Lyrical

"It is a fair, even-handed, noble adjustment of things, that while there is infection in disease and sorrow, there is nothing in the world so irresistibly contagious as laughter and good-humour." - Charles Dickens, A Christmas Carol Dear Friends, Whether you live in good health or poor, may you travel well on your journey, and may your eyes face the horizon with courage. May all your regrets dissolve like the dust from your footsteps, and may your find enough strength within to fulfill those dreams you deem worthy of the sacrifice. May pain and sorrow, that cannot survive the sting of good…
"Can't you do something to make this pain go away?" No, my child, but understand that the greater is your pain, the greater was your love. Only passionate hearts can produce passionate grief. Such hearts use the gift of time not only to refill what has been emptied, but to reshape sorrow into something that honors the one who was loved and is now gone. "How can I go on with this agony inside of me?" No answer will satisfy you now, my child. I could say that if you were lost at sea, battered by the wind, cold, frightened, but unwilling to force yourself to slip beneath the waves, you would…
"What is it like to be an oncologist? How long does it usually take to get your specialization? Is there anything I should know from the start that I could learn from your education over the years in and out of school?" From time to time students interested in the field of medical oncology ask me questions like those above. It is easy to respond to such requests with the platitudes one hears all throughout their school years - "Work hard"; "Study a lot and get good grades"; "Take lots of science classes"; "Shadow a doctor on his rounds." No matter how true they are, instead of focusing on…
[Editor's note: the following allegory has something to do with cancer. Sometimes we have trouble figuring out what the narrator is trying to say, so don't blame us.] There are certain bursts of perfection in summer that if noticed, bring such a feeling of joy to the observer it seems as if a window to heaven was opened, such as a crepuscular walk beneath the umbrella of a majestic tree and suddenly hearing a choir of cicadas break into song overhead. One must remain alert for the joys of this time of year, as they often announce themselves softly. While running along a country road one…
The woods are lovely, dark, and deep, But I have promises to keep, And miles to go before I sleep, And miles to go before I sleep. -Robert Frost, 1923 I saw a patient today who is about six months out from her last treatment for a vicious lymphoma that darn near killed her before she even got a chance to take any chemotherapy and targeted therapy. As often is the case, she responded so rapidly to her first treatment it seemed as if she had been snatched from the bony arms of the Sepulchral Angel by the magic within these drugs. Now she stood before me as a splendid example of one who has…
Something unusual happened to the season today, to this season which has been dragging its cold, wet feet across the month of May. The day started inauspiciously. After parting the curtains only to see another morning cloaked in gray, lethargy enveloped us like the fog outside our bedroom window. At the end of the driveway we stooped over the newspaper and then shuffled back inside, avoiding the ocean of dreariness suspended above, as if even one furtive glance would release more rain. Spring has been an imposter this year, a slow, cold turning of the earth that has kept us frowning, if…
A brief message to all those who are living with a serious disease: When you awakened today something was in the room with you. It sat patiently by the window, waiting for you to arise. It dearly wants to harm you. Are you aware of the danger? If it sees you smile it slaps you in the face, to persuade you that happiness is no longer a part of your life. If it hears you talking to a friend it poisons your words, to drive away those who love you. If it finds out you're on the way to the doctor it chokes you, to weaken your spirit at the time it most needs boosting. If it sees you sitting…
Whatever your hand finds to do, do it with all your might, for in the grave, where you are going, there is neither working nor planning nor knowledge nor wisdom. Ecclesiastes 9:10 I had a dream recently where I walked through a shimmering forest, on my way to an unknown destination. After cresting a hill I saw a large pile of rocks scattered next to the path. "You know," I said to myself, "I'll bet these stones would make a magnificent sculpture if they were stacked high." Then I walked on. After a while I came across a rabbit lying next on the bank of a gentle creek. I could see that…
This year the world celebrates the 800th anniversary of the birth of Jalal ad-Din Muhammad Rumi, considered by millions around the world to be one of the greatest poets who ever lived, yet until recently little read in America. English translations of Rumi's poems have sold over half a million copies worldwide, but has your narrator ever read even one line of his verse? Oh, let's not nitpick the particulars of his fine education but graciously move on and enjoy the beauty of this singular poet. Rumi, the 13th century Persian mystic poet, has been called the greatest mystical poet of any age…
His poetry endures because of its directness, and the literal fidelity of his beautifully circumstantial description of nature, of scenes, and places, imbued with a kind of majestic sadness which takes the place of music. -British Authors of the Nineteenth Century. Ed. Stanley Kunitz. New York: H. W. Wilson, 1936. 16-18. Matthew Arnold (1822-1888) is generally considered to be one of the three greatest poets of the Victorian Age (the other two being Tennyson and Browning). As lasting as his body of poetry is, his critical essays were more influential to the generations of poets who followed…
