Living with Cancer

by Craig Davis, PhD

Contact me at: csdavis23@gmail.com

Living with Cancer: Flat Tires

l haven’t lived in Jackson County for decades, but I am intrinsically linked to it in many conscious and subconscious ways.

I dream about Brownstown and Freetown frequently. I conduct research on Kurtz. I visit family, read The Tribune and then occasionally, I stumble into a situation that triggers memories.

On Mother’s Day this year, I walked to the La Colonia supermarket in Tegucigalpa, the capital of Honduras. On a Sunday morning, the streets are relatively safe. I needed to buy some groceries so I could make tuna melts for my daughter and grandchildren, and I always need the exercise.

I had spent the early morning researching and writing about Kurtz in 1908 before my walk. After I returned home, I would revisit three teenage experiences in a matter of moments. Like everyone else, I am a product of sophisticated composite of experiences, relationships, DNA and other factors complexly woven into the texture of my personality.

Take the simple act of changing a flat tire. When I was about 13 or 14, I was riding in the back seat of my mother’s Torino one night, returning a movie in Seymour. I think the film was “The Poseidon Adventure.” Suddenly, the car suffered a flat tire on U.S. 50 about halfway to Brownstown. We piled out, opened the trunk and found the spare tire and the jack.

As the oldest male, I was expected to somehow miraculously know how to change it. But no one had ever shown me. The other passengers made fun of me, and I grew very embarrassed.

A couple of years later when the car I was riding in experienced a flat on the same road on the way to Seymour, I found myself as the only male in the car. And again, the responsibility fell to me. But this time, I felt more confident. I had seen my uncle change a tire, so I quite proudly jacked up the car, removed the flat and attached the spare.

A half an hour later at the tire shop, the repairman walked out and looked at my handiwork and asked, “Who put this tire on?”

When I admitted it was me, he said, “This is dangerous. See how the lug nuts are on backwards. If you had driven much further, it would have sheared the studs off” and caused an accident. I was humiliated.

Eventually, I learned to change a tire and have changed my fair share over the years.

On this Mother’s Day morning, as I was returning from the La Colonia supermarket with a few groceries, I came across a car parked on the side of the street. A Honduran teenage boy, his younger sister and his mother were debating how to change a flat tire.

The act of being a Good Samaritan in developing nations can prove dangerous. In Kenya, the United Nations security officials taught us to never stop and help a stranded driver because criminals frequently pose as stranded drivers in order to rob the would-be rescuers or even carjack them.

Honduras is no safer. A few years ago, a work colleague of mine rolled down her window at a stoplight to give a beggar a few Lempiras only to have a second man sneak up from behind, put a pistol to her head and liberated her of her phone.

But within a few seconds of processing the Honduran teen and his family on this Mother’s Day, glimpses of my first two humiliating experiences with changing tires flashed through my head, and a third Jackson County lesson simultaneously struck a cord.

One hot summer day around 1976, Barry, a friend of mine, and I were traveling in his Jeep when we encountered a stalled car in the middle of our lane. Much to my surprise, Barry stopped. We helped the driver push the car off the road and onto the shoulder. Then we resumed our journey. Barry explained we should always help others in need. It’s just what country folk did.

So I set my groceries on the sidewalk and offered to help the Honduran family. The situation looked innocent enough, and the teenage boy was clearly struggling under the scrutiny of his mother.

Most Hondurans are kind. So many have treated my family and me hospitably. And I didn’t want the teen to suffer the same humiliation I had. As we removed the flat and attached the spare, I offered the youth words of encouragement.

“You were doing just fine without me … You would have changed it with no problem,” I said. “But I am happy to help.”

Just as we were putting the flat in the trunk, the father arrived in another car. We exchanged an abundance of handshakes and congratulations on a job well done. I pulled a pineapple pastry out of the La Colonia bag and gave it to the little girl.

As I walked the last half-mile home, I thought about these three Jackson County memories. About my failures and humiliations. About how I always seem to learn lessons the hard way. So many things I cannot fix. But somehow, I felt just a little bit better about the universe. When I arrived home, I made tuna melts for Mother’s Day lunch.

Living with cancer: 804-mile cross-country bike-packing trip from Indiana to Florida

There are days when I feel like my 62-year-old body is falling apart.

Aside from having cancer milling around in my prostate (getting into God only knows what type of mischief), my hearing is deteriorating. Last month, I got hearing aids. Two years ago, a hearing specialist told me I was really too young to be losing my hearing, but indeed I was. After I told him about bombing in Iraq, he said that explained it.

One day in June, I ordered stronger prescription glasses. Last fall, my left knee was scheduled for replacement, but I chickened out. My teeth are not what they used to be, and they need a lot of treatment just to keep them. The screws in the plate in my collarbone protrude from the skin and rub against my backpack or shoulder harness in a car and annoy the hell out of me. Two chunks of shrapnel in the back of my head irritate me sometimes. My right shoulder hasn’t been the same since that bar fight in Thailand many years ago.

Craig Davis during a stop along the Coosa River at Wetumpka, Alabama.

I’ll stop there. Most of you have your own list of ailments. You know the feeling.

Most of the time, I manage the tension of work and everyday life relatively well. But I am a natural worrier. Worries about finances, children and family, bureaucratic injustices and other nagging concerns ratchet up the toxic stress that threaten my mental and physical health. Daily exercise, breathing techniques, gratitude diary and other stress management tools help. But several times a month, the anxiety reaches unhealthy levels.

So once a year, I take a cross-country bike-packing trip to reboot. I need to step outside my routine and challenge my mind and broken-down body.

In 2020, I decided to ride 650 miles across Florida. Having never ridden a bike more than 12 miles at any one time, I was not entirely sure I could do it. But I cobbled together 30-, 40- and 50-mile days to complete the journey.

In 2021, I rode 750 miles from the Florida Panhandle to Louisiana and back. This year, I decided to check a box off of my bucket list and peddle from my former home in Indiana to my current home in Florida.

Long, arduous cycling trips like this challenge me, get me off of the sofa and deliver me into the lap of nature — outdoors exposed to thunderstorms, insects, morning darkness and the punishing midday heat and humidity — and remind me I am still healthy enough for one more long journey, that I am still alive, that the nursing home can wait. These trips push my body to the limit and clear my head.

I was not at all sure I could complete this year’s trip. Many things scared me. The heat, my weight and poor physical shape, the distance, but most of all, the foothills and mountains of Kentucky, Tennessee and Alabama. I had never confronted any challenge like this, and I was under time constraints. I had to be on a plane bound for Honduras no later than July 31.

I left my cousin’s house near Bloomington on July 5 and peddled up and down the rolling hills to Nashville. This first leg was brutal. I was out of shape and had never traversed hills like this before. I visited with family in Nashville, had Lucy (my bike) tuned up and left for Jackson County two days later. This leg was fun but just as hard. I visited friends and family that day and hoped to spend one more day visiting more friends. But the meteorologists had conspired against me.

At the last minute the next morning, I saw a very small window in the forecast to ride to Corydon and avoid most of the rain. Lucy and I made great progress the first hour, but as soon as we hit the big hill entering Washington County, the thunderstorms unleashed their fury. For the next five hours, torrential downpours pounded me. Just as I was entering Corydon, the rain let up. But Lucy’s front tire hit a slick, diagonal railroad track, and she bucked me off, tossing this old body onto the blacktop and cracking a few ribs.

Any sane cyclist at my age would have given up at that point. But I took a rain day to rest up, dry out and peddled on in the direction of Elizabethtown, Kentucky. When I crossed the Ohio River, I knew I had accomplished something meaningful. Now, I just had to take it one day at a time.

The hills grew more difficult every couple of days. Pushing Lucy and her 35-pound saddlebags up 1-mile and 2-mile hills became routine.

The temperature grew more intense as weathermen and women issued heat advisories almost every day. They warned to stay indoors after early morning. Several days, the mercury reached 90 or 91 before I arrived at my motel. One day, after a 2-mile mountain and countless, grueling hills and about 6 miles into a 7½-mile leg, I got sick. I thought I might pass out. No matter how much I rested or how much water I drank, I couldn’t shake the feeling. Sometimes, the distance between breaks would be 1 mile, at other times just one block.

The ribs grew worse, too. The frayed nerves at broken ends popped and rubbed against each other, sending warning signals of pain and discomfort when I pushed Lucy or breathed hard, which was all of the time. When I sneezed or coughed, it felt like my chest exploded.

Yet, I kept going. I adjusted my diet, started eating more fruit and less junk and immediately, I found a slight energy reserve and my weight began to drop. Five pounds or 10 pounds can make a big difference.

Not once did I think about giving up. Not even when I became sick and felt like fainting did I consider throwing in the towel. Not because I am tough. I am not. Not necessarily because I am determined. I am. But because I am stubborn. Extremely stubborn. Just ask my wife.

Years ago when I learned insurgents had placed a $5,000 price on my head in Iraq, I remained in the country out of sheer stubbornness. When the priced doubled to $10,000 a month later, stubbornness drove my decision to stay. A few years later, I was working in Pakistan and articles began surfacing in the Urdu newspapers stating the Taliban were targeting my work colleagues and me. My friends left, but I dug in my heals.

