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June 1, 2016: One Year from Jeremy’s Passing

Dear Friends,

It is very hard to believe that an entire year has passed since Jeremy’s passing — and yet, here we are.

Jeremy to EditAs I shared with family and friends earlier today, it’s an impossible reality that Jeremy died, one that I am living with every day. How to live without him here in the flesh? I don’t think I am any closer to having resolved this question; rather, I live out the answer each day by continuing to walk this earth — loving and appreciating my family and friends, doing all I can to help others, and experiencing the beauty in each moment, even the challenging ones.

There are many things that could be said about our beloved Jeremy. Of his enormous and tender heart, of his compassion and deep desire to be of service in this world, of his brilliance, of his understanding and wisdom, of his beauty, of his vulnerability, and of his commitment to healing and Self-knowing … but who he was and is goes beyond all of these descriptions. Every word I could ascribe to his Being-ness are inadequate.

I find myself on this day feeling quiet, and yet also wanting to create space for all of us who love him to remember him and honor all the ways he touched our lives.

As many of you know, Jeremy was, among other things, a gifted and visionary writer. He wrote a piece in 2004 that, ten years later, he recognized as prophetic. For me, this poem — called To Die While Living — echoes one of the great legacies of his life: that this life we have is a gift. Jeremy’s life has inspired me in a profound and permanent way to always remember this and to live, inhabit, and appreciate each moment as fully as possible.

I feel compelled to share this piece with you, as a celebration of him and an acknowledgement of what he discovered and then rediscovered, the truth of which continues to echo and reverberate for us all.


To Die While Living

by
Jeremy Raymond Geffen
January 2004

Throughout history saints, sages, and mystics have spoken about the phenomenon of “dying while living.” What does this mean? And how do we do it?

Dying means letting go of the known, at the deepest levels. When a wave arrives in your life that is sweeping away what you have known and loved — or thought that you knew and loved – to die while living involves recognizing and acknowledging what is happening, and allowing it to occur, with as little resistance as possible. Holding on with desire, fear, longing, or regret only creates sadness, stress, anxiety, and pain — with no change in the outcome.

IMG_0123No one told us this when we were growing up. What a pity.

The antidotes to fear, stress, anxiety, and pain are surrender, trust, kindness, and unconditional love — directed gently from the Self to the self. They soften the blows of change, transformation, and death. They ease the way. They make the unbearable somehow bearable.

Growing up, no one told us this either. Most of us had to learn it the hard, old-fashioned way, through trial and error. And through surviving depths of pain, loss, heartbreak, and grief that we thought were not survivable.

Ultimately, grace and love make this possible. Grace and love make everything possible.

In the end, we are not who we think we are. Dying while living makes this clear. Most of all, we are not the separate, limited beings we think we are — despite all appearances to the contrary, and despite however real and compelling these appearances might seem. And who we think we are is not in control — despite our best efforts to prove otherwise, day after day, lifetime after lifetime.

To die while living means to discover these truths, while remaining present in the body.

To die while living means to consciously let go of who we think we are, while continuing to eat, breath, act, and move as needed.

To die while living means to watch whom we
think we are dissolve and disappear into nothing, while remaining awake and attentive — watching, feeling, and releasing whatever arises and falls away in the process.

To die while living means to let go of the known, and to leap, or fall — or crawl — into the unknown, and to keep going — and surrendering — no matter what happens.IMG_0051

To die while living means to touch, to notice, and to feel the infinite, tender, sacred presence of grace and love that guide this great mystery of life and death. This same sacred presence is revealed in our lives and our being in every moment — if we only stop to look, listen, see, and feel our deepest essence.

To die while living means to be completely, utterly vulnerable and uncertain — to say, “I don’t know” to all questions.

To be reborn is to have this really, truly be okay … perhaps for the first time ever.

==========================

My dear love, I remain forever yours, and forever grateful for who are and for the gift of knowing and loving you …

jeremy with chick

June 4, 2015: Jeremy’s Passing

D-J-02a - Version 2Dear Friends and Loved Ones,

It is with the deepest sadness that I share that Jeremy passed on two days ago, the night of June 1st.

As you know, Jeremy had been hospitalized last March with uncontrolled bone pain. He was hospitalized for over two weeks with a great team of doctors working hard to get his pain under control. When we returned home, he had another terrible pain crisis, and we made the decision to have a pain pump installed so that he could receive intravenous pain medication, along with at-home nursing care to better manage the pain. The pain pump helped relieve his pain, but he continued to suffer from bad pain and nausea.

Over the last several weeks, his condition gradually deteriorated. He lost over 40 lbs, ate increasingly smaller portions of food, became very weak, and struggled to get around the house. Then about two weeks ago, I noticed a significant decline in his health – he virtually stopped eating (except for ice cream, which he always loved), slept most of the day, and did not have the energy to speak with his friends, even on the phone. A week ago last Monday (May 25), he worsened even more significantly. At that point, it became clear to me – and the nursing staff – that he was beginning the active dying process.

Chris Trani, who had been the Training Coordinator for The Seven Levels of Healing program for many years – and over the course of their work, became a dear friend of Jeremy’s, and later also a dear friend of mine, flew out from Portland, OR, early on Tuesday, May 26 to come help us. A day later, Jeremy’s wonderful sister, Amara, flew in from Meadville, PA. Together, we spent the next few days caring for Jeremy, walking him through the dying process, and holding sacred vigil for his transition. It was an extraordinary – and also very difficult – week. There were some very sweet moments and also some really hard ones.

My focus as his partner and caregiver was to do everything I could to create a safe, gentle, peaceful, and sacred container for his passing. It was the sweetest gift I’ve ever given or received. Chris and Amara were instrumental in helping me to create this space for Jeremy.

On his last day, it became clear that Jeremy was very close to passing. He had become unresponsive and his breathing changed and quickened. Finally, at 10:25 pm, he passed very peacefully with me, Amara, and Chris together with him. There was a beautiful energy in the room, and it felt to me like he had transitioned from one group of loving hands to another.

I know that one of Jeremy’s great sadnesses over the last couple of months has been his inability to write another blog post. He really wanted to be in touch, but just couldn’t given his worsening condition. I am sorry that he did not have this opportunity – not only to update you, but to hear back from you, which has meant so much to him over these last months.

As his sweetheart, I feel I can say on his behalf: Jeremy loved (and loves) you all so much, and was (and is) so grateful for your being in his life. Thank you from both of us for all of your great love, encouragement, and kindness through these years of profound pain and suffering.

I fully trust that Jeremy is now surrounded by love, and residing in a peaceful place free from the suffering he endured in this life. At the same time, I am grieving deeply and in a very inward place right now as I try to wrap my heart around not having Jeremy physically with me. I only know to take my life moment-by-moment, and allow myself to feel whatever arises.

I send my love and prayers to you all as you move through your own waves, pools, and rivers of emotion.

Please know that we will be organizing a memorial service later in June. I will be sending out an email with details within a few days. It would be wonderful to have you there to celebrate Jeremy’s life, if you can make it.

With much tender love,

Kristina

Jeremy and Kristina in Maui 1:2014

Mar 27, 2015: Hospitalized

I am writing with another update; this time, from the University of Colorado Hospital, in Denver, where I was admitted on March 18th.

