Talking about, friends, friends, friends. Knocking at your door, friends, friends, friends. That’s what friends are for Friends when you’re young or old, Everybody needs, friends, friends, friends….
I am sorry that your friend or family member got sarcoma. Not so much am I sorry for you, rather, I am sorry that they are going to have to take this journey. That was very cool of you to buy this book and read this chapter so that you have some suggestions from the lifeguard chair as to what may be helpful and what is not so helpful.
This book is designed to be a deep dive for sarcoma people and their friends and family, so please make sure you don’t cheat and only read chapter two here. Were I you, I would absolutely read the chapter about how to read peer reviewed journal articles because medicine is completely and totally evidenced based. This is why when you have pneumonia, the insurance company will not pay for leeches, if your doctors wanted to bleed you like they bled people with hundreds of diseases back in the day. There is no peer reviewed journal article that says bleeding someone with leeches will cure their pneumonia or alleviate any of the symptoms. Therefore, the insurance companies will not pay for it and if the insurance companies will not pay for it, then medical professionals will not do it. Because they, like you and I, like to get paid when they work. Your belief systems and my belief systems do not matter one little bit in evidence based medicine. How you and I “feel” about something does not matter one little bit in evidence based medicine. It is all about peer reviewed research, so read the “how to read peer reviewed research” next. Reading that chapter will help you understand why coffee enemas do not cure cancer, nor does any diet or any of that bullshit that slapdick Chris suggests in his bullshit book where he lies about curing his own cancer.
The tee shirt below is a cool tee available somewhere on Vint Cerf and Al Gore’s InterWebs. There is no link to where you can buy it in the book because I am writing this to fill the hole in sarcoma books, not to make money. Plus, I despise when The Man tries to buy writers. Damn The Man, even if I am…technically…The Man. Plus, I am not a fan off black tee shirts. I was, back in seventh and eighth grade when everyone was wearing black AC/DC, Kiss, and Led Zeppelin tee shirts. However, that lost its allure when I got to college and I only buy white and heather grey tee shirts these days. Back to that shirt. That shirt explains exactly what your friend or family member is going through. There is an entire chapter on pain here because sarcoma, compared to many other common cancers, can be ridiculously painful. The tumors removed are in odd places, they have to take super wide margins when they remove them, the systemic treatment regimes are some of the strongest in cancer care with horrible side effects, etc. This is your friend or family member’s life for a few years. If they are a metastatic sarcoma patient, this shirt represents their new life until the day they die, and they will die because no one with metastatic sarcoma lives. It has a survival rate of 0%, which you will see in the chapter on metastatic thingies.
What does this have to do with you? You have one job as the supportive friend or family member: remove as many bags of rocks as possible from the patient and do not ever add any bags of rocks. Simple job, yet as an active observer of friends and family for years, a job many fail. Say this out loud when the Tripping Daisy song ends. Remove. Bags. Of. Rocks. Add. None.
Let’s do a random list of questions you should never ask and comments you should probably never make. This is not stack ranked, nor is this complete. This list is just top of mind and my top seven pet peeves. Like stopping at the top of an escalator and looking around. Only morons stop at the top of an escalator and look around, thereby inconveniencing everyone following them. These are the cancer talking point versions of stopping at the top of the escalator and looking around.
How did you get this sarcoma? If you have ever asked that question of a cancer patient, what was your goal? If the goal was that you are deathly afraid of cancers of all times and you ask “how did you get this” of all cancer patients to add to your list of things to avoid, then the question could possibly be acceptable. But not really. Half the people out there will hear it in an accusatory fashion, as if they did something wrong. Sarcoma is a rounding error in genes and the result, generally, of a gene translocation. Nothing more and nothing less.
Have you prayed on this yet? This one would depend on the deity and which of the 79 larger religions the person adheres to in their personal life, however, given that the person’s chosen deity probably put the cancer in there, the odds of them wanting to immediately remove it is less than zero. If a deity wants you to have cancer, you are going to HAVE cancer. Unless you can find a more powerful deity that can countermand the sarcoma. Like the Christian Bale character Gorr the God Butcher in the 2022 Thor flick. No one has ever had their sarcoma cured through prayer in this universe and all tangential universes, so praying on it is not going to do anything. Plus, unless you are super tight with that person, you never know what their background is. They may have escaped from Warren Jeff’s FLDS cult and religion really turns them off.
Have you looked into holistic treatments or cures yet? This is tantamount to asking the person if they want to die faster. With sarcoma, everyone needs to get that primary tumor out and generally as rapidly as possible. Leaving that primary tumor in place, especially is there is significant vascular involvement, is a great way to get mets down the road. Given that 100% of “holistic” treatments and “cures” are as useful to cancer as rubbing hot apple pies on your head (each has a 0% improvement in overall survival and a 0% improvement in preventing recurrence), suggesting to your friend that they investigate holistic voodoo crap is very much akin to wishing for their death. The reason there are no peer reviewed studies that show that “holistic” things improve overall survival in literally any cancer has nothing to do with evil big pharma and it has everything to do the fact that they do not work. This goes for any diet, as well. The reason MD Anderson, Sloan Kettering and the Mayo Clinic have stand alone pages explaining very, very clearly that precisely zero diets prolong lives. Which is why strict vegans and people who have removed all sugar from their diet still get cancer at precisely the same rate as everyone else. When asking someone if they have “looked into holistic yet”, remember that is the same sentence as saying “I hope you die from your cancer”.
You can’t give up. This is interchangeable with “you never know what may happen” and “I read somewhere people who do not give up hope live longer.” Taking the latter first, that is complete bullshit and those who have hope and those who have no hope live equal amounts of time. There are zero peer reviewed studies that say “if you have hope your overall survival is longer”, so please stop that nonsense. Those sorts of bullshit comments make some sarcoma patients feel guilty when they are having a crappy day. Besides, they can give up any damn time they want to give up. And how, precisely, are you defining “giving up”? Were you the one who got the surgery and the radiation and the chemical treatments? Did you sit up night after night, trying to breathe with lung mets, or was that them? Maybe they already used up all that “hope” just living through today. Remember, you are not the one living with pain 24/7 or having trouble breathing or feeling exhausted every day, all day. That’s them. They are the one with the shitty quality of life. If you want to be a good friend, feel free to tell your friend that they can give up any time they want and you would be fine with that. Sad, yet fine. Lord knows they have enough unthoughtful people saying “don’t give up” every day in that three minutes they have to think about cancer that day.
Everything happens for a reason. In general, it is a good idea to remove this from your vernacular any way, regardless of your sarcoma friend or family. If you ever said this to me, I would very sincerely look you in the eye and say “really? Interesting. Walk me through what the reason was for Princess Di to die in a fiery car crash in a tunnel. We have had plenty of years for the reason for that to surface, so please share that with me…the reason for Di dying in that fiery car crash.” Then I would wait for you to answer and you might shrug it off and say ‘well, that is a one off” and I would reply “OK, then let’s explore Andres Behring Breivik killing 77 people, many of them children, in Norway in 2011. Plenty of time has passed and if everything happens for a reason, walk me through that one.” Not everything happens for a reason. Some things happen for a reason, like using the designated hitter in the National League and progressive taxation. You could very clearly explain the reason for each of those to me because they are in the “some things happen for a reason” bucket. Sometimes bad things just happen. No need lying to your friend or family member by positing that there is some cosmic significance to the bad luck.
Stay positive! This is in the top three of “don’t say”, as this list is not stack ranked. Who are you to tell someone who is probably in pain 24/7 and sucked it up to have lunch with you or call you to “stay positive”, unless…of course…you can figure out a way to take on their pain for a weekend? Because of my lack of a colon and eight weeks of post op radiation after surgery to my pelvis, sometimes I crap my pants. I do not even feel it coming on, it just happens. Do you know how hard it is to “stay positive” when any time you may crap your pants. You may be in line at the super market and BOOM…crap your pants. How positive would YOU be if you could crap your pants at any time. The right side of my penis and the right side of my pelvis look like Deadpool on one of Deadpool’s good days, from the radiation poisoning. It hurts each and every time I urinate and I no longer want to have sex with anyone because I picture them screaming and running from the room in terror when they see my crotch. Do this. Don’t have sex for two years and get a urinary tract infection for two years straight so that it hurts every time YOU urinate and then have all your friends toss “I know you are sexually frustrated and there is no end to that and it hurts each and every time you pee, but remember to stay positive!” Would you like that? Think about that the next time you want to tell a cancer peep to “stay positive” And that horseshit about “well, if you are positive and you can manifest yourself to recovery, then you can make your cancer go away” or the “people have cured themselves with the power of positive thinking” garbage. I know a lot of people who have died from cancer, more these days. All of them were incredibly positive and all of them are dead. Your point is not valid. Allow your friend or family member to be miserable whenever they want to be miserable without your platitudes about positivity. Give them room to be miserable without giving them an impossible task like staying positive while washing the crap off their leg in the shower.