When men dressed like the Taliban assassinated a friend of mine one block away, I still refused to leave. Even when the media produced 135 newspaper articles, TV talk shows and other digital news in four languages about me, threatening my safety, my refusal to quit the country was rooted in pigheadedness.

Had it not been for an order from U.S. Ambassador to Pakistan Anne Patterson that I not return from leave in Paris — because she could not ensure my safety — I would have stayed even longer.

Old coots like me don’t surrender easily when challenged. I have walked away plenty, don’t get me wrong. But on my terms, usually when I was fed up with some untenable circumstance or in the face of nonsense or when anger got the best of me.

This 804-mile journey across five states, however, did not reach any of those thresholds. In fact, despite the physical and mental challenges, the rewards well outpaced the setbacks.

I saw some of the most beautiful farms, fields, pastures, hills, forests, ponds, lakes, rivers and streams that the United States has to offer. I encountered dozens of kind, caring and interesting human beings. I watched interesting behaviors of bulls, cattle, goats, donkeys and horses. At one farm, a bull began running alongside me with two dozen cows and calves trotting behind as if I was going to feed them all. Horses and donkeys almost always stopped grazing to watch me. One calf came right up to the fence vying for my attention.

I saw beautiful birds, deer, foxes and other wildlife. I rescued a turtle on the highway in Alabama.

One daughter told me my writing was therapeutic for me, and she was right. I write the blog for readers, for family and friends and to chronicle my journey. Imagine how interesting these paragraphs and photos will be to grandchildren and their offspring in 50 or 100 years. I would love to read a journal covering 24 days in the life of my grandfather or great-grandmother.

Several people have asked me if I feel a sense of accomplishment now that I have completed this year’s journey: Five states and 804 miles in 24 days. Yes, of course, overcoming all of these challenges and reaching targets, staying on schedule, create meaning, fulfillment, a victory of sorts.

Although, indeed, my body is deteriorating, it is not quite shot. I am not dead. I am still here. Still kicking. Still peddling.

We’ll see what next year brings.

Read the entire 800-mile travel blog at marvingray.org.

If you have a bucket list of your own, please share it with me at csdavis23@gmail.com.

Living with cancer: 804-mile cross-country bike-packing trip from Indiana to Florida

Wednesday: June 29, 2022

Change of Plans

This week my employers, my staff, my family, and I agreed that I would stay on another year in Honduras. The project is doing well. Although it is a huge challenge – the most difficult of my career – the team is talented and dedicated, and we are making solid progress. Monday, Tuesday, and Wednesday, we held a retreat for about a dozen program experts to ensure we close out the year strong and meet our targets by the end of September. 

My employers, staff, and I also agreed that I would reduce my work hours, take time off, and hand-off some of the more stressful assignments to my deputy, who is much better at them anyway. 

However, there has been a change of plans. Instead of riding from Panama City Beach, Florida to St. Augustine and back, I decided to check something off my bucket list: A bike trip from Bloomington, Indiana to Panama City Beach. On Monday, I will meet one daughter, Tellie, in Florida before she flies to Honduras, and ride back to Indiana from Florida with Helen (my oldest daughter) and her sons after spending a few days on the beach. Like most of you, I absolutely love my time with the kids and grandkids. 

Yesterday, I completed the bulk of my pending work assignments, took the two little grandkids who live with us to the park, and walked a mile or so while they played. When we got home, I started arranging things for the trip: downloading my wife’s photos from previous trips in Guatemala, El Salvador, and Ecuador from the GoPro camera to her laptop, packing a few critical items, digging out keys for vehicles and storage (where I have my bike), making reservations, and starting to plan the trip. Typically when planning a trip, I focus on the distances between stops along the most direct route possible. I prefer to ride about 40 miles per day. But the availability of accommodations really drives the route. If there are no rooms within 50 miles or so, then I have to rethink the route. But this year, there is another important variable that I must factor in: Elevation. The hills and foothills from Kentucky to Alabama are daunting. I have never attempted anything like this.

A feature on Google Maps makes it a little easy to chart out a course by providing detailed elevations along the entire route. You can run your cursor over the route and see how high the hills will be. Some rise as high as 1200 feet above sea level, and as much as 500 feet in one day. So, I can identify, and to some degree avoid, larger hills. Last night, I got about halfway through the mapping exercise before I realized I was ignoring the kids who wanted to watch Dr. Strange, so I suspended the search. 

At 2:30 am, I found myself wide awake. That rarely happens to me, but I had a lot on my mind. I made coffee, fed the cats, cleaned out the litter box, and resumed the search. 

This trip will prove to be the most challenging yet. For one thing, I am ashamed to say, I am still about ten pounds over my biking weight. Second, the distance will reach nearly 800 miles, about 50 miles longer than last year’s trip. I also have a deadline this year. I am racing against the calendar. I have to catch a flight back to Honduras, so I need to increase each daily trip by 5-10 miles. If you add the hills and foothills and the excessive heat this year, I realize this is my greatest physical challenge to date. And if I am honest with myself, I don’t know if I am up to the challenge at the age of 62. 

On the other hand, considering the uncertainty of the prostate cancer, I feel I must push myself to attempt the trip this summer while I still am healthy enough to do it. We never know what the fall might bring. Or the following year, right?

While this was one of my most challenging years ever, it was also one of the most rewarding ones. Last September, I learned for the first time that I had a daughter, Anna, and a granddaughter who live in Indiana. A couple hours after learning this, I called her. We talked for a few awkward minutes, and right before we hung up, I said, “I love you.” She laughed and said something like, “Thank you.”

I don’t know why I said it. Except that it was spontaneous. It was genuine. And it was true. 

We have chatted nearly every day since then. I met Anna and my granddaughter in person for the first-time last December. And they came twice to see me in Florida during the three-month period of cancer diagnoses, biopsies, and testing. These girls are amazing. Beautiful. Funny. Intelligent. 

After losing a toddler many years ago to pneumococcal meningitis, I felt that Anna and her daughter were gifts from God. Blessings like this do not happen very often, so you must embrace them when they do, right? I never thought about the years I had missed, only about the blessing I now have.

Even when I was grappling with the cancer diagnosis, trying to process it all, I was so grateful that I had lived long enough to get to know both of them. Come what may!

So now, this change of plans allows me to visit these three daughters and the grandchildren, see cousins, my father, and my aunt and her family. I will check off a box on my bucket list and see some of the most beautiful back roads and countryside that the United States has to offer. I have visited or lived in about 45 different countries, but there is no more beautiful place on earth than southern Indiana in the spring and summer.

Living with cancer: change of plans

Monday: June 27, 2022

Pre-Birthday Celebration

I suspect many of you celebrate birthdays on days that are not the actual dates. A child’s birthday falls on a school day, so you postpone the party until the weekend. In fact, in our house, we have extended birthday celebrations for the grandkids for about a week. We usually have cake and ice cream on the actual date. Then go to a movie, out to eat, play video games or something else on the weekend. On another day, we let the birthday child pick a family movie and meal to be delivered. They usually order pizza or pupusas (a thick Salvadoran stuffed tortilla-type of pita bread) and we set up a little table and watch the movie in front of the flatscreen. On another day, we go for a walk, allow the kids to pick out a drink and a snack from the pulperia (a family-owned store run out of a home), go to the pool, and play a game of UNO or something else. 

With my imminent departure and five-week vacation in the US, we decided to have a pre-birthday party for Grace, who turns eight in a few weeks. Pre-birthday walk, trip to the pulperia, pool, pizza, movies, cake, and modest gifts from grandpa. Plus, the smaller kids helped me pack, which they always enjoy. Grace was really happy, and so my guilt for being away diminished.

If nothing else, the cancer diagnosis has accelerated my efforts to be a better grandfather. When you see your grandkids once a week, or every few months, it is easy to be patient and fun-loving. They come over for a few hours, and you spoil them, and then they go home to a structured, disciplined home, right? But when you adopt your grandchildren, and you become a fulltime parent, you must provide that structure and discipline. And speaking for myself, I sometimes forget about the grandparent kindness and patience that the children need and deserve. Since well before the diagnosis, I realized this shortcoming in my grandparenting skills. So, I had been giving extra effort. But it wasn’t until after the diagnosis that I really started making some significant progress. The structure and discipline are still in place, but I do more talking and explaining and seeking conversations, and much less complaining and raising my voice. I do much more smiling and hugging and joking. 

The two little kids, nine and soon to be eight years old, have their own rooms and own beds, but they sleep at the foot of our bed on a small removeable mattress. They always have an excuse for why they can’t sleep in their own room—too hot in there, want to watch TV with us, can’t seem to fall asleep in there—but to be honest, I love having them close. The fourteen-year-old just started sleeping in her own room a couple years ago. 

My grandmother may have been the single greatest influence in my pre-adult life. Most of my values, I acquired from her. I was grama’s boy. When there was turmoil in my life, I often went to live with her. When I was tiny, I remember sleeping on a small mattress on the floor with her. She would ask me to rub her back or give me a quarter to brush her hair. I developed my sweet tooth from her: homemade purple grape juice, Ding Dongs, pies, cookies, you name it. When I was about 11 years old, I remember sitting in the cab of the pick-up truck and she bought us can of Coke to share. She told me, “I could live off of this.” Every evening we would have popcorn or vanilla ice cream with chocolate syrup in front of the TV. As a teen, I remember watching Carol Burnett, Green Acres, and the ABA Pacers. We both loved George McGinnis. 