It is very strange to be writing from a chair next to my hospital bed, but it somehow feels important and helpful for me to share a bit of what has been going on.

These have been very difficult and critical days.

On Sunday morning, March 15th — after struggling for a number of days with worsening bone pain that had become increasingly impossible to control, along with increasing generalized weakness, a feeling of shortness of breath when lying down, and episodes of severe nausea and vomiting — I went to the ER at Boulder Community Hospital, in Boulder, CO.  Low and behold, I was found to be quite sick with pneumonia, dehydration, and anemia. I had also, quite clearly, become intolerant to the increasingly large doses of narcotic medications I had been taking for so long to manage the bone pain I’ve been struggling with for so many months.  The pain was now very severe.  After being admitted to the hospital, it was a huge relief to finally be able to collapse into the care offered by the doctors and nurses who were caring for me.

It soon became evident, however, that I was going to need even more expert and intensive treatment for the bone pain.  So — to my great fortune — on Wednesday, March 18th, I was transferred to the Acute Pain Management Service at the University of Colorado Hospital, in Denver.  This group is one of the few in the region that offers a fairly new and radical approach to treating intractable pain and opiate intolerance with a three- to five-day infusion of IV ketamine.  Ketamine is a powerful anesthetic and pain medication that can reset one’s opiate receptors when used in this way, and — for many patients — allow re-introduction of a simpler and more effective pain management regimen.  The technique is fairly new, and somewhat controversial.  It requires constant, careful monitoring of the patients’ cardiac and respiration functions.  But it is slowly gaining acceptance throughout the country as more and more studies show its potential and effectiveness.

The infusion started late in the evening of my my arrival on March 18th, and in my case, it ended up being a five-day infusion.  One of the hallmark features of ketamine can be a dissociative experience of feeling separated in some way from the extreme, painful drama going on in the body, and being able to observe one’s pain from a more objective perspective.  At the same time, it can deeply soften the normal psychological boundaries and defense mechanisms that arise in many situations in life, but especially in a serious, or life-threatening, circumstance.  In this context, the medication can promote a powerful relaxation of those ego boundaries and defense mechanisms.  Deep emotional lability and intense feelings of loss of control can surface.  Buried memories, visions, emotions, and insights can come flooding out.  And the process continues 24/7 … for five days.

This is certainly what happened to me.  The five-day infusion was as emotionally cathartic as it was helpful from a pain management perspective.  But is was not an easy journey to take.

After the ketamine infusion was completed on Monday, March 23rd, I was transferred to the oncology floor, where I am still residing.  We are now in the post-ketamine phase of the treatment. I’ve been started on methadone and IV dilaudid for breakthrough pain. It seems to be working, as the bone pain is under much better — but still not complete — control.  I am hoping that things will continue to improve and I will be able to go home sometime next week.

Meanwhile, in the midst of all this, I had a number of other serious medical issues that required attention.  I’ve been receiving IV antibiotics and supplemental oxygen for the pneumonia, which is also slowly resolving.  I’ve needed numerous IV sticks for continuous IV access and, after multiple painful attempts to start IV’s in my arms, I finally had a PICC line placed on March 24th for reliable IV access — another invasive procedure which I had hoped to avoid.  I was also suffering from increased pain with swallowing related to my underlying achalasia and the recent (February 9th) lower esophageal surgery I underwent. This pain was now exacerbated by the recent episodes of nausea and vomiting I’d had, caused by narcotic overload.

Very significantly, on March 11th — just a few days before coming into the hospital — I also began taking the daily oral targeted therapy vismodegib, which was recommended by multiple physicians to try and gain control of the cancer.  So far, I seem to be tolerating it fairly well, which is a huge blessing and relief.  We shall see in time if the drug is effective, or not.  But at least for now, it doesn’t seem to be hurting me.

The ordeal of these hospitalizations, and the intensity of the issues I’ve been dealing with, have been profoundly exhausting, painful, and scary.  They have brought the reality of my mortality, deep vulnerability, and lack of control — and the very real possibility of death from this cancer — more fully into my conscious awareness than ever before, by far.  All I can do is continue to walk the path each day, as best as I can, and see where it leads, trusting that I am somehow, and unmistakably, being guided in every step.   I know this is the deepest truth, even when I feel my heart breaking from the ordeal I have obviously, somehow, been destined to undergo at this time in my life.  I have been pushed to my limits, and beyond, over and over again — especially in this most recent process of dealing with these multiple problems, in the setting of such abundantly clear uncertainty and the unknown.

Kristina has been with me — as usual — every step the way.  She has been spending much of every day with me in the hospital, and staying at a nearby hotel in the evenings so she can get some rest.  We have both been exhausted by this process, and look forward so much to the possibility that things will, indeed, become stable enough so I will be able to safely, and confidently, return home sometime next week.  I am so blessed by her love and presence in my life.

I also want to acknowledge and honor the remarkably kind, caring, expert care and attention I have received from so many doctors and nurses at Boulder Community Hospital and the University of Colorado Hospital over the past two weeks.

If some of you have felt how even more out of touch I’ve been during this time in particular, I hope this blog post helps explain how utterly impossible it has been for me to stay in touch.  As always, this is doubly painful to me, because I treasure our contact so much.   It helps me to heal — especially when the night is darkest, as it has been recently.

So, until we can be in direct contact again, I send my love and gratitude for your continued love, prayers, caring, and good wishes.

 

 

Mar 8, 2015: Difficult Choices

This is a difficult blog post to write and share.

On February 23rd, I underwent CT scans of my chest, abdomen, and pelvis, as scheduled.  Compared with my previous scans in late January 2015, the new scans showed mild further progression of the many bone lesions I have been dealing with now for nearly two years.  The chest CT scan also showed a small (0.5 cm) lesion in the right lower lobe that is worrisome for a possible lung metastasis.  This was obviously disappointing to see.

On March 3rd, I returned to the University of Pittsburgh Hillman Cancer Center for a follow-up consultation with Dr. Tawbi, the wonderful oncologist who I originally met on February 3rd.  We reviewed everything in great detail.   There are three basic treatment paths I could pursue at this point.

The first path would involve treatment with one of the emerging immune-based therapies that have received so much promising attention in the oncology world over the past couple of years.  These drugs are not FDA-approved for treatment of sarcoma.  There is one trial that would be very relevant for me.  Unfortunately, however, as it turns out I am not eligible to participate because I do not meet the trial eligibility requirements.

The second option would involve trying one of two “targeted” drugs that have shown activity against cancers that have a gene-mutation that was discovered in the genome sequencing assay performed on my tumor about a year ago.  One of the drugs is available only in a Phase 1 clinical trial — which I am eligible for, but do not feel I can participate in because the logistics involved are overwhelming (for example, I would have to either move to Pittsburgh for two-three months, or travel there weekly for the first nine weeks — which I am just not strong enough to take on.)  The second drug is available off-trial, and has shown promise for patients with the gene mutation I have.