How are you feeling? While this seems like the logical thing to ask, imagine if you will when you got back from your honeymoon. You know how it was fun to describe your honeymoon for roughly a week, then you got really tired of talking about your honeymoon? That is how it is when every single person you speak with in any given day starts every single conversation with “how are you feeling?” This, of course, does not apply to those type of people who like to whine on and on and on and on about how they feel terrible and why the hell would you want to give one of those people a softball like “how are you feeling?” any way? This especially applies to those with chronic sarcoma that has mets or keeps recurring. You know how they feel almost every single fucking day of the year? They feel like shit because they have a cancer that never, ever, ever, ever ends. And when they get their next scan the doc will probably call and tell them they have more cancer and then that cancer will start hurting in that place eventually. When you ask someone with a chronic sarcoma how they are feeling, you are also saddling them with a bag of rocks because they will probably lie to you and say something like “aces” or “I feel great!”. That is their way of lying to you so that maybe you quit asking that question every damn time you call or text them. Final note on this one: a lot of sarcoma patients figure out how to live their lives as best they can by packing the cancer away in a box for hours at a time each day, not to be thought about while in said box. Know that your asking “how are you feeling?” all the time…when you now know the answer is “like shit”…pulls that cancer out of the box. That’s not cool.
While we are on the topic of phone calls and texts, also know that there are roughly a trillion topics that are non sarcoma related that you could discuss with your friend or family member via phone call, email or text. There are the Dodgers. Or how the Houston Astros are a bunch of cheating bastards who, for some odd reason, were allowed to keep each and every win that they cheated on in the World Series year. There are volcanoes and NASA and how even years later, it is truly fascinating that the CERN large hadron collider was able to identify and track the Higgs Bosun god particle. Along those same lines, there is dark matter and all the theories around dark matter. There are dogs and cats and puppies and kittens. There is the world inflation rate being at roughly 7% and how when the whole world’s inflation rate is at 7% it is extremely hard to drive your own country’s inflation rate below 5%. There is Elon musk, whether you love him or believe he may be the largest douchebag to ever live in the Silicon Valley, which happens to be my opinion of him. Those topics right there could take up four or five hours and I have not even started scraping the trillion topics that are not related to sarcoma.
It is extremely boring to talk about cancer day in and day out when you have cancer. Unless, of course, you are one of those morons who defines themselves by their cancer and wears it like a badge of honor. An odd behavior, given that millions of people get cancer each year and roughly 90% of them live a long life. It’s not that terribly special that you lived, given that most people live who get cancer. I have an ex who had a simple lumpectomy years ago and the way she describes herself, you would think she beat brain, pancreatic and liver cancer all at the same time. People like that need to just shut up and move on with their lives. In any event, find something else to talk about 99% of the time with your sarcoma friend or family member. My three sisters and I have spent the last three years talking and texting and have spent .001% of that phone time on sarcoma. It is ridiculously easy to do.
Sarcoma patients…how do you make sure you do not have to deal with those who overuse the seven items above or people who always want to discuss cancer? Simple. Do not take their calls or answer their texts. I have done that for three years and it is blissful. Now, to be fair, tell people well in advance that you will be ignoring them if they break the rules. My rules are three simple rules: do not ask me how I am feeling, do not talk about cancer and do not ask me where my Winnebago is. Because those three questions would be all I get and they bore the daylights out of me. Set your boundaries, make your rules and then stick by them. You’ll be glad you no longer communicate with those who disregard your boundaries because they would have ignored ALL your boundaries any way. I do not miss the 173 people I benched two years ago. Not even a little bit.
Finally, given this three thousand two-hundred fifty-seven word soap box diatribe, what can you do to help? You know what sucks on bad days? Cleaning the house. I especially hate cleaning the house because I cannot easily band over. Quite often, my place looks like Fred Sandford’s front and back yard. Pre-pay a house cleaning service for the for six months. Hire a lawn crew for a quarter to spruce up and maintain their lawn. Subscribe them to one of the hundreds of places you can find on line that ships a dozen fully made meals a week. Take them to a movie and don’t talk at all during the movie. Especially about cancer. Find a local wash and fold and pre-pay it for a year and tell them you already paid for it and they need to start dropping off their laundry there once a week…because you already paid for it.
The key is you pay for whatever you do up front and then they cannot argue with you because there are no refunds. You can lie about that. It is A-OK to lie to a sarcoma patient, especially the terminal sarcoma patients. The odds of that terminal patient catching you in the lie before they die is super duper low. Lie away! Tell them they look dead sexy when they are emaciated or bloated, the two most common cancer looks. I digressed. Pay in advance and lie and say there are no refunds. Are they barely making ends meet because having long term sarcoma is expensive and it is challenging to work when you want to sleep eighteen hours a day? Find a means by which you can get cash to them without making them feel like a bum. For example, maybe you rob a bank and after removing the dye pack, you hide the cash in a garbage bag and then hide that in the bushes and leave an unsigned note on their door.
Whatever chores and daily tasks in your life that you find annoying on a weekly basis is probably something in their life they find annoying. Even more so now that they have cancer. Not as annoying as hearing “you have to stay positive”, “everything happens for a reason”, “you can’t give up”, “how are you feeling” and “have you looked into holistic things” all day long, yet annoying. Help the remove or finance the annoying things in their life and you will probably not get blocked on their iPhone.
(This is best read while listening to the Flaming Lips tune at the link below)
Do you realize that you have
The most beautiful face?
Do you realize
We’re floating in space?
Do you realize,
That happiness…makes you cry?
Last week, July 21, 2018, was my cancerversary. Thirty-six months ago last week I had a radical orchiectomy in same day surgery at Scripps Green because I did not feel like spending the weekend in the hospital and because my healing powers at home, with the cats, are legendary. My surgeon removed an orange sized tumor from my pelvis, where it had taken up residence on my right spermatic cord. If you are not familiar, in a radical orchiectomy, the surgeon begins the incision up near the hip flexor and cuts downward to the top of the penis, then dissects roughly 7 inches to either side, makes a five inch incision in the scrotum and then removes the spermatic cord, the tumor (if you have one….I would assume everyone who chooses this surgery has a tumor….it would be a super odd elective thing to do sans cancer) and the testicle all in one piece. 99.9% of spermatic cord cancers are sarcoma and the key to sarcoma tumor removal is a very, very, very wide excision.
This is what they removed: that’s the tumor up at the top there, enclosing the spermatic cord. That was one big ass tumor. It grew from acorn sized to that big in under 100 days. Given that the lesions in my lungs are the same flavor, I never expected to see month thirty-six.
While I was quite stoned post surgery in PACU, I knew the news was bad when my surgeon kept looking at his shoes while explaining that he had sent the mass for biopsy and we would have the results in a week or so. I have lived in surgery for thirty-four years and know that you can generally eyeball a tumor when you pull it out and tell how malignant it is. After reading the science on DDLPS from 2018 to 2021 and seeing photos of DDLPS tumors, you can absolutely tell a DDLPS tumor from a well differentiated liposarcoma by looking at it. Homeboy knew what our journey was going to look like that afternoon.
My brother from another mother, Stevie JC, and I left the hospital, went directly to the West End bar in Pacific Beach and had a bourbon drink wake for my missing spermatic cord and testicle. Then we had some cake and I went to bed after listening to the Flaming Lips song “Waiting for Superman” a dozen times and playing along with it on the 12 string guitar. Because I was still quite stoned from surgery. The Flaming Lips are quite excellent when you are stoned and “Waiting for Superman” is quite excellent when you are diagnosed with terminal cancer.
A few weeks later, after bouncing from Scripps pathologists to Indiana University pathologists to a Sloan Kettering pathologist, my final path report came back. Grade III dedifferentiated liposarcoma with vascular invasion, necrosis, and a mitotic count of 40. A “high” mitotic count is 10. I have had some docs I have met along the way doubt that my mitotic count was 40, then I send them my path report and they reply back “damn, boy…that thing must have grown like The Hulk.” The incidence of liposarcoma in the spermatic cord is .3 per one million people. Three tenths of one person per million people. Grade III DDLPS in the spermatic cord occurs at a rate of .1 per million people. In comparison, the incidence rate of breast cancer is 1 in 8 women.
