In the Hands of the Masters

Yall are going to have a hard time getting me out of this cowboy hat…

I got a blast of reality in Houston last week. It was about a month since my last visit- a month where life largely returned to “normal”. I was back in my routine for the most part, and on most days I could ignore the specter. I feel great here at home, even with the chemo. In Houston, however, things are different. There is no “normal”. There are constant reminders of the situation everywhere. It is surreal and sobering. That said, I am still living the dream and I managed to enjoy myself.

On Tuesday I was scheduled for a 6:45 a.m. blood work appointment (which is cruel and unusual). I left D to catch up on her sleep and schlepped my way over to get stuck. Afterwards I had a couple of hours before my ERCP (that’s an Endoscopic Retrograde Cholangiopancreatography for those playing at home) and decided to treat myself (because, y’know, I’m worth it). I figured that if I was going to be in Texas for treatment, the only suitable memento would be a custom-fitted cowboy hat. I summoned an Uber and trekked out to what is apparently THE place to get a hat in Houston.

I walked in to The Hat Store and was greeted by a couple of gentlemen. They had a cosmic yin-yang thing going on- one tall and lithe, the other short and built like a fire plug. The fire plug, Gary Cohen, is the owner. I told him why I was in Houston and why I was in his store. He probed me about how I would be using the hat and for what purposes. He took his time to show off various models, and describe their relative merits. We found a straw number that was quite clearly meant for me. At this point, all of the hats are unformed- the brim is flat and the top is rounded. The next step, shaping, is pure art.

Uncomprehendingly, he did not ask for my signed photo
for the wall. I think I'll send him one anyway.

He asked if I had a particular shape in mind (which of course I did not). I said that I wanted something functional and relatively traditional - and nothing crazy like the concert cowboys. “Hmm, with your face, you’re going to want the alpine”. Mr. Cohen stepped behind the counter and turned open the valve on his steaming machine and proceeded to work his craft. Deftly maneuvering the hat on and off the steam, he started bending, coaxing, and shaping the straw. He constantly checked his work putting the hat on my head and observing, then taking it back to the steam for more. He was very keen for my input in the shape (apparently, serious hat folk are very particular about shaping). I was quite happy to leave the shape to his practiced hands. In the end, we were both very pleased that my hat was MY hat. He showed me a variety of hatband options, and I went with a peanut brittle crocodile strap (cause, y’know, I’m worth it).  We settled up, Mr. Cohen gave me some tips on hat wearing, care and maintenance, left me with some kind works, and I was off.

I spent more time than planned in The Hat Store, so it was a race to get back to M.D. Anderson to make my procedure on time. (Which I did…barely.) I left my hat with D for safekeeping, got undressed, put on the silly gown and settled in on the stretcher. After getting poked, prodded and prepped by a variety of very pleasant people, the doctor showed up. You will remember Dr. Lee as the superstar endoscopy guy that unraveled the mess that is my biliary system to place the stent that relieved my jaundice and made my chemo possible. I mentioned to one of the nurses that Dr. Lee performed a near miracle on my last ERCP, and he replied in an almost reverent tone “That’s what he does, all day, every day, he’s amazing”. When he arrived, Dr. Lee easily and comfortably deflected all of my praise and admiration, and accepted my thanks. We had a chat about the procedure (a replacement of his masterwork) and he started on his way. Before he left, he turned, pulled out his phone and asked if he could take a picture with me. “Only if I can take my picture with you, and only if I can wear my cowboy hat”. He asked that we not post anything to social media, to which I grudgingly agreed, and he was on his way.

Lee and Me.
(Faces have been disguised to protect the studly)

Coming out of those procedures is always a bit of an uncomfortable time for me. In that drug-induced fog, I apparently have a habit of spilling my guts and emotionally gushing my love and appreciation for everyone within earshot. Dr. Lee came back for a visit and to give another humble report of a masterful performance. He gave me his sincere best wishes and told me that I had won the hearts of everyone on his team. How in the world I could win anyone’s heart with a tube down my throat, sedated, drooling, and lying buck-naked on my stomach is beyond me (I’ll have to look into that), but he made me believe it nonetheless.