The third approach would be to pursue more conventional chemotherapy treatments, of which I have already received 11 cycles of two different chemo regimens (after three months of a different targeted drug, in the spring of last year). The chemo drugs did show evidence of improvement … but were accompanied by very difficult side effects.

Dr. Tawbi, and several other specialists I have consulted, have encouraged me to go ahead try the targeted therapy that is available to me right now.  Of course — as with any anti-cancer medication — there are very likely going to be more toxicities and side-effects.  This is no small matter, because I continue to struggle mightily every day with severe bone pain, requiring very high doses of pain (and other) medications, and fatigue.  I am also still healing from the achalasia surgery I underwent last month.  In addition, even though this drug is targeted against my particular gene mutation, it is unclear how well it will work.  Furthermore, taking this drug now (or any other anti-cancer drug, for that matter) will likely make me ineligible for a variety of potential clinical trials in the future, because it will be my fourth line of systemic treatment.  Most clinical trials require that patients have only received three prior lines of systemic treatment.

I acknowledge that the past number of weeks have been qualitatively more difficult than perhaps at any other time in my journey so far. The pain and fatigue that I have been experiencing have reached a new level.  The clinical data for any of the drugs available to me is also limited and uncertain.  Enduring this level of pain while also trying to make a decision between several less than optimal treatment choices has been extremely hard.  At times, I have questioned whether I even want to continue with treatment at all.

Nonetheless, after agonizing over these very difficult choices, I am inclined to go ahead and give this new targeted drug a chance.  Despite the challenges, I feel compelled to continue to try to find a way — at the very least — to stop the progression of my cancer.  This drug (that targets the genetic mutation I have) offers that chance, and even the possibility of a very meaningful response.  But it is unlikely to be an easy path.

I will be meeting again with my local oncologist early next week, and expect to start the new treatment soon thereafter.

Meanwhile, I want to say “Thank You” again for your continued love, prayers, and good wishes.  There is so much that Kristina and I have had to deal with in all of this.  Walking the cancer journey consumes so much time and energy, and has been exhausting.  This continues to make it extremely hard to stay in touch with family, friends, and colleagues more directly, which is very painful for me.  It is a great blessing to be in touch through this blog, and to receive your expressions of love, encouragement, and support.  Thank you again for reaching out, as you are able.  It means a great deal to me.

Feb 21, 2015: Post-surgery update, and next steps

A lot has happened since my last update on February 6th, and there is a lot coming up in the next two weeks.  I’m writing with another brief update.

To begin, I underwent the “POEM” achalasia surgery on February 9th, as planned.  This was undertaken to relieve the hallmark symptom of achalasia, which is difficulty swallowing due to constriction of the sphincter between the esophagus and stomach.  The surgery itself went well, but it was exhausting and the recovery has been more difficult and longer than expected.  I am still regaining my strength.  The swallowing symptoms — while definitely improved — are taking time to resolve as well.

Since coming out of the surgery, I’ve also had some very difficult, recurrent bone pain, particularly in several distinct skeletal sites (especially the lumbosacral area) which has puzzled me and my physicians.  It may represent tumor progression in these particular areas, or an unusual interaction with the general anesthesia, a combination of both, or something as of yet undetermined.  It is disturbing not to know.  However, I am very blessed to have the guidance of a wonderful palliative care/pain medicine specialist — Dr. Beth Mazzola — and she has been a God-send in helping me get the bone pain under control.   This is finally happening.   It has required taking very high doses of narcotics — which have their own unique array of unpleasant side effects — but there has definitely been improvement in the past few days.

In the midst of this, there has been one extremely positive development.  This past Tuesday (February 18th), I had a follow up MRI of my brain.  This was done to assess the effects of the stereotactic radiation I received this past November, as treatment for the very scary intracranial lesion involving the skull and underlying dura that was originally discovered last October.  Remarkably, the dura lesion was essentially completely resolved.  There are also no new lesions noted anywhere in the brain.  It is hard to overstate how positive and important this result is.  At the least, it opens the doorway for me to continue pursuing additional treatment options for the cancer as a whole.

As I’ve mentioned before, the treatment options available to me at this point are, unfortunately, limited — and it is not clear at all which one will be the best and most accessible next choice for me.  As a next step in trying to determine this, this coming Monday (February 23rd), I will undergo CT scans of the head, chest, abdomen and pelvis.  These scans will give a high-level overview of what is happening with the disease throughout my body, including whether or not there might be a bony site that needs radiation treatment.  The scans will also be important in determining my eligibility for potential enrollment in several clinical trials that my consulting physician at the University of Pittsburgh Hillman Cancer Center — Dr. Hussein Tawbi — is encouraging me to consider.

The trials he is proposing are complex and involve cutting-edge targeted therapies.   One involves a drug that can unleash the body’s immune system to more actively fight the disease.   The other two trials involve different drugs that specifically target an unusual gene mutation which was found to be present in my own cancer genome sequencing, performed in November 2013.  Each of these different trials have stringent eligibility criteria and unique logistical requirements, and each of the drugs involved have their own spectrum of side effects.  My eligibility for the trials is still uncertain, and I am not sure about which I would choose — if offered.

I will learn more about all of this when I return to see Dr. Tawbi in Pittsburgh on Tuesday, March 3rd — if I am strong enough by then to make the trip.   If I cannot participate in any of the trials, or feel that they are just not right for me — for whatever reason — I will have to make a decision about whether or not to continue on with more conventional chemotherapy treatments.   These choices are also not easy or clear at all.  I will just have to cross those bridges when I get to them.

In the meantime, my plate remains very full with continuing to heal and recover from the recent surgery; continuing to manage the bone pain I am experiencing; going through with the CT scans scheduled for Monday (February 23rd); and preparing for the trip back to Pittsburgh.  I also continue to do everything else I can to help myself get well, as much and as often as I can in the midst of this whirlwind.

As always, the loving presence and support of my beloved Kristina makes all the difference in the world.  It is hard to imagine walking this difficult path without her love and support.  It is also wonderful to have her mom, Jeanne Holmes-Buttner, visiting us for four days from her home in Florida.

The kind and incredibly beautiful comments and posts from so many of you also remain a great blessing for me.  Managing everything required to walk this path (and there is so much more I could say about it all ….) is not only exhausting, but extremely time consuming as well.  Staying in touch via the blog means a great deal.  Thank you again for taking the time to read the blog, and for staying connected as you are able.

With much love,

Jeremy

Feb 6, 2015: Trip to Pittsburgh and Upcoming “POEM” Surgery

Kristina and I had a busy and eventful week.  I’m writing to give you a brief update.

We flew to Pittsburgh on Monday, February 2nd, and made it safe and sound despite a big storm in the Northeast that day.   On Tuesday morning, February 3rd, we had a very meaningful consultation with Dr. Hussein Tawbi, the director of the sarcoma program at the University of Pittsburgh’s Hillman Cancer Center.

Dr. Tawbi was wonderful.  He is an extremely bright, caring oncologist — and very knowledgable about and experienced in dealing with rare and challenging sarcomas like mine.