These two little maxims seem connected so I would like to share them both: "Death is not the greatest loss in life. The greatest loss is what dies inside us while we live." -Norman Cousins (1915-1990) Of all the quotations written about living and dying I find this one to be absolutely stunning, a soft reminder of the shame of allowing the universal vicissitudes - so daunting at the beginning, so trifling at the end - to ruin your life. "If something comes to life in others because of you, then you have made an approach to immortality." -Norman Cousins Not that we all sit around wailing…
There are two ways to live: you can live as if nothing is a miracle; you can live as if everything is a miracle. -Albert Einstein Let us go singing as far as we go: the road will be less tedious. -Vergil One of the peculiar aspects of my job is that I often have the bitter pleasure of meeting people whose time left in this world is as brief as the arrogant reign of summer. Just as the evening breeze begins to chill, these patients wither and fall quietly to earth for the simple reason that they are fatally stricken with cancer. Modern day treatments can eradicate some malignancies but there…
Wishing you all the blessings of family, work, friendship, faith and most of all good health. If I may I'd like to show you a piece from one of my favorite artists - Daniel Garber (1880-1958). For more information about this leading member of the "Pennsylvania Impressionists" click on the link. A peaceful afternoon in the autumn countryside is another blessing - I envy those of you who are enjoying such a delightful scene like the one Garber painted above.
[Editor's Note: In honor of the first day of October (and by request) here is a brief essay first posted the C.O. in 2004. In honor of the practice of improving one's prose, I've asked him to re-write the thing, to which he has grudgingly agreed to.] Last weekend I got off the couch and took a long walk through the crisp forests of Missouri, a journey long overdue. As I tramped along, the bronze and yellow-gold giants of autumn towered over me, lightly swaying in the October breeze. Fall is a poignant time for many people, representing turning points that are deeply embedded in the psyche…
Oncologists have many wishes. Their pockets are crammed with them. They lie awake in the early morning, while trees outside their window slowly shed gray shadows left behind by the fleeing night, wondering who among the many people walking the earth today will not live to see twilight return, and they quietly make wishes. An old cliché states that doctors don't really want cancer to be cured, because then they would be out of a job. As for me, nothing could be farther from the truth. Every day I pray for someone to unlock the crucial secret of the aberrant cell's immortality, so that it…
[Editor's note: this essay is adapted from a post written on September 7, 2005] Oh it's a long, long while, from May to December, But the days grow short when you reach September... After a dozen weeks of heat, of searching for green canopies of shade, of donning wet bathing suits and dodging buzzing bugs, summer is coming to a close. Now as the earth has done for more cycles than can be fathomed, it will begin to lean away from our sun like a 6th-grader avoiding a kiss and produce the second of the two seasons of change. Now is the time for dreamers to reflect on the annual shedding of…
For all those secretaries, nurses, medical assistants and other staff members who spend their days working in a doctor's office - this comment, made by one of my patients today, is for you. Please do not ever think that your efforts to help the sick are unappreciated. You are more valuable to the patient (and the doctor) than you think. "Mr. X, congratulations. You are now five years out from your diagnosis. I know you've been reluctant to have your portacath removed, but now after five years I think it is time to get it out. Then you won't have to come to the office every month to have…
"In the future days which we seek to make secure, we look forward to a world founded upon four essential human freedoms. The first is freedom of speech and expression --everywhere in the world. The second is freedom of every person to worship God in his own way-- everywhere in the world. The third is freedom from want, which, translated into world terms, means economic understandings which will secure to every nation a healthy peacetime life for its inhabitants --everywhere in the world. The fourth is freedom from fear, which, translated into world terms, means a world-wide reduction of…
[Editor's note: Finally The C.O. is packing up to return to the grueling routine that all those must face who are not retired and relaxing by their lake cabin. It's about time!] After two weeks of getting sand in the suit by day and stars in the eyes by night, my idyll by the blue water of the north has ended, and it is time to wander zombie-like through airports and parking garages on my way back to my real life, filled with real people - some of them in desperate need. Before closing the door on this annual chapter of summer I must ask: Is it possible to shift one's attention from a…
Treating cancer sometimes involves walking a fine line between helping and hurting patients. We oncologists find ourselves moderating internal debates between the little angel on our right shoulder and the little devil on our left as whether to expose someone to the toxicity of chemotherapy in an attempt to blast the invader slithering through lymph nodes, or the liver, or some other helpless part of the body. Experience alone cannot give physicians good judgment, although it is essential in their maturation. There is another gift, the sine qua non of the pinnacle of medicine, that gives…