Posts in the Personal Category

While we were in Florida on Rebecca’s Make-A-Wish trip to Disney (and other parks), we were asked a few times which of our kids was the Wish kid.  And I suspect that quite a few more people just assumed it was Carolyn, since her hair is still buzz-cut short.  Rebecca was able to fully enjoy the trip and be an active part of it, every bit as much as her siblings and cousins, and the pictures and videos we all took are full of laughter and excitement from all of the kids.

This has been one of the many fortunate aspects of our misfortune: Rebecca has never really been sick, in the “I feel ill” sense of the word, since she recovered from her surgeries last fall.  The tumors in her head haven’t had any measurable neurological effects, and if they’ve made her a little more irritable or irrational, well, this is a five-year-old we’re talking about.  How could anyone tell?

Even the chemotherapy and radiation therapy had no major side effects.  We tend to think of cancer patients as thin, pale, bald, weak, and vomiting, as much from the toxins we pour into them as anything else.  Rebecca has remained as energetic, luminous, and irrepressible as ever.  Now that she’s stopped her Avastin treatments, she’s able to go back to gymnastics class, and is eager to do so.  She’s even kept a full head of hair, albeit with some loss of hair volume.  We can see that there’s less hair, but a random passerby on the street would never suspect she was a cancer patient, let alone near-terminal.

Thus our new mantra: “Today she’s okay.”  We don’t know what tomorrow will bring; but really, who ever does?  We live with a more present, known danger than most, but today she’s a normal kid.  She’s so normal that even we can forget, sometimes for hours at a time, that she’s terminally ill, that a lump of runaway growth sits behind her eye and threatens to one day kill her.  She’s so normal that we have the space to make our family’s life (mostly) normal.  We hope that tomorrow she’ll be the same.  Whenever our fear of that tomorrow rises, we say to ourselves and each other: “Today she’s okay.”

We’re still working to find treatment options, of course.  There are some promising leads developing even as other leads that looked promising have been closed to us.  A driving force in that search is the desire to keep her as healthy as possible — to preserve her quality of life while still trying to extend the quantity of her life.

It’s a balance almost incomprehensible in its gravity: to decide how much quantity to risk in exchange for protection of the quality, to decide how much quality we can sacrifice in an effort to add quantity.  Before all this, I would have thought maintaining that balance would be paralyzing, but it isn’t.  If it ever starts to become so, we have only to look at her, still full of life and vigor, to know what to do.  We may be the captains of the ship that carries her, but we steer it by the light of her star.

Today she’s okay.  And so today we’re okay.

• Today She’s Okay was published on Friday, April 18th, 2014.
• It was assigned to the Cancer and Parenting categories.
• There have been thirteen replies.

Our first day here at Disney World, we tried to go on Big Thunder Mountain Railroad, but it was closed “for refurbishment”, so we decided to try Splash Mountain instead.  In addition to being a ride that was right there where we were, it promised to cool us off a bit.  Going from 30ºF to 90ºF in the space of a day was a bit rough on everyone.

Carolyn and Uncle Jim sat in the front seat of the log boat, and Rebecca sat between me and Kat in the next seat back.  Things started well enough as we splooshed and bobbed around bends, but fairly near the beginning of the ride, you get a glimpse of its (sort-of) end: a fifty-foot drop down to a splash pool.  Rebecca, seeing a log full of people fly past us down the ramp, the screams of its riders trailing in its wake, wasn’t at all happy.  She switched instantly from being amused at the water occasionally splashing her parents to scared of what was going to happen.

The various animatronic displays along the way helped distract her, but she kept returning back to her fear of the big hill.  Kat and I soothed her as best we could, telling her it would be all right.  She generally accepted this, calming down until the next time she remembered the big hill that lay ahead.  She never cried, exactly, but the fear was still there, an almost physical thing at times.

“I don’t wanna go down the big hill!”

“Honey, it’s all right.  It’s going to be okay.  We’re right here.  Mommy and I will keep you safe.”

“No, I don’t wanna, it’s too scary.”

“I know, sweetie.  I know you don’t.  But there’s no need to be afraid.  It’s coming and it will happen and then it will be over.  Try to enjoy all the little shows before.”

“Daddy, please let me get off the ride.”

“I can’t, honey.  If there was a way to get off, we’d take it, but there isn’t.  The ride goes where it goes, and we’ll go with it, together.”

“I wanna get off this ride!”

