ON TAKING RISKS
To laugh…is to risk appearing the fool.
To weep…is to risk appearing sentimental.
To reach out for another…is to risk involvement.
To expose feelings…is to risk exposing your true self.
To place your ideas, dreams, before the crowd…is to risk their loss.
To love…is to risk not being loved in return.
To hope…is to risk despair.
To try…is to risk failure.
But risks must be taken, because the greatest hazard in life is to RISK NOTHING.
person who risks nothing, does nothing, has nothing, and is nothing.
She may avoid suffering and sorrow, but she simply cannot learn, feel,
change, grow, love or live. Chained by her certitudes, she is a slave.
She has forfeited freedom. Only a person who risks is free.
From Martha Graham to Agnes De Mille
is a vitality, a life force, a quickening that is translated through
you into action, and because there is only one of you in all time, this
expression is unique. And if you block it, it will never exist through
any other medium, and it will be lost. The world will not have it.
is not your business to determine how good it is, nor how valuable it
is, or how it compares with other expressions. It is your business to
keep it yours clearly and directly, to keep the channel open.
do not even have to believe in yourself or your work. You have to keep
open and aware directly to the urges that motivate you. Keep the
"Hope is the one antidote…I've had Parkinson's for 16
years, and I know I'm never going to get better. But I still have a life worth
hanging onto. And that is enough."
Excerpted from an article by Joel Havemann, Times Staff Writer
November 23, 2006
WASHINGTON -- For people with Parkinson's disease, the rest of your life begins on the day of your diagnosis. It's your own Sept. 11…It's unforgettable.
For me, that day was Feb. 5, 1990. It was like a death sentence with no chance of a pardon. I was told control of my body would slip away. I feared the same would happen to my mind. The deterioration would be gradual, like the disintegration of a glacier — at the end of each year, more of the glacier would have dropped into the sea.
I'm by nature a hopeful person. I don't say that as a boast but merely as an observation. It's not that I think everything is ideal. Right now I have a terrible time keeping upright when I walk. I'm so likely to topple over that I go out of my way to stay firmly planted in a chair. Just getting up from my desk to go to the bathroom requires a major commitment. Do I really have to go? What used to be routine now involves considerable thought.
There is realistic, look-the-future-in-the-face kind of hope, and there is Pollyannish hope. Mine is strictly the first type, possibly to a fault. I have abandoned hope that medical science will deliver the cure that it's been promising just around the corner ever since my diagnosis.
Hope, for me, is a state of mind, not focused on a particular prospect but rather attached to something more amorphous, less definable. My neurologist, Stephen G. Reich of the University of Maryland medical school, puts it nicely. "Hope," he says, "gets us out of bed in the morning: hope that we'll accomplish something great at work, hope that we'll see our kids do something cute or clever, hope that we won't get into a car crash." "Hope tempers pain, and as we sense less pain, that feeling of hope expands, which further reduces pain…”
For me, the routine activities of daily living, like hanging up my pants, are becoming less routine. I can no longer shave with a blade; I'm not ready to die of a slit throat. I used to be able to get in and out of the bathroom in the morning — showered and shaved, with teeth brushed and hair combed — in 15 minutes. Now it takes half an hour.
When I was diagnosed with Parkinson's at 46, Dr. Reich tried to reassure me that life did not end with the diagnosis. I remember blurting out, "Maybe so, but what will I be like when I'm 60?" Now it's 16 years later, and I'm still a functioning member of society. Will I be able to say the same in another 16 years? I hope so.
KIDS DEFINE LOVE. WOW!
group of professional people posed this question to a group of 4 to 8
year-olds, "What does love mean?" The answers they got were broader and
deeper than anyone could have imagined.
"When my grandmother got arthritis, she couldn't bend over and paint her toenails anymore. So my grandfather does it for her all the time, even when his hands got arthritis too. That's love."
Rebecca- age 8
"When someone loves you, the way they say your name is different. You just know that your name is safe in their mouth."
Billy - age 4
"Love is when a girl puts on perfume and a boy puts on shaving cologne and they go out and smell each other."
Karl - age 5
"Love is when you go out to eat and give somebody most of your French fries without making them give you any of theirs."
Chrissy - age 6
"Love is what makes you smile when you're tired."