I believe that even now my nightly ritual of Diet Coke and nightly popcorn in front of the TV—watching the Pacers while in season—or other shows with the grandkids is subconsciously attached to a web of pleasant memories of my grama. 

My taxi comes to pick me up at 7:15 a.m. this morning, and my alarm was set for 5 a.m., but I was awake around 4 a.m. while everyone else was asleep. I was met in the bathroom by the two cats who wanted to make sure I don’t go back to bed before feeding them. Spots, the white one, bites my shins if I don’t move quick enough to the door leading to the stairs. After feeding them and making my coffee, I opened my laptop and turned on the Panama City, Florida news feed live. The cable company provides three stations from New York City and one from Miami. Those are fine, but I prefer the Panama City news.

I write these last few words to the blog before I depart for the airport in Comayagua. My wife and I take these sole trips for a few weeks. At 59, she tries to go hiking in Pakistan, El Salvador, Guatemala, Ecuador, or somewhere at least once or twice a year while I stay with the kids. It is now my turn. I fly to Houston and spend the night. Then leave for Panama City where I will meet my daughters and two grandchildren. Naturally, I have doctors’ appointments and need to get my bike out of storage and plan for the 21-day bike packing trip from Indiana to Florida. 

As off-the-charts introverts, my wife and I cherish our alone time. Riding a bike for six hours a day, and then walking around a new town, before holing up in a motel room to write, read, and watch TV – allows me an abundance of time to think – to reflect, to analyze, and to process my life. The exercise helps me to challenge myself and retore energy to my body and mind. 

Introverts also need interaction of loved ones to remain healthy. I remember sitting in rooms after work for months and months in Iraq, Pakistan, and Yemen wallowing in my loneliness and self-loathing. I hope I never experience that again. But three or four weeks alone, achieving physical and mental goals, can be very refreshing. I hope it helps me recover from the burn-out I have been struggling with these past three or four years. And hopefully return to Honduras in five weeks reinvigorated and ready to resume my work and life challenges. 

Friday: June 3, 2022

The Decision

I absolutely love my weekends. I covet my time off. 

I exercise, take the kids for walks and to the pool, make silly videos or play a game of UNO or Bounce Off with them, work on my projects, read, write, conduct research, watch family movies, and I evem order food delivery through a Honduran app called Hugo – which is similar to Door Dash. 

From Friday afternoon through Sunday night, I run on a natural high. I really enjoy life.

But recently, my energy level has become depleted. My commitment to a 40 or 45-hour work week has spiraled into 55, or 60-hour ones. The work stress has climbed too. The job has become even more demanding, probably much like yours. It is a job I absolutely love, though. Almost as much as my coveted weekends. 

I love my staff. I try to motivate them while insisting on results: returning out-of-school youth to the classroom, helping them graduate high school, finding employment, and helping them realize their dreams in Honduras. None of it easy, but there is little more professionally rewarding than editing and submitting weekly reports that describe how my team has motivated young dropouts to return to high school, complete the year, and reenroll the following year, or how we trained and place youth in jobs that allow them to pursue their dreams in their own country.

A couple of weeks ago, I traveled to La Ceiba, Honduras on the coast of the Caribbean Sea. I spoke to a group of university interns, who beat all odds to emerge from the most dangerous neighborhoods in the city to succeed in college. They motivate me to work harder, do better. On that trip, my team trained a young woman, coached and prepared her with a mock interview, and set up a real interview at a local restaurant that was hiring. The next morning, she started her first day as a server, and my team and I went to the restaurant and took photos and spoke to the owner. It made my day. 

But the 60-hour work weeks and mounting stress are taking their toll. A month ago, I resigned, giving my supervisors six months to find a replacement. I proposed a plan to work parttime as an advisor on this same project from Florida, travelling back and forth, for the next two years. But after careful consideration, my supervisors rejected the plan. They had good reason; no complaints from me. But now I am faced with the choice of either signing on for one more year and trying to reduce the hours, manage the stress better, take more time off – and toughing it out – or return to Florida and take a different, less rewarding job.

One day last week, I hit a wall. At 2pm, I climbed up on my bed and turned-on Netflix. I just didn’t have the energy to work anymore that day. Two days later, I went to the doctor, updated her on my cancer and how burned out I felt.

She said, “No other physical issues?”

“The prostate cancer is not enough?” I asked. 

She read my file and told me, “I see you were here in 2019 for Burnout Syndrome.” 

“Yes.”

After a few tests, she told me, “You are in good physical shape. Better than good… You are just mentally stressed,” and overworked. She said I needed to reduce my stress and work hours. To recharge my batteries. She also suggested that I speak to a therapist. “I don’t think you have processed the cancer diagnosis,” and the trauma of the attacks in Iraq. 

I didn’t tell her that a week earlier, I waited on the line for 30 minutes for my first virtual appointment with my new therapist, but she never showed. 

When I was diagnosed with cancer in January and experienced moments of self-pity, my cousin who had just undergone prostate surgery told me, “It is not the time to think of yourself.” We have to hold everything together and be strong for everyone else. For our spouses, our children, siblings, and grandchildren. We have to make good financial decisions now, so they are just a little better off after we are gone. 

Since I returned to Honduras in April, I have largely put the cancer out of my mind. My surgeon and I opted for Active Surveillance, which means a PSA test every six months to see how it advances. A biopsy once in a while.

But gone is the self-pity. I have a loving family and supportive friends. I have understanding and flexible supervisors (a bunch of them). My Honduran staff are amazing in every way. They motivate me with their smiles and attitudes. And I have great doctors.

Now is decision time. Every one of you who have reached retirement age have faced the same dilemma. In fact, many of my family and friends have retired only to come out of retirement to resume a profession they loved. You motivate me.

I told my bosses that I would make the decision in about ten days. I am flying to Florida in late June for business, and I plan to take a month off, ride my bike from Panama City Beach to St. Augustine and back. I want to read, write a travel blog, and think. 

Living with cancer: The decision

Thursday: April 14, 2022

“The Good Patient”

I am a darn good patient. I know that because I follow doctors’ instructions, take my medication, show up to doctor’s appointments early, and don’t complain about long waits in the waiting room.

Take the weekend that I went to John Hopkins Imaging north of Baltimore for tests. Not just one test, mind you, but two. I had flown to Baltimore on Friday afternoon. Spent the night with Cassie, my daughter. On Saturday morning, she drove me to the imaging center. We parked and entered the office. 

“I have an appointment for some x-rays,” I told the receptionist. “Please tell me that you have a lot of forms for me to fill out.” She laughed and gave me a clipboard full of them.

When they called me back, an x-ray tech led me into a room and asked me to take off my shirt and change into a gown. She slammed a film tray into the wall bucky stand and made me stand in front of it.

“Take a breath and hold completely still,” she said. I did.

“Let out your breath,” she said. I did.

She removed the film tray and repeated the process a half a dozen times with me standing in different positions. I was good at this.

When she said, “You are all done,” I could tell she was impressed. She didn’t have to say a word. 

I just knew that she had ever seen anyone hold their breath as well as I did. When she said, “Don’t move,” she had never witnessed anyone not move like me. I had an advantage, though, I didn’t tell her about. I had years and years of practice sitting in the recliner and not moving. 

That afternoon, I put together a coffee table desk for Cassie so she could sit on her sofa and study. She’s a grad student at the University of Maryland.

She made me my last solid food of the day: A sandwich. In the evening, I had pudding cups and some other soft foods. Let me tell you: A pudding cup is not very filling.

If undergoing digital exam after digital exam, and receiving a prostate cancer diagnosis were not humbling enough, the Fleet enemas did the trick. 

After a humiliating half hour reading instructions, lying on the floor on my left side with my knees at my chest, and fulfilling my duties as a good patient in my daughter’s bathroom, I emerge looking sheepish, I am sure. 

“Ever had an enema?” I asked my daughter. 

“No,” she responded.

“You don’t know what you are missing,” I told her. “I bought a twin pack. Feel free to take that last one.”

She wasn’t taking the bait. 

The next morning, we got up very early. I wasn’t allowed any coffee, which is always irritating. We drove 45 minutes from the south of Baltimore back to John Hopkins Imaging for an MRI. 

I signed two papers and told the receptionist that I was a little disappointed that there were not more forms to fill out. She wasn’t amused this time.

My daughter and I sat and took the obligatory doctor’s office photo, both smiling. We make the most of these medical adventures. If you gotta do it, why not enjoy!

Around 7am, an MRI technician ushered me back to a phlebotomy chair, where he took my blood pressure and temperature. 

“How are you feeling this morning, Mr. Davis?” he asked.

“Well, it’s a little cruel that I couldn’t have coffee,” I reminded him. 

“Yeah, I know,” he responded. “But at least you are our first appointment of the day, so in about an hour you will be drinking coffee… Those poor people who come in the rest of the day have to wait much longer.”

Yeah, yeah. Silver linings.

He inserted an IV line and escorted me to the MRI room. There I met another technician. I forget what she told me her specialization was. But I have seen enough Grey’s Anatomy to know that you need at least two medical professionals to conduct an MRI: One to monitor the computer-generated imaging and a second to stand over her shoulder to micro-manage.