He had a lot to share. Of note, he carefully reviewed the results of a gene sequencing assay that was performed on my original tumor specimen about a year ago, which actually revealed three specific gene mutations.  Dr. Tawbi feels strongly that one the of the three mutations in particular is a potentially viable candidate for treatment with one of two new “targeted therapy” drugs. One of these drugs is FDA-approved (although for a different kind of cancer than I have), but could nonetheless potentially work for me.  The second drug is being studied in a clinical trial that is available in his program.  He asked me to return to see him in a month, after undergoing another series of MRI and CT scans.  Right now, I am very inclined to go.

Dr. Tawbi felt that — given how severely exhausted I am from my last cycles of chemotherapy — it would be reasonable for me to take this time as a break off treatment.

We returned home Tuesday evening, feeling very tired but glad that we had made the trip, and gratified to have Dr. Tawbi on our team.

Also of note, Dr. Tawbi recommended — as have several other of my doctors —  that I go ahead with the surgical procedure mentioned in my last blog post, to try and relieve the difficult swallowing/achalasia symptoms I’ve been struggling with for many weeks, before proceeding with any further systemic cancer treatment.  I’ve decided to go ahead with this procedure  — called a “POEM” procedure (which stands for “Per-Oral Endoscopic Myotomy”) — this coming Monday, Feb 9th.  This will be done by a terrific gastroenterologist at the University of Colorado, in Denver, Dr. Norio Fukami, who I saw for a consultation on January 22nd.

I admit that I am daunted about undergoing yet another surgery at this time, for a variety of reasons.  First, I still feel quite weak and exhausted from the last cycles of chemotherapy.  The procedure also requires general anesthesia, which I have found from significant personal experiences takes a toll on my system.  There are also risks involved — as with any surgical procedure.  I’m also not looking forward to a post-op recovery time that requires a liquid diet for a minimum of two before the surgery, and four days after the surgery — and it is unclear how long it will really take to fully heal from this and eat normally again.   Nonetheless, I am convinced that this procedure is the best option I have available right now.  And I feel certain it is important to try.  I want to keep doing all I can to keep moving forward, and being able to get adequate nutrition is essential.

The surgery will happen on Monday morning, in Denver, and I will be kept in the hospital overnight.  If all goes well, I’ll be discharged on Tuesday and return home to Boulder.

There is a lot more I could say about all that is going on — but these are the most pertinent details for now.  I wanted you to have a sense of the highlights.

Thanks as always for your love and support…

Jan 31, 2015: A Current Update

IMG_1496It’s been another very intense two weeks on the cancer journey.

I had followup MRI scans of the spine on Monday and Tuesday, Jan 26th and 27th, as planned.  The scan results are somewhat complex and hard to interpret — which can happen in oncology more frequently than one might expect.  On the positive side, most of the bone lesions are stable in size after the last two cycles of chemotherapy, and there are no new lesions noted. This was really encouraging.  On the other hand, several of the existing lesions increased in size, and, unfortunately, the scans showed signs of recurrence of the worrisome problem involving the T3 vertebral body lesion that I’ve been following and treating for many months.  It is now, once again, coming close to the spinal cord. This is scary and unsettling.

On Wednesday, Jan 28th, I reviewed the findings with my medical oncologist, Dr. John Fleagle.  Given the complex findings — and the types and extent of treatments I’ve already received almost non-stop over the past 16 months — he agreed that the next steps forward are not clear.  

Yesterday, Jan 29th — which was Kristina’s 35th birthday — we went to see a radiation oncologist in Denver whom I’ve seen before, Dr. Dennis Carter, to hear his thoughts and opinions about whether or not the T3 lesion needs to be radiated again, and if so, how urgently.  He acknowledged that treating it now could be helpful, but felt that I have some time to make a final decision.

On Monday, Feb 2nd, Kristina and I are flying to Pittsburgh, PA, for a consultation on Feb 3rd with Dr. Hussein Tawbi, a medical oncologist who is the director of the sarcoma program at the University of Pittsburgh Hillman Cancer Center.  He is also the principal investigator of a number of clinical trials that could potentially be meaningful options for me at this critical juncture.  Hopefully, he will have other helpful insights and recommendations about how to proceed in this situation.  I am eager to see how that visit goes, and what he recommends.  We’ll be flying back home to Colorado on the evening of Feb 3rd.

In the midst of all this, I have unfortunately also been experiencing continued toxicity from the last cycle of Doxil (#4), that I received on Jan 8th.  For some reason, this cycle really wore me out.  I’ve been exhausted, and have had generalized stomach aches, nausea, and very low appetite.  Usually by this time after a cycle of chemotherapy, I have recovered and am feeling generally well.  But not this time.  It has been very discouraging.

If all this weren’t enough, in these last number of weeks I’ve also continued to struggle with recurrent symptoms of difficulty swallowing solid food.  This is caused by the rare achalasia syndrome that I was diagnosed with in 2011, at the time I was also diagnosed with sarcoma, and which I have mentioned briefly in previous blog posts.  Over the past three years, I’ve been treated four different times with endoscopic procedure that includes dilating the lower esophageal sphincter with a balloon, and injecting botox into the sphincter muscle to allow it to open more easily.  Initially, the treatment worked very well. But a year ago the symptoms recurred, and then again they recurred this past fall.

Last week, I saw a gastroenterologist at the University of Denver, who specializes in a relatively new endoscopic surgical procedure, called the “POEM” procedure (which stands for “peroral endoscopic myotomy”).  The procedure has a high chance of relieving the symptoms, but there are risks and potential complications associated with it as well.  It requires anesthesia, at least day in the hospital, and a recovery period of a week to ten days.  He has recommended that I go through with the procedure, and I am strongly considering it.

So, that is a brief overview of the current landscape. It is an understatement to say that our plates have been very, very full.  As always, Kristina and I are doing our best to sort through all these issues and challenges as thoughtfully and carefully as we can.  For now, more chemo or further interventions of any kind are on hold — at least until we return from Pittsburgh. I feel that my body and soul need a period of rest, and some time to recover and heal. Kristina and I continue to move through all of this one day at a time, with as much surrender, wisdom, focused action and intention — and as much heart — as possible.

I will keep you posted as things continue to unfold.

Meanwhile, I want to thank you as always for your love, prayers, and good wishes.  They continue to move and inspire me, and are a great source of comfort and encouragement. As always, I would so much like to be able to respond and be in touch directly with each of you, but with so many things swirling around right now, both inside and out, it is just not possible.  I hope you understand.

With love and appreciation …

Jan 17, 2015: My Sweetheart, Kristina Holmes

Last week I received my fourth dose of chemotherapy with Doxil.  The treatment was delayed a couple of days as I was fighting off a nasty cold, but I was able to proceed with treatment on Thursday, January 8th.  This cycle of treatment was again quite a difficult experience.  Lots of bone pain, fatigue, and generalized malaise, but not as difficult overall as the last one.   Fortunately, the symptoms are now starting to subside and I am beginning to feel more normal again.  I am scheduled to undergo more MRI scans of the spine, on January 26th and 27th, to assess how things are responding to the last two cycles of Doxil.  It is a nerve-wracking experience to be “on hold,” so to speak, and not know what the scans will show.  If they suggest the Doxil is no longer helping, I will have some tough decisions to make about what to do next, because the next options are not so great.  So, I am doing all I can to focus on staying positive, and trusting that all will be well.

