when they play each other. So she wore her Orioles garb at the game. This caught the attention of Mike, the usher in our section and a prince of a guy, who seated me promptly but couldn't locate a seat for Kate. "No seats here for Orioles fans!" he exclaimed. Once finally seated, Mike just ragged on her the entire game. We laughed our way through it all.

A touching moment occurred at season's end. Mike introduced us to his fiancee and his grandson, who was just a few months old. Never have you seen a person smile with such joy as Mike did on that day.

From a sports perspective, emotions flowed the most in a playoff game when Jayson Werth hit a walk-off home run in the bottom of the ninth inning to win that game for the Nats, forcing an elimination game the following night. Then, on that next night, with the Nats one strike away from advancing to the next round in the playoffs, Drew Storen, the relief pitcher, failed to hold the lead and lost the game for the Nats. And the season ended right there.

From utter joy to utter depression in less than 24 hours. An emotional roller-coaster, it was. But as we left the ballpark for the last time, I reflected on it all. Now many months removed from a life-threatening illness, I was actually able to feel emotions that had nothing to do with cancer. I was able to begin rebuilding relationships with those I cared about and who cared about me. I was able to meet new friends.

Yes, I was still struggling with the longer-term effects of cancer. But I was moving forward. I was building a new life, with a new set of experiences. As we walked to our car, I looked up with thanks at the crisp October sky, held Kate's hand, and said, "Next year will be even better." And I wasn't talking only about my baseball team.


24. Bud





"It's Jim."

"Oh, hi."

Thus began my recent phone conversation with Bud, my oldest brother. Actually, his formal name is John, which everyone calls him, except for his family. We call him Bud. Don't know why. Might be a holdover from 1950s culture, when he born. Also could be that Bud is John Jr., and my mom didn't want to say, "John," and have two people respond to her...assuming either my dad or brother would actually respond.

This day found Bud/John is pretty rough shape. He had suffered a nasty fall that completely ruined his right arm and shoulder, which he promptly reinjured with another fall, forcing him into a wheelchair for fear of a three-peat. Then bad went to worse. A particuarly aggressive infection found its way to the shoulder area, and prevented doctors from performing surgery. Additional tests revealed that Bud was suffering from liver failure. The wheelchair suddenly became a hospital bed.

"How are you feeling?"

"Oh, well, you know."

I didn't really know, but I knew enough. As Bob, my other brother, explained it to me, Bud suffered from a genetic deficiency in his liver. Like all of us, Bud had inherited two genes that affected his liver. Think of the genes as a good one and a bad one. Most people inherit two good ones. Some inherit one good and one bad, which makes them a possible carrier of liver disease. Inherit two bad genes and liver failure often results. Bud had inherited two bad genes.

"How much pain are you in?"

"It comes and goes, but it can get pretty bad."

"Do you know what's happening to you?"

"Oh, yeah, I know that."

Liver disease and an infected shoulder weren't Bud's only problems. About 10 years ago, he suffered a brain hemorrhage that permanently robbed him of certain mental and physical faculties. So much so that, still in his early 50s, he was forced into retirement. He had been an active Catholic priest and college math professor. He had been the intellectual powerhouse in our family. And now, he couldn't teach anymore. His priestly duties were significantly reduced. He sometimes struggled to get words out of his mouth. And he was sent to a retirement home for priests at the University of Notre Dame.

Years earlier, Bud's heart problems required a pace maker be inserted into it. And he experienced seizures from time to time. Safe to say, he had experienced a lot of suffering. And now, he was confined to a bed, laying prone and not able to read or otherwise occupy his mind. This I could relate to. My experience with bladder cancer -- chemotherapy, surgery, complications and recovery -- often left me with the vast emptiness of time.

"The biggest problem I experienced was getting from hour to hour," I said.

"It's tough. It's tough. The nurses and doctors fill some of that time. Mom, dad and the others (our family members) help, too. But I'm still left here." Sing songs in your head, I suggested.

"Bob says the gameplan is to get you strong enough to qualify for a liver transplant."

I said that, knowing that his chances might not be so good. After all, his body was withering away in a bed, his liver filling with toxins, and the counter-acting medicines creating other problems. His shoulder was mangled, and he couldn't stand. And his prior medical problems might make him an unlikely transplant candidate.

"Yeah, they want to get me to Chicago, and see what the doctors say."