Cancer is by no means uncommon. By 2030, the incidence overall will increase to 45% and by 2050 that rate will hit 50%. Americans born today will have a 40% chance of developing cancer and one in three will be diagnosed by 65. Those are higher odds than having one spouse for your whole life. Fortunately, the vast majority of cancer these days is treatable, with an overall survival rate in 2020 of greater than 85%. Metastatic DDLPS had a 5 year survival rate of 0% in 1970 and has a 5 year survival rate of 0% in 2021.
My first lung lesions appeared ten months after surgery. The “you’re fucked” aspect of sarcoma is limited to several binary things, which makes it pretty simple to figure out. One of those “you’re fucked” things is lung lesions appearing in under twelve months.
Sarcoma, while rare, is relatively easy to figure out when you have all the “you’re fucked” variables ready at hand and if you can interpret Kaplan Meier charts and read clinical studies. The overall survival of metastatic pelvic dedifferentiated liposarcoma at 18 months is 50%. It is 23% at 24 months. In the clinical research it is less than 2% at 36 months. It is an odd feeling getting geared up to die, basing your gearing up on science, and then not dying. Same feeling as if you spent a day training to skydive and then you get on the plane and go up to 12,000 feet and the pilot circles and never opens the door and lands.
I made nine friends on the one social media site I use to look at liposarcoma things and we emailed back and forth. Seven had DDLPS and two had pleomorphic liposarcoma. Eight of the nine are dead now. We met and then they died, pretty much exactly when science said they would die. Within two years. They all had wives/husbands and children and there is something fundamentally unfair about outliving them all. My favorite golden retriever in the galaxy, Gus, got sarcoma nineteen months after I got it and he died three months later. I think about those I outlived in the past three years, late at night, when my chest pain keeps me up.
That feeling is even more odd these days….this day, thirty-six months later. Three years ago my timeline was “I’m going to die some time in the next two to three years, certainly by month thirty-six”. Now that dumb luck allowed me to hit three years, theoretically, it is “I am going to die some day soon”. The minute and second hands have sped up a bit lately, but the upside is that it’s sort of like a roller coaster than only goes up. You might die Tuesday, then you don’t die Tuesday so the roller coaster goes up another ten feet and you crank up White Zombie’s “More Human Than Human” and do the “one more day” jig while making coffee. On that roller coaster that only goes up every day.
And the down part of the roller coaster? It’s never been a sense of impending doom or anything like that. Not for the last two years when science said my body would murder me or day to day now as the chest pain increases. While I have been a control freak my entire life, there has been a certain sense of peace for the last two years: surrendering to the eventuality of this thing. There is an unmeasurable spiritual value to surrender. And surrender is completely different than submission: surrender is a willful acceptance. A very chill, peaceful acceptance.
Like what they teach you in most yoga classes and instead of being all sweaty and loose at the end of the yoga hour, you die. It’s not like you get a third eye or special wisdom when you get a shelf life, you are simply forced to admit to yourself that Buddha was right. Everything is quite temporary and all of this may just be an illusion that can go “poof” at any time. Sometimes without warning. Or, better still, like in some of the Vedic Buddhist texts where Maya is a “magic show, an illusion where things appear to be present but are not what they seem.” Maybe all of this is an illusion…depends on which bucket of Buddhism you toss your marbles into. That being said, here are some of the lessons from the last thirty-six months.
Thirty-six lessons… learned during the last thirty-six months:
Time tends to move faster when you are on the clock. Thirty-six months ago feels like just yesterday. Time plays tricks on you when you are the clock. Mostly. But sometimes it passes too slowly, or sometimes too fast or it does not make a difference. Like the seasons in Florida.
Given that, slow the fuck down.
When you slow down, find reasons to laugh out loud. Every hour. Actively look for things that make you laugh like a rabid hyena every hour of the day, then laugh like a rabid hyena for a while.
Most tales that involve large quantities of drugs, a painful break up, or someone dying at the end are shaped by incongruous details. Pay attention to the incongruous details.
Although completely wrong from a mathematical point of view, the Cantor set part in John Green’s “Fault of Our Stars” holds lessons. This part where Hazel Grace talks to Augustus. “There are infinite numbers between 0 and 1. There’s .1 and .12 and .112 and an infinite collection of others. Of course, there is a bigger set of numbers between 0 and 2, or between 0 and one million. Some infinites are bigger than other infinities…I cannot tell you how grateful I am for our little infinity. You gave me forever within the numbered days, and I’m grateful” Then Hazel and Augustus find a ton of time to make out. Even though they are both hand grenades. You can always find more time to make out. Everyone should make out more. Write that down.
The reason that “Fault in Our Stars’ quote is incorrect is that there are precisely the same infinite number of numbers between 0 and 1, 0 and 2 and 0 and a million. I spent a weekend proving that to myself…because I slowed down and found time for things I love. Like math proofs. I never had time for math proofs before this. The problem is that there are far more real numbers than there are natural numbers and there is no simple way to line up the reals and the naturals in a proof. To prove it, you have to start with Cantor and then do proof by contradiction and that will take you a whole damn weekend to do. Then the sets will be different sizes, which then leads you to the fact there are multiple levels of infinity with the reals having a larger set. Nonetheless, the infinities between 0 and 1 and 0 and 2 are not different sizes. That is a math lesson I learned.
You don’t need 90% of the stuff you have. I got rid of 90% of the stuff in my La Jolla home when I moved into the Winnebago and do not miss any of the stuff.
You always run out of money faster than expected, especially when you outlive your Kaplan Meier and science.
If your parents raised you correctly in The Land of Cleve, you can figure out how to get by on broke levels of cash. I was down to $14 last month and $17 a week ago and none of the cats starved.
I should have moved into a Winnebago years earlier. There is plenty of room in a Winnebago for a single man and three adult cats and a Winnebago can go anywhere. People still want to make out with you, even people you do not know, if you live in a Winnebago. That was a big concern I had in Q1, 2019 because I do love making out.
Pain is relative. You can always take more pain, even when you think you are at your limit. Pinky swear.
The times when the pain is a 9.8 (because you always save your 9.9 and your 10 for a rainy day) and you lay in bed wishing science had applied to you because if you’re dead it does not feel like this….will always be followed by the morning where you wake up and are glad you beat science. Because regardless of the pain level, alive and playing “Ripple” on a 12 string for the cat is better than dead. And you can always take more pain. Eight weeks ago the on and off stabbing pain in my chest from the largest tumor became a 24/7 thing and at first I thought I would go nuts with it and said to the cats “I don’t know if I can take this pain” and now? I am used to it. Pain is relative. You can always take a little more pain.
That being said, while pain is inevitable, suffering is only optional.
Take some time to sit and think every day. Just sit. And think. Like that dude in “Sound of Metal” with his donut and coffee, in that room all alone at 5 a.m.
Some of those times when you are just thinking, go back through all your relationships from 7th grade on and just remember the fun parts. We tend to focus on the endings in relationships and all relationships end badly with super messed up nuttiness. Odds are 93% or so of your time in each relationship was chock full of fun. Spend some intentional time thinking back on all those beginning of relationship times. Those were some damn good times.
The high desert can be just as beautiful as the ocean, especially on a clear night with a full moon and stars, well away from city lights.
Life is game that can only be played, never truly won.
Go see as much live music as you want to see. See some live music every week. I skipped at least half the concerts I could have attended from 21 to 53 because of work. I regret missing 100% of those shows now. I missed seeing The Who because of work. And Leonard Cohen. And I skipped John Prine three times because of work, then he shuffled off the mortal coil. Go see more live music. Never skip a show for work.
You can always toss around a few more “I love you”’s every day.
A lot of people are freaked out about death, which is a shame. They are uncomfortable talking about it. Unlike marriage or having your first baby or things like that, we never talk to dying people about what it is like to be dying. Not everyone is going to get married or have a first baby, but rest assured….everyone is going to die. If you treat it as a beautiful, very natural part of the whole journey, it will not freak you out.
There is no “always”: there is only right now.
Maximize right now.
It’s amazing the things you appreciate when time has the slightest bit of importance.
When you do not have the option of doing it tomorrow.
And the phrase “some day” loses the vast majority of its meaning.
All these things (the appreciation, the loss of options and “some day” becoming meaningless), combined, unburdens you and allows you to do what you want, whenever you want to do it. Which would be a kick ass way to live life every day, with our without cancer.
