Chapter 53: rediscovering music; old self

 

Rediscovering music; old self:

Around the middle of October 2021, without work as a physician, I began to lose a sense of purpose. Although through writing I still felt that I was making some minor contribution; anything small to prove to the world my existence. I signed up for various volunteer opportunities—none that came to fruition—as well as a local medical orchestra through the university. I received emails for the orchestra amid radiation therapy and in no condition to go to regular rehearsals or practice. After I missed the first rehearsal it felt as though the train had left the station. While I still received emails and was assured that I could join at any time, something inside me told me that I shouldn’t or that I couldn’t. Would I even be able to practice adequately to be a quality addition to the orchestra? For goodness’ sake, I could barely read music while playing violin anymore because of my visual deficit, or so I had told myself. I was scared: I didn’t want to discover that after all this I had become a bad musician, that I had experienced a death beyond than that of my vision. So, I ignored the emails as they came each week. My violin sat against the wall nearby my stand with various Bach and etude books. One day I would pick it up again, and then I could join this orchestra, I would tell myself.

In mid to late October, my friend from High School, Karrie, came to visit briefly. I got us tickets to go to the Utah Symphony Orchestra since they were playing Brahms’ symphony number 4, and both of us loved Brahms. The opening piece was Verdi’s “La Forza Del Destino,” which is a relatively trite crowd pleaser. The second opening piece was by an Italian composer named Rota (whom I had never heard of) who was apparently most well-known for early film scores. The piece was dreadfully disorganized and lacked any central thematic motifs. It had the feeling of a 12-year-old writing a story that was stitched together with endless “and thens.” Brahms however was incredible. As I sat there listening, I remembered the older times when Karie and I would go to the symphony in Seattle, or when she came to my community orchestra performances. The second movement of the Brahms’ 4 was preformed especially well and seemed to capture Brahms’ deep-seated loneliness and longing for Clara Schumann. Afterwards Karie and I commented on the concert, both agreeing that the Rota had some neat ideas but needed a new architect and didn’t work as a solo piece. The Brahms we agreed was terrific and we were so excited to have been able to watch a concert again after years of pandemic. Once we got back to my apartment, we finished the rest of the Brahms symphonies. Brahms was very appreciative of the timbre of the clarinet, and so Karie especially liked him being herself a clarinet player.

Following the concert, it felt as though something old had awoken again within me. I don’t know how to describe it, but I felt like myself again. I felt motivated and passionate about something. And I felt like I had also lost my way. Suddenly I wanted to practice and burry myself in music again. I wanted to study Japanese and become fluent. I wanted to devote my time to some sort of study, and sort of study and emerge as someone better or more complete. I didn’t know where this motivation and passion had been except that it had returned. I felt like a lost traveler who had just been handed a lantern. Soon, the lantern cast dark shadows that threatened to overtake the light. Could I hold onto this motivation? Should I? Would it be worthwhile to pursue this growth if I were looking at months to live? I knew the statistics. It didn’t feel like there was a right answer.

But I had fun trips coming up and then many more small things. It would be easier to go along with the things I had already planned think little else of it. I ignored the urge for music and study. I began watching TV shows in my brief amounts of spare time while I planned for my trips. It did feel vacant. Again, the feelings of inadequacy flooded in. After so much work to become a physician, it felt as though I was doing nothing with my life—as though I had decided to take the time left to slowly descend into something abyssal without fighting my fate in any way. I was terrified that this writing would become my contrived legacy. At the same time, I felt a pressure: I should be travelling and doing all the fun things I wouldn’t have otherwise had time for.

I should be living this life full of joy and excitement and new experiences. At least that’s what I felt I should be doing. More than that, I felt that others expected me to do those things, and that if I didn’t, I would be disappointing them. As though by not going out doing extravagant things and travelling, I would be preforming a disappointing death. Vacant is the only way I can think to describe the feeling:Like being an actor for a role but given no backstory or motivations to the character—just go and do things that seem exciting.