"When I was going through cancer, staying with Kate was my biggest motivator to keep living. Do you have something like that to live for?"

"Yeah, I always have."

This made me feel better. I assume he was referring to his faith. Bud is my sibling that I know the least. He is 10 years older than me, and for the short time we shared the same house he was very private. Then, he was off to Notre Dame for college, UCLA for graduate school, back to Notre Dame for the priesthood, and then to a Catholic college in Oregon, where he spent most of his time. So I haven't seen him very much.

Broaching the unbroachable, I asked, "have you thought about what it might mean to die?"

God knows those thoughts crept into my mind during cancer, especially alone at night. So I figured I was qualified to asked the question.

"Yeah, but I'd like to avoid it for a while."

Ah, wit and truth at the same time. That's Bud. He has one sharp mind, even in a diminished state. He can weave in and out of focus, of course. But when he's on, he's on.

Case in point: when I was a kid, he took Bob and me to a Washington Senators baseball game. Bud is a big baseball fan. A a few years ago, Bud came home for a few weeks. So I returned the favor and took him to a Washington Nationals game. On the way to the park, he was kinda spacey. Once the game began, boy, was he locked in. He chattered on and on about game strategy, why the National League is a pure form of baseball because it doesn't use a designated hitter for the pitcher, and asking questions about the Nationals players. What a joy to see.

"I know talking and thinking can make you tired. I know it did for me. So I'm going to let you go now."

"Okay," he said in a fatigued voice.

"Hang in there."

"I will."

That was the last conversation I had with Bud. He was too weak to travel to Chicago for the transplant evaluation. And he died soon thereafter.

When it came time to tell people the news, my mom made a few calls and then got to my name. "But I couldn't tell you," she told me as her eyes teared up. I believe she thinks that death weirds me out more than the others. And of course, it's not a rosey subject. But I also feel that, because of my cancer, I am more in tune with the concept.

I know what it's like to have an illness you might not confront the reality of near-term live moment by endure pure know what to live for. In that sense, Bud and I were in the same boat.

But he entered a phase I had not: knowing when all is lost. I don't know what that feeling is like. At least not yet. What gives me comfort is this. While in hospice, and still feeling pain, another priest came to Bud, said prayers over him, and blessed him. Bud's face turned calm and rested, suggesting that pain had left his body. He really did have something he treasured in his life -- his faith in God -- and now it was helping him transition to a new life.

Let's hope that God gives Bud's soul a big hug. We no longer can.


Update: Bud had quite the funeral for a Catholic priest. When his casket arrived at the great doors of the Basilica at Notre Dame, more than 80 priests escorted him into the church and then to the cemetery. He was surrounded by love.


23. Work

Once Dr. Schenk told me that cancer had not returned, I had little time to relax and celebrate.

After all, wiithin one week in early January 2012, I had surgery to fix my neobladder...a cancer ER visit to keep my bladder from exploding....removal of my catheter (one of life's joys)...a blood test to measure the effectiveness of medication staving off another embolism...physical therapy to continue rebuilding strength in my body...and a general check-in with Dr. Ditaranto.


There was something else, too. Following this whirlwind, I finally retuned to work. The last time I had worked full days on the job was back in April 2011. I did a little work from home in September, and logged a few hours here and there during December. But those times seemed like short breaks from my normal routine of coping with cancer. Now, I had to reenter the workplace. And it wasn't easy. In fact, it was, and continues to be, extremely hard.

From my perspective, returning to work meant entering an alternate universe. For eight long months, all my thoughts and energies were focused on cancer. The diagnosis. The treatments. The surgeries. The complications. Survival. The long road ahead.

Despite the horribleness of everything, I had left my prior life and entered something different. Certainly not better. But different. I had a new focus (holding onto life), new routine (coping with side-effects), new friends (nurses and cancer patients), and new opportunities to appreciate the joys of daily living (drives in the mountains, lunches with family and friends).

Now, I had to incorporate work back into my life. Not shift my focus from cancer. Rather, expand it. Because cancer and its after effects would continue to be with me. All kinds of thoughts went threw my mind.

What kind of clothes could I wear? With my stomach still tender from surgery, I had been wearing sweat pants for a while now. How should I carry around the personal devices I needed? Would the rest rooms at work be conducive to my new needs? How many hours could I work before fatigue set in? Could my body stand all the running around (it's a metaphor, ok?) from work to medical appointments and back? And, mentally, did I have the energy or desire to think about work matters?