IMG_1576 - Version 2Meanwhile, however, in this blog, I want to share about one of the greatest gifts and blessings of my entire life — my special, precious sweetheart … Kristina Holmes.

Kristina and I met in 2011, just shortly before I was diagnosed with cancer … and she has been with me every step of the way of this journey.  It is hard for me to imagine how I could have made it this far without her love, support, encouragement, and presence in my life.  She has been a true God-send to me.

Here is the short story of how we met, and a little bit about who she is as a person.

Kristina and I met in April 2011, in Boulder, CO, soon after I had begun developing ideas for a second book.  She is a talented literary agent, and we were introduced by a dear, mutual friend, Peggy Wrenn, who felt we might be a good professional match for my new book given our many common interests.  It’s not an understatement to say that the sparks were flying between Kristina and me during our first 2 hour meeting in her office in Boulder.  There was so much to talk about, and we were both excited by possibility of working together on this new book.  We met again about a week later at a local coffee shop to continue the conversation.

About 2 hours into this second conversation, it was absolutely clear to me that Kristina was a very special person, with very special qualities — and she was very beautiful, too.  As the conversation grew deeper and deeper, I slowly but surely came to the clear realization that I was very interested in getting to know her personally; even more so than pursuing a professional relationship.  The more I realized this, the more I found myself squirming around in my seat at the coffee shop, trying to figure out how to diplomatically tell her this.  Finally, I took a deep breath, and jumped in.

“Kristina,” I said, “I want to share something with you that feels risky for me to share, but it also feels important that I say it.  What I want to say is that, after all these hours we’ve spent talking, I realize that I’d really rather date you than hire you as my literary agent.  I know this is risky to say, and I hope you are not disappointed, but it’s honestly how I feel.  I’m just at that stage in my life where I’ve learned how important it is to speak the truth.  I have no idea how you will respond to this, but at least you know where I stand.”

Then, after a long pause, and after taking several really deep breaths, I asked, “So … what do you think?”

The look on Kristina’s face at that moment was a unique combination of shock, surprise, blushing, and trying hard not to look away.

After what seemed like an interminably long time, she finally responded.  She said, “Thank you for being so honest.  I really didn’t see that coming until you spoke it.  I’ve been concentrating so hard on your work, and your new book, that I wasn’t thinking about this other possibility.  But I am very open, and even interested, in getting to know you personally, too.  Unfortunately, though, I just can’t do it right now.”

My heart flip-flopped when I heard this, and I asked her “Why not?”

She replied by letting me know that she was at the tail end of a relationship that was essentially complete, but she needed some time to fully transition from that.  She was also leaving soon to go to the summer Book Expo in New York, and then to spend some time with her mom in Seattle.

“Oh no!,” I exclaimed. “Well, can we at least go out for lunch or dinner before you leave?”

“No,” she said. “I’m really sorry.  And I’m not saying no forever.  I’d really like to get to know you, too, on a personal level.  But I just can’t right now.”

Despite my sincere efforts to persuade her otherwise, she held fast to her boundary.  We agreed we would drop exploring working together professionally, and she left town about two weeks later, as planned.

I was really bummed.

Over the next several months, we had minimal contact until July, when she emailed me from Seattle, checking in to say hi and opening up the doorway to renewed communications.

IMG_1479 - Version 2We spent the next three months talking on the phone regularly, sending a lot of emails, and getting knowing to know each other even more deeply.  We were surely intrigued about each other, and eager to learn more.  Finally, we decided that I would come to Seattle to visit in person for the weekend, and also have a chance to meet her mom, who is a remarkable person herself.  So, on Friday, October 21st, 2011, I flew to Seattle. Kristina met me at the airport.  I rented a car, and we drove to spend some time with her mom.  Then, we left for an adventure at a small, beautiful hotel on Whidbey Island.  It was a deep dive together.  On Monday, I flew home.  The next day, we talked again and decided that Kristina would fly to Boulder that upcoming Friday, and we would spend ten days together.

Kristina arrived that Friday afternoon, and we had a peaceful weekend getting to know each other even more.

Then, the bomb fell.  The very next week I was diagnosed with cancer … while she was in the midst of our ten-day visit.

Just prior to my trip to Seattle I had experienced some pain in my calf.  An ultrasound and MRI showed a small mass in the right tibial nerve.  A top-notch surgeon in Denver said it was almost certainly benign, but needed to be biopsied.  I shared all of this with Kristina when I went to see her in Seattle, and she came with me to Denver for the biopsy during that ten-day stay.  A few days later, she was with me when the surgeon called to tell me that the biopsy specimen was not only not benign, but, in fact, it showed a high-grade malignant sarcoma.

In that moment, both of our lives changed forever.

After completing the call with the surgeon, I explained to Kristina that dealing with this tumor was going to take some real time and energy, and could become very serious.  As an oncologist, I fully understood, and explained, that it would require a complex surgery on my right calf, very likely many weeks of radiation, and a potentially long rehab process.  I also explained that the cancer could certainly spread at some point, and even eventually threaten my life.  I reminded her that we had not known each other that long, and that she had no obligation to stay.

What happened next was one of those rare “moments of truth” that can happen in one’s life, in which a turn of events can go in one of two completely different directions, and the consequences could hardy be more different.

I watched carefully as Kristina took a long breath, and then, without blinking an eye, said she felt inexplicably, but clearly, called to stay with me — at least until the surgery was completed.  And after that, we would see what felt right.

Amazingly, Kristina stayed with me leading up to and after the surgery, which took place the following month, on November 23rd, the day before Thanksgiving.

And we’ve been together ever since.

It is hard to find words that adequately describe the intensity of the roller-coaster ride that we have been on together over the past three-plus years.  All I can say is that — by some inexplicable miracle of Grace — Kristina has been there with me, accompanying me through multiple surgeries; serious infections; dozens of MRIs, CT scans, and PET scans; weeks and weeks of radiation; countless consultations and follow up visits with a large number of doctors and specialists; five separate trips to Memorial Sloan-Kettering Cancer Center in New York; and multiple rounds of exhausting, debilitating chemotherapy.  We even moved together to Asheville, NC, in July 2013 — when I was in remission and where I had been recruited to be the medical director of the Mission Health System Cancer Center.  And then, when the cancer metastasized further in the Fall of 2013, we moved back to Boulder, CO together, in December 2013.

Through it all, Kristina has been unflinching in her capacity to remain steady and present in the face of the intense pain and sorrow, losses, struggles, and the ongoing uncertainty we’ve been living through — including the ultimate confrontation with the very real possibility that I could die from metastatic cancer.

IMG_2230 - Version 3I have marveled, so many times, at Kristina’s profound inner strength, and her commitment and determination to do all she can do to help me find a way to fight and heal and live — while simultaneously remaining fiercely committed to her own deep, inner psycho-spiritual growth, healing, and awakening.

If you ever wondered if “miracles” and “angels” are real, look no further.  For me, Kristina has been and is both a miracle and an angel in my life.