I have also had a few other MRIs in my life. Once in Indianapolis upon returning from Pakistan when I had migraines that a Pakistani doctor thought might be a tumor. Fortunately, it was only malaria. A second time was in Thailand after a motorbike accident that left me with nine broken bones and a punctured lung. And the last time was in Florida a few years ago when a neurologist was looking for something that he didn’t find. MRIs are no big deal. Noisy as hell, with a lot of holding still, but we have already established that I am pretty good at that.

The MRI technicians had me lie flat on the patient platform. They urged me to not move for the next 45 minutes. The man asked me what type of music I wanted to hear. I said, “Classic Rock,” and he proceeded to reward me with 50’s and 60’s music instead. Male MRI technicians almost never put on Classic Rock when you ask them to.

One of the techs pushed a button, and the platform slid up into the MRI tunnel, and it began its magnetic resonance imaging process, which is a series of loud, non-stop clanging and banging for ten minutes at a time. Even with the earphones covering my ears and emitting unwelcome 50s and 60s music, the jackhammering was ruthless. Then out of the blue, it just stopped. A few seconds later, the clanging and banging resumed, and the series repeated mercilessly.

But I went with the flow. Glad that I hadn’t had any coffee so that I didn’t have to fight the urge to urinate. It would have been embarrassing to ask to stop the jackhammering so I could go pee.

Once on a two-hour flight from Dar es Salaam, Tanzania to the new capital, Dodoma, I made the mistake of having a cup of coffee before we boarded. When we entered the tiny box, two-propeller plane, I realized my mistake. No restroom. The last hour and 15 minutes was pure torture. Even back in 2017, I suffered from frequent urination. I survived the flight with my dignity in tact, but just barely. On the return trip, I made sure that I dehydrated myself before departure.

But on this morning, lying on the platform inside the MRI tunnel, I was dehydrated, and I was able to remain still. So still, in fact, that I was sure the two MRI techs were impressed. I could imagine their conversation.

“Hey, that guy really holds still,” the man would say.

“Of all the 62-year-old prostate cancer patients we have ever had on that platform,” she would respond, “this guy is by far the stillest.” 

“I know,” he would continue. “I hope I am able to hold that still whenever I am sixty-two.”

“In your dreams,” she would say, putting him in his place.

About halfway through the 45-minute ordeal, the clanging stopped, and the male tech came on headphones and said, “Okay, we are going to start the IV.” He reminded me that I would feel something cool enter my bloodstream.

He was right. I felt something cool enter my bloodstream. Some sort of dye so they could see what was going on with the prostate.

Then, when I was doing really well and thought I was going to crush this test, I felt the urge to sneeze. No one told me what I was supposed to do in the case that I felt the urge to sneeze. Not even the stillest of patients could remain immobile if they had to sneeze, right?

Worse yet, I knew that once I start sneezing, it would trigger a chain-reaction effect. I might sneeze 15 or 20 times without stopping. I can do some serious sneezing when it comes right down to it.

So, I bit my tongue. And kept biting for the next five minutes until the urge passed.

Then out of nowhere, the clanging stopped, and the platform began sliding out of the chamber, and I rejoined civilization.

“You did well,” the woman said, referring to the test. Which was a little surprising, considering I hadn’t studied.

“You can get up now,” the man said.

“I was hoping I could do it again,” I told her. 

Both of them laughed. “No one has ever said that,” the woman commented. 

No, I bet not.

Being the good daughter that she is, Cassie was waiting for me in the car and drove me to a nearest Starbucks, where I bought a cup of coffee. It was raining, but I felt good that I got my first coffee.

We drove back to her apartment and rested the remainder of Sunday. I was due to work from Cassie’s place on Monday and then fly back to Florida early Tuesday morning. The surgeon had predicted that the MRI would pick up nothing or perhaps just the slightest irregularity. But Sunday evening when the results came in to my MyChart account, I read them and didn’t like what I saw. There was definitely a cancer mass.

Monday morning the Radiation Oncologist called me. He explained that the cancer may mean that “your Gleason score may be higher than a 6,” he said. The Florida surgeon who did the first biopsy may not have gotten a core sample from the mass. “I would like for you to have another biopsy,” the oncologist said.

The Florida surgeon got 12 cores in December biopsy. Now the Maryland oncologist wanted another 12 or 13. But he didn’t do biopsies, so he suggested my Washington, DC surgeon do it. Seemed like everyone wanted a piece of me.

To be honest, I was a little discouraged when I learned that my cancer might be more advanced than initially thought. One doctor had already misdiagnosed me as being cancer free. Perhaps the second one had indeed missed that mass. I let the frustration grow throughout me for about ten minutes. Then I moved on. There was absolutely nothing I could do about it except follow the doctor’s orders and get a second biopsy.

Since I was due to leave the next morning, I had to make a snap decision. Fly back to Florida in the morning as planned and return to Maryland in a few weeks, or reschedule my flight and hope they could schedule the biopsy within the next week or so.

Being the good patient that I am, I stayed. 

Saturday: April 9, 2022

“A Better Human Being”

Many years ago while living in Florida, I sold cars: Toyotas and BMWs. For an introvert, it was a great character builder. If I didn’t sell a car one week, I didn’t get a pay check. So I had to learn how communicate with people from all walks of life: Judges, construction workers, police officers, teachers, doctors, farmers, you name it. And I had to convince them to buy a car from me when the very same product was for sale just down the road. And I had to do it while telling the truth.

As a collective field of professionals, car salesmen have earned their reputation for dishonesty. But individually, you can meet some amazing people in car sales. Take my boss, or instance. His family owned a chain of dealerships. He was a strong motivator and supervisor, and even a better human being. I still stay in touch with him. 

My first week on the job, I met Rick R. He was about two decades older than me. We’ll call him the elder Rick. He was a bit of a character. We were about as different as two people can be. Divorced with adult children, the elder Rick was a loud extrovert known for cutting corners and upsetting management. He spent much of his free time drinking and partying. He spent his weekends out on his boat, water skiing, partying, and drinking. If the weather was bad, he would host wild parties at this house. He often would show up in the morning at work with a hangover and sit at his desk wearing his sunglasses until about noon.

Despite our differences, we established a friendship. Once we won a trip to the Bahamas for selling the most cars in a month. I took my wife, who was about seven months pregnant at the time. She had never been to a casino before, so we decided we would watch our money, save back about $100, and then go gamble the last night before leaving.

The elder Rick took his girlfriend, Pam. On the first night in the Bahamas, he and Pam went to the casino and lost all their money. So, for the rest of the trip, my wife and I bought most of their meals. As a result, we never got our night on the town. On the morning of our departure back to Florida, right before leaving for the airport, we went to the casino with $20 that we had managed to save, and we gambled it away. It took us about 15 minutes. 

A few years later, my boss moved to their new Honda dealership location down the street. I followed him and shared a desk with another Rick. Rick H. Again, we were very different people. The younger Rick was six or eight years older than me, divorced, and spent much of his time fighting with his ex-wife over custody of their kids. He would arrive to pick them up for the weekend to find that his ex-wife had taken them out of town. He sold just enough cars to pay his bills each month, and then took the rest of his time off to spend with his kids or his girlfriend, Pam. The younger Rick and I quickly became friends. He was misunderstood by many of our colleagues, but I saw a genuine humanity about him. 

One day, a former car saleswoman, who I had worked with at Toyota, rushed into the parking lot, jumped out of her car, and threw open the showroom door. “Come with me,” she said anxiously, “I heard Rick just killed himself.” We hurried to the elder Rick’s house, which was only a few blocks away. I knew that he had fallen on hard times. Lost his job. Split up with Pam. Had his boat repossessed. But I hoped that the rumor was a mistake.

When we got to his house, the front door was locked. We knocked, but no one came. We rushed around back and slid open the patio door. Immediately, a nauseating odor attacked us. We covered our noses best we could and proceeded inside.

“Hello… Rick… Is anyone home?” we asked as we entered cautiously. The closer we got to the bedroom, the stronger the nauseating odor became. At the doorway, the stench of death was overpowering. Rick’s pillow and headboard were splattered with blood. 

I was devastated. I had failed him. How sad must a human being become to take their own life? And I was not even a good enough friend that he could confide in me. 

Back at the showroom, I called the police. I told them who I was, and an officer was kind enough to tell me what he knew. I worked the rest of the day and drove to Pam’s trailer after work. I sat inside with her in the dark. She smoked cigarettes and told me some of the problems that Rick had been going through. How they had fallen out. 

As I drove home, I remember listening to the Travelling Wilburys’ song “Not Alone Anymore,” which had just come out. Although I know that Roy Orbison was singing about a lost love, this song reminded me of the elder Rick. How sad he must have been. Standing in the rain. “The heartache and pain. It hurts like never before.”

I wanted to cry, but tears wouldn’t come. 

Over the next few months, I read a couple books on suicide. I tried to process what had happened, but I couldn’t find any peace. Intellectually, I realized that his death was not my fault, but emotionally, I couldn’t shake the guilt.

Over time, I decided to move to Costa Rica. I needed a change. I would teach English, work on my flawed Spanish, and enjoy Central American culture and food for a while. I flew to San Jose and interviewed for teaching jobs. A few days later, Rick H. and his girlfriend Pam met me in the capital. We looked at a house that I eventually rented and we walked with the landlord through the countryside one afternoon. On another occasion, we sat at an outdoor café, and they drank beer to the sound of a mariachi band. They loved Costa Rica.

