Prologue: The Hazardous Side of Adventuring
The dictionary informs me that ‘adventuring’ is to “engage in hazardous and exciting activity, especially the exploration of unknown territory.” And at the outset of this blog – when my wife and I covered 11 countries during a four-month sabbatical – we focused on the ‘exciting’ portion of that definition, covering copious amounts of unknown territory and having a delightful time doing so.
In retrospect, I should have known that ‘hazardous’ was right around the corner. I mean, we certainly had our moments in those early days; in this blog alone I ran afoul of a cactus, navigated the French health system amidst extreme illness, and came face to face with a literal dumpster fire.
So then, when the pandemic descended upon us, I thought to myself “Ah, this is the hazardous portion.” If slinking around while trying to avoid germs while other people don’t seem to care about projecting them isn’t hazardous, I’m not sure what is.
Alas, my friends – it can be, and it soon became, much, much worse. The degree of hazard that I experienced has compelled me to tell my story in the form of a warning related to the upcoming election, as in less than a month’s time our country could find itself embarking on an epic and, yes, hazardous adventure.
Below is an op-ed that I submitted to the Washington Post, New York Times, The Guardian, Los Angeles Times, Chicago Tribune, USA Today, and Boston Globe. It was met with silence from all. Therefore, I did what any self-respecting author would do and published it myself. The fact that I’m even alive and writing this today is a miracle which serves as a testament that my adventuring days are not over; I can only hope that it’s now the exciting ones which are around the corner.
Putting My Money on You
This time, the statement from my wife – “You need to go to the ER” – did not come in the form of a question nor with a hint of uncertainty. That’s when I knew that my reflexive “But…” had no chance of escaping my mouth. In retrospect, it was thrown off course somewhere around the underappreciated organ known as the pancreas.
By this time my eyes and my skin had been yellow for two weeks. Normally a robust eater, I had started feeling over-full after consuming a third of my normal volume. The worst part was the itching for which there was no relieving scratch. I called it hell; doctors would later inform me that it was jaundice.
Upon arrival at the local ER, the receptionist took one look at me and said, “I bet $20 bucks it’s the gall bladder.” Though taken aback that she was diagnosing me, I was oddly comforted that we might simply be talking about an organ that many friends have had removed, the slightly more important cousin of the appendix. “Phew”, I thought, realizing that I would have time to sign paperwork on our house purchase from the luxury of a hospital bed.
Several tests and signatures later, the doctor popped in. I figured I was on my way to a quick release and perhaps some champagne to celebrate our new home. But the doctor’s dour look was a bit disconcerting, and his first words even more so: “You may have pancreatic cancer.”
The next few weeks are hazy, though I’m sure it included a couple of endoscopies, a referral to Fred Hutchinson Cancer Research Center, a move to Seattle, and several pieces of increasingly terrifying news with the ultimate result that I, an otherwise healthy individual in the prime of my life at age 45, had the cancer with the lowest survival rate of any cancer.
The silver lining, my oncologist told me, was that they had caught the disease prior to metastasis, meaning that there was a chance – if all went well in chemotherapy – that they could operate, remove the tumor, and save my life. Surgery is an option for less than 20% of those diagnosed with pancreatic cancer as symptoms don’t usually show up until after the cancer has metastasized. The onset of all my symptoms came after a day in February in which I took some friends out to a greasy lunch, breaking from my normally healthy routine. I’m not sure if doctors would recommend putting your stomach through a decathlon with no training to reveal hidden illness, but it seemed to work in my case.
As our nation enters the final month of the presidential sprint, there is one question that stands out and will inform my vote: which party wants to keep and expand the Affordable Care Act?
Two concepts that this act brought to life are very important to understand:
- Health insurance companies are prohibited from denying coverage or charging more for people with pre-existing conditions. This will continue to be critical throughout my life, and as both cancer diagnoses and survivorship increase this will be increasingly important for our community at large.
- Health plans are required to have out-of-pocket maximums that limit how much insurers can charge for covered services each year. In 2024, the maximum for an individual is $9,450 and $18,900 for a family. These limits ensure people don’t need to go bankrupt to obtain medical treatment.
There are still opportunities for expansion of this law. Did I mention that I was working full time all the way through chemotherapy? Part of the reason I chose to do so was to maintain normalcy, but certainly in the back of my mind there was fear of losing my job.
The most insane aspect of our health system is the degree to which our health care is directly tied to our ability to obtain and hold down a job with good benefits. The Affordable Care Act has removed some of that burden with the concept of the open market. However, I meet people who have opted to carry no insurance as these plans are not that affordable for folks who are not employed. Given that these people will ultimately transfer the burden of their care onto our emergency systems, this is not a good outcome for any of us. Bernie, you were speaking so forcefully about nationalized health care – get back out there, my friend!
My story is in progress. Even after a pancreatic tumor is removed and a patient is cancer free, this elusive disease comes back nearly 80% of the time. And when it comes back, science has no answers, and the conversation becomes more about providing comfort as the patient succumbs to this terrible disease.
I am living proof that any one of us can be waylaid in life’s prime. The good news is that I caught the disease early and doctors were able to shrink the tumor via chemotherapy and remove it via surgery. Almost a year out from surgery there are no signs of the cancer returning. I am spending my summer paddleboarding, cycling, and enjoying life with my wife and puppies. Life is amazingly good.
I might find that receptionist and collect my 20 bucks. And I’ll go to Vegas and put that on you to make the right decision in November.