“I wish we could get off, Rebecca, but we’re on the ride now and we have to take it all the way to the end.  I know you’re scared, but we’re right here with you.  We’ll keep you safe, sweetie.  You don’t have to be afraid.”

We’d arrived at the bottom of the last climb, the one that would take us to the big drop.  She looked up the ascending tunnel into the bright, bright light streaming down, and shrank back, quivering, her eyes wide with fear.  She knew the moment was close.  I leaned in next to her, keeping my voice level and light.

“I know, Rebecca.  I know.  I know you’re scared, but it’s going to be all right.  It’s going to be all right.  It’ll be all done very soon.  Mommy’s here, and I’m here, and we’re with you until it’s over.  We’ll stay with you all the way to the end, all of us together.  We’ll be right here with you.  Always.”

The log was drawn up the hill, the drop coming closer and closer, relentlessly.  My arm around her shoulders, Kat’s arm around her shoulders, both of us hunched toward her tiny, trembling body pressed against our sides; and as we came to the precipice, she shut her eyes and squeezed our hands tight.

• All the Way to the End, All of Us Together was published on Tuesday, April 8th, 2014.
• It was assigned to the Cancer, Parenting, and Rebecca categories.
• There have been twenty-four replies.

Our situation, and my posts, have been the cause of sleepless nights and fallen tears for a great many people.  In some ways I feel bad about that; it occasionally feels like I’m forcing our pain onto other people, which isn’t exactly a friendly thing to do.  But I know you’re here because you want to be here for us, and here, words are how we commune.

But why, I am occasionally asked and occasionally ask myself, am I writing about Rebecca’s cancer instead of doing other things?  There are a number of reasons.

Part of it is that I’m creating a precisely timestamped chronicle for later, the historian in me asserting itself.  This is where a lot of my tweets come from, as well: the desire to record something at the moment, so that later I’ll be able to say whether X happened before or after Y or how many days apart two events actually were.

But it’s also for Joshua, if he wants to know more about his sister and what happened to her, when he’s older; and for Carolyn, if she ever wants to revisit this time or see it from my perspective, to compare against her memories.  And perhaps for others, if I ever decide to collect these fragments into some sort of longer work.

More importantly, writing about what’s happening and how I feel about it allows me to organize my thoughts and give some structure to what’s happening.  In a situation where so much is beyond our ability to do anything at all, this is something I can shape directly.  It allows me to feel some small measure of influence.  It lets me face my fears by naming them.  It helps me get a handle on a few shards of this overwhelming thing that defies any real understanding.

And of course I’m grieving online.  I do that here so that I can put it away elsewhere, so to speak.  When I’m with the kids, I can be there for them as the father I’ve always been and hope to keep being, rather than the hollowed-out ruin I sometimes feel like.  Grieving here, through the words that come to me, makes that easier to do.  So I write and tweet.  A little bit of pressure release.

But most of all, I am sharing Rebecca with you, with anyone who will listen.  We’ve always felt it’s up to our kids to become themselves and then bring themselves to the world in their own way, to meaningfully affect it and be affected by it.  In the words of Khalil Gibran:

We’ve always meant for our children to fly free of their own accord, on the arc of their choosing, when they were ready.  Rebecca will almost certainly not have that opportunity.

So now we are her archers.  In the Web, I have a bow that can send her arrow all the way around the world.  If her flight is to be short, then let it be far, a trail of purest fire etched across every sky, more beautiful and wondrous than any comet could ever hope to be.

• On Writing was published on Friday, April 4th, 2014.
• It was assigned to the Cancer, Parenting, Rebecca, and Writing categories.
• There have been forty-six replies.

We had guests for dinner, as we often do, a house full of squealing, laughing children and their grownups, preparing dinner and trying to figure out who would get stuck with setting the table.  We’d all gone up the street to the elementary school to test out their new playground equipment and try to fly a kite in the random spring breeze, running around an open field and trying not to slip in the mud.  Now we were back and ready to eat.

Rebecca played and laughed with the other kids, all obvious traces of our conversation earlier that day erased by the simple joy being a five-year-old, living wholly in the moment.  Playing impromptu tag, hiding around corners to shout “Boo!” and cackle with delight, singing pop songs and musical numbers with her sister and friends.  Because for all that’s going on, you would never know to look at her that anything was wrong.  We can even forget, from time to time.  She lives just as she always has, full of energy and smiles, and we’re determined to keep it that way as long as we can.