The next day, it was biopsy time. They stuck a big ass needle between my ribs and into my liver to get the sample. With the drugs, the experience wasn’t all that bad- although it was disconcerting to hear the doctor say “We’re going to check to see if we have enough material, don’t move, there’s a big needle sticking out of your liver”. The biggest problem was the fasting. Because I had to fast for both procedures, and because there is no solid food after an ERCP, I went from Tuesday at 5:45 pm until Thursday at 5:00 pm with no solid food and only 12 ounces of broth for fluid. On Thursday at 5:01pm I went directly from the recovery room at the hospital to downtown Houston for a steak the size of a toilet seat (cause, y’know, I’m worth it).

So, one week and two masters of their respective crafts. I am quite jealous of people who have dedicated themselves to the pursuit of perfecting one thing in life. My journey has been somewhat different, having spent my time trying to learn as much as I can about as many things as I can. In the end, we can each choose only one path, but it’s certainly a pleasure to watch the master travelers.

This week’s listen: Still on the Noel Gallaher. He is, bar none, my favorite lyricist of all time. This week I’ve been admiring his craft on While the Song Remains  the Same.

Good Grief (or, Basketball is a Young Man's Game)

I've always fancied myself as being self-aware. I’m good at knowing my faults and limitations, and at understanding most of the underlying motivations that drive my behavior. I questioned that self-assessment this week as I tried to place myself in the Kubler-Ross grief model. According to some of the materials I’ve been given, the cancer patient often undergoes similar stages: Denial > Anger > Depression > Bargaining > Acceptance. The problem is that I can’t really tell where I am on that spectrum. Here’s my take:

I’m not in denial. I’M NOT IN DENIAL! But seriously, I’m fully aware of what’s going on and what my prognosis is. I suppose, however, there is a chance that I am in a very deep subconscious level of denial that is allowing me to maintain an even keel. There is a difference, however,  between resolve in the face of tough situation and the denial of that situation. Verdict: Denial? A river in Egypt.

As a man who is prone to fits of temper, the fact that I skipped the anger stage is somewhat surprising (I feel a bit cheated). I keep reading that people often ask “why me?” when faced with a tough situation. Strangely, that question never really occurred to me. I must admit, however, that from time to time when I see a douche bag walking down the street I think to myself “why didn’t that guy catch cancer?” I immediately feel ashamed for the thought, because that’s not what’s in my heart and I wouldn’t wish this on even the worst Delta Bravo. (but I will cop to getting a comedic kick out of it).  Verdict: Anger? Only that we live in a world where Beiber and the Kardashians are “newsworthy”, and Sandra Lee has her own cooking show (two, if you can believe).

A casual observer of my preferred playlist last week might think that I am in deep depression. I’ve been very heavy on The Smiths, Depeche Mode, and The Cure.  Those who know me well, however, know that I would have listened to them during a rainy, overcast week anyway. I’ve been in a great mood and I feel outstanding. Verdict: Depression? Not even on Chemo Mondays.

Bargaining is the one phase that has never made much sense to me. I can’t really see the utility in trying to wheel and deal with God to improve a situation. If you believe in God then you understand that he has a plan. It seems to me that the ask should be for the strength and insight to handle a situation rather than be removed from it. To be fair, I do have hope that our plan for treatment will be successful, and in some of the grief models that is considered bargaining. Verdict: Bargaining? I don’t think so, but I suppose that depends on your definition.

In the end, we have acceptance. I now realize the fault in the Kubler-Ross model. The model works best with an inevitable outcome. I feel like I've accepted the news and the possibilities. I haven't, however, accepted that death from this tumor is inevitable. I suppose the model then dictates that I’m in denial (or bargaining). So, F the model (am I in anger now?) Verdict: Acceptance? I accept that I have cancer, and I accept that death from this tumor is statistically likely. I think, however, that I'll beat it.

