Wrestling with Prostate Cancer

THE DIGITAL EXAM

How to Cite

Masten, R. (2001). Wrestling with Prostate Cancer: THE DIGITAL EXAM. M/C Journal, 4(3). https://doi.org/10.5204/mcj.1918
Vol. 4 No. 3 (2001): Sick
Published 2001-06-01
Fiction

February 15, 1999

THE DIGITAL EXAM

digital
was such a sanitary hi-tech word
until my urologist
snuck up from behind
and gave me the bird
shocked and taken back
I try to ignore the painful experience
by pondering
the conundrum of homosexuality
there had to be more to it than that
"You can get dressed now"
was the good doctor’s way of saying
"Pull up your pants, Dude,
and I’ll see you back in my office."
but his casual demeanor
seemed to exude foreboding

"There is a stiffness in the gland
demanding further examination.
I’d like to schedule a blood test,
ultrasound and biopsy."
the doctor’s lips kept moving
but I couldn’t hear him through the sheet
of white fear that guillotined between us
CANCER! The big C! Me?

I spent the rest of that day
up to my genitals
in the grave I was digging.
Hamlet gazing full
into the face of the skull
"Alas poor Yorick, I knew him well, Horatio.
Before scalpel took gland.
Back when he sang in a bass baritone."

desperate for encouragement
I turn to the illustrated brochure
the informative flyer
detailing the upcoming procedure
where in the ultrasound and biopsy probe
resembled the head
of a black water moccasin baring its fang
"Dang!" says I jumping back

relief came 36 hours later
something about the PSA blood test
the prostate specific-antigen results
leading the doctor
to now suspect infection
prescribing an antibiotic

of course five weeks from now
the FOLLOW-UP APPOINTMENT!
and as the date approaches
tension will build like in those
Mel Gibson Lethal Weapon films
when you know
there’s a snake in the grass
and Danny Glover isn’t there
to cover your ass

***

April 2, 1999

As it turns out, at the follow-up appointment, things had worsened so the biopsy and bone scan were re-scheduled and it was discovered that I do have incurable metastatic advanced prostate cancer.

Of course the doctor is most optimistic about all the new and miraculous treatments available. But before I go into that, I want you to know that I find myself experiencing a strange and wonderful kind of peace. Hell,
I’ve lived 70 years already — done exactly what I wanted to do with my life. All worthwhile dreams have come true. Made my living since 1968 as a "Performance Poet" — Billie Barbara and I have been together for 47 years — growing closer with each passing day. We have four great kids, five neat and nifty grandchildren. All things considered, I’ve been truly blessed and whether my departure date is next year or 15 years from now I’m determined not to wreck my life by doing a lousy job with my death.

LIKE HAROLD / LIKE HOWARD

like Harold
I don’t want to blow my death
I don’t want to see a lifetime
of pluck and courage
rubbed out by five weeks
of whiny fractious behavior
granted Harold’s was a scary way to go
from diagnosis to last breath
the cancer moving fast
but five weeks of bitching and moaning
was more than enough
to erase every trace of a man
I have wanted to emulate
his wife sending word
that even she
can’t remember what he was like
before his undignified departure
no —
I don’t want to go like Harold

like Howard
let me come swimming up
out of the deepening coma
face serene as if seen
through undisturbed water
breaking the surface
to eagerly take the hand
of bedside well wishers
unexpected behavior I must admit
as Howard has always been
a world class hypochondriac
second only to me
the two of us able to sit for hours
discussing
the subtle shade of a mole
turning each other on with long
drawn out organ recitals

in the end
one would have thought
such a legendary
self centered soul would cower
and fold up completely like Harold
but no —
when my time comes
let me go sweetly like Howard

***

April 7, 1999

The treatment was decided upon. Next Monday, the good Doctor is going to pit my apricots. From here on the Sultan can rest easy when Masten hangs with his harem. Prognosis good. No more testosterone - no more growth.

Now, don’t get me wrong, I’m not looking forward to giving up the family jewels. I must say that over the years they’ve done me proud and to be totally honest I don’t think Billie Barbara will be all that disappointed either. I’m told that Viagra will help in this area., However, I’m also told that the drug is very expensive. Something like twelve bucks a pop. But hell, Billie Barbara and I can afford twenty four dollars a year..

Some thoughts the morning of—

Yesterday I did a program for the Unitarian Society of Livermore. About 60 people. I had a bet with the fellow who introduced me, that at least 7 out of the 60 would come up after the reading (which would include my recent prostate musings) and share a personal war story about prostate cancer. I was right. Exactly 7 approached with an encouraging tale about themselves, a husband, a brother, a son. I was told to prepare myself for hot flashes and water retention. To which Billie Barbara said "Join the club!"

