Saturday, December 31, 2022

A Little Bit of a Statement

I had a note from my primary care physician last night, following up on those raw chest CT results:

The CT chest results came back abnormal. Please keep your appt in January, we will discuss this in more details. I will also send the referral to the lung doctor.

Potentially bad health news always gets me thinking about certain things, things I suppose it gets everyone thinking about. Specifically, 1) mortality, 2) responsibility, and 3) options. It also generally results in a certain attitude on my part that I'd like to share before there's any chance that I might turn into a fearful, whiny, blame-shifting, first-four-stages-of-grief type. So:

  • Mortality: Absent massive advances in medicine and technology and so forth, we're all going to die. I won't try to bullshit you by claiming I like the whole idea, but at least as far back as my teens I've accepted the proposition, and for a long time expected my own death to come fairly early. I drove fast. When I joined the Marine Corps, my wanted and expected MOS was infantry, not admin clerk.  Both in and out of the Corps, I engaged in reasonably risky physical behaviors like crawling through caves, rappelling off of cliffs and helicopters, etc. I tried several ("illegal") drugs widely considered scary and dangerous, although I never became a habitual user of those. And yes, I started dipping snuff at 12 and smoking at 16. It's not that I believe in a Big Rock Candy Mountain afterlife or anything like that (I just don't know what, if anything, happens after one dies, although I engage in some comforting speculations and childhood-inculcated fears). It's that I have preferences as to how to live, and that I've allowed those preferences to outweigh any dread of dying.
  • Responsibility: That's mine. All mine. Big Tobacco didn't tie me down and shove cigarettes in my mouth. I knew from childhood ("Surgeon General's Warning ...") that they were referred to informally as "coffin nails" for a reason. The Marine Corps' (very effective) recruitment approach is to discourage potential enlistees with stories about how difficult and dangerous it is, and I grew up in the shadow of Vietnam with stories from veterans (and their surviving family members),  e.g. Apocalypse Now on the screen, etc. I heard the "just say no to drugs" messaging. I got the lectures on how I was going to get myself killed skateboarding, rock-climbing, etc. I cannot say I wasn't warned, repeatedly and stridently, about every dangerous decision I made. I made them. Me. Nobody else. If I die because I did stupid things, the stupidity involved was and is mine and mine alone.
  • Options: Here's where it gets variable. I've known many people with terminal or likely-terminal diagnoses/prognoses. Some of those people have chosen to take every conceivable offered measure to extend their lives. Their call to make. For me, it's a cost-benefit thing. If I'm told I have six months to live in relative comfort, or that I can possibly extend that to 12 months with a series of measures that are painful to me and inconvenient to my family, I plan and hope I'll stick with the plan, to go with the six months. I've always thought I'd rather have six not-too-terrible months than 12 really bad months, knowing that the end is coming either way. But I suppose I might change my mind when it actually comes to that fork in the road.


A digression based on the "options" section:

I know many people who are interested in, have researched and used or practiced, etc., "alternative medicine." Nothing against that, and if I get a diagnosis justifying it I may well try a thing or two -- especially of the palliative, but also possibly of the treatment, variety.

I also know a few people who spend a lot of their own time and energy on "life extension" in general. Again, nothing against that. If it's how you roll, I hope you're enjoying life. For me, it comes back to something like the "six not-too-terrible months versus 12 really bad months" thing. I've always found it interesting, but not interesting enough to set aside much time or energy for. Spending 40 hours enjoying life less in the hope of getting an extra 40 hours to also enjoy less because I'm using that 40 hours to try and get another 40 hours isn't my idea of a good investment. But some people enjoy the quest itself, so they're getting a good deal either way, aren't they?

Anyway, the real takeaway I hope you'll get out of this post is that if I later suffer some kind of breakdown and start whining about it all and trying to blame others for my impending death, that will just be bullshit. I expect to die, and unless a drunk driver falls out of the sky and lands on me or something, I expect the way I die to have been a reflection of my life choices, not something unfairly inflicted on me by others.

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