When all is said and done, the model is a useful for people and those who care about them to understand their feelings and what they’re going through. Frankly, after this exercise, I don’t have much use for it. I know I’m facing a challenge, and I’m prepared for it, come what may. That behind us, on to the weekly update...

This was my first week of chemo, and it was a good week. The treatment session itself wasn’t a bad experience. I got to sit in a fairly comfy reclining seat while hooked up to the IV pole for a few hours. Having brought my computer, I got to work for a bit, listen to some music, and watch a bit of Netflix. It was somewhat disconcerting as I was, by at least two-decades, the youngest person in the treatment room that day. Around lunchtime, a group of volunteers brought in homemade sandwiches and snacks for us. Oh, the comfort to be found in a good pimento cheese sandwich. In the end, the first day of chemo wasn’t a traumatic or profound experience- just another step on the journey.

The day after chemo I felt great. Good enough, in fact, to join my buddies for a game of old man basketball. The games resembled the first scene of Saving Private Ryan; we had men dropping right and left. My homie blew out his ACL, another strained a glute (no lie), we had a man go down with a back, we twisted an ankle, and I strained a calf. In the end, we played for a couple of hours, and I didn’t hold anything back. After the game we went off to get something to eat and tell lies about how well we played.

My last recorded dunk in July of 2013.
Video Credit: Spence (I was showing off for him)

This was the first time I’ve played where I actually felt my age. Since my mid-thirties, I have attempted to dunk on (or near) my birthday each year. This year (42) was the first that I couldn’t, but I got close and my legs still felt lively. On Tuesday, the legs felt flat. Flat, I tell thee. I am certain that this has more to do with age than chemo, though. I think it’s safe to say that serious basketball is behind me. Don’t cry for me though, as I suspect that this is more a natural function of age than cancer.

The first week of chemo has come and gone, it was a breeze. I didn’t feel the fatigue that doctors forecast, but I did get drowsy a few times. I suspect things will get more difficult in the weeks to come, but for now I’m living the dream. Off to Houston to see the kind folks at M.D. Anderson this week, wish us luck. 'Til next time, keep it ill.

This week's chemo soundtrack provided by my all time favorite Noel Gallagher (who has an excellent new album out). I'm really digging on Ballad of the Mighty I right now.

Death and Taxes

If one is diagnosed with stage-four gall bladder cancer and blogs about it, at some point the topic of death must be broached. I could think of no more appropriate time to bring up the subject than tax week. Some things just go together: peanut butter and jelly, salt and pepper, death and taxes. Considering that I  just wrote a tax check for more than my cancer treatment will cost, I would much rather write about death.

When I was thirty-one, after we were married and before we had kids, I told D that I was ready to die. To be certain, I had no death wish, my comment came from a place of gratitude. This was my way of saying that I was genuinely thankful for having lived a full, eventful and blessed life. I was raised by a close and loving family; I lived in God’s own Alabama, in the majestic mountains of Colorado, in the stark beauty of New Mexico, and in the Scenic City; I played basketball at a very high level; I ran a couple of marathons; I completed an Ironman; I was blessed with great friends; I knew a number of girls, and married the best one; I traveled at home and abroad; I saw Alabama play in bowl games; I saw Birmingham City win at Villa Park; I purchased a house; I had my share of drink and cigar smoke; I saw Oasis play at Madison Square Garden and Ray Charles sing Georgia at the Olympics. (That list could go on for a while). On the other side of the scale, nothing really bad had ever happened to me either: no one very close to me had died (that I was capable of remembering); I never had a serious illness; I never broke a bone; never had a surgery; and despite being “broke” in college, I never had to seriously worry about what I was going to eat or where I would sleep. In short, I had lived a very good full life in three short decades.

