The surgery that will change my life
When I first met my surgeon after receiving my diagnosis, he had a frank discussion with me.
“You’ll need to have an 8 to 12 hours long surgery to remove the stomach and the esophagus.”
I extrapolated what he said and understood that this was not going to be a small surgery. In essence, this type of surgery has the same effect as bariatric surgery, usually offered to patients when weight loss is unsuccessful despite aggressive lifestyle changes and medication. At a height of 6 feet and a weight of 143 lbs, many would consider me to be lean. To some, this might seem to be a gift, but in my case, my inability to gain weight, having weighed 140-145 lbs my entire adult life, is rather a nuisance. Weight loss through a bariatric-style surgery is a legitimate concern for me.
“You’ll need to eat small, frequent meals.”
I’ll have to find ways to eat 6 to 7 meals a day at set times, regardless of whether I were to be hungry. Again, weight loss is a legitimate concern for me, but I’m sure I’ll adapt.
“There is a 5% chance of a leak, which is life-threatening.”
I would have been surprised if the surgery carried no risk. I convinced myself that the surgeon looked diligent, and that the 5% will surely be reduced to 0%.
“You’ll need to sleep at a 45 degree incline for the rest of your life.”
Can’t afford to choke on digestive fluid in my sleep. I’m sure it won’t be a big deal.
“This surgery will change your life.”
My life… will never be the same. I replayed what the surgeon said to me over and over again in my head. As a physician, when I deliver difficult news, my interaction with a patient lasts 15 to 30 minutes. Some patients respond with tears, while others remain stoic (such as myself). It has never occurred to me that the patient can take the doctor’s words, and replay them 5000 more times for weeks on end. How I felt in my surgeon’s office had no correlation with how I felt when I got home. The seed of bad news that was planted in the office became a tree by the time I got home. Bad news are exhausting. I’m still having a hard time visualizing my future lifestyle, but for now, I need to focus on the fact that the surgery will help save my life.
It has never occurred to me that the patient can take the doctor’s words, and replay them 5000 more times for weeks on end.
Creating the bucket list
My surgeon insisted that I focus on fulfilling a bucket list before my treatment started. Chemotherapy, at the time, was still a month away, which meant I had a month to “enjoy life.” My initial understanding of a bucket list was a list of all the life experiences and dreams I need to fulfill before I die. This included visiting all 5 continents, skydiving, flying on a hand glider, scuba diving, and one day going to space. Many of these items were simply not feasible when you have an unpredictable bleeding mass in your stomach, and had to be close to a hospital. Stephanie, my partner, suggested that we go on local adventures while I still had the energy to do so. This idea quickly died when we realized our appointments for the month. In preparation for chemotherapy, I ultimately had 16 appointments scheduled with doctors, counselors and a dietician. I spent 3 days admitted at the hospital for a diagnostic laparoscopy, which is a minor surgery under general anesthesia to see how far the tumour had spread inside my abdomen. I underwent a handful of imaging tests that required fasting and a half-day of waiting. While the calendar was packed, we did spot a few holes of free time and we had managed to organize 3 days of surfing in Kincardine, Ontario, a 3-hour drive away from Toronto where we live. The idea was to get away from the city, spend some time together surfing, and come back in time for our PET scan. The morning of that trip, I got a call from the PET scan technologist to review the preparation needed for the day of the scan. It turns out that I wasn’t allowed to do anything strenuous, such as jogging or riding a bike, for 3 days prior. To preserve our trip, we had tried to envision ways to surf without exerting too much, and discovered that the only way to do so was…. to not surf at all. My FOMO did not outweigh the risk of a false positive. We ended up cancelling our trip. We had other traveling ideas that were also shut down, as there was simply not enough time to enjoy them.
Redefining the bucket list
The very things that stopped me from fulfilling a bucket list became the bucket list.
My bucket list was further transformed as the month went by. With a good chunk of the month dedicated to being inside a waiting a room, I started making plans to catch up with friends and family at the hospital. I figured that we were going to talk about my diagnosis at some point, and there was no better way to share my journey than to have them walk beside me. Unexpectedly, I enjoyed unique moments with close ones during these outings. This is when I realized that in the process of accomplishing non-bucket list items, I discovered what really mattered to me. It wasn’t going on global adventures or having unique lifetime experiences. It was simply spending quality time with friends and family, and nurturing those relationships. Nothing else mattered. My numerous medical appointments facilitated these priorities. The very things that stopped me from fulfilling a bucket list became the bucket list. My new list did not generate as much adrenaline as my old one, but it doesn’t mean I didn’t derive the same, if not greater, satisfaction from it. In doing so, I worried less about the future, and focused more on the present. In the end, the remedy against bad news recurring in my head wasn’t about seeking new experiences, but rather opening my eyes to things around me that I took for granted. In my case, it was quality time with family and friends.