I sometimes believe that I am either a poor communicator and or, somehow, I am totally misunderstood. My first response is to always examine my own words, thoughts, and actions to make sure that I did not, inadvertently, say something or do something that might mean I am lying to myself. If am not totally convinced of my own sincerity then I apologize because nothing is of greater importance to ones self and the world in which one exists than that of honest and open communication.

I know I am dying. I also know that I look very healthy; I have gained my weight back, my hair is coming back, and my skin color has returned. Of course, to most people that would signal a remission, a successful recovery. Right now, for limited and extended stages of small cell lung cancer the reality is, “SCLC occurs in about 15% of all lung cancer diagnoses and is among the highest causes of cancer related deaths, second only to pancreatic cancer. It is sneaky in that, by the time symptoms present, the disease has already metastasized. With a front-line standard treatment of chemo- and immunotherapy, initial results are usually good. The challenge is to research and develop treatment options for when the disease returns, with a vengeance, often within 6-8 months. Overall survival rate is 9-11 months with fewer than 5% surviving five years.

If, your idea of ‘hopefulness’ is derived from a desire for a cure and then a long life you are honestly being unrealistic and are causing yourself undue eventual hardship and grief. I am HOPEFUL, in whatever time I have left, to seek out a QUALITY of life rather than a QUANTITY of life. I know how fortunate I have been, as I have had so few ‘bad’ days during the course of my treatment, but I also have to acknowledge that I rolled out of bed lots of times when I did not want to: I knew I had to get up every day or I would be giving into cancer. I have lost quite a bit of my motor skills and my memory, cognitive skills, hearing, and vision have deteriorated also. I am also aware that in the case of SCLC it normally does respond well to the initial treatment (chemo and immunotherapy), it’s the, all but guaranteed recurrence, along with the issue of comorbidities that is the biggest issue.

I have always, “…marched to a different drummer…” and I do not plan to change now. I am thankful, and hopeful, that I was given a very clear signal of impending death, because that has given me an opportunity to leave a legacy, to hopefully, make a difference. I have always been an idealist, who originally graduated from college with a deep sense of obligation to change the world. It did not take me long to realize that I can only change the part of the world that I come into contact with, and I have focused exclusively on making a difference in that small world for my whole adult life. I also realized very quickly, with a SCLC diagnosis, that I could enjoy more, achieve more, and be successful at creating a Quality of life than I could hoping for an improvement in a Quantity of life.

I cannot determine how long I live but I can determine how well I live. I will continue to reach out, to talk freely, and to share. I will continue to write, and to continue to leave gardens as much as I can. If you focus on longevity and do not obtain it, you have lost. By focusing on the quality of my remaining days on earth, I will not only succeed at leaving a legacy, of making a difference, but I might also be one of those lucky 5% who end up surviving for five years. One also must be concerned with comorbidities; with only one kidney and COPD, I know what I am dealing with.

That makes me the most hopeful one. Hopefulness must be grounded in reality to be successful; it’s like the difference between a dreamer and a visionary. One is grounded in reality and the other is not. The visionary has a greater opportunity to achieve more than the dreamer for having a sound grasp of reality is critical to success in any endeavor.

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