Over the past decade things have only gotten better. I started a business with people I love and respect; I started a business for myself; I designed and built a house for my family; I’ve designed and built houses for others; It taught architecture at a university; I’ve been back to England a few times and on to Amsterdam, Paris, Rome, Cordoba, Malaga, and Granada; I’ve seen the morning sun bathe St. Peter’s and the evening sun set on the walls of the Alhambra; I’ve played on the white sand beaches at Seaside and on the black sand beaches of Costa Rica; I've cooked fancy food in my house and eaten fancy food in a world class Parisian restaurant. (That list could go on for a while). In fact, things have been so good that I felt like I’ve been getting away with something. From a selfish, personal perspective the idea of dying now as opposed to sometime in the future isn’t really that troubling. I am confident in what I will find on the other side, I’ve lived a very full life, and I have seen and done things that most people on this planet don’t get to.

In the past decade, however, the two greatest things have happened as the boys have entered my life. All of the events listed above pale in comparison to what my boys mean to me. It is because of them that I can no longer honestly say that I’m ready to go. Of course, there is an element of self-interest as I am very keen to watch them grow up for my own personal satisfaction. From a broader perspective, my dread is of them growing up without their father. I don’t want them to feel that kind of pain and grief. I want to be there for them for everything. (I will revisit the father/son topic in a future post, stay tuned).

All of that said, I have no intention of cashing in just yet. It’s easy for me to write about death and to keep a positive attitude because I don’t believe that this will kill me (this time). That belief is most certainly grounded in naiveté and probably sustained by a health dose of denial. I know what the prognosis is, and I am aware of the statistics, but I have a feeling that we’re going to win this one. (If I’m right, then we’ll celebrate. If I’m wrong, then I won’t be around to hear anyone say I told you so.) Over the years I’ve played in a number of games where a team is down big with time running out, when the seemingly impossible happens and we’ve come back to win. There is a special feeling in those instances that despite the score and time, victory is the only outcome. Call it confidence, call it swagger, call it faith- but it’s special and it’s real.

This is also one of those blasted times where the parent has to practice what they preach. From time to time, the boys get upset when they’re losing- whether it be one their own sports games, or watching one of their favorite teams playing on TV. I constantly tell them not to focus on the score or the clock, but to focus on playing each play as hard as they can. I’m also fond of telling them that it is important to play as hard as you can for the entire game, regardless of the score, because that is the measure of a competitor. It’s never all right to quit... We must finish what we start....It’s not over ‘til the fat lady sings...(and so on).  It appears that I am now receiving a full dose of my own medicine. Admittedly, this is an extreme method of teaching, but I will lead by example if only for their sake.

So, there you have it, my obligatory post on death. While we’re on the topic, this week marks the death of one of my heroes. Louis Sullivan died on April 14, 1924. For those of you who are new to the blog, you might enjoy reading about another of my great adventures during the Summer of Sullivan. Chemo starts tomorrow (April 13), and I’ll let you know how it goes. Oh, and don't forget about your taxes, it's the one certainty in life.

One last death-based observation: In August of 1977 Elvis died. That summer he played his last four shows in Des Moines, Madison, Cincinnati, and Indianapolis before returning to Tennessee to die, aged 42. As fate would have it, last summer I visited Des Moines, Madison, Cincinnati, and Indianapolis, then turned 42...will my friends please help me keep clear of  Codeine, Valium, and Morphine prior to heading to the bathroom.

Keep Right On (to the end of the road)

Apologies for being late, running long, and including too many selfies. I'll try to do better next time.

Prior to the unpleasantness of the past few weeks, I booked a trip for my oldest and I to go to England to see friends and watch football (soccer). After the news dropped, I cancelled the trip. This cancelled trip was one of the hardest things for me to swallow in this ordeal. My nightmare was of a future where Spence would be forever tortured by the big trip with his father that never happened. That thought absolutely gutted me. After the dust settled, however, I found that I had two weeks before chemo started, and that in fact the dates for our trip were still feasible. After a quick check with the doctors, it was back on.

