Going Back to School

Summer’s end means going back to school. I remember how I loved to shop for all the essential necessities of learning: new notebooks, pens and pencils, erasers, and a binder with carefully tabbed dividers for each subject. I obsessed about getting brand new notebooks for the new semester because it made me feel like I was getting a fresh start to my ho-hum academic career. In retrospect, I think I was a little OCD about school supplies and not nearly enough about studying.

I had a stable home life and I was solidly in the middle of the bell curve throughout high school. Like most teenagers, I was not attentive in class.  I was a below grade reader as a sophomore and had to take remedial reading classes. I joked around with friends in class.  We didn’t take anything or anybody too seriously. High school was a requirement for growing up. I got through it, but it was not something I relished. Maybe I had ADD or ADHD, but those were not a common diagnosis in my day.

My friends and I had nicknames for our teachers. We dubbed my English literature teacher “Rosebud” because of her tendency to use too much rouge. My German teacher was “Frau Schmidt,” a heavy-set woman from Bavaria. She had blonde braids on the side of her head and wore flowery embroidered dresses. She looked like she could have been one of the Von Trapp children from “The Sound of Music”. 

My gym teacher and health instructor was Mr. Orr, a leathery old man from Brooklyn.  He was a former boxer who sounded like he drank and smoked too much. He had a broken nose, and spoke with a deep gravelly voice. When someone got out of line in class, he would clench his fists and rasp, “Hey kid, how’d you like to eat a knuckle sandwich?”  It was hard to take Mr. Orr seriously.

By far the worse teacher I ever had was my algebra teacher, the tall, lanky and invariably grumpy Mr. Miller. I admit I was no angel in class, but I’ll never forget the time I went to see him after school about a “d” grade I had received. He responded to my inquiry by contemptuously saying “Get out of my sight! You make me sick!” That one encounter ended any chance I had of becoming an engineer or physicist. Math class for me was like being in a foreign country where you don’t speak the language. I could not understand how the letters “A” and “B” could add up to anything.  They aren’t numbers!

I liked English literature, history, and music and did fairly well in those subjects. In my senior year I was a member of a barbershop quartet, trained by a very popular music instructor, Tim Lutz.  I was also involved in drama and became a Thespian.  It seems I was more attuned to literature and the arts than I was to math and science.

I became a good student in college and something of a scholar in graduate school.  Entering grad school at the age of twenty-seven, I had gotten a taste of the real world and was motivated to learn. I actually enjoyed academia and was sorry when it ended. Funny enough, I did my master’s thesis on a project that used a sophisticated statistical technique, logit analysis, to predict certain outcomes. The same statistical technique is used in medicine to predict the likelihood of someone developing a disease based on lifestyle or environment factors.

When I learned I had lung cancer I knew enough about statistics to ignore the depressing averages and instead focus on being the outlier who did not fit the typical lung cancer patient profile. I had no desire to just be average, with a 15% chance of five-year survival.

The lesson to be learned is that every cancer patient should understand they are not a statistic; each individual is different. Outcomes will vary widely.  A good patient, like a good student, needs to be his or her own best advocate.  Educate yourself about your disease; understand the biology of what is happening to you, evaluate your options, seek advice, and don’t be afraid to ask questions or challenge your doctor. 

Nothing is more important to living a happy life than your physical and mental health. The key to your future good health is getting an education. Welcome back to school!

Donald J. Trump....Really?

Who do you favor to be the next president of the United States and what are the characteristics of the person you hope will be elected to the most powerful office in the world?  What are the issues that are most important to you?  What are the policy changes you would like to see made that would be transformative for the future of our country.  In a word, what do you think needs to happen to get us “back on track” to being the “greatest nation on earth” and a “shining beacon of hope” for the world?

For me, the preservation of all life and the caring for our physical and emotional well-being is the most important issue, followed closely by our economic life.  No one should be without food, shelter and clothing. All of us should have access to healthcare when we get sick.  We should be safe from crime and physical or emotional abuse. We should all be afforded the opportunity to earn a living wage, love who we want, and not be condemned for our beliefs. All lives matter… black, white, Hispanic, Asian, gay, straight, young, old, male, female, disabled, and unborn. We want a society that protects our most vulnerable members and provides equal justice and equal opportunity under the law.  We don’t want government intervening in every aspect of our lives.

