Objects in Mirror are Closer Than They Appear

As I look in the side view mirror, I can see death gaining on me as I travel down this road of life. Every breath, closer to death. That goes for all of us. It’s been a rough couple of weeks. I am unable to perform live music these days. I had to cancel band rehearsal. I had to cancel an upcoming kirtan gig. I had to scale back my personal training routine and seek physical therapy. We talk about hospital beds, and wheelchairs – maybe even motorized ones.

I used my cane for a couple days this week. I ran into an acquaintance this week at the cafe with my cane. I was sure we had talked about my terminal illness a few years back. They didn’t remember. Believe it or not this has happened a bunch of times with different people, even close friends and bandmates. I gave them the quick recap of the past four and a half years in about two minutes. When I was finished they said “you’re smiling”? I hadn’t noticed I was smiling, but when I became aware of it, I smiled even more. I guess I was happy to be able to drive to the cafe, walk with my cane, on a hot summer day, enjoying the sunshine. Life was good. Yes there was pain, but my thoughts and emotional reactions to it were under control. This is not easy. In fact it is the hardest thing I’ve ever tried to do. And It’s scary too.

I’m trying to balance being with the pain and watching my reaction to it, and then giving in to pain relief medication or another round of steroids. Please note, I believe steroids work better on the cancer pain (inflammation) in this body than the low level opioids do. So far they have obliged giving me steroids a couple times since December 2024. Tomorrow I start another round. Most pain and palliative care clinics, hospice, and cancer centers are all too eager to dole out opioids for the pain. I don’t think steroids are traditionally used long-term for pain. But the reality is a terminally ill person is in pain, they are going to die sooner rather than later, so why can’t we have a discussion about dying all doped up with opioids versus the using steroids as an end of life, pain management option. I am not a medical professional. There are a few really bad outcomes using steroids long term. But using opioids for end of life puts you in la-la land, totally out of touch, not really aware of the end of this life. I’m really going out on a limb here writing this post, because I may cave to the pain and cry out for the opioids at some point. But I’m consciously trying to use my practice to see the impermanence of this physical body, the feelings of that body, the perceptions of what’s going on, and the thought patterns that arise. It’s really hard. I want to die being aware of what is going on around me. That last breath. Last thought. Last sound. Last smell. Last touch. I want to take with me the wisdom that the mind creates the ego and the mind creates all our karma/actions. That’s what I intend to bring into my next existence. I know that may sound deep, or weird, or heavy or crazy – but that’s where I’m at these days. I have plenty of time to study these things since the cancer has limited what I can do and where I can go. Now I see why my teacher calls the cancer and the pain “a gift”. It gives me ample time and opportunity to study and learn more.

On a practical note, my blood tests results are moving in the wrong direction, the current cancer drugs have stopped working, and I’ve been called in for more scans earlier than scheduled. I also have a referral to the pain/palliative clinic. In the meantime I’m going to start the steroids tomorrow. Then we head to Long Island to visit family and stop in Manhattan for a few nights, just one last time. Next onto Costa Rica with some dear friends for a week of chill. Mid August I have more scans and appointments. After that there’s a fairly new treatment plan with Pluvicto (another whole blog post on that coming soon). I will do all this with a smile on my face because life has always given me whatever I’ve asked for and some things I didn’t ask for. But the lessons of mindfully facing disease and death is truly invaluable. Every breath, closer to death. See you soon. Love you guys.