Enjoying the broken glass – A cancer patient adopts a Buddhist monk’s philosophy

The experience of a physician with cancer who adopts a Buddhist monk’s philosophy

"Do you see this glass? asks Thai meditation master Achaan Chaa. For me, this glass is already broken. I enjoy it; I drink from it. It holds my water admirably and sometimes reflects the sun in beautiful patterns. If I tap it, it has a pleasing ring. But when I put it on a shelf and the wind knocks it over, or my elbow sends it off the table and it falls and shatters, I say, ‘Of course.’ When I understand that the glass is already broken, every moment with it is precious."

According to Buddhist sages, stress, anger and resentment arise when things do not go as we want or expect

The solution is simple: imagine things going wrong, imagine them turning out differently from what we hoped or planned, expect the unexpected. And accept it. When you have a treasured glass, cup or object, see it as already broken. If it breaks, you will be calmer about it.

I sat in a chair on my enclosed front porch. It was mild, peaceful and shaded. I was content, wondering how long it would last. A warm July breeze brushed my face.

Buddhism says, “Everything changes.”

During the 11 and a half months my wife spent dying of lung cancer, I learned the meaning of hubris. Want something, work hard to make it happen, and it will happen. Every week I thought I knew what would come next: cancer drugs, metformin and aspirin, along with care, love and intention, would shrink the tumors. They did, but then she developed a pulmonary embolism.

And pneumonia.

Stay on top of the doctors. That will help.

And scarring in her lungs.

Insist on pulmonary (respiratory) rehabilitation.

And the cancer resurging.

Take her to Manhattan for a second opinion.

And dependence on oxygen for 24 hours.

Take her to Boston for a third opinion.

Weight loss, and a lot of it.

My wife hated her fat feet. Eventually, they became the kind she had always wanted: slender, like a model’s. I used to think her fat feet were sweet. I loved touching them and kissing her. It made me feel close. Her eating disorder returned amid the chaos of cancer. Her oncologist told her to eat protein. She would order a bagel and butter. A plain bagel. She knew what she could control. Eating disorders teach that.

Please, Lisa, have some protein. You are so frustrating.

That was the point.

Seeing how much curiosity she aroused, she admitted she was very spoiled. She had rebelled against every kind of control, but cancer has no concept of authoritarianism. It was what it was. Over the next 2 months, I thought intermittently about the speech I would give at her funeral. That was something I could control. After she died, I became more humble.

It took me a long time to reach the point of pulling myself together. I learned to love my quiet life and my own company.

My daughter and I had the following conversation:

- Dad, it has been 5 years. It is time you had a girlfriend.

(Of course she is right)

- What about COVID? I do not want to leave you without a parent.

- Dad, create a quarantine circle. Control the number of people in your life.

(That is risky)

- It has been 5 years, Dad, not 3 weeks.

I joined the two best dating sites for educated singles. Excited as I signed up, armed with my daughter’s blessing, I was ready to look for another love, but this adventure was not a search for a cure for grief. I went on a few dates and thought about the future as well as the present.

In mid-August, I saw my primary-care doctor for my annual examination. I timed it for a lull between COVID-19 waves. Proudly, I said I was vegan, exercised regularly 5 days a week, meditated and took my vitamins. I also do not drink alcohol or smoke. My physical examination was fine, and my weight remained in the normal range, even with muscle gained since my last visit. Pilates contributed a lot.

The next day, my doctor emailed my blood-test results. I like dark chocolate and cookies and worried about blood sugar, but it was only 92. I also eat a lot of peanut butter and cook with plenty of olive oil, yet my cholesterol was 150. That pleased me, and I kept reading his email.

- The thing is, your PSA jumped from 2.75 to 8.5. You should see a urologist.

That sentence filled me with dread. I thought of my patients over the years with prostate cancer. Most lived. Some died.

Thinking ahead, drawing on my medical training and determination, and reaching trusted colleagues, I sprang into action. That always leads to a solution. Writing to a colleague in the urology department of a large health system, I wondered whether my high PSA could be from strenuous Pilates: when working on your core, you press on your pelvis. To check, he wrote that I should stop exercising for 5 days and repeat the PSA. I felt relieved. Surely that was it, I thought, and it would be fine.

Then I spoke with an old friend, a brilliant oncologist. I expected him to ease my worries further. He did not.

- It is unlikely to be exercise. Possible, but unlikely. More likely, there is a process in your prostate.

My stomach cramped.

That does not mean cancer. It could be prostatitis (inflammation of the prostate), or something else.

If I had prostatitis, I would have fever and painful urination. I have neither. The flow is a little slow, but my prostate has been enlarged for years.

We argued back and forth, each taking both sides.

Cancer or not cancer.

It is out of my hands, we finally decided, as if thinking something influenced it. I will tell my urologist that I want prostate imaging if he tells me simply to monitor my PSA. Sometimes it is difficult for doctors to see things as they are when their patient is a doctor. Sometimes it is difficult to be a patient as a doctor. We are not supposed to get sick.

Buddhism holds much wisdom.

Everything changes.

I will try to embrace that again.

Enjoy the glass. It is already broken.

It is so easy to forget.