In recovering from cancer treatments and radical surgery, I knew I had to create a new normal for myself. But was my old workplace to be part of that new normal? Time would tell.

Things got off on a good note. When I was at home, I had told very few colleagues of my condition. But most knew something bad was up. Now I was able to visit with folks I hadn't seen in quite a while. And that was mostly a good experience. People sharing good wishes, relief and support.

Also, I was fortunate in that my old job was waiting for me. While I was away, my colleague, Patti, expanded her duties to perform mine as well. And now she was eager to give them back. She was great in debriefing me and easing my transition. Indeed, for weeks, I had her continue to run team meetings because she was more plugged in than I was.

At the management level in the business, there had been a lot of turnover since I last worked there. So I had to get to know a whole new set of people. Not knowing my condition, some came up to me and said, "Love your bag!" Oh well. Relationships often start on odd notes.

But then things started to go south. In meetings, I noticed how much, and how little, things had changed. People would talk in jargon and rattle off a series of acronyms that mystified me. For a while, I could ask the dumb, obvious question -- excuse me, but what the hell are you talking about? -- and it dawned on me how the English language gets so perverted in a corporate environment. And how little the things they were talking about really mattered.

Case in point: I asked folks what had transpired during my time away. Know what some talked about? Internal politics. Turf wars. Personality conflicts. I sat. I listened. And I couldn't have cared less. I was supposed to shift my mindset and care about things like that? I don't think so. Sounds corny, but once you've had cancer, your priorities are forever changed. And there's very little room for the bs some people engage in at work.

Fortunately, other things needed my attention. Like planning out how many meetings I could attend without using the rest room...making sure I took my bag to each meeting...determining where were the best places to use the restroom...and making sure I gave myself enough time in between. My neobladder was still on the clock, if you will, so I always had to have in mind what my time intervals were.

Added to all that, of course, was expanding my mental focus to the substance of work. What needed to be done? Who's going to do it? And could drama and internal politics be kept to a minimum? For a while, the substance of my job did re-engage my chemo-fried brain. My job involves shaping communications on mortgage and housing-related issues. And it's interesting stuff to me. Hey, I thought, I remember this part of myself.

But then, reality set in. I couldn't do this anymore. Deep in my heart, I knew it. Maybe it was too early for me to come back. Maybe it was my lack of energy and desire to fight internal battles. Maybe it was just that my future shouldn't include this part of my past. Whatever the cause, I knew I had to sit down with Kate.

She listened. She heard me. She knew where I was coming from. And she gave me perspective: I was still recovering physically and mentally from a life-threatening disease; I had only just begun to adjust to daily life with a neobladder; and I still had lots of medical procedures and milestones in front of me.

Her advice: Stay focused on my health, and introduce no other change in my life. Meaning, stay in my job, and stay there for however long it takes for my medical condition to normalize. Only then could I really think about what kind of work to do going forward. After all, I knew how to do my job, Kate said, just don't get involved in the internal bs. If people interpret this as not caring about my work, then so be it. I had bigger battles to fight.

Now it was time for me to digest what she just said. I was so bummed. Her logic was so rock-solid, I couldn't find a hole in it. I just wish it was a rock-solid argument to go. Instead, I stayed. And it didn't take long for Kate to be proven right.

The surgery in early January definitely made it easier to void my bladder. Obstructions were removed and the openings to my ureters were kept open. But in the following weeks, it gradually became more difficult to voidr. The mucus production factory was back in operation, and with it my need for cathing. Cathing then led to inflamation in the urinary canal, which of course required more cathing. Vicious cycle.

Because I was still on blood thinners, I couldn't take anti-inflamatories to calm things down. All this led to one day at work, in mid-February, when I tried to cath myself in the rest room. I had barely inserted the catheter when blood came gushing out. Lots of it. My heart started to race. Holy God, the catherter must have torn something in there! What should I do now?

I needed to stop the bleeding. This took several minutes, which felt like hours. Good God, I thought, what had I done? Blood was all over the place. Once the bleeding slowed, I set about clearning up. Through a combination of what I had in my bag and the rest room, I managed to return the area to at least presentable.

Then I had to leave work. Fast. But where should I go? To Dr. Schenk's office? If so, which one? Reston or Loudoun? To the hospital? Same question. Which location? Without a firm answer in my head, I grabbed my things, rushed to my car, and sped out of the garage. Sweating, heart racing, I thought, let's try Schenk's Reston office. It was closest to my work, about 15 minutes away.

