Thursday, April 17, 2008

I don't cry

I don't cry anymore... I'm pretty normal actually, not very emotional, sometimes I feel guilty and I force my mind to think of my dad, but the sadness doesn't come. It's okay... this is life, the next chapter of our lives will be defined by cancer, I can handle it.
My father began the preliminaries to begin a chemotherapy regimen. 5-FU. He told me the name so I could research it and give him all the details. I'd rather pluck my eyebrows out than do what I've been asked. I know its poison, I know even though this supposedly has mild side effects, they're probably still on par with rat poison.
Whereas before I'd read about drugs and look at their side effects as obscure statistics that happen to a certain percentage of the population taking the drug, now each word has my father's image attached to it.
Here's the list:
acute cerebellar syndrome
• agranulocytosis
• alopecia
• anemia
• angina
• anorexia
• ataxia
• bowel ischemia
• chest pain (unspecified)
• confusion
• conjunctivitis
• contact dermatitis
• coronary vasospasm
• diarrhea
• drowsiness
• erythema
• esophagitis
• fetal abortion
• GI bleeding
• hepatitis
• injection site reaction
• jaundice
• lacrimation
• leukocytosis
• leukopenia
• maculopapular rash
• myocardial infarction
• nausea/vomiting
• neutropenia
• nystagmus
• ocular irritation
• palmar-plantar erythrodysesthesia (hand and foot syndrome)
• palpitations
• pancytopenia
• photosensitivity
• pruritus
• pulmonary embolism
• skin erosion
• skin hyperpigmentation
• skin irritation
• skin ulcer
• ST-T wave changes
• stomatitis
• teratogenesis
• thrombocytopenia
• thromboembolism
• ventricular tachycardia

Believe me you're the lucky one, if you don't know the definition to most of these words. Even though cancer's touched other members of my family, at least for me, only now that its someone as close to me as my father, due I appreciate the horror. I can see now why so many are dedicated to find a cure and work so hard to help those affected by this disease.
On the other hand, having gone through the rollercoaster of the past week, I feel like the experience should be a prerequisite for becoming a doctor. My eyes have opened to a whole new world, not just in regards to cancer, but to the emotions related to any lethal diagnosis. They teach us early on in Medical school to be emphatic to our patients dilemmas, but how can you be if you don't understand. Obviously as I've state early I can't imagine what my father feels, but I know now what the family members have to deal with, and the doctors role in attending to needs of family members is often tragically overlooked.
Another realization I made last night was that I'm a coward for making an excuse of this situation to not study. The past week every time I'd sit down and open a book, I'd loose concentration and get up, telling myself, "it's not my fault I can't concentrate right now." Human nature is to use situations of grief to make excuses to not live up to responsibilities. I'm glad I made this realization early on...

Tuesday, April 15, 2008

The Sprinkler


I got home the other day, when I was back home, and quickly parked my car, and headed for the front door. As I passed our front lawn I noticed a sprinkler head that had broken off, leaving the bare piping in the ground. Surely to create a geyser of water shooting up in the air the next time the sprinklers turned on. Normally I wouldn't take a second notice, "Dad will fix it," He always had. For the past 20 years living in the U.S. I think my dad took more joy in tending to his gardens than anything else in his life. Whether it was laying out the sprinkler system in our first house and forcing my brother and I into hours of manual labor clearing the grass less lawn of all the rocks, or begging us to spend ten minutes helping him plant flowers in the backyard of the house we live in now. My brother and I had an endless number of excuses to get out this work, and while my dad would be annoyed at time, in general he didn't mind. This was his passion and he probably took a great deal of pride knowing he was responsible for the beautiful gardens we enjoyed every year. He did take great offense though, when we would come home after a long period away and not notice his new flowers or added trees.
As we lay in front of the TV he'd beg "please just come outside and walk through the garden for five minutes....," "look at the new pomegranate trees I planted," "look how the fig trees flowering this year, I have to find a way to keep the birds away." His endless struggle with the squirrels and birds in our backyards is legendary. I guess it was never a struggle though, more of a give and take because whenever he'd find a new nest in one his trees he'd go to great lengths to protect it and ensure its survival, knowing well that when those chicks grew up they were going to be ones feasting on the bounty of his labor driving him crazy.
Again we'd use excuses or yell back we'd seen it and it was very nice, "great job dad" not really paying attention, just humoring him so he'd leave us alone, to watch the Laker game, or sportscenter, or some other none sense. Ever since I developed an interest in photography he's begged me endlessly to spend time taking pictures of his gardens, wanting to preserve something that was all to temporary. I never did, maybe a picture here and there, but I never gave it the attention I should have. Funny because when I was actively interested in photography my greatest complaint was I didn't have anything to photograph. I'd look at magazines longing to travel to desert or the ocean or the forest or somewhere to take great pictures, all the while reading comments from great photographers stating that the great eye finds the most beautiful subjects in his own backyard. Why did I never understand that? I wish I had, I really wish now that I would have spent days photographing every square inch of that yard, every flower, every tree, every bush, every tomato plant... everything, why didn't I?
Back to the broken sprinkler, strangely this time when I noticed it I paused, I gave it a second thought. "Whose going to fix this?" a devastating thought for me, I wish I knew how to express this accurately. My dad who had fixed everything from the garden to the car, to the house, to our family, I now felt could no longer fix a stupid sprinkler. I denied this though, surely he's not that sick. I picked up the sprinkler head ran inside and found him laying on the couch.
"Dad, the sprinklers broken in the front yard, you want to me to go out and buy what you need to fix it."
I wanted so bad to hear, don't worry about it, I'll take care of it just leave it there...
instead he glanced at the sprinkler uninterested and said,"don't worry about it the gardener will be here next week he'll fix it."
As so often happens when faced with a moment of great signficance, I ignored it, I knew how horrifying that statement was, but I choose to move on. I told myself I'll fix it, make him proud... I didn't I left the sprinkler head on the table and moved on, knowing full well that you can't let a sprinkler stay broken for a week...
Three days later the day I was to fly back, I heard my dad yell out,"did you fix the sprinkler." "No," I responded, "I thought you said the gardener would fix it."
I've never seen my dad so disappointed before, I couldn't believe how much of an idiot I was...
I had to fix that sprinkler, I ran to the garage grabbed the tools and went to work, an hour later I completed the task that would have taken my dad ten minutes, but had successfully fixed the problem. I couldn't be more proud. I ran to the living room where he still lay, groaning, proudly exclaiming that I had fixed it and that he didn't have to worry about it.
He thanked me, and said,"wow I can't believe you actually fixed it." Words that I was proud of at the time, but now bring me great shame. Would I have actually left that house with out performing the simplest of tasks to help him out? Am I that useless?
Now I wonder whose going to take care of all those things my father did when he was well. What's going to happen to our beautiful garden, our house, our life... if anyone was a foundation for a family my father was, not just for ours but other families, those of his brothers and sisters in Iran, those of his friend who had died a few years ago, what will we all do.
He'll go to the oncologist today, and find out his fate, his probable fate, they've been wrong before. Its natural I guess when faced with this situation to think I wish I would have taken advantage of the time we had, I wish I would have listened to him more, I wish I would have watched him fix a sprinkler so it wouldn't take me an hour fumbling around before I finally figured it out, but those thoughts are overshadowed by my fear that I won't get to see him do the things that made him so happy anymore.
If his fate his heaven which it surely is, I pray its one huge garden with a slope so he can plant flowers and trees, and build that waterfall he had always planned to build in our backyard.