A few months later, my wife and I moved to San Jose. And I began teaching. Our last child was born there. I was in the middle of life’s struggles: to work, raise kids, and put food on the table. Occasionally, the younger Rick would call me, and we would talk about running a business out of Costa Rica selling used cars. But it never materialized. One day he called me. He spoke again about the business. I could tell he was unhappy. He was struggling with his ex-wife, he missed his kids, he and his girlfriend had split up, and he was suffering financial problems. I encouraged him to come and visit. To spend some time in the country he had enjoyed so much. Try to take his mind off his problems for a while.

A few days later, the phone rang in the middle of the night. That is never good news.

The younger Rick had killed himself. 

This one struck me particularly hard. Not only had I failed one friend, but I had failed two. What type of human being does that? 

I am largely an optimist, but for the life of me, I couldn’t find any silver lining. 

Some 30 years later, I still think about the Ricks, the Pams, and the trips abroad with them. I still miss them.

Well before the cancer diagnosis, I had tasked myself with being a better person. With the little time that I have left, I want to be a better father, better grandfather, and better husband. To be a better supervisor, employee, and coworker. I am striving to be a better friend. Better listener. A better human being. 

It’s not as easy as you might think. There is not blueprint for it. No work plan. It takes more than just desire and willpower. It takes undying commitment and self-discipline. And it takes practice. 

And some days, I do okay. On others, I fall short. But I am making some modest progress.  

I would welcome any tips you have.

Friday: April 1, 2022

Published in The Tribune

“Life’s Cruel Ironies”

Jim was a friend.

He also was a victim of one of life’s cruel ironies. We have all seen them, experienced them or witnessed them firsthand or at the very least heard about them.

Jim was a Vietnam veteran who worked with me at the Bureau of International Labor Affairs at the U.S. Department of Labor in Washington, D.C.

Shortly after the U.S. occupation in 2003, a bureau supervisor came into my cubicle to ask me to go to Iraq to help rebuild the Ministry of Labor and Social Affairs, and I agreed immediately. I was the only one of 100 or so bureau staff who spoke Arabic, but my labor experience was limited to projects that withdrew children from the worst forms of child labor across the globe and returned them to school.

The supervisor also told me he would pair me with Jim, who had significant workforce development experience — training people for the labor market — in Bosnia. Jim would arrive a week or so behind me.

However, I was assured I needn’t worry about leadership. Another veteran labor expert, who had been seconded to the Office of the U.S. Trade Representative, was conducting a short-term assignment at the Coalition Provisional Authority in Baghdad. The USTR official would show me the ropes until Jim arrived.

I flew to Fort Bliss in Texas for processing in August while Jim remained behind. He kept postponing his dates for personal reasons, which I felt was very selfish. He cited preplanned family events, but after each event, a new one seemed to pop up. Only years later would I understand.

One day at Fort Bliss, I wrote my father a letter. I said I felt everything I had done in my life up until that point — living in Pakistan and India, living through the civil war in El Salvador, studying Arabic in Jordan, traveling in Egypt and Palestine, visiting Afghanistan twice, publishing a book on the Middle East, among other experiences — had prepared me for this assignment. I was now equipped to deal with whatever life threw at me.

Boy was I ever wrong.

The Department of Labor assigned me to CPA in Baghdad, where I would become deputy senior adviser to MOLSA. The night I arrived at Saddam’s palace inside the Green Zone, I was given a bed in some dark, gloomy room with dozens of other civilians and military officers from a host of other European and Middle Eastern countries.

It was nearly midnight and I couldn’t sleep, so I went to the MOLSA advisers’ office in another part of the palace, but naturally, it was locked. I then strolled through the palace and found myself outside. I sat on the steps, watching the crescent moon — symbol of Islam — suspended over palm trees. I attempted to reconcile the surreality of the situation.

I noticed a few other insomniacs were standing or sitting, smoking cigarettes. The occasional military helicopter flew overhead as I watched civilians and military carrying on conversations in an array of languages as they passed back and forth in front of me. Up and down the stairs. Two men were unloading cases of plastic water bottles.

The August evening heat was tolerable. I could smell dust in the air. I shuffled these few moments of serenity against the backdrop of Baghdad. A civil war was brewing outside the walls of Green Zone.

Although I couldn’t hear gunshots at that moment, I knew insurgents were planning terror attacks against civilians at the CPA. A few days earlier, an Iraqi insurgent had stepped up behind an American soldier on the street in Baghdad and shot him in the back of the head.

I didn’t know it at the time, but things were about to get worse — much, much worse.

The next morning, I walked into the MOLSA advisers’ office. There were two U.S. Army civil affairs officers working already. A lieutenant colonel served as senior adviser. The other was a very intelligent and professionally mature captain. They would both become friends and protectors.

The USTR labor adviser was a stocky man in his late 50s or early 60s who wore close-cut white hair with a neatly trimmed matching beard. He was a bit of a legend at DOL, known for two-martini lunches and his short temper. He was also a bit of bull in a China shop. One of the first things he told me was “I am a train, and if you get in my way, I will run over you.”

After initial introductions, I learned we were going to the MOLSA compound the following day for a meeting with Iraqi officials to discuss a revival of WFD services.

The labor adviser asked me what I knew about the field. I told him very little. He frowned and gave me an International Labor Organization book on the topic and said, “Read it. You are now our new expert. We are going to go into that meeting and introduce you as our new expert on employment and workforce development, and you had better not tell them any different.” I think it was at this point he told me about him being the train.

Despite his irritable nature, the labor adviser was generally likable and friendly when he was not threatening to run somebody over. He was extremely competent and had lots of good stories about working overseas.

One thing I thought I could bring to the team was a better understanding of the Middle East and Islam. I had spent much of my life studying the history, culture and religion.

I had read the Koran twice in English and parts of it in Arabic. Arabs in Bethlehem, Cairo and Amman had treated me and my family with unexpected kindness and hospitality. Muslims in Pakistan, India and Afghanistan had protected and cared for me.

Yes, today’s insurgents were Muslims, but they only represented an extremist sliver of Muslim society. They did not represent Islam any more than American religious extremists who bombed or terrorized abortion centers represented mainstream Christianity.

So I read the ILO book, studied WFD, made some notes and overnight became CPA’s “expert” on WFD and employment. I set up an office in the ruins of an old training center at the MOLSA compound about 30 minutes from the palace.

Jim’s delayed mobilization stretched throughout all of August and September. About this time, the USTA adviser left for D.C. and gave me his hotel room at the Al-Rashid Hotel to save for him until he returned,which he never did. So I gladly moved out of the communal bedroom of the palace and into the hotel, which was on the edge of the Green Zone. By mid-October, I was still alone.

When Jim finally arrived, he moved into the Al-Rashid Hotel with me. I made myself a pallet of a sleeping bag and some blankets on the floor, and Jim took the bed. I was ecstatic. He did have a lot of experience, and he patiently and methodically shared ideas, strategies and memories. I grew to trust him.

In the evenings, we would sit around the pool. Jim and my other MOLSA colleagues would drink beer, and I would drink Diet Coke.

We could hear automatic rifle fire just outside the Green Zone. He would say, “That is an M-16” or “That is a Kalashnikov.” Over the next several months, I also would learn the distinction between them.

On the night of Oct. 25, we were having a drink around the pool, and Jim commented on how he felt that Baghdad was much more dangerous, compared to Vietnam when he was stationed there. I grew tired and ready for bed, but Jim and the others encouraged me to stay for another round. I had another Diet Coke and tried to absorb the experience.

Finally, I excused myself and retired to the room. I fell asleep on the floor, and Jim came in a little later and slept in the bed.

Around 6 a.m. the next day, I woke up to use the bathroom. Even back then, my prostate was forcing me up two or three times a night. I remember blaming that last soft drink for waking me at that hour.

A few seconds later, I reached the hall, and the room exploded. The detonation was so loud I couldn’t hear it. I touched the back of my head with my right hand and saw blood. I turned around to see the thick curtains billowing horizontally like flags in the wind. A heavy cloud of concrete dust and smoke filled the room. I could smell the burnt odor of cordite.

Several things went through my head at once: A mortar had struck our room … The blood on my hand meant I had been struck in the head with shrapnel … That small sliver of Muslim extremists had tried to kill me … I had to flee now … That last Diet Coke had saved my life.

As I ran, a second shell struck the room.

Marvin Gray’s “Welcome to the Dark Side” captured much of the horror, the fear and the guilt of that day. When I found myself outside the hotel, I suddenly realized I had abandoned Jim. So I went back in determined to ascend the stairs and find Jim, but before I got to the stairwell, I found Jim on a sofa with a towel around his arm. A man was holding pressure on a huge wound to keep him from bleeding out.

I took over for the man and escorted Jim outside to safety, holding pressure on the wound until the military ambulance arrived some 20 minutes later. He underwent emergency surgery and was medevacked to Germany the following day. His time in Iraq had come to an end, but mine had just begun.

The 26th happened to be my wife’s birthday. I called her to let her know I was OK before she saw it on the news.

That afternoon, I returned to the room to get our bags. The pallet on the floor was destroyed with shrapnel the size of deer slugs. One of life’s ironies for me was the realization that if I hadn’t had that additional Diet Coke the night before, I would not have gotten up at that precise moment before the mortar hit. I would have died.