Terri - age 4
"Love is when my mommy makes coffee for my daddy and she takes a sip before giving it to him, to make sure the taste is OK."
Danny - age 7
"Love is when you kiss all the time. Then when you get tired of kissing, you still want to be together and you talk more.
My Mommy and Daddy are like that. They look gross when they kiss."
Emily - age 8
"Love is what's in the room with you at Christmas if you stop opening presents and listen."
Bobby - age 7
"If you want to learn to love better, you should start with a friend who you hate,"
Nikka - age 6
"Love is when you tell a guy you like his shirt, then he wears it
Noelle - age 7
"Love is like a little old woman and a little old man who are still
friends even after they know each other so well."
Tommy - age 6
"During my piano recital, I was on a stage and I was scared. I looked at all the people watching me and saw my daddy waving and smiling. He was the only one doing that. I wasn't scared anymore."
Cindy - age 8
"My mommy loves me more than anybody.You don't see anyone else kissing me to sleep at night."
Clare - age 6
"Love is when Mommy gives Daddy the best piece of chicken."
"Love is when Mommy sees Daddy smelly and sweaty and still says he is handsomer than Robert Redford."
Chris - age 7
"Love is when your puppy licks your face even after you left him alone all day."
Mary Ann - age 4
"I know my older sister loves me because she gives me all her old clothes and has to go out and buy new ones."
Lauren - age 4
"When you love somebody, your eyelashes go up and down and little stars come out of you."
Karen - age 7
"Love is when Mommy sees Daddy on the toilet and she doesn't think it's gross."
Mark - age 6
"You really shouldn't say 'I love you' unless you mean it. But if you mean it, you should say it a lot. People forget."
Jessica - age 8
Before You Swat the Wasp...read this.
Lying out by the pool in my condo complex, I opened my eyes and noticed a yellow-jacket perched on the empty chaise lounge next to mine. It was sitting there, about a foot from my bare foot. I felt the fear well up inside, triggered, in all likelihood, by the memory of being repeatedly and painfully stung in the neck by a yellow-jacket when I was nine-years old. As soon as my fear arose, so too did the desire to vanquish it by killing the wasp. I sat up. It would be easy; the yellow-jacket was motionless, I could simply grab one of my sandals and give it a solid swat. The threatening insect would be crushed by my shoe and the source of my fear would disappear. I could then lie back down, close my eyes and rest assured that I was safe.
I continued to sit there, observing both the yellow-jacket and my fear with equal amounts of fascination. The wasp was a living creature. Was I willing to take its life in a preemptive strike because of the possibility that it might do me harm? But look how long that stinger is! Because of what some other yellow-jacket had done to me almost forty years ago? It hurt so much I still remember even thirty-eight years later! When it wasn’t buzzing angrily or giving any indication it planned to strike? But that could change in an instant! Kill it now before it has a chance!
I watched the yellow-jacket carefully. In truth, it seemed utterly indifferent to my presence. It gave no indication that it was planning to sting me. It seemed like it was sitting on the chaise lounge in order to rest its wings or to absorb some of the wonderful warmth of the sun – the same reasons I was sitting on my chaise lounge. Who knows? I’m not a wasp so I can’t even pretend that I could ascertain the reason for its presence on the lounge; I could only observe its behavior.
The longer I watched the yellow-jacket the more it seemed that it was simply on its yellow-jacket journey and that it really wasn’t concerned with me at all. I watched my fear and saw clearly that it was based on a possibility, but not a certainty, that the yellow-jacket might cause me harm. My fear was based on my projection of what might happen in the future; the reality of the moment was that the yellow-jacket was sitting there minding its own business. Still, there was a real risk. Which would win out: my desire for self-protection or my regard for the sanctity of life?
I decided that my fear about the yellow-jacket’s potential to harm me, real as that potential was, did not give me the right to bring its life to an end. I laid back down on my chaise lounge and closed my eyes, willing to allow the wasp and my fear to co-exist. When I reopened my eyes several minutes later, both had vanished. The lesson was powerful.
Jan Zahler Lebow
following piece was written by Genia Feigenblatt-Zwirn who has been
married to her wonderful husband, David, for 62 years. She was born in
Bendzin, Poland, a city very close to the German border in the regent of
Obershleizien. She says that at times when she is thinking of those
terrible years of her youth, she finds relief in writing about it.
