A Very Bad Week

On any other given week I would make a big deal about how Alabama losing the National Championship Game was such a contributor to the bad week I had. Sadly, Alabama football- which has been such an important part of my life for forty years- just didn’t mean much this week.

This was a terrible week, a life-definingly terrible week. I’ve actually had a few in a row, but this one was a doozy. For several weeks I’ve been dealing with a massive case of jaundice and suffering from abdominal swelling (I think I may have mentioned that in the health update of the last post). The short-term solution to relive the discomfort associated with ascites (the swelling) is a procedure called a paracentesis- they slide a long needle into your abdominal cavity and drain off abdominal fluid. During my first procedure they drained 4.4 liters off my gut. Put in perspective, that’s about ten pounds worth of fluid…more than 2 two-liter bottles of coke…six bottles of wine…a baby…all within the abdominal cavity. The bad news is that once you drain the fluid it starts to reaccumulate immediately. This procedure is repeated until there is a diagnosis of the cause. 

There are essentially two causes, a) some form of liver disease, or b) a web of cancer cells in the abdomen that do the same. As you may have suspected, cancer is the cause of my ascites. Unfortunately, my cancer is not treatable. To provide some form of relief, they’ve installed a peritoneal drain (a pluerex). This is more or less a permanent version of the paracentesis. The pluerex is tapped to drain fluids every couple of days, reducing the swelling and my considerable pain.

In the end, this is my situation: I can’t take chemo to treat the tumors due to the jaundice. Without treating the tumors the jaundice and ascites get worse. The ascites also interfere with my ability to eat, contributing to my steady weight loss. I look more cadaver than man these days. All of this is to say that there is nothing they can really do for me now. My next step is palliative care, likely to be followed by hospice, and eventually death. How quickly this process progresses, whether I will follow that pattern, and how long this might take are all variable. Who nows what the future holds. 

The doctor believes that I’ve got a couple of months left. But considering how I feel and how I look, I'm much more likely to guess weeks than months. He suggested that I start thinking about what I want to do with the time I have left (as if I haven’t been doing that since March 2015). As a fellow workaholic he suggested I start making contingency plans for how to transition out of that world. 

Surprisingly, the Chattanooga transition wasn’t that difficult, despite the fact that I’ve devoted myself to urban design in Chattanooga for the last sixteen years and loved virtually every moment of it. I’ve loved the work, and I’ve developed life-long friendships based on it. That said, I feel that I’ve done what I can for the community. My work here over the past few months has become a drain. So late in the week I had a chat with my staff, wrote a letter of resignation to the board, and had a wonderful night’s sleep. I wish the new Design Studio and my eventual successor all the luck in the world, and expect to see to great things to come from them in the future.  

Iowa is a different case altogether. I love the work were doing out there, and I love the clients I work with. The work is challenging and fulfilling and is transforming the community. Health permitting, I think we still have a few things to accomplish before we part ways. My client and I have resolved to find a way to continue that work into future (if not quite as robustly)- cancer be damned!

I'm thankful for being given the opportunity to help
establish the Chattanooga Design Studio. I'm so very
proud of what our collaborative effort produced.

Throughout the process D and I have been honest with the boys and have given them no more or less than the objective facts about my condition as it has played out. While I don’t mind talking about possibilities and implications with family and friends, we opted to only update the boys if we have solid news. As of Tuesday we had more solid news. 

I've done some hard things in my life. I ran a marathon- hard. I made it through graduate school- hard. I’ve passed a number of professional exams (AICP, LEED AP)- each hard in their own way. I finished an Ironman-incredibly hard. I designed and built my own house- hard. I told my children 2 years ago that I had cancer- hard. I’m no stranger to doing difficult things. Telling my children that I have weeks to live, however, is by far the most difficult thing I've ever done. I thought the cancer notification was going to be hard, but the boys took it in stride. I think they've seen enough stories of people beating cancer that they assumed their “Ironman-tough” dad would be able survive to as well. The fact that I made it for a couple years beyond the official news, and people have been telling them how great their dad is doing probably reinforced that notion as well.

Tuesday evening we sat the family down and I delivered the news. I’ll spare you the details, but it was gut-churning. In two years of dealing with cancer-emotionally, spiritually and physically- I haven’t experienced any form of pain as excruciating as watching my children react to the news that I’ve got weeks to live. It’s tough to say any more than that this week.

Because I’m now unofficially retired, I should have more time on my hands to update ya’ll if the spirit moves. I’ll do my best to do just that. In the meantime, remember that I love you, and please spare a prayer for my boys if you get a chance.