Pain heals, chicks dig scars, glory lasts forever. That is Shane Falco’s lesson. Sorry about that. Not mine. Solid lesson, though.
All things fall apart. Everything breaks. Don’t sweat the broken things.
You can cut out 100% of the people in your orbit that do not add to your day and not miss them at all. You won’t miss them even a little bit. If you feel anxious or tired after speaking with certain peeps in your orbit? Quit taking their calls forever.
If you cut out the things you do not like doing, you will be way happier. I cut out 100% of the things I didn’t like doing. I hate talking on the phone and I gave it up. I don’t miss talking on the phone. I hated first dates, so I quit dating. And I sort of wish I had given up all the things I gave up ten years ago.
Everyone should read more poetry. All poetry.
There is a large amount of dumb luck involved in longevity, once diagnosed with sarcoma. I have done exactly nothing to extend my life, from a “treatment” point of view and here I am. Dumb luck. Plus, I have always been oddly successful in good bar fights, despite the three broken noses. In bar fights and with metastatic sarcoma, I give as good as I get. That moron who wrote “Chris Cures Cancer”? That is dumb luck, too. Surgeons create our longevity. Plus, that moron Chris had stage II colon cancer and like 90% of people with stage II colon cancer live. He did not “cure” anything. How the heck is that dude’s book a best seller. Damn snake oil salesman.
Everyone is the star of their own romantic comedy. That’s from Hank Moody and true to the core.
But mostly, just slow the fuck down. One day you, too, will be on the clock and when that happens you’ll kick yourself and say “Mulligan told me to slow the fuck down and I ignored him. Shit.”
Slow the fuck down.
Do you realize
Instead of saying all of your goodbyes…
Let them know you realize
That life goes fast
It’s hard to make the good things last…
Postscript For Sarcoma Newbies, Especially the Liposarcoma Newbies: Lessons From the First 36 Months
After I kick the bucket, my book “You Walk Him and Pitch to the Rhino: A Misanthrope’s Guide to Sarcoma” will come out. In this book you will find evidence based deep dives on everything you need to know about sarcoma. Most web sites have all the same blurbs about sarcoma. “Misanthrope’s Guide” goes deep on every topic, including crapping your pants and the history of sarcoma going way back to William Cooley in 1891 and using murine and zebrafish models for research and how to read peer reviewed studies and dozens of more topics. Moreover, it is one of the few books that says it is A-OK to embrace death as an eventuality because everyone dies but not everyone knows what is going to murder them, like you do. Maybe. If you have metastatic sarcoma, which is your connective tissue trying to murder you. It’s like “Clue”, but instead of Mr. Mustard in the library with the candlestick, it is Mr. Dedifferentiated Liposarcoma in the lungs with the mets. In the meantime, here are some helpful hints and things on which to do your own deep dive. For symmetry, there are thirty-six. The book has many, many more.
It is all about your histology, your grade and the location. You can pretty much predict your future based on the histology, grade and location of your tumor. And the size, depending on the location.
Given that previous sentence, take the time to do deep dives on your histology, grade and location every week. Vint Cerf and Al Gore created The InterWebs for things like this. It is super easy to do deep dives on your exact histology and grade and location by searching with quotation marks like this: “histology, location, grade”. For example, “dedifferentiated liposarcoma, pelvis, grade 3”
All histologies behave differently: well differentiated liposarcoma behaves differently than pleomorphic which behaves differently than mixoid which behaves than dedifferentiated. Mixoid round cell behaves differently and responds to different things than WDLPS, DDLPS and pleomorphic. Etc, etc, etc.
Stay the hell away from message boards and social media sites: for the most part, they are populated by morons, liars and the criminally insane. Medical social media, on average, is 67% liars, morons, and the criminally insane.
Teach yourself to read peer reviewed research immediately. The only thing that matters is peer reviewed research. Some random on-line person in Toledo and their experience with sarcoma means nothing in regards to you. Only peer reviewed research means anything to you. Evidence based medicine is evidence based. That dude in Toledo is probably full of shit any way. They don’t have sarcoma. They are just lonely and joined a sarcoma group.
Even if that dude in Toledo actually has sarcoma, they are a data point of one. Virtually nothing that happened to them applies to you. The only thing that MAY apply to you is peer reviewed research where the “n” is high enough.
Incurable means not curable and some things are incurable. No one is hiding anything from you. Strangers on The InterWebs are not going to have some magical mystery cure. Were there a cure, we would all know about it. Some things are incurable and absolute. Like starting a land war in Southeast Asia. Never, ever start a land war in Southeast Asia. Even if some stranger on The InterWebs writes “oh, yeah…I started a land war in Southeast Asia and won.” They are lying.
If you have a high grade tumor or metastatic sarcoma or local recurrences and if your insurance will cover it, get to a sarcoma center. The peer reviewed research says your outcome will be better at a sarcoma center under those conditions.
Half of us sarcoma patients will be A-OK forever and ever and ever and ever. Those are pretty good odds. Better than the odds of like, a plane crash.
Half of us, the ones who get mets to the lungs, will die. Technically, everyone in the world is going to die, you just know in advance what is going to murder you. If you want to prepare for that, the best reference book in the galaxy is BJ Miller’s “Beginner’s Guide to the End”. Dr. Miller is at UCSF and he is a genius with a heart of gold.
There is nothing wrong with embracing the eventuality of death, being at ease with that eventuality and then having some damn fun with it. Record some messages for a year after you are dead and pay your cell phone forward 2 years before you die. Have your BFF send those messages to people in the middle of the night after you die, from your phone, as text attachments. “Hey, Bob, this is Mulligan. Saint Peter and I want to know why you touch yourself so much and I am truly shocked at how little you floss. Those teeth are forever…….floss! Oh, and Saint Peter said your porn choices are very, very odd porn choices.”
Sarcoma hurts. Sometimes it hurts a lot. Stay ahead of your pain. If you want a good book on using things like weed and mushrooms and such to control your pain and anxiety, buy Michael Pollan’s book “How to Change Your Mind”. Michael Pollan is also a genius and one hundred percent of the info in his book is backed up by peer reviewed, evidence based medicine and studies.
The placebo effect in pain control is upwards of 50% in some studies, meaning that if I told you Hostess Ho Hos will control your pain, 50% of people will get pain relief from Hostess Ho Hos. For a bit. CBD “working” is all the placebo effect.
Always, always, always get surgery with a great surgeon who has done surgery on sarcoma patients. It is a different kind of surgery. Remember when Michael Jordan played semi-pro baseball? He was a great athlete at hoop and not so much at baseball. Get yourself a surgeon who is MJ playing hoop.
100% of the peer reviewed research will show you that best shot you have a curative ending is surgery. Surgery with the right surgeon.
Never, never, never believe the morons and liars on social media who claim that herbs or essential oils or coffee enemas or special sugarless diets will “cure” your sarcoma. They are lying and if you listen to them you will probably die faster. The fastest way to die is to not have surgery. When you chose not to have surgery or not to listen to actual medical professionals, you are choosing to die faster. Which is all well and good…who am I to tell you how fast to die. You die when YOU want to die. I just hate snake oil salespeople. Google “Shut the Fuck Up About Your Bullshit Cancer Cure” by James Fell, if you would like a good read some time.
Those with metastatic sarcoma, you are most likely going to die. And by “most likely”, I mean you are definitely going to die. It might be in 6 months or it might be in 40 months, but you are going to die. Metastatic sarcoma patients, these days, always die. Maybe in 5 or 10 years that will change, but today all the metastatic sarcoma patients die. Wrap your arms and head around that as soon as you can so that you can go have some damn fun. There is a shit ton of fun to be had out there!
You are not “giving up” if you embrace the reality that you are going to die. If you have people in your orbit who do not realize the ignorance involved in telling a terminal cancer patient not to “give up”, cull them from the herd. Do some pruning. They will spoil your fun once you embrace the eventuality of death and start having some fun. They will probably not even rob a bank or a 7-11 with you. That is still on my bucket list. I am saving it for the last week.
There are states with death with dignity laws. I have a death with dignity doctor and I hired him early on. If you have metastatic sarcoma, there is no rule against interviewing palliative care teams while you still feel awesome. There is also no rule that says you cannot hire a death with dignity doc while you still feel great. No one puts baby in a corner…..
Regarding chemo or immunotherapy, do the following when considering one:
Find the overall response rate. It is an actual number. Like 11%. That is the percentage of people on which the chemo/etc worked. If a study says the overall response rate is 11% it means that if 100 people were on that drug, it worked on 11 of them. It means that if YOU go on that drug, there is an 89% chance there will be no impact on your sarcoma.