But when I got there, the office was closed. Damn. It was lunchtime. What next? I went back to my car and dialed Schenk's cell phone. He had been generous enough to give it to me. And I thought I would use it only in case of emergency. Well, this sure felt like a frigging emergency! Fortunately, because my car has Bluetooth, I could dial and talk while I sped away, now towards his Loudoun office. Another 20 miinutes away.

A nurse answered, saying she was now with Schenk in surgery at Loudoun Hospital. I told her what happened. She relayed the message to Schenk. He said go to his Loudoun office, and he would meet me there. (The office and hospital being close to each other.) When I got there, the staff had already been alerted, they took me into a room, and they quickly prepped me. Schenk arrived a few minutes later.

He was focused. He slung off his medical bag, barely said a word, grabbed a catheter, and inserted it all the way into my bladder, pushing hard once he met resistance, breaking through the inflamed area. I would need to keep this in for a week so things could calm down. Then he instructed Karen, his nurse, to bag the catheter. And he was off. Five minutes max. Boom.

Karen then strapped me up, and I headed home, with my blood-soaked clothes in tow. Lots of thoughts went through my head. God, I hate catheters. And I have to keep this one is for an entire week! Yuck. I probably need to tell my parents and family about this. How can I do that without alarming them? How should I take care of work-related matters? But my overriding thought was, Kate was right. I really did still have a lot of medical stuff in front of me. I only wish I knew what was next.


22. Cancer Again?

Christmas 2011 was a great milestone to meet. One, it meant time with my extended family and friends. Two, it meant I was still alive. Both pretty good things. But just as God giveth...

After coming home from a lunch with my friend Tricia, I sat down on the couch and noticed something odd. My right leg felt very hard. I wish it was all that muscle I was busy rebuilding. But I knew better. I lifted up my sweatpants and saw that my leg below my knee was much bigger. Not necessarily a problem. For a long time, my right leg has been bigger than my left. Years ago, a back injury caused severe atrophy in my lower left leg where, for all practical purposes, I have no left calf.

So, I thought, this is bigger than usual, but is it something to worry about? Since I already had experienced a pulmonary embolism, I wondered if blood clots were making a return visit. I picked up the phone and called my primary care doctor. Lynn, my favorite nurse, told me not to fool around with this and head straight for the ER. Sigh, another trip to the hospital. Well, at least I knew the way by now.

First order of business: have a sonogram to check for blood clots. It would take a little while to get everything ready. So I just laid there and tried to relax. Then it happened. I looked down at my leg again. I could see my leg literally shrinking before my very eyes, back to its normal size. Must be the healing powers of the ER. Or maybe God really was watching out for me. Or both. Still, I needed the sonogram. So off I went.

When you go through as many serious medical procedures as I had, you hope and pray you have access to the best medical professionals in the business. We tend to think of the doctors and nurses in this regard, and God knows they're absolutely critical to your care. But technicians matter, too.

For example, performing my ultrasound was BJ, who has a big, warm smile. He grew up in Virginia, moved to Nigeria for several years, then came back to the States to join the Navy. After his service was up, he settled in San Diego. But, get this, he found life there filled with TOO much leisure. To improve his skills as a medical technician, he moved back to Virginia and has worked at Loudoun Hospital since 2007. And because he did, he was able to help me.

His verdict on my leg: all clear. What a relief! BJ gave me a high five and his finding was confirmed by a doctor. Got through that one, I thought. I headed prepare for the clean-up operation on my bladder.

Thinking that this surgery would be minor, I asked my son Stephen, home during the winter break from James Madison University, to drive me back and forth to the hospital. I thought it would help him emotionally to see that some surgeries are pretty straightforward and devoid of trouble.

We dutifully reported to Loudoun Hospital on Friday, January 6, 2012, met with the same nurses who had prepped me a few months before, and saw Dr. Schenk. "Ready?" he asked. Since this surgery was designed to remove obstructions that had forced me to use catheters on a daily basis, boy was I ready.

The procedure: Schenk would expand the opening from my ureters to my neobladder, which were healing in a constricted manner since the radical cystectomy a few months earlier. He would keep the openings, well, open by dialating them. And he would remove other obstructions that had popped up along the way. All this would radically reduce my dependence on catheters. The downside? He might to have to perform this surgery every so often. Kinda like getting an oil change, I thought.

