God Doesn't Leave Voicemail When He's Leaving a Wake-Up Call

How many times do we say during our lives: “well that was a wake up call”. I haven’t tried to count the times, but I suspect that over my 54 years I have used the expression somewhere between 5 and 10 times, mostly with regard to business issues and perhaps some personal issues. But this is different.

First, I know myself. If someone had said to me: “Scott you have prostate cancer and you’ll be okay after some treatments” I’d figure out a way to fit everything into my current life and schedule and then get on with things. But that’s not what happened here.

First, when I finally connected with the urologist by telephone on December 18th – and he told me ‘you have a lot of cancer’, he also said “I think you are going to survive this”. I have held onto that sentence for two reasons: one – he told me that he thought I was going to survive. And two, he told me that he thought I was going to survive. In other words, its still a bit iffy. So he has my attention.

Then Carol and I go to his office the next day to have a more thoughtful conversation about the diagnosis, treatment options, etc. In the course of that discussion, he spins around in his chair to use his computer. Logged onto the Sloane Kettering website (which I have subsequently visited numerous, numerous times) he begins to type information into the nomogram. For those of you not familiar with prostate cancer nomograms – its your roll of the dice. It’s a table, developed by Sloane Kettering that tells you the probability of being cancer free after various forms of treatment, 3 5 and 7 years into the future (and conversely it tells you the likelihood of not being cancer-free and all of the implications of that).

The urologist types in my clinical stage as T-3b. I may write more about clinical staging at some later point, but for now, understand that the higher the number, the worse the cancer. And the staging, clinically, only extends from 1 to 3. Hello.

He reads the results of the nomogram, turns back around to face Carol and I and says “this isn’t always right. Its based on averages – and hey, you’re in good shape and physically fit, so you’ll probably do better than this is showing” (or something similar). We stagger out of the office with Dr. F’s suggestion that we pick up Dr. Patrick Walsh’s book “Surviving Prostate Cancer” and begin our drive to Sanibel (from Pennsylvania).

18 or 19 hours of driving provides an opportunity for a lot of thinking. And I thought about the nomogram results most of the way to Florida. I also thought about recent death of Dan Fogelberg which I had read about several days before my diagnosis. Dan Fogelberg was diagnosed with prostate cancer at age 53 and in December (of 2007) he died – at age 56. As I write this, I am once more taken by the synchronicity.

By synchronicity I mean the convergence of several events at one time. (1) cancer diagnosis; (2) overstaging of my cancer in the nomogram and the resulting poor prognosis; and (3) the rapid death of Dan Fogelberg following a diagnosis of the same disease just three years ago.

Holy shit, Sherlock. I later began to understand things more clearly. First, my PSA (15.3) was likely elevated because of the DRE the previous week. How much it was elevated is still unknown to me. Second, my clinical staging was T2-b (and possibly T-2a depending on who was conducting the DRE). Third, Dan Fogelberg was diagnosed with advanced prostate cancer at the age of 53 – and the good news for me was that most indications were that my cancer was not advanced or if it was, it was only locally advanced.

In January, I finally understood why. I needed a wake up call that would get my attention. Otherwise, I was going to ignore it. I wasn’t going to ignore prostate cancer, mind you, just the wake-up call. Clearly God knows me better than I know me, and when he decided to get my attention, he pulled out a few stops. At the risk of making up a conversation, I imagine things might have gone this way: ‘I’m going to give this guy Scott a wake-up call’. I hope he pays attention to this because lots of time guys, in particular, don’t realize what a gift I’m giving to them."

Thanks God - I got the message!