Another irony was that despite all of my efforts to educate my peers on the difference between the sliver of Muslim extremists and the vast majority of nonviolent Muslims, the sliver had killed one man and injured about a dozen more.

For Jim, the irony was not so much that he had survived a year in Vietnam as a soldier with zero injuries, only to be wounded as a civilian in Baghdad within days of his arrival.

In fact, if I were in D.C., Jim and I would meet for lunch every Oct. 26 to celebrate our survival. We always felt like the luckiest two men on Earth.

Rather, the cruel irony emerged a few years later when — after surviving both Vietnam and Iraq — Jim fell down some stairs to his death.

Today, I think about Jim sometimes when I am running stairs or while riding my bicycle cross-country along the Gulf Coast.

With this new cancer diagnosis, I ask myself if I too will fall victim to another wicked twist of fate.

After surviving civil wars and insurgencies in El Salvador, Iraq, Yemen, Afghanistan, Somalia and Pakistan, will it be the prostate cancer that takes me out? Or perhaps get clipped while riding my bike through Mississippi? Or will I trip while running stairs and fall to my death?

Sunday: March 27, 2022

“Introversion”

I am an off-the-chart introvert. Every time I take the Meyers-Briggs personality test, I score an outstanding on introversion. My job requires that I talk all day, attend meetings, coach and mentor staff, provide feedback, give presentations, and communicate orally. These are skills that I had to develop and even enjoy at times, but they don’t come naturally for me. After all these years, I still have to work at it. 

I used to think that there was something wrong with me. But over time, I have come learn that it’s just the way that I am hardwired. Quiet: The Power of Introverts in a World That Can’t Stop Talking by Susan Cain helped me understand myself better. To feel less guilty about my discomfort with certain social and professional situations.

When I finish my work day, I am exhausted by all the personal interaction. I need isolation to recharge my batteries. I retire to my bedroom to read or watch TV or write or something I can do by myself. I like my family to watch TV with me or just hang around. But the last thing I want is to engage in a conversation. This makes it hard for my wife, kids, and grandkids who feel the need to talk. They deserve my time and attention. And naturally, I feel guilty.

I can go days without ever leaving the house, except to go for a walk. But even for off-the-chart introverts, too much isolation can be unhealthy. 

The cancer diagnosis has increased the danger associated with isolation: that I crawl into my own head and over analyze my shortcomings (there are many), that I doubt and second-guess myself, or that I rehash and agonize over past mistakes. 

I recently flew to John Hopkins for what was to be a routine MRI. My return ticket was scheduled for five days later, but I ended up saying more than two weeks. The doctors found something they didn’t like on the MRI and decided they needed a second, more focused biopsy this time to determine if my first diagnosis might be wrong. Maybe the cancer was more progressed than initially thought.

This led to a battery of pre-op tests and medical visits of all types.

Instead of allowing myself to self-isolate and wallow in self-pity, I redirected my attention to constructive targets and healthy distractions to get me through each day. I distracted myself with humor that helps my mental health. As does exercise, which releases those endorphins that we all know help us feel better all day long. I also try to focus on family, work, and personal projects. 

Helping others also helps me. Most of us know this. That’s why many of you coach young people, volunteer at a shelter, collect can goods and toys for the less fortunate, work in the medical profession, and carry out countless other altruistic tasks. 

Take that Friday of the second biopsy, for instance. When the anesthesiologist learned what I do for a living, he told me that he and a group of other medical professionals had been going to Guatemala for a decade to perform pro bono surgeries for the less fortunate. He said, “I think they (the doctors) fly back home having received more than they’ve given.” 

He is right, of course. Helping others can be very rewarding. That is why I selected the field I did. 

When I was an undergraduate, my philosophy professor once asked the class to consider if Mother Theresa helped the downtrodden in the slums of Calcutta (or Kolkata), India out of self-interest, even selfish reasons: She took pleasure in helping others.       

While sitting in my pre-op cubicle that Friday morning, I began to ask myself if the very opposite might not be true when the nurse wrapped a rubber tourniquet around my arm, examined and discarded a couple of perfectly plump veins on the underside of my arm, only to insert a long IV needle in a vein at the side of my wrist. Every time I moved my wrist, I could feel the needle tear into the vein. As a result, it was impossible to find a comfortable position to lay my hand. Forget about navigating through my phone to send silly texts or photos to the family! The limited range of motion was annoying. Have you ever tried to hold out the phone to take a photo of yourself with a needle stuck in the side of your wrist?

A second nurse who came in a few minutes later and connected the IV line to the catheter in my wrist called it “situational,” meaning that unless it was positioned just right, the IV wouldn’t flow. In fact, blood back-flowed a few times. 

“I see that this is your second biopsy,” the second nurse told me. 

“Yes, I had so much fun the first time, I wanted to do it again.” 

This tickled her. 

She then proceeded to ask me about 50 questions, mostly the same questions that the first pre-op nurse had asked me two days earlier. I didn’t mind. Introverts like talking about themselves one-on-one under the right circumstances. Plus, I knew all the answers. Date of birth? Medications? Any pain? Medical history? Felt like I was scoring a 100 percent.

One question that everyone from the receptionist to the first nurse, second nurse, anesthesiologist, surgical room nurse, assisting surgeon, and primary surgeon asked was: What is your date of birth?

They are obsessed with this question. At first, I wondered if this was some kind of test to see if as a 62-year-old cancer patient, I still had the mental faculties to remember my own birthday? 

But as it turned out, it was standard procedure. They just wanted to ensure that I was who I said I was, and that they didn’t mix me up with another patient and end up removing my ovaries or some other critical organ by mistake.

On this particular Friday morning, there was another Davis in pre-op, so they had placed an “alert” in my file, and every medical professional who came into my cubical that day, always triple-checked to see which Davis I was. 

“Do you have any health problems?” the second nurse asked.

“Well, I have prostate cancer,” I responded. 

Any fever? Headache? Sore throat? Blood in your urine? 

“Are you in any pain right now?” she asked.

“I have this pain in my right wrist that just flared up this morning,” I told her.

This brought a smile to her face.

After a while, the surgical room nurse wheeled me out of my pre-op cubicle and through the larger pre-op unit, where health care professionals in hospital uniforms and scrubs were milling about with clipboards, sitting in front of computers, or standing talking to each other.

“So tell me,” I asked her, “is it like Grey’s Anatomy here?”

She chuckled.

“No, there’s no McDreamy here. Or if there is, I haven’t seen him.”

We picked up the anesthesiologist along the way who helped push my heavy gurney through some double doors. I was actually pretty comfortable. I was covered in blankets. Relaxed. Felt like I was in good hands.

“Just don’t forget to wake me up,” I reminded them.

“We won’t,” the nurse said.

Then we made our way down a short hall on the right, took a left, and cruised through some more double doors. We went down a longer hall, hung a right, and entered the operating room.

The assisting surgeon was already there. They introduced me to new doctor. I forget what he did, but I am sure it was important.

They had me move over from my comfortable gurney onto a tiny platform barely as wide as my shoulders. They slid a pair of compression leg sleeves onto my bare legs, and the sleeves immediately began to contract and relax. It was cold in there, and I only had on hospital-issued gown, mask, hairnet, and footies. So they covered me with a heated blanket. 

About a minute later, my primary surgeon came in, and someone told me, “Turn over onto your left side. A little more… Bring your knees up to your chest.”

This left my bottom exposed, which was the idea, of course. But for an introvert with a room full of strangers, it was hard to imagine a more awkward exhibition.

“Here take this pillow and wrap your arms around it… There. Are you comfortable?”

“Oh yes. This is my favorite position,” I told them.

They got a kick out of that.

A short time later, I woke up in recovery, went back to post-op, got dressed, and a kind black man rolled me outside and helped me into my daughter’s car.

We drove back to the hotel room in Arlington, Virginia, and I got online just in time to participate in a four-hour online workshop with my colleagues in Honduras.

The next morning was Saturday, and my daughter and I walked down to Francis Scott Key Memorial Bridge over the Potomac River between Virginia and Washington, DC. We patiently waited for the sun to rise. 

The sunrise was worth the wait. Beautiful. Calm—despite the roar and vibration of cars passing both ways over the bridge. Joggers and walkers passed us on the bridge. A few stopped to take photos. Rowing crews and boats streamed underneath the bridge. 

My daughter and I talked. A year or so ago, my son told me that our family never talked. Not about anything important. Maybe he was right. His mom and I are both introverts. And talking was never our strength. It didn’t come easy for us. And we needed to do better with the time we had left. Less complaining, and more explaining and listening.

But my daughter and I talked. She had been going through a very difficult period herself. And naturally, I was worried about her.

My aunt once told me, “No matter how old our children get, we never stop worrying about them.”

She was right.

However, in the last 24-hour period, I had not once thought about what the biopsy results might be. I hadn’t self-isolated or felt sorry for myself. I had just lived the day. Tried to enjoy every moment.

I will deal with the results when they come back, and not a moment before.

Friday: March 18, 2022

Published in The Tribune

“The More, the Merrier”

John Hopkins Kimmel Cancer Center is one of the best treatment facilities in the world. Perhaps the very best for prostate cancer. I flew from Florida to Baltimore, Maryland in February for consultations with two specialists.

