Author's note: I originally wrote this post in June 2021, when I had completed the course of treatment originally proposed for my cancer (aggressive chemoradiation and surgery). It never got published because the cancer rollercoaster took an unexpected turn before I could complete it. So here it is now, with some updates towards the end. PS. I *love asterisks*
******
The treatments went well. My body is healing. There is no evidence of disease. Now what?
I have always hated decision making. I am a chronic second-guesser, a "what-if"-er of the highest degree. Woulda-coulda-shoulda by nature as long as I can remember. And that way? Lies madness. (Or more specifically, clinical depression.) It's very, very rare that I ever have enough certainty, enough information, to know know that I'm making the right decision.
Fortunately, I have had a few decades of trial and error, and error, and more error, to work on my decision-making system, which is sort of a combination between Pascal's Wager and a clip from an old Japanese game show, both of which I learned of during some pretty formative years.
The first major influence is pretty mainstream. My introduction to Pascal's Wager was in a 3rd-year Philosophy of Religion class.* I've forgotten most of the names and ideas, but Mr. Pascal's always stuck with me with its elegant, fearful symmetry:
Believe God Exists | Believe God Doesn’t Exist | |
God Actually Exists | Yay! Heaven! | Uh oh! Hell! |
God Actually Doesn’t Exist | Can’t feel crushing disappointment when you’re dead. | Can’t feel ultimate vindication when you’re dead. |
Without getting into my opinions on its validity in a multi-denominational world**, this is still a dry, intellectual exercise that doesn't really get into what it means to make a decision and live with it. It doesn't account for the odds, how to improve them or mitigate harms, or even how to decide when to make a decision.
So I like to combine Pascal's Wager with That Show Where People Run at a Door Without Knowing if it's Made of Wood or Paper, which was shown to me on one of those special days in school that only People of a Certain Age will remember - the Day the TV Gets Rolled Into the Classroom.
Now when I'm faced with a big decision, I run it through Floyd's Gauntlet. I figure out what's at stake, how many walls are between me and a good outcome, what are the odds I get through them, if I can live with being wrong, and when I have to decide. I imagine putting on my metaphorical helmet and running towards an allegorical door, and dealing with the hypothetical outcomes.
I've used it pretty successfully for some major life decisions (Should I have a child? Should I go back to law school at 35? Should I watch a new movie, or Tremors again?)***
And most recently - should I live like my cancer is cured?
I'm a few weeks into my PLTC course (part of the requirement to become a lawyer in B.C.) which takes about about 110% percent of my productive capacity. Is this a good use of my life? Should I be pursuing 17-year-old Floyd's dream, carrying on as if this was just a highly unpleasant detour on the road?
Using just ol' Blaise's framework, I came up with this:
Believe Cancer is Cured | Believe Cancer isn’t Cured | |
Cancer is Actually Cured | Yay! I was right! | Yay! I was wrong! |
Cancer is Not Actually Cured | F*CK ME | At least I’m prepared! |
The answer seemed obvious. Hope for the best, prepare for the worst! Live like you're dying, carpe diem, mindfulness and kale and whiskers on kittens.
And then I started imagining what the gauntlet would look like. It was hard, because lung cancer is chronically underfunded and understudied, so statistics around survival are often too broad or outdated to be useful.
The generally accepted number is that 1 in 3 people survive 5 years after a stage 3a lung cancer diagnosis.
There's a wall in front of me. It has three doors. One door is made of paper. Two doors are made of wood.
But my odds were better. I was relatively young and healthy, able to access and tolerate aggressive treatment, which had seemingly gone well. Maybe my odds were as good as someone who had been diagnosed at stage 1.
The wall has 10 doors. Nine of them are made of paper.
Or maybe it's like that one study that most closely matched my circumstances.
Five of them are made of paper.
Then my oncologist called to let me know that my treatment had been so successful that I no longer qualified for the "miracle drug" that had changed the face of treatment for my type of lung cancer.
She suggested another two rounds of chemo. It had a proven 5% increase in 5 year survival.
There are 20 doors. 11 of them are made of paper.
*****
That's as far as I got in June. Because as I was writing it out...I kinda had a teeny-weeny, complete emotional breakdown. I've cried a lot in my life - happiness, sadness, frustration, embarrassment, forgetting to wash my hands after cutting jalapenos and then going to the bathroom - but tears of terror are in a class of their own. And I was sitting there, writing this blog post, and the understanding was slowly sinking in that behind the paper door was the future with everything I wanted (watching my child grow up, a rewarding career, supporting my family and friends, making the world a better place, recording my album of accordion covers of eighties music, etc.) And the fake doors weren't made of wood, but of a slow and painful death by cancer.
I packed up my binders of legal materials and wrote to my supervisor, the Law Society, my PLTC instructor. Not right now, I said. Just a little more treatment. Just to be safe.
Partway through chemo, another twist in the rollercoaster - the mystery spot on my lung. Maybe it's cancer, maybe it's an infection, maybe it's Maybelline. Too small to biopsy, too big to ignore. I am, on paper if not in reality, stage four. And the thing about stage four is, eventually, there is only the wall. There are no doors.
******
*This course also culminated in what is probably my favourite final exam question of all time, "Is it possible to believe in God?", on which I enthusiastically handwrote several pages and hope to type a slightly shorter blog post at some point. (My answer, by the way, was "No".)
**Which God? "Believe" how? What if actions and not belief are what matters to God? HOW CAN YOU POSSIBLY KNOW?!?!
***Yes, yes, and, at least once a year, Tremors, because that movie is FLAWLESS.