I’m reminded of a movie I remember seeing when I was younger: A woman gets a “screening” CAT scan and gets misdiagnosed with a terminal cancer. She then goes to live her bucket list of travel and experience. At the end of the movie, she is barely stopped from jumping and killing herself because she wishes to claim her own death. I understand that feeling now. The thing about a bucket list is that you want to eventually have the opportunity to refill the bucket. No person wants a bucket list with finality. It’s a tool to alter perspectives and realize things you want, but not a list of to-dos at the end of one’s life.

I haven’t picked up the violin again, although I started taking morning walks with audiobooks, which felt like a step in the right direction. Although I didn’t know what I was trying to accomplish. I had begun to be disappointed in my own writing for becoming too list-like and straightforward without adequate reflection. I began listening to primarily classical music, which blossomed thoughts and ideas in me like spring flowers after heavy rain. My mind began to feel more active.

But then I began to feel another loss: I was once an outdoorsperson. Since the recurrence I had done no camping, no hiking, no sort of adventure outside. I looked at pictures of brown trails through beautiful evergreens. A river flowed nearby. I wanted desperately to be there again. But how could I with all my treatment devices? Survival seemed at odds with my ideal life.

I think that I will eventually return to the path of growth, to practicing violin and studying Japanese—that is, if my next scan shows stability. I’m still looking for reassurance that things will be OK for some amount of time. My dentist told me recently about a friend of his who had medulloblastoma and received some sort of immunotherapy and has now been without cancer for 5 years. The pembrolizumab I was receiving was immunotherapy… would it be enough? Did I dare to hope for an incredible outcome? It seemed that hoping and living toward a good outcome was antithetical to living the most probable reality. Did they have to be so different? At this point I regretted nothing in my life and would do the same things every time. Should I not remain the same as I was before? But I had already become less curious and less motivated. It was a strange form of depersonalization. It felt as though I were waiting to return to a person and a body that only once was, and that now I was stuck in a dumber, blinder, and physically weaker body that I could only escape by escaping cancer. It was a dumb thought. This experience hasn’t given me any new wisdom, just a closeness to death that others are yet accustomed to.

I think of my patients with cancer, the ones I saw after my initial diagnosis. Mostly pancreatic… did I help them? Was I able to bring an empathy that no other doctor could bring because of my own situation? When I thought about what was best for them, was it fair to think of comfort care? Would I want comfort care now? Absolutely not. I wanted as much vibrancy in my life as I could maintain. But I am still learning what that means. I didn’t want to be comfortable. I want to be stressed and challenged and forced to face my situation head-on. One more chance to live the most in a short amount of time. I don’t know what this means but I hope to learn.

Perhaps my biggest issue is that I do not want to be comfortable. I want to struggle to find meaning and to be happy. To make something more of myself than I am now. I want to collapse with my mind and with my body and learn where the mind and the body and the universe intersect, even if only in passing. But I only wish these things if I can memorably experience them—which is perhaps antithetical to the whole concept. Maybe it’s something I’ll discover for myself later.

I’m naïve for thinking about this in such a binary way. It was a skill I developed to become a better doctor and diagnostician. Separate the problem into several smaller questions that could be answered, then compile, diagnose, and treat. Diagnosis and treatment were the easy parts. But for me life will not be all or nothing. It will be a series of small deaths before the finale. The left side of my vision has already died. It’s gone and it will never come back. Then what, use of the left side of my body? A portion of my right frontal lobe? The problem is antithetical to the Ship of Thesis paradox. Rather than exchanging the planks of a boat, we remove pieces of me. When I dock, how many pieces need to remain to still consider me, me? Are there pieces that are more significant, that remove more identity? If I can’t do, but I can still think, am I still me? But nevertheless, “doing” seems to establish significance. My death in the universe will come before death to myself or to those around me.