“To Those Who Perished, With Faithful Love”
By Genia Feigenblatt-Zwirn written in 2007
The hour is late, the night is quiet. My eyes tell me that it is time to go to sleep. However, my brain refuses to give the order. That’s when I begin to fantasize about the what-if’s, the could-have and should-have-beens. This has happened many times since the end of World War II and our liberation from the Nazi nightmare. Of course, hindsight is always 20/20.
conjure up all kinds of scenarios. My parents immigrated to Palestine
when I was an infant, 3 months old, in 1925. They stayed there for 2 ½
years and returned to Poland. What if they would not have done so?
None of us would have to have lived through Hitler’s hell.
if I would not have hidden my parents in the bunker that fateful day,
June 22, 1943? What if my parents, my little brother and me, our entire
family, would have gone to the round-up when the Nazi henchman
surrounded our ghetto, together? Perhaps we would have gone to the same
concentration camp. Maybe someone, besides me, would have survived.
comes the torment the pain and the regret. No matter how many times I
have tried to reason with my logic, I still cannot forgive myself for
not doing something to change the course of events. Although I know
that at that time I could not do a thing, nothing can make up for the
loss of those precious lives. No amount of tears or the passage of time
can erase the ache in my heart.
Someone once said that we are the masters of our fate…are we really? I, for one, doubt it. For if we could make free choices in our lives, we survivors of the greatest calamity in the history of mankind surely would have chosen not to become victims. I must believe in destiny. For, if indeed we are able to choose and we made such wrong choices, how are we able to live with ourselves?
only need to look around to see what is happening now in our world
which our leaders call peace…how ironic. At any given moment, in any
place in the remotest corners of our planet, people are fighting. Is it
their choice to kill or be killed? There will never be an answer to
the ages, the romantics call for love, the idealists for equality and
the human race for the most precious of all commodity’s, freedom. The
right to live, the right to believe in whatever one’s persuasion is, the
right to grow.
So where are those pioneers who taught us to respect the fundamental right for every human being to live in peace? Where are our sages that made us believe that it is written in our Sabbath prayer, “Days pass, years vanish and we walk sightless among miracles. Lord, fill our eyes with seeing and our minds with knowing. Let there be moments when the lighting of your presence illuminates the darkness in which we walk.”
Maybe this is what we get in life, a few great loves: loves that return us to ourselves when we need it most. And maybe some of those loves aren’t people, but places—real and adopted homes—that fill us up with light and energy and hope at moments when we feel especially tired or lost. That is the beauty of love in all its forms. We don’t know when or how it is going to save us.
Fighting Big C in the course work
By Mary Engel, Los Angeles Times Staff Writer
July 28, 2007
6 a.m. June 26, 2007: I open my eyes to at least 15 faces within three feet of mine, staring at me expectantly. Everyone is calling my name. I find it frankly amusing. What's up, everyone? Hi! Why are you asking ME what's going on? I have no idea! And can I please go back to sleep? Yes, I know where I am, yes, I know my name, hi mom, why are you crying?
Joshua Lilienstein was supposed to be one of the people in the white coats, not the guy in the hospital gown. A near-death experience was not how he had intended to study medicine.
Back in April of 2006, Lilienstein was 26 and a month away from completing his first year at USC's Keck School of Medicine. Then he discovered a hard, irregular-shaped bump in his right testicle. What followed would both test him and teach him to be a doctor.
The resident on duty that day in the family medicine clinic diagnosed MSD — Medical Students' Disease, a particularly virulent form of hypochondria. Undeterred, Lilienstein sought out a radiologist, whose own hypochondriac jokes sputtered to a stop when the ultrasound confirmed a tumor.
Within a week, Lilienstein underwent surgery at the USC/Norris Comprehensive Cancer Center to remove the cancerous testicle. Immediately after his final exams in early June, he had a second surgery at a San Francisco hospital to take out the lymph nodes behind the major organs in his abdomen.
For the next five months, he said, everything — except for having cancer in the first place — was "peachy." Testicular cancer is, after all, highly curable when caught early, as his was.
By November of his second year of medical school, he was feeling so optimistic that he almost convinced himself that it was perfectly normal to develop a beer belly in just a few weeks. Then, at a six-month post-surgery checkup at USC/Norris, a CT scan detected tumors — lots of them — in his abdomen.