If you have visited a casino and played blackjack….which is the one game where the house only has a 1% edge, probability of an overall win in blackjack is 42.22%, a tie is 8.48%, and a loss is 49.10%
Within that overall response rate, find the most important impacts an agent can have: performance free survival and overall survival improvements
An improvement in PFS of 42 days means that instead of growing additional tumors in say, 3 months, the peeps in the study grew new tumors in 4 months and 2 days
And overall survival is the holy grail. That means people live longer on that agent.
There are precisely zero (0) agents for liposarcoma that provide even an extra day of additional overall survival. The average overall response rate for all liposarcoma flavors is around 15% and of those 15 people out of 100 that get a response, none of the 15 got a single extra day of life.
Mixoid LPS tends to have a higher response rate. As mentioned above, learn to read the peer reviewed studies so that you can make an educated decision.
Ask how much the agents cost. They can run $10K to $20K a month and you do not get a refund when they do not work.
Ask what the primary side effect profiles are, how they will impact your quality of life. Ask what the secondary side effect profiles are and how they will impact your quality of life.
Regarding chemo, immunotherapy, etc. Whether to pursue them (based on the science) and how long you stay engaged based upon your side effect profile is an intensely personal decision. Make that decision yourself with your friends and family around you, taking into consideration the items directly above this. To some, a 15% overall response rate is an excellent number.
If you want to get a general idea of how long peeps with what you have live, learn how to read Kaplan Meier curves. Kaplan Meier curves are real. They use the law of large numbers and the law of large numbers is infallible. If the Kaplan Meier says that 75% of peeps with what you have die by month 25, then 75% of the peeps who have what you have die by month 25. And then 25% of people live past month 25. There is no magical mumbo jumbo there, it simply is. So, go have some damn fun.
CBD does not cure cancer. CBD is a bunch of crap: there is no peer reviewed research behind CBD. There is peer reviewed research behind weed and THC and they work great on anxiety, pain, and appetite. Go. Full. Weed.
Everyone with sarcoma loses something pretty significant. I lost my pelvis. If you must go on message boards and social media sites, don’t be the slappy on the social media sites who complains about losing their eye or losing a kidney. Some people lose legs and arms. Our one unifying thing in sarcoma is we lose a lot of ourselves.
Don’t waste a minute worrying about the things you lose. They are gone. Focus on what you have left. Some days I find it hard to walk because the radiation did a number on my spine and hips. On those days/weeks..I read.
Radiation does not work on well differentiated and dedifferentiated liposarcoma. It sort of works on some flavors of pleomorphic and mixoid. Make sure you discuss this with your sarcoma team, especially if they are discussing post-op radiation. Radiation for sarcoma, post op, tends to mess up your body. A lot.
This is what my pelvis looks like now. I also cannot walk well because the 8 weeks of radiation did a number on my lumbar spine and hips. My radiation oncologist did not tell me that radiation does not add a single day to my life and would significantly impact my quality of life. Do not repeat my mistake if you have dedifferentiated liposarcoma. Post op radiation for DDLPS does virtually nothing in terms of adding to overall survival. Ask your radiation oncologist to carefully walk you through the peer reviewed research on outcomes and long term side effects if she/he suggests post operative radiation for DDLPS. Show them these pictures and say “Mulligan’s pelvis started degrading 20 months AFTER he finished post op radiation. Will MY pelvis look like this? He said it hurts like crazy and bleeds and makes him feel like one of those lepers from the Steve McQueen movie ‘Papillion’.” Then have them walk you through the peer reviewed research on your type of liposarcoma. According to science, post operative radiation does NOT work on DDLPS or WDLPS.
If you do not want to live where your sarcoma team is, don’t. I have chosen to live in Kanab, Utah where it is chill and remarkably beautiful and 9 hours from my San Diego team and 5 hours from my Phoenix team. If you get yourself a great local doctor and care team, you can live wherever you want for your final year(s).
You can look far and wide and not find anything on The InterWebs that tells you how your chest will feel when your lesions grow. Allow me to help. The lungs, like the brain, have very few pain nerves…however, the rib cage and the area around there is super duper enervated. Wherever you have the largest lesions, it will feel like a little man is in there, stabbing a stabby thing outwards from your lung lobe. You will get used to that pain. Seriously. It will become a dull ache in the background, eventually, but it will be scary the first month or so. The breathlessness comes and goes and also trips you out pretty good,. When your O2 drops to less than 84 at night, as it will do, your brain will wake you up. Find some things to do at 3 a.m., like Netflix. Or making out with a significant or insignificant other. Some days the breathlessness will be super bad and some days you will not feel it at all. Which is pretty trippy. Know this: even on your worst stabby pain day and loss of breath day, there will be better days coming up. You’ll get some good days again. Pinky swear.
There are plenty of good books on the end parts. Try Randy Pausch’s “Last Lecture” or Paul Kalanithi’s “When Breath Becomes Air” or Atul Gawande’s “Being Mortal”
Speaking of writers, “Prozac Nation” author Elizabeth Wurtzel died in January 2020 from metastatic breast cancer. Or, rather, from complications related to metastatic breast cancer. She did a good job writing about death, too. Her final printed words were brilliant, especially given the lexicon of books she left behind. She wrote this:
“Do you know what I am scared of? Nothing. Cancer just suits me. I am good in a fight. This one goes on for the rest of my life. But I have been fighting within myself in one way or another all along. I am used to it. I cannot think of a time when my mind or my body was not out to get me. I am at ease with discomfort. I am a ballerina doing a pirouette with perfect turnout in toe shoes, and it does not even hurt any more. I am elated. I love spinning this way. I would not have it otherwise. I am a con artist and cancer is my final con.” (Elizabeth Wurtzel: 1965 to 2020)
Prep your friends and family to deal with both the ending (if you are going to end) and the grief before you shuffle off the mortal coil. Take that on, as much as you can, so they can enjoy the ending, too. Imagine “Avengers End Game” without that magnificent ending. Endings can be a great deal of fun if you make them fun.
Go have some damn fun.
I have no idea why WordPress started again at 1 there above. Rest assured there are 36 of these suggestions. Best of luck to you in your sarcoma journey and look for this book after I shuffle off the mortal coil in January 2022.
(This letter is best experienced while listening to this exact live version of Stephen Kellogg’s songs “Milwaukee” and “Roots & Wings”. If you are a slow reader, loop it. You are welcome)
Happy graduation. Apologies for the delay of two weeks. I was being held for ransom by The United Federated Forces of the Symbionese Liberation Army and when Patti Hearst starts talking about power to the people, she never shuts up. That, or I was trying to nail down the perfect additional rap bands for you.
I find it odd that we celebrate this particular thing that literally almost every kid that does not end up in prison at 17 is able to accomplish. Especially geniuses like you. Nonetheless, I will celebrate it along with you because I am always up for a good party. Given that the devil is not wise because he is the devil, the devil is wise because he is old, here is my collective advice to you at high school graduation. If you have any questions or need clarification on any of it, just let me know. These are not stack ranked or in any order of importance. They are stream of consciousness, like Hunter S Thompson’s writing. Here you go.
Always be up for a good party.
Read everything Hunter S Thompson wrote, starting with “Fear & Loathing in Las Vegas” then” Fear & Loathing on the Campaign Trail” all the way up to 2016’s “The Last Conversation”, published after his death. Anyone wanting to understand politics ought to read all of Hunter’s books. Everyone with an IQ over 140 like you is required to read all of Hunter’s books. There are thirty-three, so start now.
Don’t be afraid of makeup. Makeup can be fun. Back in the 1990’s when the Stone Temple Pilots were in San Diego every other month for a show, we would give me some damn smokey eyes for the shows and I’ll tell you what. Those blue eyes our genetics made will POP with some damn mascara. So don’t be afraid of makeup.
Or traditional gender roles and such.
Speaking of which, be an ally to the disenfranchised and dispossessed at all times. Whether the person being disenfranchised is being so because of religion or gender or sexual preference or their race, always be an ally to the disenfranchised and dispossessed. If you believe in that Catholic heaven thing, quite literally the ONLY thing that will get you into heaven is being an ally to the disenfranchised and dispossessed. You know who has had it pretty damn easy for several thousand years? Guys like us. White men. You know who has had it pretty tough for the last few thousand years? The disenfranchised and the dispossessed. So, use that power you have that we got for free by being born white men and help out those who did not get that “get out of jail free” card. Plus….like I said….heaven. Ticket right in, my man.