I ended the presentation with one of those inspirational poetic moments. A hot flash, if you will. "It just occurred to me," I said, " I’m going to get rich selling a bumper sticker I just thought of — REAL MEN DON’T NEED BALLS

A couple of days after the event

The Community Hospital of the Monterey Peninsula is referred to as CHOMP, and the afternoon of April 12th I must say this august institution certainly lived up to it’s name.

The waiting room in the Out Patient Wing is an event unto itself. Patients huddled together with friends and family, everyone speaking in hushed voices. The doomed keeping a wary eye on the ominous swinging doors, where a big tough looking nurse appeared from time to time shouting: NEXT! Actually the woman was quite sweet and mild mannered, enunciating each patient’s name in a calm friendly manner. But waiting to have done to me what was going to be done to me - the chilling word "NEXT!" is what I heard and "Out Patient Wing" certainly seemed a misnomer to me. Wasn’t the "Out-Patient Wing" where you went to have splinters removed? Of course I knew better, because in the pre-op interview the young interviewer, upon reading "Bilateral Orchiectomy" winced visibly, exclaiming under her breath "Bummer!" I recently came across this haiku —

bilateral orchiectomy
the sound a patient makes
when he learns what it is

Our daughter April lives in New York and couldn’t join the Waiting Room rooting section so as her stand in
she sent her best friend Molly Williams. Now, Molly works as a veterinarian in a local animal shelter and a
when I told her my operation was supposed to take no more than half an hour, she laughed: "Heck Ric, I’ll do
it in five minutes and not even use gloves."

NEXT! My turn to be led through those swinging doors, pitifully looking back over my shoulder. Wife,
family and friends, bravely giving me the thumbs up. Things blur and run together after that. I do remember
telling the nurse who was prepping me that I was afraid of being put to sleep. "Not to worry" she said, I’d
have a chance to express these fears to the anesthetist before the operation would begin. And as promised the
man did drop by to assure me that I would get a little something to ease my anxiety before he put me under.
When the moment finally arrived, he said that I might feel a slight prick as he gave me the relaxant. Of course,
that is the last thing I remember - the prick! Obviously, I‘d been suckered in by the mask man’s modus
operandi.

On the other side of this I surface to begin the waiting. WAITING for the catheter to be removed — for the
incision to heal — WAITING to see if the pain subsides and I can loose the cane — WAITING to learn if my
PSA will respond to treatment. Waiting—waiting—waiting—and I’ve never been a cheerful waiter.

***

May 7, 1999

The doctor tells me I must keep taking Casodex— one a day at eleven dollars a cap - for the rest of my life. And no more doctor freebees. No wonder the listed side effect of this pricey medication is depression. But the recent funk I’ve fallen into is much deeper than dollars and cents. In the past I’ve had my share of operations and illnesses and always during the recuperation I could look forward to being my old self again. But not this time .... Not this time.

Funny bumper stickers can only hold reality at bay for a short while. And anyway Billie had me remove the
homemade REAL MEN DON’T NEED BALLS bumper sticker from the back of our car — She didn’t like the
dirty looks she got while driving around town alone.

***

Eight months later

BILATERAL ORCHECTOMY

never could
look up words in the dictionary

in a high school assignment
writing an autobiography
I described my self as a unique person
scribbled in the margin
the teachers correction fairly chortled
"unique" not "eunuch"
how could he have known
that one day I would actually become
a misspelling

backed against the wall
by advanced prostate cancer
I chose the operation
over the enormous ongoing
expense of chemical castration
"No big deal." I thought at the time
what’s the difference
they both add up to the same thing

but in the movies these days
during the hot gratuitous sex scene
I yawn…bored...
wishing they’d quit dicking around
and get on with the plot
and on TV the buxom cuties
that titillate around the products
certainly arn’t selling me anything
I realize now that
although it would probably kill them
the guys who went chemical
still have an option
I don’t

philosophically I’m the same person
but biologically
I ‘m like the picture puzzle
our family traditionally puts together
over the holidays
the French impressionist rendition
of a flower shop interior
in all it’s bright colorful confusion

this season I didn’t work the puzzle
quite as enthusiastically...
and for good reason
this year I know pieces are missing
where the orchids used to be

"So?" says I to myself
"You’re still here to smell the roses."

***

January 13, 2000

Real bad news! At the third routine follow-up appointment. My urologist informs me that my PSA has started rising again. The orchectomy and Casodex are no longer keeping the cancer in remission. In the vernacular, I have become "hormone refractory" and there was nothing more he, as a urologist could do for me. An appointment with a local oncologist was arranged and another bone scan scheduled. The "T" word having finally been said the ostrich pulled his head from the sand and began looking around. Knowing what I know now, I’m still annoyed at my urologist for not telling me when I was first diagnosed to either join a support group and radically change my diet or find another urologist. I immediately did both - becoming vegan and finding help on-line as well as at the local Prostate Cancer Support Group. This during the endless eighteen day wait before the oncologist could fit me in.