One of the great relationships in my life started in 1991 when I met an Englishman named Jem Jones at the University of New Mexico. We were fraternity brothers and fast friends. He introduced me to Birmingham City Football Club- a club that I have supported ever since. Space will not permit me to describe exactly how much Jem, his parents (Alan and Anne), and his wife and daughter (Sarah and Sophie) have meant to me over the years. With two-day notice, they paused their lives, dropped their plans for the Easter holiday and helped Spence and I with the trip of a lifetime.

The details of the trip are beyond description, but I will hit the high points. Uncle Jem met us at Heathrow on Thursday and it was off to the races. We spent that first day touring London: Tower of London, St. Paul's, Big Ben/Parliament, Westminster Cathedral, Buckingham Palace, etc. I made a pilgrimage to Fergus Henderson’s St. John, but unfortunately the restaurant was closed for a private function and I didn’t get to eat there. To ease the disappointment we stopped off at a very traditional pub near Smithfield Market so that I might hazard a pint. For lunch we stopped by M.Manze, an old school pie and mash joint. The highlight of the day was Spencer’s reaction to the stewed eels I encouraged him to try (it went down as you might suspect). We stopped in Southall for a curry as we made our way out of London and on to the lovely village of Henley-in-Arden.

Pie & Mash (and the infamous stewed eels)

Friday's activities were the original reason for the journey. As noted before, I am a massive Birmingham City supporter, and have passed that along to the children. One of the things I have always wanted to do for the boys is to bring them over and find a way to arrange for them to be mascots for a Blues home game (the mascots are the kids who walk out of the tunnel with the players just before the game). With the help of the Joneses, we sorted this out, for the home fixture against Rotherham. We got a couple hour tour of the grounds and locker rooms, he met all of the players, got to play on the pitch for a bit, and escorted Blues into the stadium (he was paired with a fellow left-footed #3, Jonathan Grounds). Blues won 2-1, extending their remarkable streak of being undefeated when I am in attendance (six games over eleven years). My highlight of the day was getting to sing the unofficial Birmingham supporter's song Keep Right On with Spence. I've always loved this song but the events of recent weeks have put the lyrics in a different light:

As you go through life it's a long, long road

There'll be joys and sorrows too

As we journey on we will sing this song

For the boys in royal blue.

We're often partisan - la la la

We will journey on - la la la

Keep right on to the end of the road

Keep right on to the end

Though the way be long let your heart beat strong

Keep right on to the end

Though you're tired and weary

Still journey on 'til you come to your happy abode

With all our love we'll be dreaming of

We'll be there. At the end of the road.

Birmingham!!!! Birmingham!!!

More footy was on tap for Saturday with a trip to see West Bromwich Albion at the Hawthorns. We were treated like royalty at the home of the Baggies and got another stadium and locker room tour. Unfortunately, we were unable to bring any luck to the Albion who fell 4-1 to Queen’s Park Rangers. That evening, an all-star cast of English C.Rushing cronies made their way from all over the midlands to join Spence and I for dinner. In attendance were such luminaries as Alan (Spence’s English Grandad), Uncle Sted, Simon onions, Uncle Tim, Uncle Filth, Uncle Pauly, and of course Uncle Jem. These men are top, top blokes, and friends that I an unworthy of. Yes, I did hazard another pint, and yes, Spence did learn some new English words.

Sunday was essentially a day of rest. We had a big English breakfast with the Jones clan, then took a leisurely tour of the Cotswolds with stopovers in Bourton-on-the-water and Stratford-upon-Avon.

Monday was quite the road trip. The main of objective was to get to Bournemouth to watch our Blue boys take on the league-leading Cherries. Along the way we stopped off at the impressive Stonehenge (strike that from my architectural bucket list). The second strike off the list was a stop at Salisbury Cathedral. This is an outstanding building, and home to an original Magna Carta. This is also a place of great significance for me in this bigger journey. I excused myself from Jem and Spence for a bit, found a quiet corner, and had a special prayer. Perhaps some day I will write about it, but I will leave it for now.