Eventually, it was time to take the little ones up to bed, which Kat and I divided up with a family friend.  Suddenly, I heard Kat’s voice breaking.  She was in the nursing chair we still have hanging around the house, Joshua on her lap, ready to read his bedtime stories.  Rebecca was standing next to her, still and calm.  I sat on the footstool, my legs just behind Rebecca’s.

“Rebecca told me she’s scared that she’s going to die and be all alone.  Baby, we will be always be with you, always always always.  You will never be alone.  Okay?”

My hand was on Rebecca’s back, tears in my eyes but not on my cheek.  I asked if she understood what Mommy had said.  She nodded, her eyes cast down in thought.  We thanked her for telling us what she was feeling, for trusting us.  She nodded again, and turned to look at me.  Looked into my eyes, and saw everything that was there.  Gave me a sad, affectionate smile, put her arms tenderly around me, and kissed me gently on the cheek.

My little girl, my child, trying to soothe my pain.

---

Later, as she lay under her princess blankets to read her own bedtime stories with a family friend, I came in to tell her good night.  She was holding a book about kids who have cancer.  We have such books, now.  I perched on the edge of the bed next to her and smoothed back a riot of her curls.

“Can you tell Daddy why you picked this book to read?” our friend prompted.

“Daddy, I’m reading this book because it will help me be strong — ”, she curled her arms in classic strongman pose, then dropped them, “ — and brrrave.”  She beamed up at me.

I smoothed back another curl, affectionately tweaked the end of her nose, and looked directly into her eyes as I said, “Sweetie, you are already by far the strongest and bravest person I have ever met.”

A wide grin, a little chortle, and then she flung her arms wide.  I leaned down and she leaned up, our arms circling each other, squeezing just hard enough.  I held her lean, solid weight close, her body strong and light, and for those moments I felt no sorrow, no fear, no pain, not for her and not for me, not for any of us.  There was just a calm peace rooted in the strength of her love and the bravery of her heart, and nothing else.

• The Evening was published on Thursday, April 3rd, 2014.
• It was assigned to the Cancer, Parenting, and Rebecca categories.
• There have been twenty-two replies.

We asked Rebecca to sit with us on the half-couch situated against the short wall of the child psychologist’s small office.  She clambered up into Kat’s lap, facing toward me, looking at me sidelong with her unique mixture of shyness and impishness.  I was already having trouble drawing my breath, arrested by her affection for and trust in us, and pierced by the knowledge of what we were about to do to her.

“Honey, we want to talk to you about something.”

Her eyes dropped, her face melting to something wary and withdrawn.  She knows, I thought.  She knows, and we have to say it anyway.

“Remember the bad rock?”  No expression on her now as she began to curl up, slowly, so slowly.  “The tumor in your head that the doctors can’t take out?  And you know how Mommy and Daddy have been looking for special medicine to make the bad rock go away?”

We waited for a nod, some signal that she understood.  After a moment, her eyes darted to the side as if looking for escape routes.

“We haven’t been able to find special medicine, sweetie.  We’re still looking, but we might not be able to find any.”  Tears were streaming down Kat’s face.  Down my face.  I could barely see Rebecca’s face, she had lowered her head so far as she hunched forward, away from Kat, into the space between her parents.

In a small, choked voice: “Do you understand, honey?”

A pause.

Her head nodded fractionally, spasmodically.  And then her jaw started to quiver.  Silent.  Quivering more and more and her face twisting in anguish and then she started to wail.  She collapsed backward into her mother’s embrace, still curled into a ball, crying desolately, hopelessly.  Keening.

All three of us, sobbing and clinging to each other.

She had known ever since the tumors returned.  She had expressed her fear in a few whispers, soothed by our reassurances that we were still looking for special medicine, and now she knew we were telling her she was going to die.  She knew, and was terrified, curving her small body into a ball surrounding her pain as we tried to make a shield of our arms, futilely trying to protect her when the killer and the pain were already inside the shield.  Inside her, where nobody could get it out.  So our arms and bodies instead became a blanket inside which she could mourn her own life and try to cope with her terror of going away forever.

We wept what seemed like an endless ocean of suffering, but after a time, it started to ebb.  We could speak again, barely, and thought she could hear us when we did.  We had to ask her, even though we knew.  Even though I would given much to never say or even hear what was coming next.

“Are you scared, Rebecca?”

A nod through tears, her jaw quivering again.

“Can you tell us what you’re scared of?”