At the radiation oncologist’s office, I entered the waiting room early one morning just as an elderly man was being called back. He stood and left his wife to guard his coat and sock cap. Every other seat in the room was marked off for COVID-19 measures, so I took a seat well behind the wife in the otherwise vacant waiting area. She turned around and looked at me as I began to check my phone. I suspect in my hoody, I looked threatening to her. Perhaps there had been a spate of assaults or robberies in her neck of the woods lately by gray-haired, 62-year-old men in hoodies. Or maybe she just thought that I was an unnecessary Covid-19 infection risk. Whatever the motive, she stood up, grabbed her and her husband’s coats and caps, and moved to the far end of the waiting area where she could keep an eye on me. Her husband’s sock cap fell to the floor before she could sit down.

“You dropped the hat,” I told her. (I can be very helpful when I want to be.)

She stopped, pivoted, and glared at me. Then her gaze went to the floor. She hesitated, as if wondering if the cap was really worth it somehow. And then picked it up without a word. 

My youngest daughter came in a few minutes later from parking the car. One benefit of my recent diagnosis has become the fact that I have gotten to spend time with three of my four daughters. Over the past few years, I have come to realize more and more that enjoying time with family is one of life’s greatest gifts. The family usually gathers during the holidays at our place in Florida each year. I love for them to come and hate for them to leave.

Living overseas makes visiting more frequently difficult and expensive. Every year I asked myself if this should be my last year overseas. Should I switch to part time remote work from Florida, where I can travel to Indiana and Maryland more frequently to visit family. Or should I tough out one more season. I love my work, my career, my bosses (I have several), and my staff. The work is very rewarding.

I used to tell my kids when they were growing up to get an education so that they can find the career they love and would do for free if they could afford it. To get paid for doing what you would do for free is one of life’s greatest blessings.

Last spring, the day before I was supposed to leave Florida to arrive in Honduras—well before the cancer diagnosis—family had gathered from Indiana and Maryland for a few days. My son had grilled out, and we were eating. The kids and my wife were all talking and laughing. The grandkids joking and chattering. Two or three conversations were going on around the room at the same time. I was silently listening and observing; something I rarely do. Supper spilled into an UNO game when suddenly, an illuminating and peaceful realization washed over me: This was a snapshot of my retirement. I was no longer the center of attention. I no longer had to lead the conversation or even comment on topics. I would just sit back, relax, and enjoy my offspring. The love of my life: My children and grandchildren. They were unwittingly taking the baton from here. I had done my job, for better or for worse. I had raised them as best as I could. Helped to education them and nurture them. Screwed up time and again. Embarrassed them. Encouraged them. Lent them support and wisdom on occasion. But I no longer had to lead them. It was now out of my hands. They were going to be fine without me. The road had been long and hard. For years and years, we had lived hand to mouth. Rushed to sporting events and practices. Battled through the teen years. Drug overdoses and automobile accidents. Unexpected pregnancies, and glorious child births. Purchased used cars and paid for college tuition, used appliances, cheap clothes, car seats, and dental bills. We had adopted grandchildren.

And I was weary. It was okay to slow down.

This was one of the most peaceful moments that I have ever experienced.

So now, a year and a cancer diagnosis later, I am faced with the same dilemma: Transition to part-time at the end of the year or one more season?

A radiation oncology nurse led my daughter and me back to an examination room. The primary oncologist’s associate entered and interviewed me, taking notes on a tablet. He left and returned with the primary oncologist. They explained my condition and answered all my questions. They were thoughtful and professional, laying out the three options: Active Surveillance, Surgery, and Radiation. 

Although they were talking about a potential cure through radiation, the oncologist explained the potential side effects: Incontinence, impotence, frequent urination, rectal bleeding. Whatever the patient’s condition is now, “it is only going to get worse. Not better.” 

There are, in fact, no good options. There is no real benefit to getting cancer—except for getting to see family more or some other silver lining that only an optimist can glean. Each of the three options has its advantages and disadvantages. But no one survives unscathed. 

But survival is survival. And cure is cure. And prostate cancer, if caught early, is much less lethal than, say, a heart attack or a stroke. Thanks to the advances of modern medicine over the past two decades, there are options.

And I am pretty much content to take what life gives me. Always have been. In fact, I remember having failed an interview for a job in Washington, DC many years ago because when one of the panelists asked me a question about an impossible situation, I answered, “When life gives you lemons, you make lemonade.” He didn’t like that answer, and he told me so. “What you should have said,” he informed me, “is public-private partnerships.”

Well, I couldn’t argue with that. Especially because at the time, I had no idea what public-private partnerships were. 

The radiation oncologist then asked me, “Do you mind if I examine your prostate?”

“No, go ahead,” I responded.

My daughter excused herself, and I proceeded to drop my drawers and bend over the examination table so that he could probe with his finger. When he was done, he asked, “Do you mind if my associate, Doctor… examines your prostate?”

“Sure,” I said, “The more the merrier.”

Sunday: February 27, 2022

They say that if you have to contract cancer, prostate cancer is they best type to get because it is treatable, even curable, if caught early.

They caught mine early, almost by chance.

In October 2021, I had to take a mandatory physical because I was starting a new contract in Honduras. I had ignored the annual Prostate-Specific Antigen (PSA) Test recommended by my urologist for the past three and a half years, so I had the Honduran doctor who was doing the physical conduct a PSA. She did, and the results came back high. She sent me to a Honduran urologist the same day.

In the back of my mind was my cousin. Having been diagnosed with cancer a few months earlier, he was finalizing his plans for a prostatectomy, which would take place in December. My mind had already resigned to the fact that I might have cancer, but at the same time, I was thinking that it was highly unlikely that we would both be diagnosed with prostate cancer within months of each other. What are the odds?

The Honduran urologist’s tiny office was in the basement of the same clinic I had my physical exam. When I entered, a Spanish podcast was playing loudly on his phone. As he was asking me questions about family history and my health, I had the urge to request him to turn off the podcast. It was annoying. But I didn’t say anything.

After he conducted a digital exam, he said, “You don’t have cancer.” But then he paused the consultation to interrupt the broadcast droning on from his smart phone. Until that moment, I thought he was listening to a recording. But it was a live university lecture about prostate cancer. He corrected something the lecturer had said and then went on to describe my case to the lecturer and to the entire class. “Sixty-one-year-old American male… PSA score of 5.7… He came in very worried that he might have cancer, but he doesn’t. He has prostatitis… I am prescribing antibiotics for the next six weeks and then repeat the PSA test…”

What the urologist lacked in professionalism, he made up for in multi-tasking!

He then proceeded to set the phone down, leaving it on speaker so we could hear every word of the virtual lecture. I was grateful that at least that he put the phone on mute while he explained to me that my prostate was healthy and finished the consultation. He predicted that my PSA would drop when I repeated the test in six weeks.

For the next month and a half, I did as instructed. I am typically an obedient patient.

I was very busy at work, starting up this new project, hiring staff, establishing systems, opening offices, having back-to-back meetings all day, drafting and editing reports, plans, and analyses. My wife and I were doing the usual planning of our annual holiday trip to the condo to Florida. This year, we were going to drive from Panama City Beach, Florida to Indiana, and among other things, visit my cousin who was undergoing the surgery. To complicate matters, we had just learned that after three and a half years, our Honduran landlord wanted the house back: His son was returning from overseas and needed a place to live. As a result, we were exploring options, viewing potential residences, negotiating, and trying to decide what was best. We needed to secure a place within a couple of weeks before leaving in mid-December, because when we returned to Tegucigalpa in January, we would only have about five weeks to complete the move.

So I came very close to not conducting the second PSA test. The doctor himself, told me, and the audience of the lecture that I didn’t have cancer, right? So why take the time off to go down to a laboratory and have them draw blood when I knew the PSA was going to drop?

But I did the test. And by the end of the day, the results came by email: My PSA had spiked. Even then, I considered blowing off any further testing or consultation. My thoughts were, “So it had spiked. Big deal. I knew that I didn’t have cancer. The Honduran urologist told me so himself.” Unless, he had misdiagnosed my condition.

I sent a message to my cousin, who said that I needed to get a biopsy immediately to find out for certain. Of course, he was right. I called my urologist in Florida, whom I had not seen in seven or eight years. All the doctors in his office were booked through the holidays, but when I told the health care worker my PSA score, she said she would find a slot for me.

You know, there are some really good people in this world. People who are not only competent at their jobs, but who care about doing good work, doing what is right, and genuinely care about others. This woman was one of them. (When I went in for my consult in December, I asked to meet her, and thanked her for working me into the schedule. She was genuinely touched. I could tell that she didn’t get a lot of recognition from patients. Doctors get most of the glory. Their team usually receive the complaints.)

My wife, three grandchildren, and I flew from Tegucigalpa, Honduras to Houston, Texas, where we spent the night. We got up the next morning and flew to Panama City Beach, Florida. Two days later, we drove to Indiana to visit family. I was so grateful to be able to spend a little time with my cousin. I drove him home from the hospital a few days later. I learned a lot from his diagnosis and treatment experiences over the past several months. He educated me about options.

So when I finally had my consultation in Florida about ten days later, I was more informed than I would have been otherwise. When I pressed the urologist, he told me that if he had to guess, he would say that I had cancer. The next day, we did the biopsy. And a week later, his assistant read me the results in the office.

