Tuesday, October 15, 2013

"Take Care of My Negatives:" Coping with Cancer and Thoughts of Death


It was not even five o’clock in the morning when they came to wheel John out of his hospital room to prepare him for surgery.  

In November last year, we discovered that his prostate screening antigen level was elevated. A month of being on antibiotics did not bring it down, and a series of tests revealed that he had stage two prostate cancer. The year’s months passed while he hopped from one doctor to another, seeking a second, third, fourth opinion.  I was getting exasperated and told him that he was running out of urologists to consult.

I did not want to nag him, so I enlisted our daughters’ help to convince him to undergo a biopsy, the only definitive test to determine if he indeed has cancer or not.  Finally, he did, and the verdict was as feared – he had the dreaded Big C. We made a new round of doctors, and diligently researched on the Internet, as we “shopped” for a treatment option. All doctors tried to soften the blow. They told us what we have already heard and read about prostate cancer – that it was a slow moving cancer, and as one doctor said “if we could choose a cancer, this is what we would choose.” Another doctor said some men who have prostate cancer could die of old age and not even need treatment for their prostate cancer.

But just as we were heaving a sigh of relief that he had the least troublesome kind of cancer, one doctor said he should make sure that the cancer is contained only in his prostate. He prescribed scans to check John’s bones and abdominal organs. We were back on the rollercoaster of anxiety and apprehension as John dutifully submitted himself to the scans and waited for the results. Thankfully, both scans were negative.

But the different ultrasounds and scans also showed that he had a stone in his ureter. One doctor prescribed medicines to try to melt it, while another doctor ordered a lithotripsy (shock wave treatment to break down the stone so he could pass it down). John went for the lithotripsy.

He rejected radiation therapy (too time-consuming, too many trips to the hospital) and decided that he wanted surgery. Having narrowed down his choice to the most radical treatment meant looking for the best doctor and the best-equipped hospital. Consulting with friends and relatives in the medical profession, we were told about robotics surgery, and that the latest equipment were available at St. Luke’s Medical Center at Global City. Two doctors were needed to perform robotics surgery – one to handle the robotics while the other stood by the patient’s bedside, prepared to do traditional surgery, in case something went wrong with the robotics equipment. The two doctors whom we had approached at St. Luke’s were both trained and experienced in doing robotics-assisted prostatectomy, and reassured John that he would fine no matter which surgeon he chose. He didn’t think it was right to let them toss a coin to decide who would be the lead surgeon, so John decided to go for the older doctor to handle the robotics.

John worried about the cost of the operation until I told him that it would be covered by his Blue Cross medical insurance. Our insurance was reimbursement-type, but our broker had mentioned years ago that if we made prior arrangements, Blue Cross could pre-approve the procedure and hospitalization, and we would not need to advance payments. That was another worry off his mind, as we made the trip to the hospital.

We checked in the night before the 7:00AM scheduled surgery.

The hospital staff was friendly and efficient, with nurses or doctors introducing themselves and explaining their roles, (“I am Nurse Christine, your night nurse. I will be attending to you until 6am, when your day nurse, Jerry, would take over.”) They pointed to the features of the room – the buzzer to call nurses in, the lights, how to raise and lower the bed or parts of it, what time the doctors were expected to come. They patiently explained all the procedures that they were required to do, and what the patient should even expect to feel and experience. Before all that, as a standard security measure to make sure that they are dealing with the right patient, they asked him for his name and birthday.

They prepped him for the surgery, putting in I.V. needles on both hands, even though only one received intravenous fluids that night. We were introduced to the new machines that detected the flow of IV fluids – which beeped when the flow was blocked. John must have had a restless night, as that machine beeped many times through the night, and I had to press the buzzer just as many times to call in the night duty nurse to restore the flow.

He was awake, and so was I, when they came before five o’clock in the morning.

 I stood up and walked the few steps from the daybed where I was supposed to sleep but hardly did, to just outside John’s hospital room door that was as far as I could join him. He held my hand, and whispered, “Harvey, take care of my negatives.”

This is 2013, and we no longer shoot with films, and therefore have not been handling negatives.  But his admonition takes me back further than 13 years ago when we gave up analog cameras to embrace the digital revolution.  It takes me back to 1972, and to another hospital situation.

John’s papa had gifted him with a new Honda 300cc motorcycle, and young and recklessly daring as he was (24) at that time, he accepted a dare from his friend, Ernesto, to a race on Roxas Boulevard (then called Dewey Boulevard). (If I may digress a bit, the whole stretch of Dewey Boulevard lined Manila Bay then, and Manila’s famed sunset could be enjoyed by any who would sit on the breakwater that ran parallel to the boulevard. In later years, reclamation projects pushed forward the shoreline, and we have lost this easy access to the magnificent colors of the sun’s going down).

Since his friend had a more powerful motorcycle,  John was given  “partida” – allowed to have a headstart.  After a couple of minutes of driving alone, he heard his friend revving his engine. As the sound of the other motorcycle’s engine grew louder and nearer, John steered his motorbike to the right side of the road, to give his friend space to overtake.

But his friend – violating basic Philippine (same as U.S.) driving rules – overtook on John’s right side, and the two men and their motorcycles collided. His friend was not harmed, but as John later recalled, his last memory after their motorcycles crashed was of him “flying, and looking back at his motorcycle.” He landed face and belly down on the curb, the full impact of the crash leaving him unconscious.

He was rushed to the “Hospital de San Juan de Dios,” just a few meters away from the scene of the accident. One of his mother’s employees (as I recall, his nickname was Taba) rushed to fetch me from the apartment that I was sharing with my brother, while someone else summoned his mother. He was still in the emergency room when I arrived, but they were getting ready to wheel him into the X-ray lab. John must have been in terrible pain and probably having thoughts that he could possibly die as a result of this accident, when he very faintly whispered, “Harvey, please take care of my negatives.”

Miraculously, he had no fractures, but his skin –on the right side of his body, from his face down to his finger tips – was peeled off, exposing his flesh, as if he had suffered third-degree burns. It took a month in the hospital (how he survived a month in a hospital is another story) before new skin grew.

When he was finally released from the hospital, he went straight into doing photography. One day while going through his files of old negatives, he called me, and with grim expression on his face, and great drama in his voice, asked me, “Do you remember that night that I had a motorcycle accident?” “Yes, of course,” I answered. “And do you remember that I asked you to look after my negatives?” “Yes, of course, I remember.”  Those life-or-death moments are difficult to forget. Just as I braced myself for possible bad news, John broke into an impish grin, and said “Well, I’m sorry that I thought I was leaving you my most valuable legacy – but there is nothing among my photos that is of value.” Relieved that he was out of danger, we could now afford to laugh at how much we cared and shared about each other, even with how little we owned.

Forty years later, as he said those words again, “Take care of my negatives” I was not sure what to think – was he thinking that he was near death once more, was he sharing our in-joke, was he reassuring me that four decades later, his negatives must have escalated in value, what exactly was his message? Confused, worried and anxious, I sat alone on the bench in that empty hospital room, and turned to prayer.

It’s been a month and a half since that surgery. His PSA level is down to .0003 (maximum is positive 4), and while it is still difficult to get him to rest and take it easy, he is more patient with himself, and willing to slow down, just one bit. This is what John has to say, after his encounter with the Big C and his near brush with death:

Since my operation... I have had a different outlook in life... Patience is now a virtue that I hold close to my heart... Savoring every moment of whatever Life has to offer me... I watch young people in love and see old couple enjoying the mall, little children playful and laughing... I see grouchy old men too... I hope one day I won't be one... Learning new things which I should have learned a long time ago... Luckily, I still have time left...