***

IRON SOCKS

time now
for a bit of reverse prejudice

I once purchased some stockings
called "Iron Socks"
guaranteed to last for five years
they lasted ten!
but when I went back for another pair
the clerk had never heard of them

as a cancer survivor… so far
in an over populated world
I consider the multi-billion dollar
medical and pharmaceutical industries
realizing
that there is absolutely no incentive
to come up with a permanent cure

***

From here on, I’ll let the poems document the part of the journey that brings us up to the present. A place where I can say — spiritually speaking, that the best thing that ever happened to me is metastatic hormone refractory advanced prostate cancer.

***

SUPPORT GROUPS

included in this close fraternity...
in this room full of brotherly love
I wonder
where I’ve been for the last 11 months
no — that’s not quite right…
I know where I’ve been
I’ve been in denial

after the shock of diagnosis
the rude indignity of castration
the quick fix of a Casodex
why would I want to hang out with a bunch
of old duffers dying of prostate cancer?

ignoring the fact that everybody dies
we all know it
but few of us believe it
those who do, however
rack up more precious moments
than the entire citizenry of the fools paradise
not to mention studies
showing that those who do choose
to join a support group
on average
live years longer
than the stiff upper lip recluse

and while I’m on the subject
I wonder where I’d be without the internet
and the dear supportive spirits
met there in cyber-space
a place where aid
care and concern are not determined
by age, gender, race, physical appearance,
economic situation
or geological location

and this from a die-hard like me
who not ten years ago
held the computer in great disdain
convinced that poetry should be composed
on the back of envelopes
with a blunt pencil while riding on trains

thank god I’m past these hang-ups
because without a support system
I doubt if this recent malignant flare-up
could have been withstood

how terrifying…
the thought of being at my writing desk
alone… disconnected
typing out memos to myself
on my dead father’s ancient Underwood

***

PC SPES

in the sea that is me
the hormone blockade fails
my urologist handing me over
to a young oncologist who recently
began practicing locally having retired
from the stainless steel and white enamel
of the high tech Stanford medical machine

in the examination room
numbly thumbing through a magazine
I wait expecting to be treated
like a link of sausage
another appointment ground out
in a fifteen minute interval
what I got was an 18th century throw back
a hands-on horse and buggy physician
with seemingly all the time in the world

it was decided that for the next three weeks
(between blood tests)
all treatment would cease
to determine how my PSA was behaving
this done, at the next appointment
the next step would be decided upon
and after more than an hour
of genial give and take
with every question answered
all options covered
it was I who stood up first to go
for me a most unique experience
in the annals of the modern medicine show

however
condemned to three weeks in limbo
knowing the cancer was growing
had me going online
reaching out into cyberspace
to see what I could find
and what I found was PC SPES
a botanical herbal alternative medicine
well documented and researched
but not approved by the FDA

aware that the treatment was not one
my doctor had mentioned
(I have since learned that to do so would
make him legally vulnerable)
I decided to give it a try on my own
sending off for a ten day supply
taking the first dose as close after
the second blood test as I could

two days later
back in the doctors office I confess
expecting a slap on the wrist
instead I receive a bouquet for holding off
until after the second PSA

then taking
the PC SPES container from my hand
and like a Native American medicine man
he holds it high over his head shaking it
"Okay then, this approach gets the first ride!"

at the receptionist desk
scheduling my next appointment
I thought about how difficult it must be
out here on the frontier
practicing medicine with your hands tied

***

PREJUDICE

"It's a jungle out there!"
Dr. J. George Taylor was fond of saying
"And all chiropractors are quacks!
Manipulating pocket pickers!"

the old physician exposing his daughter
to a prejudice so infectious
I suspect it became part of her DNA
and she a wannabe doctor herself
infects me her son with the notion
that if it wasn’t performed or prescribed
by a licensed M.D.
it had to be Medicine Show hoopla
or snake oil elixir
certainly today’s countless array
of practitioners and patent remedies
has both of them spinning in their grave

but Ma
you and Grandpa
never heard the words hormone-refractory
even the great white hunters
of our prestigious cancer clinics
don't know how to stop the tiger
that is stalking me

and so
with a PSA rising again to 11.9
I get my oncologist to let me try PC SPES
a Chinese herbal formula
yes, the desperate do become gullible
me, reading and re-reading
the promotional material
dutifully dosing myself between blood tests
and this
against the smirk of disapproval
mother and grandfather
wagging their heads in unison:
"It won’t work."
"It won’t work."