On the other hand, anything threatening life is a legitimate target of government, whether we are talking crime, disease, pollution, food or work place safety. Key to our health and physical well-being is education. Without a universally well-educated population, life, liberty and the pursuit of happiness will be never be achieved for all.

In this political season we are looking for a leader who has the credentials to unite the country and solve our most pressing problems, which are many.  We need someone who can set an agenda to address those problems that can positively impact the greatest number of lives.  Let’s not be fiddling in the kitchen while the barn is burning.

Like many Americans I’m bewildered by the poll numbers favoring the ever controversial, always bombastic Donald Trump, who understands and lives by the mantra that “there is no such thing as bad publicity.” I remember reading Trump’s self-aggrandizing book “The Art of the Deal” back in the 1980’s and being impressed by some of the stories he told about the things he did for the City of New York.  But fixing a failed skating rink public works project or opening cheesy casinos in Atlantic City are hardly sufficient credentials to becoming the elected leader of the free world.  Unfortunately, the vainglorious Trump seems to be sucking the oxygen out of the room for more the more serious candidates, like Ohio Governor John Kasich, who impressed me as someone, among the Republican contenders, who wants to unite the country and is both compassionate and well qualified.

What are the burning issues that threaten life in the United States?  The headlines are dominated by stories about ISIS, radical Islamic terrorism and Iran’s nuclear ambitions. The enemy of the United States is also ignorance, poverty, hunger, addiction, disease, crime, and, inequality.  I only hope these issues are going to be addressed by Republicans in the upcoming campaign season.

I see the 2016 presidential election to be a potential turning point for the country; we are going to either continue down the current path to a point of no return, or we are going to change direction and begin to address the issues the American people care about.

A few weeks ago I wrote about the coming cancer boom, which anyone with half a brain knows is in our future. You don’t hear Presidential candidates even talk about cancer as an issue, despite the fact that one-in-four American lives will be lost to the disease. 

Has government done everything it can to prevent, detect, treat and cure cancer? Hardly.  Federal funding for cancer research is down 26% since 2003 and the FDA continues to create roadblocks to off-label use of promising new drugs.  Meanwhile the cost of cancer drugs is skyrocketing, sending more and more people into bankruptcy. The Affordable Care Act has not solved the problem because, while more people are covered by insurance, many of the insurance policies people can afford have high deductibles and co-pays.  

Who can afford a 10 percent co-pay on chemotherapy costing $150,000 a month?  Donald Trump can, but I don’t think he cares.  Nor will anyone else in Washington care about cancer unless you the voters do.  In this political season, make you feelings known.

Cooking in the Sun

I love the outdoors, but today’s column isn’t about summer barbeque. My Dad was from Brooklyn New York and was not into camping, hunting or fishing.  He did, however, teach me to play golf and that is the outdoor activity I most enjoy today.

As a kid I loved all sports. I was always out in the summer sun playing kick-ball, baseball, tag football, volleyball, basketball, racket ball or tennis.  When I was working, I was either cutting grass or painting or doing some sort of outdoor maintenance work or some part-time construction job.  Growing up I was working or playing in the sun from dawn to dusk seven days a week.

The thing I enjoyed most during the summer months in high school was driving down to the Jersey shore with a gang of friends.  We’d go to Ocean City and hang out on the beach for hours or walk the boardwalk. Invariably we stayed in the hot sun until we were burned to a crisp.  I remember one summer getting so sunburned on my back, I blistered.

In college for several summers I got very tanned driving an old tractor, hatless and shirtless, from dawn to dusk cutting the roadside grass. I covered 40 miles or so a day, driving in one direction from the break of dawn to sunset.  Then I would park the tractor and hitch-hike back to where I left my car.

In my youth I didn’t know that too much exposure to the sun could lead to cancer.  Working in Tokyo for many years, I was hardly ever in the sun, so I never gave it much thought.  I had an office job and most of time I was commuting by subway.  On the weekends in Japan I went sailing in the summer and skiing in the winter.  In later years I got into equestrian riding and would ride out doors on the weekends all year long. It wasn’t until we moved back to Florida in 1998 that I became conscious of how much sun exposure I was getting.

