Today is My Eleventh Birthday!

I do believe in rebirth, although not in any religious sense. There is something quintessentially American about the idea that no matter how badly you've ruined your life, you can always pack up your essentials and light out in the middle of the night, not stopping until you're far enough away that no one knows (or cares) who you are. Because your history defines and confines you, your old self must be left behind in order to be free. This has been the central theme of American literature from its earliest beginnings to today. Every immigrant has understood this fact. It is not a myth. Call me Ishmael.

Usually, they go west

More universally, you will recall that Odysseus claimed that when he had had enough of adventuring, he would walk inland carrying an oar on his shoulder. When he got to a place where no one knew what an oar was, he would retire there.
The transformation, however, is not complete. Life is something you understand. By escaping your past, you can do what you need to do to write a new history for yourself without making your earlier mistakes. You're still on planet Earth, after all.

On the other hand, like it or not, something fundamental changes on the day you're diagnosed with an incurable, universally-fatal cancer like multiple myeloma. Everything seems the same as the day before except for you. The family is still the family, the house and the job are still the house and the job, and you still unaccountably plan to live in Cleveland when you retire. Slowly, though, the deeper truth begins to seep through the fear, confusion, and self-pity: although everything appears to be the same, you no longer know what anything means. The language has changed. It is the most profound transformation that can happen to a person, like being dropped into an alien culture on a different planet. Or perhaps, afflicted with complete amnesia, you look about the rooms of your life asking, who was this person?

Eleven years ago today, lying face down in a ring for the amazingly painful procedure called a CT-Assisted Needle Biopsy, I was diagnosed. On that day I left my old life behind. On that day I was born again.

On that day my purpose became to restore purpose to my life. What meant the world to me yesterday had been stripped of meaning. Beyond an obvious need to understand the medical calamity that had befallen me, I did not know what to do. Few of us do.

Although multiple myeloma can, for an unlucky few, move with bewildering swiftness, the vast majority of the recently diagnosed will have years of life left. In 1998, when I was diagnosed, the median survivability with conventional chemotherapy was three years: with a bone marrow transplant, it was five. Today, with newer treatments and smarter application, the numbers are much better.

Once out of immediate danger, the questions start pouring out. What do I want to do with the rest of my life? What should I do? What must I do? What is important and what isn't? A complete reevaluation is clearly in order.

In my case, at fifty-three years old and at the height of my career, I found myself retired, losing a huge part of life that had given me structure. I could hardly replace the intensity of purpose work provided with my primitive ideas of retirement. Was travel important to me? (Quick answer: I've traveled out of San Diego twice in eleven years.) I had recently been separated from my wife: what kind of relationship was possible for me now, if any? How much of the time I have left can I afford to devote to music? Is there a book I need to write? Before diagnosis, I thought I had all the answers. Afterward, I hadn't a clue.

Like a newborn, I was thrust into a world I could see but didn't understand. A process of exploration and testing had begun. I would have to learn again what everything meant. I was, well, born again, recognizing everything, understanding nothing.

In a way, the process has been salutary. As Samuel Johnson said, "Depend upon it, sir, when a man knows he is to be hanged in a fortnight, it concentrates his mind wonderfully." Although there always is a sense of running out of time, there is also a massive decluttering, an improvement in the signal-to-noise ratio, a quasi-spiritual journey with many surprises along the way. For those not in denial, a new sense of priorities eventually emerges, priorities that often are far more thoughtful and sound than those they have replaced.

Just as every coin has two sides, the catastrophe of diagnosis is balanced by a better set of values. I want to leave you with one other thought as I set out to celebrate my eleventh birthday. I'm not a Buddhist, but here's the koan I live by: every curse has a blessing on the other side. The challenge is to find it.

Although I've lost the long future I had imagined, I must confess I would have botched much of it. My time now is shorter, but the quality is ever so much better. The dross is being purified away: what is left is solid gold. Despite the pain and uncertainty of the fight against cancer, I've achieved a happiness more solidly grounded than before. You can too.