She wept again, unable or unwilling to say the words.  Kat and I choking on our pain and her pain as Rebecca sobbed with renewed terror, clinging to Kat and squeezing my hand in hers.

We asked her again, as gently as we could through our anguish.  And again, later, when we had all recovered enough.  And again.

Finally: “Baby, can you whisper it to one of us?”

She nodded, miserably.

“Who do you want to whisper it to?”

She pointed at Kat.  Shifted her head up and around.  Whispered, her voice so tiny and full of pain and fear and breaking into another wail:  “Of dying.”

I will never know how long we wept with her.  What we said to try to soothe her pain even a tiny bit.  How we tried to comfort and protect her.  I will always remember how utterly helpless and wounded and shattered I felt, the sick ache in the center of my chest.

Eventually the tears came to an end, as all things must.  She hadn’t moved from her place, curled up against Kat, still holding one of my hands.  Her face was clouded and stormy with the echoes of her tears, but there was some measure of calm.  It let Kat and me come to the same place, quiet and still in the shadow of all our grief.  We asked if she had any questions; she shook her head.  We told her we loved her.  She whispered, almost but not quite crying again, “I love you too.”  We kissed her, almost but not quite crying again.

And then it was time to tell her sister.

• The Truth was published on Thursday, April 3rd, 2014.
• It was assigned to the Cancer, Parenting, and Rebecca categories.
• There have been one hundred eighteen replies.

Further review by several radiologists of the cranial MRI from last Thursday has identified multiple flare sites throughout Rebecca’s brain.  These are areas of irritation that indicate emerging tumors.

So we won’t be going to Philadelphia for surgery.  The recovery time afterward, and the possibility of brain damage from the resection, mean that removing the large tumor might actually reduce the amount of quality life ahead of her.  The odds are overwhelming that there will be no surgery at all.

We are meeting with the Cleveland Clinic team on Monday morning to work on finding a clinical trial that is open and would be appropriate for her medical condition.  There are other, more experimental treatment ideas we will investigate, again as appropriate for the situation.  But the sad truth is that she may not live long enough to get into a trial or attempt a new treatment.  The fact that there are tumors emerging in multiple places means she never really had a chance to be cancer-free.

All we can hope to do now is delay the progression of the cancer as much as possible, without unduly sacrificing her quality of life.  It’s theoretically possible that the right treatment, whatever that might be, can bring the tumors to a near-halt, but that would be a miracle in itself.  To see a regression would be a miracle beyond miracles.  The cancer is just too aggressive and too pervasive.

The doctors tell us she’ll be completely fine right up to the point where she suddenly isn’t, and then it will most likely be over within a few days.  Much like last August.  That will almost certainly be within weeks, or maybe a few months from now.  Or it could be today.  They can’t say, and even if they could, I don’t know that we’d ask.  It really is better not to know what day your child will start to die.

I just wish they could tell us how the process will unfold, so we could prepare for it and make it as comfortable and free of fear as possible for her.

It is still possible that treatments will push that day off, maybe far enough for Rebecca to turn six and go to Cedar Point as soon as it opens this summer.  That was her top wish when Make-A-Wish came, to go to Cedar Point and win all the boardwalk games.  Being Cinderella at Disney was her runner-up wish.  We hope that we have enough time to make at least that wish come true.

We told Carolyn and Rebecca this morning.  They took it very well, because they still trust and believe in us and our ability to fix this, and we can’t bring ourselves to take that away from them.  Better to let them hold on to that sense of safety, even if just for a little while longer.

• Flare Sites was published on Saturday, March 29th, 2014.
• It was assigned to the Cancer and Rebecca categories.
• There have been forty-two replies.

Yesterday, the news came that Fred Phelps had died.  A lot of things have been said about him, some reflective, many unkind.  I always thought that whether or not he actually believed it, he promulgated a particularly consistent (and therefore, it might be argued, honest) strain of theology.

Because if you truly believe that everything is in God’s hands, that everything happens due to God’s will, and that God should be praised for His works, then yes, if you thank God for good fortune and miraculous happenings, then you should also thank God for MH370, for 9/11, for dead soldiers, for abortions, for tragedies, for anything and everything that happens.

You should thank Him for the tumors in a little girl’s brain.

---

Yesterday, we got the news that a new tumor has emerged, far from the site of the first tumor, outside the proton radiation zone.  It’s growing incredibly fast.  The MRI eight weeks ago showed nothing unusual there, and now there’s a white blotch almost the size of her left eyeball.

