Categories
Being human Reflections on Life, Being Human, and Medicine Reflections on the Christian Life

How to Drive on a Country Road and What It Can Teach You About Life

I learned how to drive on country roads. These roads are crowned. That means that they are higher in the center and lower on the edges. This must be to help the water to run off. They are wide enough for two cars to pass but there are often no lines on them. You must use your judgment when meeting a car as to how the two of you share the road.

I had to learn how to drive on these roads. 

Early on I would get over to the side too early. 

As I saw a car coming, I would slide to one side so that we could pass. Oddly I would find that the other cars would seem to take over even more of the road. Often, they would rise to the top of the crown. Sometimes it was so bad that it felt that they would even run me right off of the road. I had a few times when it was really scary.

I had to learn how to drive on these roads. I was not doing it properly.

I learned that I should not get over so soon. I would in fact take a position more centered on the road. As we grew near to each other only then would I get over and we would each take our fair share of the road. 

Everything worked much better when I would do it that way. I drive that way to this day.  I was never told to do this. But by trial and error I have learned that this works much better. Before this I have seldom ever really talked about this technique. When I brought it up with my wife however, she laughed and told me that she has watched how I do this. She completely understands and agrees that it works well.

I felt odd doing this at first. It felt almost like I was being a bit rude. I was pushing for or exerting my rights to the road. It was not the attitude of the humble servant that I had learned in the Bible. Instead I was asserting myself. The humble servant approach was getting me hurt. It was letting the others take serious advantage of me. They did not seem to recognize the gesture when I got over early. On the contrary they put both of us at risk when I did so by taking too much of the road. 

Oddly, by pushing them – by taking the center of the road and getting over later – I was helping them to be safer. 

By exerting my rights, I was actually making things better for both of us.

By letting them hurt me, I was hurting them.

By holding them accountable, I was helping them.

I was being better – perhaps even more kind – by not being so permissive.

That is a hard lesson. I do think it is one of the really important lessons of life. It is one of those issues of balance that is not obvious but which is so wise.

We all have to live together. We all ought to treat each other with respect. We all ought to recognize the rights and boundaries in our interactions with each other. The Bible is right and true when it teaches us the immense value in being humble and serving others. But there is a balance. It does not mean that we let people destroy themselvesby abusing us or our rights.

Let me explain more:

  • If I value you, I will respect you. 
  • I will believe that you have the capability to be civil and kind and that you will treat me properly. 
  • I should expect better of you so that you can achieve better. 
  • Kindness and proper treatment of you means that I expect you to treat me properly.

If I give up on you, then I am committing a wrong against you. I am assuming some pretty awful things about you. By taking on the role of a martyr in our relationship I am sacrificing you and my respect for you.Oddly – by letting you take advantage of me I am treating you poorly. I have sacrificed who I think you are. I have stopped treating you with respect.

This is all based on an unfortunate but very true reality of human existence. We all are inherently selfish. This is a sad but true fact. Without boundaries or restraints on us we do tend to take advantage of each other. This is a part of what it means to be a human in a fallen world. We all want to think that we are wonderful and giving and selfless. But when someone “gets over too soon” on the road of life, we tend to take the main part of the road. We do this ALL THE TIME. We may not even notice that we do this. It is a big part of being human. And the world will never make sense to you until you can recognize these tendencies in yourself.

I will openly and honestly confess that I have seen this tendency in myself. I don’t want to think that I do this, but I do. I hope that you can understand that you do this as well. Yes, it is wrong, and it is not “pretty” but it is the way we all are.

I function best when I have honest relationships. 

When I have friends who truly value me, they respect me enough to hold me accountable. If I hurt them, they say, “No. What are you doing?” This immediate correction pushes me back to the type of person that I want to be. They are believing in me and pushing me back to being a better person. If they meekly let me walk all over them, they are causing a deep harm to me.

And so there must be a balance in our relationships.


Please be humble. Do not think more highly of yourself than you ought. That is good.

Please be a servant. Where you are able, please help others. In so doing the Lord can and will notice and honor you.

But also, please be honest with people. Push them to be better versions of themselves. If they are harming you by their speech or actions, do not let them do so. Say, “Ouch!” Say, “No!” Say, “What are you doing?” 

For you see, you have a responsibility to others in life. You must take your own portion of the road and hold it. You must push them so that they treat you and others properly and with respect. You must push them to not be selfish. You must be honest about the harm that they are doing when they are selfish. 

And oddly, this is an immense kindness to them. You are helping them to be better persons. While you may be willing to suffer the consequences of their mistreatment of you, you may be harming them when you do so. 

Here is how to drive the roads of life:

  • Drive safely. Pay attention to the other people around you. Be alert.
  • Take the part of the road that you are due. Expect them to give it to you. Do not yield it up too soon. Maybe even push over the line toward them a little bit to get their attention if necessary.
  • When the time comes to meet, yield readily. With humility and servitude slide over to your side of the road so that there is more than enough room to pass.
  • Smile at them as you both pass each other with dignity and respect.
Categories
Medicine Reflections on Life, Being Human, and Medicine Updates on my health

Scanxiety and No Evidence of Recurrence

I had my first follow up CT scans on Wednesday. I just got the results this morning. They show no evidence of recurrence.  That is of course great news and so I thought I would give an update on my health and progress.

As you may recall, adrenocortical carcinoma has a high rate of recurrence. 

  • Plan is CT scans of the chest, abdomen and pelvis every 3 months to ensure that the cancer has not come back.
  • I completed 25 radiation treatments on 12/14/18.
  • I have been on oral chemotherapy (mitotane) to reduce the risk of recurrence.
  • My pathology said my cancer was low grade but had some higher risk features.
  • My next appointment with Dr. Hammer is on 2/12/19.