"And blammo," he recounted in the first entry of the blog he began that month. "Suddenly everything, everything, everything, is up in the air."
Day 1. Monday Nov. 13, 2006: [The cancer's spread] places me in a not-too-euphemistically named "poor" prognosis category. The outcome for this group is maybe not much better than flipping a coin …
EVEN in a class of 170 idealistic and committed medical students, Josh Lilienstein stood out.
As one of the few to enroll in a dual program leading to both a medical degree and a doctorate, he combined a doctor's humanitarian wish to help others with a scientist's analytic curiosity.
"He's just naturally inclined to ask questions about what's going on and why is this happening and what does this mean," said Dr. Peter Katsufrakis, the outgoing dean of students at USC's medical school.
The blog, http://www.jlilienstein.blogspot.com , said Katsufrakis, forced the aspiring physicians to think about whether they were ready for a career that would inevitably involve death and loss.
Judging from the comments, the blog prompted such reflections from an even wider circle of readers: "I want what you've got," wrote a longtime family friend. "Not the cancer, just the attitude."
In the meantime, Lilienstein took a medical leave from his studies.
He bypassed the standard chemotherapy treatment and opted for an experimental regimen that used higher doses of drugs over a longer period of time. He recalled his father saying, "We've gotta hit this thing hard, hit it out of the goddamn park."
For the next 16 weeks, he would check into USC/Norris on a Monday to begin five days of what he called "life-giving poison." He would check out on Friday and spend the next few days recovering at the Los Feliz apartment he shared with his girlfriend. Then he would check in for another five days of poison.
The drugs left him tired, then jittery, then tired again. One sentence on his blog — "Must force myself to be social" — spoke volumes about a man his own mother described as a party animal.
Nov. 23: I get told a lot that this experience will one day make me a better doctor, and i am even starting to believe it. all of a sudden i feel a lot of sympathy for old people. the similarities are stunning: constant dependence on others; discomfort that will not go away; feeling like there are things that i used to do that are no longer possible, that who i was no longer exists …
BY mid-December, Lilienstein's belly was shrinking and his tumor markers were falling, signs that the chemotherapy was working.
the intensive treatment continued. The plan remained to "knock it out
of the park," even as cistoplatin — the miracle drug that in 1973
transformed advanced testicular cancer from a death sentence to
survivable — attacked healthy cells along with the cancer cells.
Losing his hair was the least of it. His hands tingled. His ears screamed. He spent whole afternoons retching.
Dec. 15: Suffering is highly overrated, my friends. i really think i could develop all the empathy i needed in life with about 24 hours of misery…. days on end is really overkill.
Christmas brought three weeks at his parents' home in Palo Alto, where he was able to continue treatment at Stanford University Medical Center. He also found time for trips to the beach, walks in the woods with the family bluetick hound and a 12-hour "blowout house party."
Josh's father, Daniel, 52, a self-taught engineer who builds communication satellites, and mother, Cheryl, 56, a physical therapist and political activist, opened their Palo Alto house to so many of their son's friends that it was easy to forget he's an only child.
His illness brought his close family closer, especially when he ended a three-year relationship with his girlfriend. ("I have to remain positive and look ahead," is all he wrote of that trauma.)
Cheryl Lilienstein put her work and life on hold to take care of her son during the debilitating chemotherapy. Her 24-hour presence opened the medical student's eyes to the importance of a patient advocate to keep track of records and cover surprising gaps in care at even some of the nation's best hospitals.
In another six months, he would learn just how crucial her presence would be.
Feb 7, 2007: I had a CT scan on Monday evening to see how things are going. The next day, a hapless resident, unfamiliar with my case, came into my room and announced the "good news!": my tumor mass had reduced by more than 50%! It took a lot of self control not to punch him in the face, for this was not good news at all. I had been led to believe that these last two rounds of chemo were basically overkill, in order to be absolutely sure that every last minute speck of nastiness had been killed off. I had begun to plan a vacation, and my re-entry into real life …
The scan, a more experienced physician later explained, most probably showed dead tumor masses. Lilienstein might need more surgery to remove them, but with 16 weeks of grueling chemotherapy over, he headed to Hawaii in March to celebrate spring break with his medical school classmates and to Lake Tahoe to reunite with old friends from his undergraduate years on the UC Berkeley ski team.
