Lucky me

Greetings from Bethesda, Maryland!

I did think about death. Not that I was in serious danger of it. But my procedure Monday could have gone wrong in a few ways. When confronted with the gamut of negative possibilities — from an unsuccessful result to incidental injuries to the big oops — I had to confront the possibility that I might hit a bad patch.

I didn’t used to feel that way. All my pheochromocytoma history has been lucky, lucky, lucky. If my cousin Eddie hadn’t had night sweats, uncontrolled pediatric hypertension, and headaches before I did, and his mother hadn’t figured out it might be a pheo, my mother and I might never have known. (We hadn’t known it was probably what killed my father, either.)

Then, years later, my cousin, being busy with life and without obvious symptoms, did not notice some fresh neoplasms growing until it was too late, but he did figure out that there was a connection between those and other family members’ diseases, and at his urging we all passed through the gates of NIH, had our genetic tests, and, where indicated, got on the VHL clinical trial.

I had no symptoms, either, but I had a great big pheo, and if it weren’t for Eddie I probably wouldn’t have found out in time. (More luck: My surgeons were great and removed it without destroying my remaining adrenal gland.) You might say I took this good fortune for granted. But how else was I to take it? Eddie’s bad luck helped me, but my good luck couldn’t help him. I’d already been leading life pretty much as I saw fit, and figured that if anyone wanted to see me ride to a fall, they could take a ringside seat. Being nervous about your luck defeated the whole purpose.

But eventually I took a few dings. For example, I had a botched cryosurgery for a VHL-related tumor that left me with a central vision defect in my left eye — not crippling, more of a nuisance. But it was the first time medicine had wounded rather than rescued me. More than that, it was permanent. I’ll have that wound for the rest of my life.

And those kinds of wounds have an effect on your idea of luck. I stopped expecting luck and began to hope for it. This is a classic syndrome, usually expressed in gambling metaphors: Lucky streak, losing streak. Snake bit. The thing is, when you can’t count of luck, and you’re not enough of a buccaneer to just go ahead and dare it to desert you, it becomes a problem. You start to treat it like a romantic object, and in the most juvenile way. It might show up, then, faithless, leave; you can’t count on it, but you do anyway. Luck itself becomes your sucker bet.

There’s another force at work, however, and that’s time, and coming to a stage in life where there are fewer and fewer sure things. When you realize that, it changes the calculus. Some people grow very careful with their markers. But other people decide that, if there were ever a time to cast their fate to the wind, it’s now.

When the doctors urged me to have this operation, I was afraid and uncertain. But then I thought, you know what: Let’s roll the dice. Luck is neither good nor bad; luck is in the opportunity. We can’t count on it, but maybe we can catch it.

I was as usual well attended by the magnificent Clinical Center staff but, like I said last week, ultimately alone. I read an old Atlantic article on the deathbed notes of Henry James, and saw how, as he deteriorated, his stately language outlived his sense. I found that comforting in a way and I like to think he did too. I don’t imagine him struggling to make sense and frustrated — at least any more than any writer does and is; rather I see him serene, nestled in the downy gift of his style, maybe even better off for being relieved of the obligation to convey meaning with it. In the long quiet hours between blood draws and vitals checks, I had the odd feeling that losing all I had, all my gifts, all of what I counted as my luck, might not be so hard. Especially with anesthesia.

So far it looks like I lucked it. No dings, no doom. My room number was 1672 if you want to play it.

While I was away I see a bunch of bullshit went down. We’ll start to sort it tomorrow. (But fuck that noise: how ‘bout that Mamdani?)