The surgery wouldn't take long. Stephen could grab a meal in the cafeteria and I would see him in recovery. He did grab a meal. And I did see him in recovery. Nothing else went as planned.

When I awoke, I saw Schenk's face. It looked depressed. And worried. "We've got a problem," he said. Oh God, don't tell me... "See these pictures?" referring to photos taken of my bladder during the surgery. He didn't need to say another word. I knew. The white material looked a lot like the tumor he had biopsied back in April. We talked a bit more. "I'll need to send these to pathology." Words you don't want to hear.

"I really wanted you to urinate normally, without a bag..." as his voice trailed off. I got the point. My neobladder's life span was about to be cut radically short. And maybe my life, too.

Then I looked at Stephen. He was shaken. Given the unexpected news, I now felt terrible for asking him to be with me in the hospital. This was supposed to be a reassuring experience for him. Not even close. He heard Schenk's words, and was stunned. The nurse next to him said, "You didn't know about this?" Tears filled his eyes.

Later, he told me, "I felt guilty that I hadn't been there for you as much as the others during your big surgery. So I really wanted to be there for you for this one. But I didn't expect this to be..." as his voice tailed off, too. Terrible? Awful? Choose your word.

Schenk wouldn't know the results of the pathology tests until Monday. This being Friday, Stephen and I headed home. It was to be the longest weekend of my life.

You can imagine the thoughts that went through my head. Cancer, again? Will I be able to survive it? Do I have the strength to go through all the treatments and surgeries all over again? After all, my body had barely survived the first go around. And that was starting from the strongest I had been in years. Even more importantly, what am I going to tell Kate?

Friday turned into Saturday. Taking my mind off the propsect of Cancer II: the catheter that had been inserted after surgery. It would need to stay in there until Tuesday. And the attachment was loose. You don't need to have worn these things to know that loose is bad. The slightest movement...ouch! Safe to say, I wasn't terribly mobile on that particular weekend. But at least it was a distraction. Kate had no such luck. "All I could think about was being scared," she said.

On Sunday morning, I awoke to intense abdominal pain. It felt like I had a football in my stomach. And it really hurt. Then I noticed that my catheter bag was almost empty. I put two and two together, and concluded that I must have an obstruction in my bladder. Pain turned to nausea and I threw up. As unpleasant as that was, it solved for my pain.

I guess the brute force the body expends when you throw up created enough pressure to push the obstruction through the urinary tract and into my catheter bag. And my bag suddenly filled up to the brim. Had I not thrown up, I risked bursting the neobladder. That would have been bad.

Later that day, the same pressure built up, the pain returned, and the bag was empty again. This time, I didn't mess around. Kate and I headed straight for the ER. There, the nurse wasn't sure how to address my problem. So she called Dr. Schenk, who walked her through how to irrigate my bladder.

She took out a syringe, dsconnected my bag, and inserted the syringe into the catheter tube. No sterile water to inject; just air. On the very first pull, the nurse removed a massive obstruction. It was frigging huge! She connected the tube back to the bag, and once again fluids gushed into my bag, filling it once again. Even better, the pain was totally gone.

The procedure was so simple that I felt stupid for needing to come to the ER to have it done. I should have known how to do that. This was a crappy way to spend a day, obviously. But at least I didn't have much time to think about whether cancer had returned.

Monday night arrived, and I was in the family room with Kate when the phone rang. Schenk's name appeared on the phone. I stared at the phone for a moment. "Dr. Greg Schenk," it read. What he was to tell me would determine my life. Should I really answer? Was I ready to answer? I walked out of the room, twinged as the catheter moved back and forth, took a deep breath, and swiped the phone.

"Jim, it's Greg." Yes, and...? Another deep breath. I closed my eyes. Then he spoke: "It's all good news." Oh, thank God. My body collapsed in relief. Greg went on to say that the material we both suspected was a tumor was, in fact, something else. He gave me a technical term for it. I hadn't heard it before, didn't care, and I don't remember it.

What I do remember is that Greg Schenk -- who started out as Dr. Doom to me, gave me blunt assessments along the way about my condition and odds, spoke words that haunted me during the night, but who I had turned my life over to survive -- just gave me a clean bill of health. He sounded as joyous and relieved as I was. I rushed to tell Kate, and we collapsed into each other's arms.

I was going to live.