The odd thing is that I was not stunned. No body blow. No slap to the face. No shock. I was resigned to doing what I needed to do to deal with it. There was nothing I could do the change the fact that I had the disease. All I could do was collect as much information as possible, study the treatment options, select one, and find the best possible doctor to treat me.

In many ways, this cancer would not kill me suddenly like heart disease. My paternal grandfather had open-heart surgery. A decade later, while in the hospital for a second open heart surgery, he was diagnosed with prostate cancer. But he never recovered from the second operation.

Cancer would not disable me over night like a stroke. At about my age, my maternal grandfather woke up one morning to find that only half of his body would respond. About a year later, he died at Schneck Memorial Hospital of complications from additional strokes.

One thing I really liked about this group of urologists in Florida is that when you are diagnosed with prostate cancer, they lend you a copy of Walsh’s Guide to Surviving Prostate Cancer. The assistant encouraged me to read it and draft questions to ask my urologist during our virtual appointment the following week when he got back from vacation. I read several chapters and made out my questions. I ended up ordering my own copy and marking it all up, trying to learn as much as I could.

Three years ago, a work colleague of mine told me she had terminal cancer. It hit me hard. She had not told any of her coworkers but me. I respected her decision not to share her condition, her privacy. She told me, “I’ve had a good life.” I couldn’t understand it at the time, but now I do.

On the day I was diagnosed, I took the opposite approach, partly because it is my nature to be transparent and partly because of the necessity of the circumstances. If I were going to stay in the US for treatment, I would need permission from my supervisors to work remotely, and I would need some explanation for coworkers. This was a new project that was under a lot of scrutiny, so I couldn’t just remain in the US with no justification.

The same day, I told all of my family members whom I could reach. I informed my supervisors in the US and Honduras. I called my two closest coworkers in Honduras and explained it to them. A few days later during a pre-scheduled all-staff meeting, I informed the 60 or so Honduran staff and one American of the diagnosis and my immediate plans.

Those who have worked with me for a while know that for better or worse, I choose transparency. When our budgets were cut in April 2019, I didn’t sugar coat the explanation to my staff. I accurately explained to them the funding problems and outlined our strategy: Manage our budget well, deliver even higher quality products, and tell our story accurately and effectively. If we were going to have to close down our project a couple years earlier than anticipated, we must do it by performing at our very best. There is no disadvantage to saving money, delivering quality, and reporting our successes.

The staff responded beautifully. We stretched the budget, went out and found additional funding, delivered the best quality products possible, and wrote success stories, newsletters, videos, reports, and other communications products that described our accomplishments. That project would go on to receive additional funding, commitments for funding above its ceiling, and nearly a two-year extension. And it is still operating well today.

So I took a similar approach to the cancer and how I would allow it impact my personal life and work life: Attack the condition with transparency, focus on making informed decisions, and performing as effectively as I could. There is no downside to dealing with the problem to the best of my ability.

Thursday: February 24, 2022

Published in the The Tribune

I once read an interview with an actor who criticized scripts that called for the character to vomit at the sight of a dead body or upon hearing some disturbing news, like the brutal murder of a child or loved one. This actor claimed that in real life, strong emotions don’t cause retching.

There may be some truth to that. It is hard to say. However, sometimes when I read Dr. Patrick Walsh’s Guide to Surviving Prostate Cancer, I get physically sick to my stomach. Occasionally, I need to set the book down and flip on the TV to take my mind off of it. A few weeks ago, I was sitting in the office of a radiation oncologist, and I felt a surge of nausea arise as he explained various details my cancer and a treatment to me. I didn’t feel the need to vomit. I was just a little ill. I felt the need to shut down. Get out of his office. Go home and climb into bed and watch TV by myself. I didn’t want to speak to anyone or think about the cancer any more.

In fact, since the initial diagnosis, I have often felt like sealing myself off from the rest of the world and wallowing in my emotional nausea. 

Of course, I can’t. I have family who relies on me. I have to work full time. I have bills to pay, decisions to make, loved ones to comfort. I have to be responsible, read and collect information on potential treatments. I have to schedule doctors’ appointments, medical tests, and procedures. I need second opinions that require airline tickets, hotel bookings, and registering for online access to medical websites for a host of health care transactions. I have to make dozens of phone calls with physicians’ offices to transfer records and test results, with the insurance company to verify coverage and network status of health care providers. I must coordinate plans and share updates with my very understanding and flexible supervisors, coworkers, staff, and loved ones. I have to run flights of stairs or walk a few miles every day to keep my sanity. I have to fill prescriptions and take medicine. I have to cook a little something or order in, go shopping, and wash my clothes and dishes. I have to talk to my wife who has returned to Honduras with the kids so we can make informed decisions, not only about cancer diagnoses and prognoses, but about movers and dates to transfer from our leased home in Tegucigalpa to a new rental five houses down (long story). We have to decide if we should sell our condo in Florida and if we should cancel our family trip this summer and try to get our deposits back.

Life goes on!

I guess that I am grappling with the relentless progression of life. The bills don’t stop coming just because of a cancer diagnosis. Grocery store prices don’t suddenly drop. There is no acinar adenocarcinoma discount at the gas pump or for your credit cards. All life’s challenges that existed before the biopsy results—children’s missed school assignments, family battles, relationship problems, landlord obstacles, internet problems, work-related stress—don’t suddenly disappear or even diminish. 

I don’t have the luxury of falling apart, of binging Netflix and Hulu for the next six months. I can’t just walk away from all my responsibilities to experience goal after goal on my bucket list (I’ve had one for years, by the way).

The mental health challenges that accompany this new reality are perhaps the most annoying. And I know something about depression. After the trauma of my son’s death, the Al-Rashid Hotel terrorist attack in Baghdad that cauterized tiny BB-sized shrapnel into my head and back, a second attack in Mosul that killed a friend of mine in the vehicle in front of me, and a terrorist media campaign against me in Pakistan; I struggled with layers of depression. 

But this cancer experience is something entirely new. I am not really sad or anxious. I am certainly not worried. I am just psychologically nauseous. While I am in no danger of a breakdown, I must remain emotionally healthy so that I can make well-informed decisions: Radiation, surgery, or active surveillance, for starters. 

After just two and a half sessions, my new therapist dumped me. She said, “I can’t help you” and recommended that I seek a specialist in trauma. While I don’t think trauma is the real issue, I did schedule an appointment. I also am keeping up the exercise, breathing techniques, my gratitude diary, and healthy communication with loved ones. 

I also decided to write a blog “Living with Cancer” as a visiting author at MarvinGray.org, a website I use to promote my fiction. I figure that every week, I can share my experiences and hear about my readers’ experiences. 

Writing has always helped me process things. Not just trauma and pain, but doubts, challenges, frustrations, and emotions. I look forward to hearing from you at csdavis23@gmail.com.

Monday: February 21, 2022

I’m a little miffed at the universe right now! Last month, I was diagnosed with prostate cancer. About seven years earlier, I became a vegetarian with the distinct goal of avoiding prostate cancer. There are all kinds of other health benefits from not eating meat, but I had hoped to side step the cancer altogether. So much for best laid plans.

While living in Kenya, my wife and I watched Forks Over Knives, a documentary about two medical doctors that dedicated their lives to researching healthy diets. They independently came to the conclusion that a plant-based diet is by far the healthiest. So, my wife and I became vegetarians. It was difficult at first to find the right recipes. But soon my wife learned to cook dozens of healthy, delicious dishes. I never really missed the meat after that.

But in January 2022, after I received the biopsy results, in a fit of adolescent rebellion, I started eating meat again. And I am ashamed to say, I am not eating anything too healthy either. I am eating a lot of fried, junk, and fast food; all the things I know I shouldn’t, just to get even at the universe. I know, it’s childish. And I will go back to the vegetarian diet in time.

My maternal cousin, who is three years older than me, just underwent prostate surgery in December 2022, so his experiences, knowledge, and insight, have given me a head start. In fact, I was diagnosed with cancer about seven or eight months after he was. His mother and my mother were sisters. What is odd is that prostate cancer doesn’t run in our mothers’ family. It runs in our fathers’. What are the odds that two maternal cousins who are about the same age would be diagnosed with prostate cancer within a few months of each other under these circumstances?

A decade ago, when my PSA (Prostate-Specific Antigen) score came back high, I feared that I had cancer. I freaked out a little. When the urologist told me that it was nothing to worry about, I relaxed and went about my life. But it is very likely that I already had the cancer then.

This time I didn’t freak out. In fact, I was pretty resigned to the outcome even before the biopsy. I knew that there was nothing I could do–no praying or wishing or hoping–that was going to sway the results. Either I had cancer or I didn’t. If the results came back positive, I would deal with it.

Dr. Patrick Walsh, the author of Guide to Surviving Prostate Cancer, explains that by the time you are diagnosed with prostate cancer, you have probably already had it for decade. Most prostate cancer is very slow moving. Walsh suggests that you take your time, collect all of the information you can about your cancer and treatments, identify the best treatment for you, and then select the best doctor to conduct treatment. Since you’ve probably already had it for a decade, a few more months spent to determine the best course of action is not doing to make much difference.

That’s where I am right now: Trying to decide between radiation, surgery, or active surveillance.