Be kind. Especially with the ignorant. You are super bright and the ignorant can wear you down, so take a deep breath when dealing with the ignorant and remember that when you go home, you’ll be you and…unfortunately for them…they will still be them. If you look at the normal distribution of humans, 100 is the average IQ. That means that 2 standard deviations are to the right and the left of 100. It does not mean that everyone is 100. Heck no. Half are below 100, and it shows. Be kind to those people, too. Especially to those people. They cannot help it that they are dumb and they will be the ones saying the most ignorant things. Like “well the southern rebel flag is about history, not about being racist”, which is maybe one of the dumbest thing anyone can ever say. That flag embodies racist thought and 99% of those who display that flag are racists.
Never own anything with that racist, ignorant southern Civil War flag on it. It symbolizes slavery and certain humans wanting to own other humans. Full stop.
When you run into an obstacle and need to think through it, three surefire ways to work your way through it are:
Listen to Warren Zevon songs. All Warren Zevon songs.
Hemingway books. Really anything Hemingway wrote, including his magazine articles. Reading Hemingway helps you think better. The three best books to read to think through something are “The Sun Also Rises”, “For Whom the Bell Tolls” and “A Farewell to Arms”
Poetry. Read it out loud to yourself in the car or in your room or under a full moon. James Joyce, WH Auden, William Butler Yeats, Johnny Keats, Langston Hughes, Maya Angelou, ee cummings, and Percy Shelley. Neruda. Blake. Shakespeare.
Never, throughout your whole life, stop listening to Warren Zevon, reading Hemingway novels or reciting poetry aloud.
It was encouraging to hear you are into rap. As you explore the genre, do not forget the ones who got us to where we are today in the rap world. Make sure you explore the following:
Big Daddy Kane
A Tribe Called Quest
Grand Master Flash and the Furious Five
The Beastie Boys, especially the early stuff and especially the short tune “A Year and a Day”. When you play “Year and a Day”, say to your friends “my godfather, Uncle Dan, can throw ALL these rhymes perfectly and they will doubt you, yet your statement holds true.
Wu-Tang Clan (Wu-Tang forever!)
The Fearless Four
Eric B and Rakim
And The D.O.C. Find some old school D.O.C. ,man. It is hard, hard, hard to find and well worth the search. The D.O.C. was amazing and then he did a bunch of E and got in a car wreck and ruined his vocal cords. That man could flow and rhyme.
Speaking of drugs. If Mother Nature did not make it, it will probably kill you. I have a lot of friends in my close circle who never did any drugs. There is really no need to ever do drugs. As you may have heard, I did a LOT of recreational drugs but only the ones that Mother Nature made. The best place to be high is at home on your own couch with three big pizzas and a two liter of root beer in front of you. Take a pass on all of the drugs that Mother Nature did not make and always always always pass on heroin, even though Mother Nature made the poppy. I have never tried heroin and never even thought of trying heroin in an experimental fashion. Heroin will kill you. Weed will make you eat those pizzas and then fall asleep on the couch.
If someone you are interested in romantically offers you heroin, run. Even if she is a super model with an Oscar, and Emmy and a Nobel Prize.
Make sure you watch all the Kevin Smith movies, all the way from “Clerks” to “Dogma”. “Dogma” is my favorite, for obvious reasons that will become clear when you watch it. Also, watch everything that was ever made for “Robot Chicken”, every single episode of “The Whitest Guys You Know” and every episode of “The Kids in the Hall”. Learn every word to the “Dinosaur Rap” video from “Whitest Guys You Know”. Here, I’ll get you started:
I’ll only spit this one time so let me take it slow I started to get high about an hour ago But then the buzzer rang, I looked out the peephole It was a whole bunch of raptors, and they just won’t go I stepped back and the knocks I just tried to ignore Thought I was safe, but they knew how to open doors And without even asking they just came on in They started smoking my weed and then they called their friends
An Allosaur is in the corner trying to pack the bong Hot boxing in the john with a Pteranodon Now a Compy and a Steg-o starting to get it on But I can barely move because this weed is the bomb Ankylosaur is making s’mores and eating Lucky Charms Pterodactyl took my whole bag of Pepperidge Farms T-Rex just went and set off the fire alarm And now he can’t get it out because he’s got little arms…….
Wherever you are, find a good therapist. I have gone to therapy every year since I was thirteen and it has been one of the best long term investments ever. Therapy is like having a guitar instructor or a piano instructor or a golf instructor, even when you know how to play golf, the piano or the guitar. The impartial feedback loop is what you want from the instructors and the therapist. When you find a great therapist? Keep him or her forever. I had Ellen in San Diego the longest. She was brilliant. She saved my life and changed my life. Find a good therapist and stay in therpay until you kick the bucket.
Fall in love a lot. There is no shame in falling in love often. Love is a huge amount of fun. If anyone says to you “oh, there Gavin goes….falling in love again”, reply to them “yeah…lucky me.”
Some time on a date before you are thirty, do this. Memorize the passage at the end of “Perks of Being a Wallflower” and take your date out to a field and bring a boom box and crank up David Bowie’s “Heroes” and look her in the eye and recite that last part of “Perks”. Man, that is a good date. I just want you to know that I was in a bad place before I started high school, and you helped me. Even if you didn’t know what I was talking about or know someone who’s gone through it, you made me not feel alone. Because I know there are people who say all these things don’t happen. And there are people who forget what it’s like to be 16 when they turn 17. I know these will all be stories someday. And our pictures will become old photographs. We’ll all become somebody’s mom or dad. But right now these moments are not stories. This is happening. I am here and I am looking at her. And she is so beautiful. I can see it. This one moment when you know you’re not a sad story. You are alive, and you stand up and see the lights on the buildings and everything that makes you wonder. And you’re listening to that song and that drive with the people you love most in this world. And in this moment I swear, we are infinite.’
Get lost. Go on short and long road trips without plugging any data into your phone. Just go and get lost. I have found the most amazing things getting lost.
Be a feminist for life. We Mulligan-blooded love and respect women and remain utterly shocked and dismayed that they are paid less and are ridiculously underrepresented in Congress.
Visit as many foreign countries as you can all over the world. Go alone from time to time and get lost there. I got lost in Nepal for three days once over near the Indian border and it was magnificent.
People will hurt you. Get good at forgiveness. I was super bad at forgiveness until like four years ago and wish I had gotten good at forgiveness by twenty-five. Getting good at anything takes practice, so you’re going to have to get hurt a lot to get good at forgiveness. Fortunately for you, conflict is inevitable in all relationships (friends, family, work, love life) and you’ll get to practice it often. Be intentional about getting good at forgiveness.
Red wine with meat, white wine with fish. I have had $12 bottles of wine that taste as good as $300 bottles of wine. When you find those, buy a few cases of that $12 wine.
Science says I will not physically be here when you get engaged and married, so here is my speech on that, well in advance. And remember, I did not get married until I was thirty-eight, so don’t rush into anything. Take your time. Just like tattoos, make sure you understand that forever is forever. It is challenging to wrap your head around “forever” before thirty. Fourteen to seventeen seemed like forever, but thirty-five to fifty-five is way more like forever, but not exactly forever. Eighteen to ninety-seven is forever. What may appear to be a forever true love at twenty may not be a forever true love at twenty-four. A lot changes between twenty and twenty-four. A lot changes between forty and fifty-three.
Back to the marriage advice. It is better to be kind than right. Learn when to shut the hell up, especially when you are choosing to be kind instead of being right. Whenever I think back to any fight I ever had with someone I loved, whether it lasted ten minutes or ten days, I regret not stopping the fight in the first three minutes. A successful marriage is all about having honest discussions about money and children, supporting the hell out of one another, being a best friend when it is hard to be a best friend, and knowing how to fight properly together. I am a big fan of marriage. I have admired it from afar for decades and love watching the good ones.
When you screw up, apologize. The only way to apologize is this three step process:
I’ll try to never do that again.
Shut the f*ck up.
Mostly, be kind.
Congratulations on your graduation, happy eighteenth birthday, and I love you.
Some years speed by faster than others. Some drag on interminably. The last year of any marriage drags on forever and ever and ever and ever and ever. The last year of marriage pre-divorce feels like an eon. July was one year since they removed my pelvic tumor and when the life expectancy from your unicorn sarcoma is roughly two or three years, I am here to attest that the past fourteen months went by extremely fast. Light speed. All things considered, it has been a most excellent year.
