on life and death

I have lymphoma. I am creating this narrative blog to provide an updated chronology of the events of the disease, as well as a chronicle of how my feelings about it are evolving and congealing into a meaningful form. It is early on in my awareness, which is a good time to start: it is 3:00 pm on Thursday, August 18, 2022, and I’ve just received the radiologist’s report of a PET-scan I had this morning.

I begin, therefore, with my initial awareness of the disease and, in installments which follow, will offer personal insights and private thoughts. It is about confronting death, not speculating upon it; and about re-assembling life, not the nostalgia of remembering it.

Because the subject is intense, each installment will be short. Asking the reader—and even the writer—to remain soberly focused on the matter more than briefly is unfair. And not productive.

“Life is pleasant,” wrote Isaac Asimov, “and death is peaceful. It’s the transition that’s troublesome.” This will be about transitions.

First Installment: living while dying

On Monday morning, the first of August of this year, I underwent a CT scan and ultrasound to investigate a suspicious nodule in my left groin that, initially, both the surgeon and I had suspected was a hernia. Some years earlier, he had repaired a hernia on the right side that had a similar appearance. On this one, however, he had noted some unusual tissue swelling that was uncommon in a hernia.

The afternoon of the scan I received a message from him to contact my internist. Before I had the chance, she phoned me. She had already read the radiologist’s report—which I, too, had read, as it was posted on my interactive web portal, MyChart.

“This is not a hernia,” she told me. As she spoke, I had on the screen before me the findings: Extensive lymphadenopathy through the abdomen and pelvis in combination with a markedly enlarged spleen raises the question of underlying lymphoma.

The narrative I had earlier constructed, explaining the years of over-stressing my core muscles, daily, on my gym’s ab equipment (certainly sufficient to cause a hernia), explaining my recent fatigue in moving to a new residence in 100+ degree heat, attributing my recent twelve-pound weight loss on excessive body stress, all of this sounded progressively weak even as I related it “This is not a hernia,” she repeated, softly. “Do you want me to tell you what you would like to hear? Or do you want to hear my opinion?” she asked, the note of patience in her voice fading.

“Of course, I rely on your opinion,” I protested meekly. “I only appear to know what I’m talking about.” It was a nervous laugh. I was bracing myself.

“You have lymphoma,” she said.

I found my reaction to be surprisingly stoic—not indifferent, but as if I were someone outside myself listening passively. Questions raced through my mind: lymphoma is a medical term not unlike schizophrenia: it conceals a wide range of demons, some less threatening than others.

An office visit with my internist’s associate on the afternoon of Aug 4 was upbeat. She indicated that the majority of lymphomas are the large B-cell subtype (80% or so) and are easily treatable—implying that, chances are, it’s what I have. She ordered a CBC with differential, to measure red blood cells.

I left in high spirits.

—Ron Wetherington