having condemned myself beforehand
the moment of truth finally arrives
I pace the floor nervously
the doctor appears at the door
"How does it feel to be a man
with a PSA falling to 4.8?"

it seems
that for the time being at least
the tiger is content to play a waiting game
which is simply great!
Mother tell Grandpa
I just may escape our families bigotry
before it’s too late

***

HELPLINE HARRY

"Hi, how are you?"
these days I'm never sure
how to field routine grounders like this
am I simply being greeted?
or does the greeter actually want a list
of grisly medical details
my wife says it's easy
she just waits to see if the "How is he?"
is followed by a hushed
"I mean… really?"

for the former a simple
"Fine, and how are you?" will do
for the latter the news isn't great
indications are that the miracle
herbal treatment is beginning to fail
my oncologist offering up
a confusing array
of clinical trials and treatments
that flirt seductively
but speak in a foreign language
I don't fully understand

so Harry,
once again I call on you
a savvy old tanker who has maneuvered
his battle scared machine
through years of malignant mine fields
and metastatic mortar attacks

true
five star Generals know much
about winning wars and such
but the Command Post is usually
so far removed from the front lines
I suspect they haven't a clue as to what
the dog-faces are going through
down here in the trenches

it's the seasoned campaigners
who have my ear
the tough tenacious
lovable old survivors like you

***

"POOR DEVIL!"

in my early twenties
I went along with Dylan Thomas
boasting that I wanted to go out
not gently but raging
shaking my fist
staring death down

however this daring statement
was somewhat revised
when in my forties I realized
that death does the staring
I do the down

so I began hoping
it would happen to me
like it happened to the sentry
in all those John Wayne
Fort Apache movies
found dead in the morning
face down — an arrow in the back
"Poor devil."
the Sergeant always said
"Never knew what hit him."

at the time I liked that...
the end taking me
completely by surprise
the bravado left in the hands
of a hard drinking Welshman
still wet behind the ears

older and wiser now
over seventy
and with a terminal disease
the only thing right about
what the Sergeant said
was the "Poor devil" part

"Poor devil"
never used an opening
to tell loved ones he loved them
never seized the opportunity
to give praise for the sun rise
or drink in a sunset
moment after moment
passing him by
while he marched through life
staring straight ahead
believing in tomorrow
"Poor devil!"

how much fuller
richer and pleasing life becomes
when you are lucky enough
to see the arrow coming

***

END LINE
(Dedicated to Jim Fulks.)

I’ve always been
a yin / yang - life / death - up / down
clear / blur - front / back kind of guy
my own peculiar duality being
philosopher slash hypochondriac
win win characteristics
when you’ve been diagnosed
with advanced prostate cancer

finally the hypochondriac
has something more
than windmills to tilt with
the philosopher arming himself
with exactly the proper petard
an anonymous statement
found in an e-mail message
beneath the signature
of a cancer survivor’s name
a perfect end line wily and wise
quote: I ask God:
"How much time do I have before I die?"
"Enough to make a difference."
God replies

***

STRUM

lived experience taught them
most of what they know
so MD's treating men
diagnosed with androgen-independent
advanced prostate cancer tend
to put us on death row
and taking the past into account
this negativity is understandable…
these good hearted doctors
watching us come and go
honestly doing what they can
like kindly prison guards
attempting to make the life
we have left
as pleasant as possible

to be otherwise a physician
would have to be a bit delusional
evangelical even…
to work so diligently for
and believe so completely in
the last minute reprieve
for those of us confined
on cell block PC
doing time with
an executioner stalking
it is exhilarating
to find an oncologist
willing to fly in the face of history
refusing to call the likes of me
"Dead man walking."

***

BAG OF WOE

there are always moments
when I can almost hear the reader asking:
"How can you use that
as grist for your poetry mill?
How can you dwell
on such private property,
at least without masking the details?"
well... for the feedback of course
the war stories that my stories
prompt you to tell
but perhaps the question can best
be answered by the ‘bag of woe’ parable

the "Once Upon a Time" tale
about the troubled village of Contrary
its harried citizens
and the magical mystical miracle worker
who showed up one dreary day
saying:
I am aware of your torment and woe
and I am here to lighten your load!

he then instructed the beleaguered citizens
to go home and rummage
through their harried lives
bag up your troubles he said
both large and small
stuff them all in a sack
and drag them down to the town square
and stack them around on the wall

and when everyone was back
and every bag was there
the magical mystical miracle worker said:
"It’s true, just as I promised.
You won’t have to take
your sack of troubles home
leave it behind when you go
however, you will have to take along
somebody’s bag of woe

so the citizens of Contrary
all went to find their own bag
and shouldering the load
discovered that it was
magically and mystically
much easier to carry

--- End ---


Author Biography

Ric Masten

None