I’m not suggesting that our personal journey together has not had its share of challenges, beyond those inherent in dealing with cancer, because it most certainly has.  We had virtually no time for the “normal” kind of romance that most couples enjoy before the almost universal challenges of life and relationships surface.  From the very beginning — literally within days of spending our first close, personal time together — we were catapulted head-long into an incredibly difficult and intense cancer journey; one which continues even now, and which continues to consume the pretext of any semblance of “normal” life — the yearning for which is such a sweet, tender, and naturally human longing.

We’ve had to learn how to work through the issues and challenges that most couples experience, in any relationship, while walking through one of the hottest fires either one of us could have ever imagined.   We’ve had to consciously grapple with one of the central paradoxes inherent in relationships — namely, how to honor and care for your partner, and yourself, in a truly honest and authentic way — without betraying yourself or them.  This is hard enough under so-called “normal” circumstances.  It is vastly more complex and challenging when one partner is facing a life-threatening illness like cancer, and virtually everything about the future is uncertain.  This is what we have been living through, from the very beginning.  Over and over again, I have been amazed by Kristina’s capacity to hold space, with as much kindness, compassion, and self-awareness as possible, for the myriad challenges we have faced along the way.

IMG_2282 - Version 3And yet, somehow, by some great mystery, and through some incredible Grace, we’ve been able to forge a way through these fires.  We’ve made it through these three-plus years and are more profoundly connected than ever before by a deep love and caring for each other, and a commitment to each other’s well-being.

Kristina’s incredible strength, devotion, dedication, and capacity to love in the midst of such an inferno is profoundly unique, and inspiring.  I have been deeply blessed by her presence in my life.  And — once again — I don’t know if, or how, I could have made it this far without her love, wisdom, and support.

So, I am very honored and happy to finally have this chance to write and share about my beloved sweetheart Kristina, with those of you who are following this blog.  She is an amazing woman, and a great being.  I am profoundly blessed and grateful to be with her.

Jan 3, 2015: Bridging the Worlds of Science and Spirituality in Cancer, and Life

One of the greateMedicine Buddha Thangka 2st gifts of my life has been the incredible opportunities I have had to deeply explore many of the world’s great spiritual and healing traditions — while also having the privilege of pursuing a deep and fulfilling career in science and medicine.  In many ways, my entire life has been an ongoing exploration of the interface between the vast domains of science and spirituality.

Now that I am walking the cancer journey as a patient — facing a very serious and uncertain prognosis, with difficult challenges along the way — this exploration of science and spirituality, the dance between them, and what I have learned in the process, has become an even more integral part of how I am living each day.

Because this exploration has been and remains such an important part of my life, in this blog post I would like to share some of the key highlights of this process and how it has evolved over the many years of my life so far.  As a result, I acknowledge this is a longer-than-normal post, because it covers a great deal of territory.

My spiritual path began as a child, growing up in a Jewish household with very special grandparents whose devotion, kindness, and sensitivity to the plight of others touched me profoundly.  As a teenager, like many others of my generation, I discovered the Eastern spiritual traditions.  I was drawn in like a moth to the flame, dived in fully, and kept going.  My first formal teacher was the Korean Zen Master Sueng Sahn, who I met and studied with while I was a student at Brown University, in 1976, at age 19.  He was an amazingly clear and powerful Zen Master, who really “showed me the ropes” about the Zen tradition, and Zen meditation.

During that time, I also met Ram Dass at a lecture in Boston.  He had returned some years earlier from a trip to India, where he met the great Indian saint Neem Karoli Baba, also known as Maharaj-ji, who became his guru.  Along the way, his life was transformed from the Harvard professor Richard Alpert into the spiritual teacher Ram Dass.

Neem-karoli-babaNeem Karoli Baba had died in 1973, and yet, at that lecture, I was profoundly moved by a sense of his extraordinary and powerful presence before me, in an unmistakably real, tangible, yet spiritual form.  My head and heart were blown wide open.  A sacred bond was established that has never been broken, and has impacted my life ever since.  After returning to Brown, I began to have powerful, spontaneous kundalini experiences, deep experiences in meditation, and a feeling that I somehow couldn’t keep functioning in the “normal” world.  It was scary and disorienting, but Maharaj-ji’s presence was never far away.

My efforts to make sense of what I was experiencing — and the impact of seminal books I was reading at the time, such as Yogananda’s Autobiography of a Yogi, Ram Dass’ epic Be Here Now, and many others — soon made it clear to me that I wasn’t going to find what I was searching for in a university.  I could not resist the expanding call for inner, spiritual exploration and understanding that was resounding in my heart and soul.  So, in June of 1976 I dropped out of college to pursue the spiritual path full-time.  On my way from Providence, Rhode Island to New York City, where I was going to meet a friend and move to California, I was involved in a horrific single-car accident on the Connecticut Turnpike that should have killed me instantly.  And yet — in a way that can only be described as miraculous — I emerged from the accident not only alive, but physically unscathed.  How I walked away from that car wreck was completely inexplicable by any rational analysis … but it happened.

Ma JayaThree days later, through a series of equally inscrutable events, I met a remarkable Hindu spiritual teacher named Ma Jaya Sati Bhagavati, who was teaching at a Jesuit Monastery in Staten Island, New York.   Within moments of meeting her I knew I had found the next phase of my spiritual path.  That very day, I moved into her community in Queens, New York.  A year later, I joined her and a small group of students in Florida, on a 40 acre parcel of land with two houses and a beautiful pond, where we began to create an ashram that quickly grew and continues on even now.  I spent four years living with Ma Jaya and her expanding community of students.  During this time, I became a vegetarian, and spent hours a day practicing yoga and meditation, diving deeply into the ocean of Hinduism and Vedic knowledge, and exploring the mysteries of the student-teacher relationship.  Those years helped me to establish a spiritual orientation to my life that has continued ever since.

After fours years in the ashram, however, another powerful, undeniable inner call appeared in my heart; the call to return to the more conventional world, go to medical school, and become a doctor.  Becoming a doctor had actually been a dream of mine since childhood, but was submerged in the tumult of growing up and the subsequent imperative of pursuing a spiritual path. After months of inner struggle about making such a momentous decision — which would require leaving my teacher and community — I left the ashram, moved to New York, and enrolled at Columbia University.   Two years later, I completed college and was accepted into New York University School of Medicine.  Enthusiastically, I dove as fully into my medical studies as I had into my spiritual studies in the ashram.

Even while in medical school, the inner spiritual calling I felt in the depths of my heart never diminished.  In 1984, when I was a sophomore in medical school, I went to Nepal as part of a medical expedition to a remote village in the Langtang Valley in northern Nepal, on the border of Tibet.  Here, the universes of Tibetan Buddhism and Tibetan Medicine opened up before me like another vast ocean of knowledge and wisdom.  Camping along the trail to Langtang, I feasted my eyes each morning on stunningly beautiful mountain vistas of Tibet that lay just over the border from Nepal, and was moved to tears.  Along the way, I devoured amazing books on Buddhism and Tibetan Medicine, including Lama Anagarika Govinda’s classic The Way of the White Clouds, and felt an inexplicable, powerful call to visit Tibet.  While on this expedition in Nepal, I spent time with a traditional Tibetan healer, and discovered the world of Ayurvedic Medicine as well, which is also practiced in Nepal and was barely known in the West at that time.  Exploring these sacred traditions was like another, exciting home-coming; a reunion with something deep and ancient and yet completely familiar to me.  I knew that somehow, I would return to this part of the world, and keep exploring.

