Inoperable Optimism.

September 25, 2023

Inoperable Optimism.

May 29, 2023

I’ve been crying a lot the past week. I lost a mentor two decades older than me. My last episode of Mad Men, much of which takes place at the Esalen Institute - a place where I have a long history with my mentor - had me bawling my eyes out. I watched a mediocre film “50/50” with Joseph Gordon-Levitt who is dealing with a cancer diagnosis. I felt sick to my stomach while trying to be entertained by the big-C.

The doctor says to Joseph, “Your case is a fascinating and unusual case.” I heard almost the same thing from my urologist when he said there was only a 1% chance my prostate cancer would metastasize within five years after my HIFU surgery in November 2021 (it metastasized within 15 months). And, I said the same thing to the doctor that Joseph did, “But, I’m going to be okay, right?” The film doctor had the same reaction as my urologist: he looked at the ground for about five seconds silently. Doesn’t give you confidence when you see that reaction.

This blog post isn’t meant to be a kvetch-a-thon. Yes, it does feel awkward walking into the Nuclear Medicine portion of the hospital so many times in the past week as if my pelvis is Chernobyl. But, I feel fortunate that I have the “best in the biz” (or so they tell me) giving my “case” attention.

Here’s a quick update. After my radical prostatectomy in June, my periodic PSA blood tests ought to be 0.1 or less unless the cancer has spread. In August, my PSA surprised the doctors as it was 0.49. Okay, we’ll deal with that. I went to a medical-spa in Austria and focused even more on being healthy (beyond the three years of frickin’ functional medical doctors I’ve been seeing and dozens and dozens of supplements I’ve been taking daily), but my PSA score grew to 0.72. And, then, last week, it grew to 0.91 so maybe this damn cancer is spreading?!  

My recent PSMA PetScan shows that it may have moved beyond my pelvic lymphs, but, on the other hand, my pelvic lymph region looks better than it did a couple months ago. Traversing the cancer journey is like traveling in Transylvania. It’s hard to understand the language. And, you constantly have to be viewing the map to understand where you are. It’s pretty exhausting and I’m one of the fortunate ones to be getting above average care. Dealing with cancer, at times, feels like a full-time job of learning a new language (and, then, teaching it to others since your friends and family want to know what’s going on). 

If you’re at 0.2 or above, you need to start hormone suppression therapy (started last week, again, after doing it for five months earlier this year). If you’re at 0.5 or above, you need to start radiation (starting Nov 20 for 7-8 weeks). If you’re at 1.0 or above (which is my trend line), you’ve got to be worried. The weird thing is I’m feeling very healthy. 

To be honest, I love all the support I’ve received but I’m also tired of people in my orbit introducing me to specialists, charlatans, and bizarre books and films. My regimen is both traditional and integrative, non-traditional, but someone going through all of this can only metabolize so many suggestions. Just tell me you love me…that’s enough. The worst is when someone, through their advice and concerns, gives me the impression that somehow I’ve willed this cancer onto myself based upon my diet, my work regimen, my pesky little thoughts. That’s happened quite a few times. I don’t think I’ve willed it, but who knows? And, yet, this isn’t what I need from friends when I’m trying to prepare myself for this onslaught from Cancer.

Toward the end of the film, Joseph asks a cancer friend at the clinic, “Where’s Mitch?” And, his friend says, “He died last night.” I cried again when I witnessed this scene. I don’t worry about dying. I’ve lived a great life and, really, prostate cancer - while being the #2 likelihood of male cancer deaths - usually moves slowly. I’m doing all kinds of things, including tapping into my inoperable optimism, that I think are going to have a great impact on my wellbeing. I think I’ll be okay and I’ll be wiser as a result of this.

I can’t stop crying, though. This film is ending. And, I just peed in my pants (yes, one of the collateral costs of a prostatectomy). I don’t want to bother others. Often, I just want to hunker down and be alone. For someone who is so steeped in understanding my emotional health and wellness, I’ll admit that occasionally I feel a little lost.

Do you know what most feels generative in my life right now? It’s Erik Erikson's statement “I am what survives me.” I’m leading four MEA workshops (three public ones and one private one) in Baja this fall and I’m really looking forward to it (and so many of our Q4 workshops are full or almost full so thanks for all your support!). I’ll probably live thirty more years and these workshops help remind me why I’m here on this planet. This week is my dad’s 86th birthday and he and my 85-year-old mom are doing a month-long cruise on the Mississippi River. I look forward to traveling with Oren for a long time, as we did earlier this month in Europe. I have good genes and I live a relatively healthy lifestyle. 

More than anything, I feel a deep sense of purpose and a loving sense of community. I’ve taken the basic steps to be here into my 90s, but you never know. And, that’s when I just tap into my “inoperable optimism” and, even despite my tears, I know that I’m learning, loving, and living in every moment that I’m alive. And, you are too if you open yourself up to that possibility.

- Chip

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