A very special place.

Away games in English football are arguably more fun than home games. The siege mentality makes the singing louder and more profane, and the camaraderie more closely felt. Much to everyone’s amazement Blues scored the first two. It was bedlam in the away in end. Unfortunately, my prayers did not extend to the afternoon football match, and we eventually fell to the better team by a count of 4-2. My undefeated record with Blues died a valiant death on the south coast of England. As they say, all good things must come to an end.

We were feeling pretty good at this point...

With our heads held high, we departed Bournemouth and headed east. We stopped by Highcliffe for fish and chips overlooking the English Channel. We eventually let Spence talk us into walking down the cliff to the water’s edge to dip our toes in. Sufficiently wet and sandy, we made our way to Winchester for the night. Uncle Jem got us safely to Heathrow terminal early morning. Spencer and I gave my dear friend the biggest hugs we could muster, and said our farewells. We are now resting quite comfortably in the Virgin Atlantic Clubhouse (which I must say puts every Delta SkyClub to shame) awaiting our flight home.

Over the course of the week I answered my friends' questions about the cancer, but we didn't dwell on it. I think I did a good job of putting it out of mind and enjoyed being in the moment. In the end, however, until the fight begins and is won, it's always right there with me.  I am so very happy to have had this special time with Spencer and with my friends. Now it's time to get back to work and see if we can beat this thing. Until next week...Keep Right On!!!

Houston? We Have a Problem.

That was a roller coaster of a week. On the balance, probably more bad news than good, but having new information is a good thing in and of itself. This post runs a bit long as this was a very full week, but I think it’s important to paint the full picture at the outset. Before we start, please accept my sincere and heartfelt thanks for all of the thoughts, prayers and best wishes that you’ve sent my way. You have meant a great deal to my family and me. Here goes…

We flew to Houston last Sunday to meet the good folks at M.D. Anderson Cancer Center. I thought we were going for a day (a three hour tour, a three hour tour…), but ended up being there for a week. I was accompanied on the trip by the C-Team- my lovely wife and my longtime friend Dr. Joe Chewning. As fate would have it, Joe is a stud pediatric oncologist who has worked at a number of august institutions such as Sloan Kettering in NYC and UAB. Yes, it is totally baller to travel with one’s own personal oncology consultant (who’s a lucky boy?)

On Monday we met with Dr. Milind Javle. A very pleasant man that I suspect is about my age. We had a chat about what he saw in the imagery, and a bit about what he thought the eventual course of action would be. He confirmed what we knew (cancer), but suggested that it was probably more advanced than we had been told previously. He also suggested that he didn’t think that surgery was an option at the moment. He explained that he would be discussing my case with the full team on Tuesday, and that we would see him again on Thursday for a more thorough prognosis based on that meeting. He scheduled another CT scan for that night, changed up some prescriptions, and bid us adieu.

By my reckoning, that left us with two days in Houston, TX with nothing to do but hang around the cancer center waiting for the phone to ring. Eff that. Three years ago I made an architectural bucket list. In that short time, I have made remarkable progress in ticking buildings off the list (I’ve written about a number of them: Paris, Rome, Spain, the Summer of Sullivan). As fate would have it, we were a mere four-hour drive from another target, Lou Kahn’s Kimbell Art Museum in Fort Worth. The building is a jewel in an almost literal sense. The play of light is what makes precious gems sparkle, and it is the play of light on concrete and travertine that makes the Kimbell such a masterpiece. The Renzo Piano addition is also very nice.