JRG - India (1986)-reducedAt the completion of the six-week medical expedition in Nepal, I made my first trip to India, to visit Neem Karoli Baba’s ashram in Kainchi, near the beautiful town of Nanital, in northern India.  I was again profoundly moved by the power of Maharaj-ji’s loving presence, which permeated every inch of the Kainchi ashram.

Upon returning to New York, I continued to explore these extraordinary Eastern traditions while simultaneously continuing my Western medical studies. This included working on a variety of cancer research protocols, while also researching and publishing work on the use of alpha-interferon as a treatment for human papilloma virus infections, which formed the basis of my medical school honors thesis.  It was a large leap from the Eastern spiritual traditions I’d been studying in Nepal and India … to the world of science and high-tech, academic medicine that I was now fully immersed in.  But I felt compelled to traverse this broad divide as fully and completely as I could.

Then, two years later, in 1985, while I was a senior in medical school, my father was diagnosed with an aggressive gastric cancer that had already metastasized at the time of his diagnosis. Tragically, he died less than four months later, at the tender age of 60.  This was, to say the least, a shattering experience for him, for me, and for my entire family.  Remarkably, I had already known — from the first week in medical school — that I was going to become an oncologist.  It was very clear to me that oncology was a field of medicine that, perhaps more than any other, involves some of the most advanced, sophisticated forms of science and technology … yet also touches some of the deepest questions about the human heart and soul, and the great mysteries of life and death.  I immediately knew that oncology was the field to which I wanted to devote my career.  I just never imagined that I would be plunged into the questions and challenges of cancer in such a deeply personal way.

My father’s death from cancer in early 1986, when I was 29 years old, was also a turning point in my medical career.  I was horrified to experience, first hand, the harsh insensitivity of the purely mechanistic approach of the western medical model, and its failure to address the human dimensions of what many people experience in the often agonizing process of dealing with cancer.  I vowed to do all I could to transform how patients and loved ones are cared for, in a real and tangible way.  A few months later, after my father’s death, I had a clear vision that I would become a fully-trained and credentialed oncologist and one day build a cancer center that embraced and integrated many forms of healing that could help patients and families heal and transform at a deep level.  Accomplishing this required first completing three years of post-graduate residency training in internal medicine, which I did at the University of California at San Diego Medical Center.

Dalai LamaDuring that time, I traveled to Lhasa, Tibet, diving more deeply into Tibetan Buddhism and Medicine, and then to Dharmsala, India, where I continued these explorations and was blessed to meet the Dalai Lama for the first time.  Some years later, I was honored to give a plenary talk at The First International Congress on Tibetan Medicine, in Washington, DC, titled Gifts from the Medicine Buddha: Three Jewels for the Practice of Modern Medicine, in which I was able to share some of my thoughts on how this amazing tradition could contribute to modern medicine, and to life.

After returning from this trip to Tibet and India, I completed my residency training in internal medicine, and went on to complete three additional years of fellowship training in hematology and oncology at the University of California at San Francisco Medical Center.  These were very challenging, but exhilarating, years, as I moved closer and closer to my goal.

After completing fellowship training, I finally became a board-certified medical oncologist and fulfilled my vision from medical school when, in 1994, I opened an integrative cancer center, the Geffen Cancer Center and Research Institute, in Vero Beach, Florida.  My staff and I offered leading-edge conventional medical treatments for cancer, along with a wide array of complementary healing modalities for patients and families.  At the base of all of this, however, our treatment was offered in a spirit of genuine respect and caring for the well-being of our patients and their loved ones. It stemmed from a true desire to do all we could to help them heal, as fully as possible, and to experience love, support, connection, and the feeling of being truly cared for — on all levels of their being.  To me, this is the fundamental shift that has to occur for medicine to fulfill its ultimate potential.  It felt wonderful to be able to help and support so many people in this way.

JTC-Front Cover (Final)In another powerful vision that occurred during this time, our approach was developed into a coherent body/mind/heart/soul/spirit program for whole-person cancer care, called The Seven Levels of Healing.  In 2000, I published the first edition of a book — The Journey Through Cancer: Healing and Transforming the Whole Person  which describes this program and whole-person approach in detail. The Seven Levels of Healing is a powerful map of what human beings encounter in the search for wholeness and healing on the cancer journey — or in the face of any serious life or health challenge.  Even more, it demonstrates a way to skillfully and effectively support patients and loved ones — as multidimensional beings — within the context of mainstream medicine.  This map became the foundation of the care that my staff and I offered to thousands of patients and loved ones over ten years, and it has guided my support and care of others ever since — including myself, on my own cancer journey.

In 2003, it became clear that my time practicing medicine and running a cancer center was complete.  I wanted to see if I could bring The Seven Levels of Healing program to a wider audience, and implement it successfully in other cancer centers — which I was able to do over the next number of years through my consulting company, Geffen Visions International.  But at a deeper, personal level, the calling for greater inner healing and understanding was compelling me to leave the day-to-day practice of medicine and devote myself more fully to exploring other healing and spiritual traditions.

These explorations involved four great paths, among others.

Papaji-laughing72To begin, one of the most profound and important events of my life occurred in 1994, when I traveled again to India and met the great spiritual master, H.W.L. Poonja, affectionately known as Papaji to the thousands of seekers who came to see him over many years at his home in Lucknow, India.  Papaji was a direct disciple of Ramana Maharishi, one of India’s most renowned and revered sages.  Papaji was himself a realized master in the Hindu tradition known as Advaita, which honors the oneness of all life and recognizes consciousness as the ultimate substratum of existence.  Papaji introduced me to this ancient tradition, and its profound approach to life.  I was deeply privileged to spend many hours in close, personal contact with him on several more trips to India before his death in 1997.  He remains a shining star in my heart and soul, and I was indelibly changed by his presence in my life.

Another profound domain for me was the field of transpersonal and Jungian psychology.  This was initially facilitated by an extraordinary transpersonal psychotherapist, Dr. Sandy Sela-Smith, who I first met in 1999.  Under her incredibly wise, gentle, and skillful guidance, I pursued over many years a long and extensive exploration of my life and personal history, and discovered profound dimensions of healing that can be accessed through a conscious exploration of the human psyche and soul.  Sandy helped me to discover and heal wounded parts of myself that had been buried for decades, that were crying for love, acceptance, and expression.  It is hard to describe how profound and transformational this process was, and continues to be, in my life.

Next, in 2004, while continuing to work with Dr. Sela-Smith, I met Dr. Stanislov Grof — the renowned psychiatrist; one of the founders of the field of transpersonal psychology; and creator, along with his beloved wife Christina Grof, of Holotropic Breathwork.  The extraordinary understanding and technology of Holotropic Breathwork offers participants — in an exquisitely designed, safe, group setting — access to deep, inner healing resources and unconscious parts of the human psyche that include and transcend one’s personal biography, and which often contain the psycho-spiritual roots of illness and disease.  I enrolled in his training program and four years later became certified as a Holotropic Breathwork Practitioner.  I have tremendous gratitude and admiration for Dr. Sela-Smith, Dr. Grof, and the leadership of the Holotropic Breathwork community, including Tav Sparks, Diana Medina, Diane Huag, Matthew Stelzner, and others.  The psycho-spiritual healing and insights I received from their guidance and skill have been life-changing for me.