Monday, April 14, 2008

Telling your father he has Cancer


As a medical student I've always wondered how I would handle the situation when I first have to tell a person and their family they have a life threatening disease like cancer.
Today, just five minutes ago, I told my father he has cancer. Last night I feared tears would flow from my eyes and I wouldn't get the words out, knowing the probably prognosis, I felt it would be impossible to get the words out and stay positive.
No tears came, I said the words, "you likely have cancer" (I coped out and didn't make it a definitive as it surely is) like I was telling him "you have an ulcer." Now I want to cry, I imagine whats transpiring in his mind as I write these words. The first realization that something, Cancer, is inside him, and what will now happen in his life...is he scared, of course, is he resilient, does he think he'll beat it, does he think of his family and how they'll cope, if I know my father this is probably the closest to the truth...
What should I do, whats my role now... as close as I am with my dad, sharing emotions has never been our strong suit, his most controversial talk with me was when I was 16 and he sat me down and told me "sex is like water, you need to survive," probably anticipating my sexual maturation and wanting to let me know that my thoughts were natural.
What worries me most, is that my father recently saw his closest friend succumb to pancreatic cancer. The worst of all cancers, still thinking about the ordeal makes me cringe with horror... the pain, the slow degeneration, his friend my uncle "a poet at heart" dealt with the disease in the most courageous and beautiful way... naive to what was to come along each step he amazed us with his resilience. My dad doesn't have the benefit of being naive to whats coming. He's seen it, recently, he was there for his friend, for their family, he looked after his children like his own, and demanded that my mother, my brother, and I to do likewise. Does he have someone to trust with his own family? does he trust that my brother and I are old enough and mature enough to take care of my mom...
Does he cry..does he.. do I want to know...
My dad has always had all the answers, he's never been frieghtened of anything, he's never shown weakness... am I ready to see it, do I need to force it out of him... what should I do
I can't write anymore.

Sunday, April 13, 2008

To my friends

Hi everyone,
I wanted to write and thank you all for all the kind words and messages you’ve left me over the past few days, I’m so sorry I haven’t answered any of your calls or returned any of your messages. I’m sure you all understand...
My father is a wonderful man, and as much as I want to say the words “ he doesn’t deserve this” I know deep inside its not about that. No one deserves to suffer, and to say those words means that I feel others do deserve to have this horrible disease brought on them.
I have no doubt he will face cancer as he’s faced every other difficult situation in his life: with integrity, with pride, and with honor, and whether or not he beats it, he’ll only be seen as that much greater of a person through the courage he undoubtedly will show.
I love him very much, and I ask all of you to please pray for him and keep him in your thoughts, I’m not the one that suffers, I thank god everyday that I’ve had someone like him in my life.

Love,
payam

A great man


I'm not a writer. My words won't inspire anyone... they don't inspire me.
I found out a few days ago my father has cancer, liver cancer, a bad form of it, I feel the prognosis is poor but I use all my mental craftiness to remain positive.
I'm selfish I know, my fear my suffering, are not for my father, they're for myself... I don't understand his suffering, i don't try to, if I'm to be honest... I'm consumed by my own fears, my own doubts.
I look at his belly and I see cancer, I see cells growing out of control destroying his body. I want to reach in with my hands and pull them out, I want to scream and blame someone, I want to take it and put it on somebody else because my father my dad doesn't deserve this. He's a great man. Loyal, proud, honest, loving, smart, funny, joyous, whatever other positive description you can find about a person you can associate with my father...
I don't want to see him go, I want to be here I want him to experience my life...

my my my, this is my pain, my fear, my suffering...
I cry, I hurt, why can't I feel for him, why can't my mind grasp what he feels