We woke up on Wednesday and hustled back to Houston. It was a good thing that we did not linger in DFW, as Dr. Javle scheduled an appointment with Dr. Herlong, the liver specialist. Part of my problem is that my tumor has spread to my bile duct, constricting it and causing a bile build up in the liver that results in jaundice (and itching like a MF). Apparently, within the liver I have a number of complex strictures. Back in Chattanooga we had a doctor perform an ERCP to put a stent in the duct to help relieve the jaundice, but by his own admission the placement wasn’t perfect.  Somewhere along the line we were told that PSC is a distinct possibility, and Dr Herlong echoed this concern. Of course, this would suck as PSC has no cure, and with my big-ass tumor I am not a candidate for a liver transplant.


As we left his office and walked through this massive medical building, I had a moment. Everyone in that building is there because of cancer. As we walked through the Sundial Room (a large space for folks to hang out), there were dozens of folks in various stages of their fight, many looking quiet frail and pitiful. I remember thinking to myself “My god, look at all these poor souls. How lucky are we.” Oops. Despite the fact that I feel good (and look great, if I may), I am very much in the shit as they are. Exactly how deep, we would discover the next morning.

Our Thursday meeting with Dr. Javle was a difficult one. The official prognosis was stage four gall bladder cancer (whereas before the consensus seemed to be stage three). The tumor has spread from the gall bladder to the lymph nodes, the bile duct, part of the liver, and part of the colon. Having researched my condition over the past few days I was prepared for the life expectancy portion of our conversation. Despite that preparation, it is no fun to hear the doctor explain that people diagnosed at stage four have a typical life expectancy of a year if they undergo treatment (and six months without). No bueno. I do not recommend you have this conversation with your doctor.

Our discussion then turned to how we are going to beat this thing. As you might suspect, we’re going to take things step by step, and upon the completion of each step, we will evaluate our options. Cure, in my case, may be elusive. Apparently, this adenocarcinoma likes to come back. If we manage to lick it this time, it will likely come back for more (but we’ll worry about that later). In the meantime, the first goal is fix the jaundice, as we can’t start chemo until my bilirubin levels come down (significantly). Toward that end, Dr. Javle pulled some strings to get their rock star endoscopy guy to do another ERCP to see if we can get a better stent, and investigate just how bad things are in the liver.

Shortly before lunch on Friday we went in for the ERCP with Dr. Jeffrey Lee. He introduced himself by calling me “the famous Mr. Rushing” and “the Ironman”, so he clearly understands that I’m highly susceptible to flattery. He mentioned in passing that Dr. Javle was probably the best gall bladder cancer doctor in the world (so I’ve got that going for me…which is nice). As for the procedure, he explained that I have a number of complex strictures in the bile duct that extend up into liver. His goal was to remove the existing stent, and see if he can do a better job of bypassing the strictures and allowing the liver to drain- with the understanding that this appeared to be a very tall order.

After the procedure, I woke up, emerged from the fog, and met again with Dr. Lee. His verdict: “I am elated!” He pulled us over to a computer monitor to show us his handiwork. He explained what was done in the previous ERCP, then described (with obvious pride) what he was able to do. The upshot is that there is no PSC, the ducts above the worst stricture are communicating, and he was able to get a great stent in to drain the liver. The next day we flew home to Chattanooga. (Update: in the three days since the ERCP, the bili levels have been slashed by half. Bueno.)

So a long, tough week ends with what appears to be our first win. I’m back home with Denise and the boys, and everyone seems to be in good place. I can’t begin to describe the outpouring of support and love that you have sent my way- please know that I love you right back. Stay tuned for next week, it's going to be a fun one...

C on The Big C

Well, the blog retirement didn’t last very long did it? As Jordan once returned to the game he loved, I find myself back in front of the keyboard. The reason for my return, however, is more serious than the fact that I couldn’t hit a curve ball. A couple of weeks ago I was diagnosed with adenocarcinoma- stage three cancer of the gall bladder that has spread to the lymph nodes, liver, and bile duct.