We are frequently asked, “How are you doing?”That is always a hard question to answer. I will try to do so here:

  1. Mitotane: Mitotane is crummy! Just to be brief: Lack of energy, feeling dizzy all the time, have to push myself to think, persistent nausea (improved by Zofran but not always), itchy rash all over, cottony dry mouth that makes it hard to swallow and talk at times, cold intolerance (chills and feeling always cold), coughing whenever I try to sleep (probably from the dry mouth?). 
  2. Work: I have gone back to work part time and have been trying to ramp up the amount of time. Early on it was really hard. I would go to work and then come home after an hour or two and collapse and just fall sound asleep. It has gotten better. This week I saw a couple of patients in clinic and that was a real joy to me. I am happy to be able to contribute again. I am frustrated that I am not myself yet and can’t just jump back into everything.
  3. Mitotane hold and dose reduction: They were having me continue to push my dose up until I couldn’t handle the side effects. I hit 5 pills twice a day about 2 weeks ago. This past weekend I was not doing well at all. Imagine feeling so crummy that you just decide to go to bed so that you could hopefully sleep instead. And then once I was in bed I would just cough and cough and not be able to sleep. On Monday I let the team at U of M know. They had me stop the mitotane for 4-5 days until I start to feel better. I am feeling a TON better (like a weight was lifted off of me). I am hoping my rash will improve and then I can restart the mitotane at 4 pills twice daily on Saturday.
  4. Scanxiety: Others have told me about this. The odds were that I would not have had a recurrence. But, just having the scan always creates anxiety. Were some of the subtle things on the prior scans just waiting to progress? Was this scan going to show horrible problems? I would read on the ACC Facebook group about all the people going through repeat surgeries, radiation and intensive chemo. I realized that all of that would change everything = total disability, complete change in life and outlook, etc… It is amazing how things can hinge so dramatically on one test result. A = you are fine. B = dramatic horrible life change. No wonder people talk about the anxiety of getting and then waiting for the test result. I wish I could tell you I was calm. It is entirely possible that I looked for my results to appear on MyHealth about a gozillion times yesterday! But I had good news!
  5. Looking good: I don’t show much on the outside. I think that is a good thing. Even when I was really nauseated and having to hold the walls because of dizziness I was told that I looked good. I know that there are many people with significant diseases that have the same thing. I mention this just as a “shout out” to those who have endured that for a long time. 

The question is are there lessons in all of this?

Drama:I prefer calm and controlled. Now I understand how medicine can be so cruel in how it gives these all or none dramatic experiences. The timely response of my team in getting results to me was so important.

Off balance: I am figuring out uncharted territory. There is no magic guide that tells you what to do or what not to do. I do not know what my body will tolerate. I just kind of need to go forward and test it. Last week I said, “If I am going to feel crummy I might as well feel crummy doing something!” It is an odd thing to try to figure out energy conservation. What should I do and how should I save my energy? And then even that is a constantly shifting thing. Most of our lives we settle into a normal pattern. The “new normal” isn’t there yet. It is constantly changing day by day and just makes us feel very unsettled.

Patience:I was feeling sorry for myself the other morning. Sometimes you just want to be back in a rhythm. Regardless of what it is – I wanted to get to a “new normal.” Even during radiation, I actually had a pattern. Now I don’t. In my devotions that morning I read from James 5: “Be patient, then, brothers and sisters, until the Lord’s coming. See how the farmer waits for the land to yield its valuable crop, patiently waiting for the autumn and spring rains.” That was what I needed to read.  The farmer can’t by anxiety and worry make the crops grow. He can’t make the autumn or spring rains come. He just needs to wait. LOTS of you have had to do this. That is what the Lord is having us to do now. It stretches me. Accept uncertainty. Faith. Figure out what today brings and accept it. Walk step by step. 

Speculation and anxiety:This is natural. I know we can say not to do this (to speculate or get anxious about what might come.) But, to be human means that you are going to think through things. I sat on the ACC Facebook group reading about how people have lived (or not lived very well) on mitotane. One discussion on “brain fog” really bothered me. My life is using my brain. It is unnerving to think that I might just have to endure 5 years of not being able to function? Is that really necessary? And how do I figure out that sort of life? And there is SO much variability. Some have awful recurrences and don’t do well. Others have terrible stage 4 disease and then completely recover. For me I have to know what all the possibilities are. And then I still have to live my life.

Are there any general lessons that I can share?

  1. Appreciate the normal. It is a gift to have routine and feel settled. Thank the Lord for a “usual” day.
  2. Be a calming presence. In medicine, the drama is intense in so many people’s lives. We should try to rationally and calmly help people navigate through it.
  3. Embrace speculation. I have tried to do this in my medical practice. When I could sense that people were guessing at the future, I would try to walk through all the possibilities with them. By naming them it makes them less scary. Then I could talk about what was likely so that we could be real. People can’t help but speculate and feel anxious. They might as well do it with some rational guidance and a dose of reality.
  4. The farmer.By my worry or mental energy I can’t make things happen. Like a farmer I just need to keep working and wait. It will come. And my worry doesn’t change anything. And there are lots of time in life where you cannot just fix everything and make the long-term plan. Oddly we rush to try to do this in medicine sometimes. Maybe it is ok to be the farmer waiting for the crop to grow.

So – how am I? Today I am pretty good because I have been off of mitotane for a few days! I have energy and my brain is working and I am not having dry heaves! I will restart the mitotane on Saturday and we will then figure out what is next.