From what we can see on the MRI, this tumor is intermingled with brain tissue.  To remove it is to cut out a piece of her brain.

It may still be removable, despite the damage that will inflict.  We are waiting to hear from CHOP whether they feel surgery is an option.  If so, then we will go back to Philadelphia, whenever they tell us to be there.  This time, the whole family will go together.  After the surgery, if it happens, there will probably be another two months of radiation and chemotherapy.

If surgery is not an option, then Rebecca most likely has no more than a few weeks to live.  The tumor is growing too fast to expect anything else.  She will never be six, or graduate kindergarten.

---

I want to tell you that I have hope and confidence in a good outcome, but I can’t.  Because, for the first time, I don’t.  I expect that the pain and grief I feel now will soon seem like the smallest of aches.

We haven’t given up on her or her treatment.  We will still do everything we can for her.  Including, when the time comes, making the best decisions we can about the length and quality of her life, when one must be sacrificed for the other.  Those choices will be in our hands, and I hope we’ll have the strength to choose wisely.

No matter what, we’ll be there for Rebecca, all of us.  Kat and me, Carolyn and Joshua, our family and friends.  For her, and for each other.

• White Blotches was published on Friday, March 21st, 2014.
• It was assigned to the Cancer and Rebecca categories.
• There have been ninety-three replies.

The Web is celebrating its 25th anniversary today, taking as its starting point the March 1989 publication of “Information Management: A Proposal”.  I was honored to contribute a small greeting to the Greetings page over at The Web At 25.  Following on that, I wanted to add a few more words here, mostly about my own Web history, because the Web is nothing if not a vast collection of all of us sharing ourselves.

I was first exposed to the Web in mid- to late 1993 by my friend and (then) co-worker, Jim Nauer, and it instantly caught my imagination.  I’d worked on some hypertext systems before, including a summer spent on a DOS-based hypertext system whose name now escapes me that was used to mark up the Ohio Legal Code on CD-ROM for a publisher named Banks-Baldwin, now a division of Thomson Reuters.  This Web thing, though, this was something altogether different and more powerful.  By late fall I’d gotten my hands on a paper copy of the HTML 2.0 specification and on December 3th, 1993, I finished marking up my first document: the Incomplete Mystery Science Theater 3000 Episode Guide.

At the time, I was a hardware jockey for the Library Information Technologies department at Case Western Reserve University, swapping out bad SIMM chips in online catalog terminals and maintaining a database of equipment serial numbers.  So in my downtime between service calls and database updates, I had the freedom to install Mosaic betas and start surfing around to see what there was to be seen.  My increasing obsession with the Web eventually led me to become Webmaster of CWRU’s first “pure” Web site.  (Before that, there was an HTTP interface to our Gopher server, which was the first www.cwru.edu.)  And as part of that, I published tutorials and compatibility charts and spent a lot of time on Usenet and mailing lists dedicated to this new Web thing.

I do remember the moment that the Web blew me away a second time, and it’s a moment of total coincidence, which is of course why I remember it.  On April 3rd, 1996, I discovered (I forget exactly how) that CNN had a Web site, and I was astonished — a news network taking the Web seriously?  Really?  So I loaded it up, and the top headline was “RON BROWN KILLED IN PLANE CRASH” or words to that effect.  We turned on a radio, and there was nothing about the crash for at least an hour, maybe more, and of course newspapers wouldn’t have anything to say until morning, and I remember thinking: What is wrong with these other channels, that they’re so slow and unresponsive?  That was my first direct glimpse of the future of information velocity, something that permanently altered my instincts.

Over the years, the Web has obviously been good to me, and I’ve tried to be good to it in return.  The original Internet aesthetic of sharing what you know and making use of what others share, one that carried onto the early Web, has always resonated with me, as did the obvious simplicity (and thus robustness) of the Web itself.  As simple as possible, and no simpler; small pieces loosely joined; openness to all — these are principles I held dear and which the Web has always embodied.  Which means that the Web helped me maintain those principles, over these past two decades, by showing that they can and do work.

As I said in my greeting for The Web at 25:

The web is the most human information system we have ever seen and that may ever be, open to anyone with the interest to build something, gargantuan and riotous and everything we are and hope to be. It’s been a privilege just to witness its emergence, let alone play a part in it.

I suppose I could have just posted that here, and skipped the lengthy reminiscing, but what fun would that be?

• The Web At 25 was published on Wednesday, March 12th, 2014.
• It was assigned to the History and Web categories.
• There have been five replies.