How in the world I got gall bladder cancer has perplexed all of the doctors. There are only about 4,000 cases of it in the U.S. per year (as opposed to ~350,000 cases of breast cancer). It is also typically found in Native or South Americans, women, people with gall stones, and typically when people are in their 60’s, 70’s, or 80’s. This particular cancer is quick, aggressive and deadly. By the time it gets to stage three, the five-year survival rate is in the single digits. I’m not daunted by the statistics though- if it was one in million (figuratively) to get it, one in twenty to beat it doesn’t sound so bad. That said,  I’m not into watching the scoreboard while there is still game left to be played.

After hearing the news I decided that I would write about my experience. While the old blog was a thousand words a week, once a week, I’m not exactly sure what this will look like. I suspect I will keep you updated on the situation, and probably venture into the realms of architecture, urban design and food as before. I don’t suspect the posts will be as long, and I don’t suspect I will be able to always keep a regular schedule (although that is my goal). For now, I will try to keep to the schedule of the old blog- look to your inboxes on Tuesday mornings.

I have heard from a lot of you, and I greatly appreciate your thoughts, prayers and best wishes. Keep sending me your positive vibes, because I'm sending them right back at you!

I know that a number of you receive the blog via an automatic email subscription. If the shift of topic from urban design to cancer is not your cup of tea, or you end up receiving too many emails, I fully understand if you unsubscribe (it won’t hurt my feelings ;)

The End.

On the first day of 2011, I wrote my first post for this blog. Four days and four years later, this is the last. The events of the past few months have put a squeeze on my writing time, and rendered the proposition of writing on this topic a bit more complex. Funding has been secured to establish an urban design resource for the city- the Chattanooga Design Studio. I've been asked to help get the organization up and running, and for the foreseeable future, that is what I'll be up to. I came to the conclusion that a personal blog on urban design couldn't coexist with this new position. I have reservations about my ability to continue writing without getting the new organization in hot water. (Starting a non-profit is going to be difficult enough without the handicap of my big mouth.) But before I go, there are few things to pay off:

-I started with a lament on the Declining Standard of Downtown Building. We might say that things have improved slightly since then. A number of big projects, however, are slated to being soon. The quality of this new development and the contribution to the public realm will show if we're back on track, or if the decline continues.

-From the first word of this blog until the last, the state of Alabama has had a representative in the college football national championship game (and the year before as well). “The last five seasons will go down as the greatest college football run for any state in the country in the entire history of the game. Five years. Two schools. Five national championship game appearances. Four national championships and one near-miss.” While the streak may be over, I don’t believe the ‘Bama dynasty is. We’ll be back.

-Coming in to today, I wasn’t sure how to pay off the cooking angle. Tonight’s dinner was a thunderbolt of inspiration. My cooking over the past four years has been all over the place- molecular cuisine with foams and spherification to asian inspiration, and offal orgies. Of late, I’m back to basics in the form of French classicism. Tonight I made a by-the-book béchamel a la Julia. I added too much pepper, and when I tasted it, I pulled an Anton Ego. This French mother sauce is made by adding scalded milk to a butter/flour roux. It turns out that this is the exact recipe that BaBa (and countless other Southerners) used to make the gravy of biscuit and gravy fame. Béchamel is nothing but a fancy word for gravy. I suppose I've always known this, but this was the first time I realized it. In a parallel universe I would've used this as a departure point for a post on the beauty of simplicity and the possibilities of variations on a theme- a mother sauce. In this universe, I'll simply say that the city is merely a series of variations on basic themes- get the basics right and the city will flourish.

The blog has been a tremendous experience. I’m not sure that I can convey exactly what it's meant to me, but it's been a very special part of my life. In the end, the best thing I can say about it is that it has been fun. When I grow old, some of my fondest memories will be of laying in bed on Saturday and Sunday mornings, soccer on tv in the background, the boys crawling on top of me, computer in lap, writing stories about Chattanooga. Thanks for reading, for your encouraging comments, your retweets, ‘likes’ and forwards. I may write again, but there's no telling when or what I'll write about. 'Til then… Forever and forever, farewell! If we meet again, then we’ll smile.
 If not, then this parting was well done.