My wife Yoko, on the other hand, being Japanese, has always minimized her exposure to the sun. When Yoko is outdoors she wears a wide-brim hat and sprays on SPF 50 sunscreen. Her attitude toward being in the sun has to do, to some degree, with what the Japanese have traditionally thought when it comes to skin “beauty.”  The geisha and the beautiful young maiko (geisha in training) powered their faces white as a way to enhance their beauty. Japanese who work outdoors are subject to getting sun “spots” or blemishes on their skin, creating imperfections. The Japanese are taught in school about the danger of too much sun exposure.

About four years ago, as I was being treated for lung cancer, my oncologist noticed a spot on my scalp that, to my untrained eye, looked like nothing more than a freckle. My oncologist thought the spot looked suspicious and advised me to see a dermatologist.  I did. One week later the biopsy came back positive as early stage melanoma.

I had surgery to remove the malignancy.  I thought the surgery would be no big deal. I was wrong. It turned out, the out-patient surgery required a two inch diameter circle of skin be removed from my scalp.  It was replaced by a skin graft that took months to heal.  The surgery left me with an ugly permanent scar on the back of my head.  Ever since I see a dermatologist every six months for a full body exam covering every inch of skin.

The worse part of this story is that my beautiful wife, who, now having been vindicated about the danger of sun exposure, nags me whenever I go out doors. “Wear a hat, put on sunscreen, and cover your face and ears with sunscreen,” she says.

It’s hard for me to admit, but she is right… I don’t want to be any uglier than I already am.  And that’s what skin cancer can do for you, or worse.

Surviving the Coming Cancer Boom

If you were born between the years 1946 and 1964 you are as young as 51 and as old as 69, which puts you and me squarely in the “boomer” generation.  I was born in 1955 and will turn 60 in October, Lord willing and the creek don’t rise.

The post-war Baby Boom created a statistical anomaly in the age distribution of the population, a “bulge” known as “a pig in the python”. The imagery is fitting.  During every stage of life, my generation has created a “boom” as it passed through.  First it was in housing and the creation of suburbs after the Second World War, then a building boom for schools, followed by a boom in higher education, technology start-ups and so forth.  It should come as no surprise that, as the “me” generation gets older and begins to retire in greater numbers, we are not only going to stress social security and Medicare, we are going to create a new boom in age-related disease. Cancer will be chief among them.

Steve Jobs, who died in 2011 from pancreatic cancer at the age of 56, is emblematic of our age. He was someone dealing with cancer at about the same time as I was.  All the money in the world could not save him.  What might have saved him was screening and early detection.  Too bad there is no way to screen for this disease.  Until recently there was no accepted way to screen for lung cancer either.  Now, at least, an annual low-dose CT scan is recommended for people considered to be at high risk – smokers or former smokers between the ages of 55 and 74 who have a 30-pack year history of smoking or quit less than 15 years ago.

I’ve been spared from succumbing to cancer, at least for the time being. But I’ve learned my lesson.  As a two-time cancer survivor (both late-stage lung cancer and early stage melanoma) I don’t miss any recommended screenings. I get screened for lung cancer and prostate cancer once a year.  I get screened for melanoma every six months.  I have had a colonoscopy every three years since I turned 50. I get a blood screening every six months followed by a visit to see my family doctor to get the results. I have a digital prostate exam on a regular basis.  I know my LDL, HDL, CSA, PSA and every other indicator in my blood that can provide a “heads up” about potential health problems. The key to surviving cancer is an early diagnosis. Without screening, the coming cancer boom will decimate the boomer generation.

I'm considered an “early boomer” (people born between 1946 and 1955). This cohort accounts for roughly 38 million Americans. “Late boomers” born between 1956 and 1964 are another 38 million people. In all, there are roughly 76 million boomers including roughly 11 million who, like Jobs, have already died. There has been an equal number of new immigrants to replace them. Baby boomers account for roughly one-quarter of the American population.