Still recovering from five months in and out of hospitals, Lilienstein found his skiing form not up to his usual standards. But "every burning turn, every winded pause, with trembling legs threatening to give out, was cause for celebration," he wrote. "I spent the entire weekend with a stupid grin plastered across my face."
March 26: There is still a bunch of gunk in there, some draped over the top of the liver, some in the center of the liver where all the lobes and the vessels come together, a big glob down at the base of the pelvis between my rectum and bladder and up around my large intestine, and maybe some little bits scattered around along the posterior body wall. It isn't clear from the CT scan how much of it is necrotic tumor, already killed off by the chemo but not yet cleared from my body, and how much of it is live tumor or teratoma, which could hang out for years before becoming a problem. Everyone agrees, though, that it needs to come out. The surgery will be long, difficult, and there are many things that could go wrong. To list them all would be unnecessarily terrifying.
His situation, it turned out, was so unusual that doctors at both USC/Norris and Stanford were presenting it at Grand Rounds, weekly forums that analyze the most interesting clinical cases.
The masses in Lilienstein's abdominal cavity were on his organs, not in them. Though no one could say for sure, doctors theorized that, in removing Lilienstein's lymph nodes in June 2006, the San Francisco surgeon performing the laparoscopic surgery may have spilled cancerous lymphatic fluid into the abdominal cavity.
As a patient, Lilienstein was horrified — and angry. But as a physician in training, he could imagine standing in the surgeon's shoes.
March 26: Apparently, when the surgeon who performed the surgery found out, he was devastated…. My oncologist at USC/Norris told me that his goal was to get me through this so that I could write up the case report myself, which I agreed to … providing that I have him, the Stanford oncologist, and the [San Francisco] surgeon as co-authors. Look out, JAMA [Journal of the American Medical Assn.]!
LILIENSTEIN "has two perspectives: patient and physician," said Dr. Rachel Naomi Remen, a best-selling author and professor at the UC San Francisco School of Medicine. "He understands the struggle of his own physicians to save him."
Even so, the road ahead was far from clear. To reach all of the masses, a surgeon would have to completely remove Lilienstein's bladder and rectum. Even that would not guarantee that no cancer remained. At the same time, any surgery short of that would leave scars that would make screening and any future surgery more difficult.
His oncologist at USC/Norris recommended surveillance only. So Lilienstein was back in his Los Feliz apartment, trying to imagine a "normal" life.
April 5, 2007: I can just go back to my life?! Huh?! You mean I live in LA again? That all of a sudden, I am expected to be an adult again? To collect quarters for laundry, to cook for one, and to wash the lonely dish by hand? I sit in (what apparently is) my apartment, alone, and realize that this last 18 hours is the longest time that I have spent by myself in a year and a half. Who am I, after all of this? In this empty, quiet apartment, I hope to have the space to find out.
April 11: OK. Deep breath. Here we go again.
Lilienstein secured emergency consultations at Memorial Sloan Kettering Hospital in New York and at Indiana University, where cyclist Lance Armstrong was cured of his testicular cancer.
Surgery was once again a possibility, but both facilities first recommended intensive chemotherapy followed by a bone marrow stem cell transplant. Chemotherapy in high enough doses to kill persistent cancers also destroys bone marrow, which produces red and white blood cells that are integral to the body's immune system. So stem cells are collected before the treatment and then replaced through an IV afterward to restore the marrow.
When setback followed setback, Lilienstein relied on his medical-student training to research options and weigh decisions. But key to surviving, he believed, was the robust support of his family and friends and his own determination to stay focused on living.
So on the weekend between the appointment in New York and the one in Indianapolis, he raced back across the country to San Francisco to be a groomsman at the wedding of Andrew Min, a pediatric intern and his best friend from high school.
Min was hugging well-wishers before the ceremony began when he came upon Lilienstein — his hair still wispy from the last chemo — and his parents.
"Josh has a slight flair for the dramatic," Min said. "He was smiling like a million bucks."
28 April: I find that I have to remind myself that just because life has taken a detour doesn't mean I have to be stuck in a meaningless eddy. I want to suck this cancer dry for all it can teach me.