In 2007, I discovered an entirely different world of healing: shamanism, indigenous healing traditions from North and South America, and the sacred plant medicines Ayahuasca, Peyote, and San Pedro.  I met a South American shaman and dived deeply into the world of shamanic medicine and healing, making multiple trips to South America, participating in astonishingly deep and transformative healing ceremonies, vision quests, and sweat lodges, and experiencing profound inner revelations.  For a while, I actually thought I would become formally trained as a practitioner in these traditions.  However, after several years, and for a variety reasons, my relationship with this shaman ended.  This was a very disappointing turn of events, and I was unclear about the direction my life would now take.

Then, four months later, I was diagnosed with cancer, and my entire world was turned upside down.

As I have shared in this blog, the cancer was diagnosed at a relatively early stage, and at first it looked like I would be cured.  But nearly two years later it returned, and then, just over a year ago, it began to spread — catapulting me even more deeply into the efforts to heal and survive, which still continues.

Along the way, for all these years — and during my entire cancer journey — I have been traversing the two worlds of science and spirituality, which have been the focus of my life for so long.  I have been trying as hard as I can to understand who I am as a human being, the meaning and purpose of my life, and how to best help myself and others to heal in the face of the great paradoxes and challenges of modern life, including cancer.

My intention has been to navigate between these worlds as consciously and skillfully as possible, and integrate the best and most important gifts and technologies they have to offer.  As a cancer patient, this integration has not been easy; first of all because the medical model — in which I was trained and practiced for many years, and which I respect on so many levels — openly acknowledges its limitations in treating, let alone curing, metastatic cancers such as the one I have.  It focuses almost exclusively on the physical dimensions of health and disease, and does not acknowledge, let alone understand, that who we are as human beings extends far, far beyond the physical realm.  Nor does it acknowledge the tremendous healing potential that can be accessed and received in the spiritual realms of life.  Nonetheless, the medical world clearly has an important role to play in my efforts to heal and live.  At the same time, the spiritual world — including the incredibly profound healing traditions I have loved and explored so deeply, and which are filled with exquisite and vital insights, treasures, and healing potential — cannot offer a clear or reliable path to a cure for me, or anyone, as well.

TeepeeOver this past year I have been blessed to connect with a beautiful community of people involved in the Native American Church, which embraces many elements of the Native American worldview and traditions.  I have participated in a number of traditional ceremonies that have been greatly healing and inspiring for me.  It is extraordinary to experience the healing energy that is created when a group of sincere, loving people gather together in a teepee, around a carefully-tended fire, for a time of sincere prayer and gratitude, and with the intention of facilitating healing for everyone.  What an incredible gift!

In the midst of all this, I am continuing — at least for now — with chemotherapy treatments, radiation treatments as needed, and regular visits with my conventional medical doctors and specialists.  I also continue to pursue a variety of complementary and alternative healing modalities that make sense to me, which feel safe and grounded, and which I find inspiring and helpful.  Most recently, on the medical front, I’ve been receiving the chemotherapy drug Doxil, on a monthly basis.  I have received three cycles to date, and have found that I generally recover from the side effects of this drug after a couple of weeks.  I am finding the courage to continue with this treatment as long as it continues to show evidence of positive benefit, which it most certainly has — although not without challenges.  Next week, I will receive my fourth cycle of Doxil, and we shall see what happens thereafter.

I am also continuing to gratefully receive the blessings of the spiritual traditions that have so deeply touched and informed my life.

In the end, it all remains a Mystery.  I  continue to do my best — pursuing the deepest blend of science and spirituality that I can find and imagine and create — while working closely with my doctors and healers to see what might be possible.

The journey continues to unfold, as I have also shared, with “focused action and intention, wrapped in the arms of surrender” … one day at a time.

I hope this overview of my journey to bridge the two vast worlds of science and spirituality will be meaningful for others  — especially those who are struggling to find a synthesis that speaks and makes sense to them, wherever they may be on their own journeys in life, or in dealing with cancer.

Thank you again for your love, support, and good wishes.

Dec 19, 2014: One Day at a Time

On December 9th, I received the third cycle of my current chemotherapy treatment protocol with the drug Doxil, as planned.  I had great hopes that this cycle of treatment would be easier than the previous two, as my body was now at least familiar with the drug and its side effects.  I was also feeling prepared and encouraged to be moving forward with more treatment.  As it turns out, however, an old adage that I have loved for a long time proved true in this situation — as it has in so many other situations in life.  And that adage is: “Man makes plans while the Gods laugh.”

Well, the Gods were certainly laughing this week.  36 hours after the infusion, I awoke with some of the most severe, intense bone pain that I have ever experienced.  Like really severe, 8-9 out of 10 bone pain, that felt like I’d been hit by a truck.  The pain persisted for several days, and required very high doses of narcotics and extra steroids to get under control.  My doctors’ explanations ranged from: “I have no idea why this is happening” … to: “This is a sign of an inflammatory reaction to the cancer cells dying in response to the chemo treatment.”  Slowly, slowly I’ve been doing my best to get though this painful period, as my wise and beloved uncle would say, one day at a time.  I’m feeling very thankful that over the past couple of days the pain is subsiding and I’ve been able to begin tapering off the high doses of medications.  But it has been an exhausting process, compounded by a deep, visceral fatigue and generalized aching that is often associated with Doxil.

Making matters only more challenging, the drugs seem to have exacerbated another rare condition that I’ve been dealing since the time of my initial cancer diagnosis — called achalasia — which can make it hard to swallow.  (I’ve mentioned this briefly, in a previous blog, and will perhaps write more about it another time.)  I underwent an upper endoscopy procedure for this on December 4th, with initially good results that seemed to dissipate after the chemo-induced pain and other symptoms kicked in after December 9th.  Sometimes, when it rains, it really does pour.

In this context, my life over the past ten days has slowed way down.  As at many other times on this long and winding road, I’ve once again been forced to take things one day at a time … doing my best to get through it all, and trying to remember that this is a process with unpredictable ups and downs.  It’s hard for me because there is so much I still want to do, and to write, and share — especially in this blog, and in a book of insights and lessons I have learned on the healing path, from so many perspectives, over the course of my life.  I long to be more active, and feel some semblance of being in control … and it’s just not possible right now.  It’s another reminder that I still have to slow down and allow the process to unfold, at its own pace  (“Focused action and intention, wrapped in the arms of surrender”).

I continue to learn more and more about embracing the great unknown at every step of the way on this journey.  It’s impossible to know what will happen next.  But I am still walking the path, as best as I can — and, right now — one day at a time.  

Thank you again for your love and prayers, and for your wonderfully kind, caring, and heartfelt comments on the blog.  They truly mean a lot!