Many baby boomers are former smokers or were exposed to second hand tobacco growing up.  In the 1950’s cigarettes were recommended by doctors as an appetite suppressant.  I remember one of my chores as a kid was to empty and clean the ash trays scattered around the house. Back then asbestos was commonly used in construction as a fire retardant. DDT was sprayed on the family lawn to kill the dandelions. Boomer generation military veterans were exposed to Agent Orange, napalm, not to mention tobacco, marijuana, and who knows what other carcinogens and pollutants.  The symptoms from all the carcinogen exposures we’ve had during our lifetime will start to show up as we begin to age.

We boomers grew up in the 60’s, the decade known for the anti-establishment, counter-culture movement, the sexual revolution and free love. That was followed by oral contraception, woman’s liberation and a boom in sexually transmitted diseases. (There were only two major STDs in 1960 -- gonorrhea and syphilis – when “Leave it to Beaver” was on TV.  Now there are over 25 major STDs!) Today we are pitched Viagra and Cialis for erectile dysfunction, and vaginal cream during the nightly news, as if not having sex is going to kill you.

The real threat to the health and happiness of the baby boom generation in the coming decade will be the ravages of cancer.  Ask your today doctor what screening are right for you.  It could save your life.

Absence Makes the Heart Grow Finder

Mark Twain once said, “The rumors of my death are have been greatly exaggerated.” I guess that, as a writer, Mark Twain also had long absences.   I am told that people have been wondering what happened to me, since I have not written an article for the newspaper lately.

I am still very much alive and actively advocating for lung cancer.  I have not been submitting columns because, frankly, I ran out of things to say. After writing 180,000 words about the under-funding of lung cancer and the unfairness of how cancer research dollars are allocated, I started to sound like a broken record.  I was afraid people would lose interest in the substance of my message.  “If you have nothing to say, say nothing” is another Samuel Clements pearl.

When I originally started writing back in 2007, I was fairly convinced I was about to die.  I had a lot I wanted to say.  It was obvious that lung cancer has not had a fair shake in terms of getting research funding.  But as time moved on and my imminent death became exceedingly extended, I had less and less to say.  Time was on my side again.  Facing what I thought was certain death brought out raw emotions from which my writing and advocacy benefited.  But after a while those emotions faded.  For me, life once again became normal. There was no longer a looming personal crisis I needed to write about.

Today I am writing at the urging of a seventy-something woman, a former smoker. She was recently diagnosed with early stage lung cancer that has been successfully treated.  She says she has a very good prognosis.  She saw articles I had written about lung cancer screening last fall and talked to her doctor.  She had also seen advertising about low-dose CT screening for lung cancer. A few weeks ago, she reached out to tell me that my efforts saved her life. She urged me to continue writing. 

The Talmud says that “Whoever saves one life, saves the world entire.” Of course I want to do more to save more lives! The question is how?  What more is there to say?

Anyone who know me knows I ALWAYS have something to say. In fact, people have a hard time getting me to shut up long enough to get a word in edgewise. It’s a personality flaw that I can readily admit to and not so readily correct. It’s the reason why writing is such a good outlet for someone like me.  It allows me to say what is on my mind without interruption.  The plan for this space going forward is to write about things happening daily in my life that may give hope and inspiration to others who are dealing with cancer or any other disease or personal crisis. 

If you don’t know anything about my background or why I started writing in the first place, let me provide a re-cap:

On October 5^th 2007, at the age of 52, I was diagnosed with Stage IIIA Adenocarcinoma (Non-Small Cell Lung Cancer).  I had an inoperable tumor in the upper posterior of my right lung that was approximately nine centimeters in size – about as big as a baseball.  The tumor has spread to the lymph nodes in the central chest and almost into my left lung. It was impinging on the central vena cava that supplies blood to the brain and it was entirely possible that I would have a stroke or worse if some kind of intervention wasn’t done immediately.

My doctors quickly determined that this cancer was inoperable.  I set upon a course of treatments that would last five years. 

As I began reflecting about what I had accomplished in my life, I prayed that God would grant me the time to re-dedicate the rest life to helping others. I felt that I had wasted precious time for most of my life.  I did not want to die having accomplished nothing of substance. I wanted to leave some lasting legacy.   

I began to write about my life and life lessons for the sake of my children and grandchildren.  That has now extended to my readers. I hope you find my thoughts about living a meaningful life worth reading. My goal is to inspire you to do more to change the world and become an inspiration to others.