Those close to me know that I had a very clear and concise plan on how I would spend years 58 to 108. First, one of my startups was going to provide several million in “(expletive deleted…rhymes with truck) you” dollars so that I could do whatever I wanted each and every day from 59 to 108. Then, I was going to get a third Master’s degree so that I could pompously say to those who pompously say to crowds “I have a Master’s degree “oh, you have one…I have three….” From 59 to 62 I was going to live in a 900 square foot condo in the Marina Towers (those round condos on the Chicago river in the galaxy’s finest city…Chicago) teach kindergarten by day and see live music each night at the House of Blues with my friend Eric Ottoson. Which is conveniently located ninety-seven feet from the Marina Towers. From 62 to 108 I was going to live on a large piece of land in Montana with seventeen dogs, three llamas and a house full of cats. This has been my plan since the mid 1990’s.
Knowing that 58 to 108 was being condensed into 53 to 55 explains why I went to Kanab for six weeks and I’ve spent three months in Montana, precisely where I wanted to retire. I was able to see a version of the sunrise below each and every morning out my front window, while the cats and I said “oooooh…..aaaaaaah.” The go-forward plan is to return to Kanab for the duration, spending most of my mornings at Best Friends, cleaning up cat poop or taking doggies for car rides and walks. Meaning that I have not only gotten ahead of my plan, I also exceeded the quota. I got to borrow thirty-seven dogs and one hundred fourteen cats in May and June and will have the same group November 2 to December 28. And I was able to spend months in Montana to see the sun rise over the mountains each morning a full nine years earlier than the plan. Parents in Chicago should thank whatever deity they pray to that I excised the middle part of the plan because their children will not be swearing like sailors at an early age.
The compressed retirement plan also explains why I have no desire to go anywhere outside of sixty miles from my Winnebago and why I have no desire to travel from state to state these days. I spent my entire adult life, from 22 to 53, traveling all over the world and the 50 U.S. states for business and for pleasure. I flew just under six million miles, stayed in hotel rooms 220 nights a year for 30 years…more nights than in my home. I have no intention of spending the remainder of my life traveling. Traveling is a pain. I like having nothing to do and no obligations on a daily basis…it has been quite blissful being misanthropic and utterly selfish.
Stranger’s obituaries are fascinating: I have read them since I was a child. I wrote mine last fall and it is utterly magnificent. Do not leave your obituary to chance. You are going to die. You are absolutely going to die and if you let someone else write your obituary with a time crunch, it is probably going to suck. Write your obituary this evening so that it does not suck. Write your own. Here is the first paragraph of mine. Go ahead and copy pieces and parts, if you like.
Daniel Charles Mulligan, (fill in date) of The Land of Cleve, Chicago and La Jolla, passed away at his home late (name of day) evening, (month/date/year) after battling raptors in the raptor apocalypse. He gave his life freely defeating all the raptors so that we may live in peace in a raptorless world. If you are walking around right now and see NO raptors? Not a single raptor? Now you know why there are no raptors and who to thank for your raptorless world. Born on July 13, 1965 in Cleveland, Ohio, he was the only son of the late Daniel C (senior). and Kathy Mulligan. And while you may think he milked that “only son” thing, he definitely chalked up more groundings, punishments, and court ordered probationary periods than any of his three sisters. all whom were angels in comparison. Dan, a nomad who lived in New England, Cincinnati, Chicago (the finest city in the galaxy) before finally settling down in La Jolla, CA, was a 1987 graduate of Miami University (the one in Ohio that was a university in 1809… long before Florida was a state) continuing on to earn an MBA from San Diego State and a Masters in Science in IT from the University of San Diego.
With this photo:
In reading obituaries through the years, I always wondered why they chose the places to donate. Some are obvious, some as obtuse as someone explaining why they “like” Ayn Rand books. They don’t. No one really likes Ayn Rand books…they are lying to you when they say they do. Most who claim to “like” Ayn Rand have read zero Ayn Rand books cover to cover. I digress.
As per the first year plan, I spent the fall and spring healing, then I sold the house, then I got used to living in a Winnebago. The next part of the plan, summer 2019 to whenever, was writing my own happy ending and marketing my “in lieu of” items. Plan your work. Work your plan.
Most people procreate and leave behind their children and grandchildren as their happy ending. I remain blissfully and selfishly childless, so my version of a happy ending involves pulling in others after I kick the bucket to help out the marginalized, disenfranchised and dispossessed. I’ve done all my giving quietly through the years: that giving involved helping out the disenfranchised and dispossessed. The sole item that bothers me about checking out earlier than expected is that I’ll be unable to continue helping the marginalized, be they animals or humans.
In advance, here are the three “in lieu of” things that will be at the end of my obituary. They will also live on in perpetuity here on the Mind of Mully in this piece and on the Wix web site that will pop up the day I shuffle off this mortal coil in this section shown below. That way, if someone wants to contribute to any of them in a year or two or five or ten, they’ll still know where to go for reference. When you click on the photo in the final web site, boom, the details pop up. Did I use a wedding format on Wix for the funeral? You bet……
Need to figure out how to change the color of the letters, though. See below. Fortunately, I have a bit of time and a useless Masters of Science in IT from University of San Diego. They discontinued the program four years after I matriculated so when people did a check on my resume they’d look at their shoes and say “ummmmm…..so, USD does not offer the MS you say you have…..” I digress. Again.
Because people like choices, the primary choices are animals or people. Feel free to do both, if you have trouble choosing. Then, the people part bifurcates into two more choices. If you are an individual contributor and have no one to hire, feel free to tell your company about The Last Mile. Or tell your friends and neighbors and your company. The Last Mile is growing rapidly and will need more and more spots for graduates over the next twenty years. Tell everyone you know about The Last Mile. And you don’t even have to wait for me to die to tell people about The Last Mile. You can tell people about The Last Mile this week and then text me and say “hey man, we just hired someone from The Last Mile!” and I will text you back “you rock….thanks for making that happen so fast! Let’s go have a celebratory cocktail.”
The Best Friends thing is easy……if you feel like supporting animals and making the United States a no kill country by 2030, then feel free to contribute to Best Friends. One of the reasons I spent so much time at Best Friends in Kanab was to meet the people there and make sure they were not nut jobs like the folks at PETA. They are not like the nut jobs at PETA…everyone at Best Friends is amazing. Also, any proceeds from “You Walk Him and Pitch to the Rhino (a Misanthropes Guide to Sarcoma)” will be split between Best Friends and the last one here, “Stories From Brian”
If you are not familiar with Best Friends, the link below will take you to the sanctuary page. If you are looking for an amazing place to spend a weekend or a week or a day, details are there on how to get registered and scheduled.
And the name of the place is not hyperbole. Here is one of my best friends I made….Audrey the Pitty. She is wonderful.
The Last Mile one is a little more involved. Several years back I attended a Ted talk where the founders of The Last Mile program (Chris Redlitz and Beverly Parenti) spoke. Since then I have wanted to hire a Last Mile graduate for an internship or full time job and have been unable to do so. I attended a Deal Day at San Quentin and met the men there on a different visit and I am a big believer in The Last Mile. And now the program is in five states with seventeen classrooms and is growing. This “in lieu of” is a long term one: I would very much like to see at least ten of my friends hire a Last Mile intern or FTE over the next three to five years. Or forty of my friends hire a Last Mile intern or FTE over the next ten years. Goals and metrics are important.
As discussed in May, I don’t have a bucket list…I lived a ridiculously lucky, awesome life thus far. However, as I thought through what was missing, my only regret was that I have wanted to hire at least one Last Mile graduate each year over the last seven and have not been able to complete that. If you can help me complete that sometime in the next five years, that would be great.
And here is the Ted talk I attended that made me enamored of The Last Mile and what it does to help all 320,000,000 of us here in ‘Merica(!)
“Stories from Brian”. This one started as “Skip a Date Night on Saturday, Stay Home and Watch Dateline to Hone Your Murder Skills and Mail the Money You Would Have Spent to Brian at PB Christian”, but that seemed a bit long when I put it down on the yellow legal pad. As discussed earlier, I have done 99% of my giving quietly, anonymously and privately through the years. One of the things I have done for ten years is leave envelopes of extra cash in the mailbox of Brian Daly, the one pastor at PB Christian. Then, when someone needed something (e.g. groceries, electricity kept on, etc) and they popped in to see Brian, he would hand them cash and help out someone who needed help. Anyone in need. Like, if an ex Jewish atheist walked in and they were unable to buy groceries for their family that week, they’d get cash. I love PB Christian because all are welcome. Literally, all. Not most everyone, except those peeps there. Everyone.