Lilienstein chose Indiana University for its reputation for curing testicular cancer and because renting an apartment would be less expensive in Indianapolis than in New York City.
The plan called for a three-week round of chemotherapy followed by the stem cell transplant. If all went well, he would have a week or so to recover. Then he'd do a second round and a second transplant.
With previous treatments, he had found that each round of chemotherapy somehow made the next one more bearable. He'd learned that he could survive the discomfort. But nothing prepared him for a dose four times stronger than what had come before.
During the first round of treatment, his feet felt numb, as though encased in cold water. The slightest noise made him wince; he couldn't understand his own mother. When the print in the book he was reading blurred, he feared that the chemo-induced nerve damage that was shattering his hearing had begun to destroy his optic nerve. It turned out that a small blood vessel in an eye had burst, a routine occurrence that his body would have quickly repaired had the chemo not killed off so many of his platelets.
Lilienstein's optimism faltered amid fears that the damage to his nerves and hearing would be permanent or that a future surgery would be even more debilitating.
June 14: I know that lots of people go through life much more incapacitated than I will be, no matter how bad side effects from chemo get, and no matter how extreme a surgery I may have to undergo. But contemplating someone else's disability is different from thinking about my own. It turns out that not only is sympathy really not the same as empathy, but that being able to understand what it is like to be in someone else's shoes doesn't mean that I have figured out how to tie my own.
The key to managing pain, he learned without needing a textbook, was to keep it from spiraling out of control — because once it did, medications could not easily rein it in.
The second round of chemotherapy brought blindingly painful abdominal cramps. On June 24, a Sunday evening, the pain drove him from his rented apartment back to the hospital. Curled up and shivering from pain and cold, he pushed the call button over and over in his search for relief. It took three hours for an intravenous pump to be set up to dispense a potent synthetic opiate, and more writhing and retching before an increased dose finally put him to sleep.
If not for his mother's watchfulness, he may never have woken up.
Cheryl Lilienstein, who had finally fallen asleep in the double room's extra bed, woke to a rattling sound. She jumped up to find her son's eyes and mouth open, his chest still. He had been given too much fentanyl.
She yelled for help, and nurses and doctors piled into the room to revive him. Again, Lilienstein was able to see what had happened with two sets of eyes.
June 26: Pain management must be among the most difficult jobs a doctor has. How do you balance the patient's awareness against their misery? How do you know you are not being scammed, when the patients themselves may not realize that they have become dependent? How do you not create an addiction while trying to help? And, by the way, careful not to OD anyone.
A week after his near-overdose, a CT scan brought shockingly good news. It showed no masses, no cancer, no need for further surgery.
But it will be weeks, maybe months, before Lilienstein recovers from the intensive treatment. Three months of low-dose "maintenance" chemotherapy lies ahead, a bulwark against what doctors describe as a less than 5% chance that cancer could return. But the bigger challenge will be getting over the anxiety that the next day, the next phone call, the next checkup could turn his world upside down again.
He is counting on the lessons learned to guide him as he heads back to Los Angeles in the fall to pick up where he left off in medical school.
"I very well may die of this," he'd said in May, during lunch near his Los Feliz apartment.
"But how do I want to live? I want to live positively and with attention. A positive attitude and a fighting spirit is a way to improve the odds, but also a way to live in the process."
New Drugs for Women
Take 2 and the rest of the world can go to hell for up to 8 full
Liquid silicone drink for single women. Two full cups swallowed before an evening out increases breast size, decreases intelligence, and prevents conception.
When taken with Peptobimbo, can cause dangerously low IQ, resulting in enjoyment of country music and pickup trucks.
Increases life expectancy of commuters by controlling road rage and the urge to flip off other drivers.
Potent anti-boy-otic for older women. Increases resistance to such lethal lines as, "You make me want to be a better person. "
Injectable stimulant taken prior to shopping. Increases potency,
duration, and credit limit of spending spree.
Relieves headache caused by a man who can't remember your birthday, anniversary, phone number, or to lift the toilet seat.
A spray carried in a purse or wallet to be used on anyone too eager to share their life stories with total strangers in elevators.
When administered to a boyfriend or husband, provides the same
irritation level as nagging him.
Suppository that eliminates melancholy and loneliness by reminding you of how awful they were as teenagers and how you couldn't wait till they moved out.