The best part of this exchange was that then Brian would invariably send me an awesome email explaining where that cash went. I would be having a long day where I took a red eye to the right coast and had meetings all day and my hotel bed only had two pillow and I’d be in a foul mood and BOOM, up would pop an email like this from Brian Daly:
Or this…in any event, you get the idea. It’s not like I have been dropping off millions at PB Christian, however, it would be nice if cash kept showing up over the years for Brian to hand out.
I’d like to keep the offense the same…really stupid simple…. on “Stories for Brian”, so the offense for #3 will be just mail Brian some spare cash. Send it in an envelope with a note like this here……then if he has a good story to tell about that cash, he will send you an email. Stupid simple: no extra work for Brian….we pretty much have two people working there. It’s a small church with one Sunday service and maybe two hundred peeps in the parish. Granted, there is no receipt, but it’s what I have done for ten years with no receipt and with the new tax plan, you’re getting hosed any way. So you may as well just send some extra cash to Brian for me with no receipt.
Maybe science and medicine is absolutely full of it and maybe I’ll still live to 108. As a lifelong believer, both personally and professionally, in medicine and science and an owner of lots of new lower lobe nodules in my lungs, I don’t think I’ll make that 108. Either way, there are the three “in lieu of” choices. People like choices.
That’s the happy ending. Feel free to be part of it………………
PS: Still here? There is one more item that will be off in the future…2021 or so. Eight weeks ago I purchased the web site for Not Today, Sarcoma. I’ve chosen to not define myself by a translocation of the 11th and 12th chromosome in some of my genes, so I don’t go around thinking about it all the time or wearing gear that disparages cancer. The one thing I have around me is a hand written note on the fridge that reads “not today, sarcoma” which I very obviously stole from “Game of Thrones” last year. If I feel like crap, I say “not today sarcoma” and go to the gym. Or put some bourbon in a travel cup and take a walk.
The biggest private funder of liposarcoma research is the annual Wendy Walk. Since Wendy died, they have raised just under four million dollars for liposarcoma research. My friends like to drink. And since the good people at the Wendy Walk already have their nonprofit built up, once a year “Not Today, Sarcoma” will have a pub crawl in twenty-five cities and send all the money to the Wendy Walk team. That will combine two of my favorite things: friends getting together to have cocktails and funding cancer research that is underfunded year after year. Deets on Wendy and The Wendy Walk are at the link below. Now, as of this writing, I still need to make sure the good folks at the Wendy Walk will take the Not Today, Sarcoma money raised……so, fingers crossed. However, if you have a Wendy Walk near you, make sure you do the walk. There is precious little research money dedicated to sarcoma…….
I have 14 cities covered currently for the pub crawl and would like to start with 25. If you want to be team lead for a city, send me an email to email@example.com and I will put you on the spreadsheet. My friends Chanda and Jessica will reach out to you as team lead when they do the first event. They run it…I just set it up. They’ll be in touch when the first pub crawl happens because I will be drinking beer from the beer volcano in the afterlife promised to all of us by the Church of the Flying Spaghetti Monster.
If you want to make shirts, this is the one I made for me. I only wear it inside because I think those who flaunt their cancer did not get enough love from their mommy and daddy. It’s a Hanes beefy tee….super soft. Not one of those nasty godless, heathen Commie Chinese tees that feels like cardboard on your skin.
This pairs up with “In Lieu of Flowers…Part Deux….So You Can Plan”. The photo below will be emailed to people who are not on social media. How can you not be on social media? How the heck do you know which friends are faking a happy marriage and perfect kids if you don’t have social media? In any event, this is the photo I am sending to those not on social media. All details are below. All salient details. If you have questions not related to the questions below, then you have way too much time on your hands to think up questions. Those are the only questions I am answering. The salient ones.
Feel free to right click on this photo here and save it as a photo and send it to your date or whomever you are bringing, if you don’t want to send the all the details in this link. Or if they don’t care what Pi is to the thousandth place.
WHERE: Main area of the Museum of Man
WHAT TIME? 6:53 p.m. to 10:49 p.m.
WHAT: I’ve fielded some texts asking if this is a living wake. No. This is my rehearsal for the post memorial service karaoke party that will take place at some point in the next two years. There will be no moribund speeches or wake-like activities. This is a happy, karaoke party with no sad crap.
HOW MANY PEOPLE WILL BE THERE? I’d be just as happy if there were just my three sisters and Mallory and Stevie JC and me and my San Diego people drinking and singing karaoke as I will be if a bunch of peeps show up. However, it looks like a bunch of peeps are coming in from out of town, so that’s cool, too. None of my friends are morons, so you’ll probably like them all. Look like anywhere between 100 and 200 people or so. Excellent cross section for maximum karaoke pleasure. Don’t worry if you can’t make this one because there will be a second one in the next year or so and you can go to that one.
WHO CAN I BRING? You can bring anyone you like, really. I did NOT post this on my regular wall because I did NOT invite everyone I am friend with on FB because some people add to a party and some….well, they subtract. So if you are here on the FB invite page and you see that I did NOT invite someone is a friend with me on my regular FB page……don’t bring THAT person. Because I very intentionally did not invite them. Because they do not add and may subtract.
ANYONE I SHOULD MEET WHILE THERE? Yes. If you see “In Lieu of Flowers: Part Deux”, there’s a part about The Last Mile. The founders of The Last Mile, Beverly Parenti and Chris Redlitz are coming down from San Fran with six or so Lat Mile peeps to join us for the evening. The human part of my “in lieu of flowers” is “hire someone for an internship or full time job from The Last Mile sometime in the next five years”. Or, have a friend hire someone now and you can hire someone next year or the year after. I think you’ll really enjoy hearing the Last Mile story, plus everyone from The Last Mile is ridiculously smart and engaging. If you want to see the Ted talk that made me fall in love with The Last Mile, here you go……..
Then, the man who runs PB Christian, Brian Daly, is most likely going to be there. If you plan on sending him spare cash down the line in an envelope, as explained in “In Lieu of Flowers….Part Deux”, you can meet him. He’s also extremely engaging and intelligent and just an all-around good dude. This is Brian here…….
Were I you, I would find those folks during the evening. Now you know exactly what they look like and you can find them. Boom. And my sister Patti is pretty hilarious once we get a few cocktails in her, too. That’s Patti: under the blue arrow.
FOOD: This is a rehearsal thing for the final thing so I am having the same company cater it….Kitchens for Good. I love their mission. They help out the marginalized and disenfranchised and that’s a damn fine mission. So I am paying for food for 125 people for this thing and there may be more people coming……so, if you plan on coming later (which is no problem at all), you may want to eat elsewhere. The menu is a Clevelanderitian theme and the pierogis are coming from my friend Greg’s business (Ohio City Pasta) in The Land of Cleve. Mmmmmmm….pierogis.
The rest of the food is what you see below, except I changed out the salad because I would rather chew on broken glass than eat blue cheese and eggs. Man, but I hate me some eggs. Grandma Douglas force fed me her nasty egg salad when I was a child: made me despise eggs. Bleh.
WHERE SHOULD I STAY: I have no idea. I guess wherever you want to stay? If you plug in “Museum of Man” to The Google it will show you where it is. Then, you can go from there. If you want to stay downtown and Uber, it’s about five bucks. If you stay in Pacific Beach, your Uber ride will be more…..how much more, I have no idea. If you live in San Diego, I would imagine you should stay at your own house.
HOW SHOULD I GET THERE? I’d take an Uber or a Lyft. Yep. That’s what I am doing. So I can drink without killing anyone on the way home. Unless I get a super bad Uber driver. Then, you never know.
KARAOKE RULES: There are no rules. It’s full contact karaoke, which means there will be various percussion instruments available (shaker eggs, tambourines, drumsticks) and I’ll have all my guitars there…..6 strings, 12 strings, electric mandolin, dobro, etc. They are all electric except for the dobro. The way we did karaoke at Chez Mulligan was you could play along with the song, you could just play a song on your own using any instrument, you can do karaoke alone, you can do karaoke with a group. There ought to be at least three mics. Maybe four if I get an extra one.
WANT TO DO SOMETHING FRIDAY NIGHT OR SATURDAY MORNING? Hey, thanks for asking. I’m going to pass. I have a solid two hours of energy in me these days and I am going to save it up for the six hours Saturday evening. Plus, I want some quality time with my three sisters Friday evening and Saturday morning! Thanks for asking, though! We can see each other on Saturday evening…
WHAT IS YOUR ‘IN LIEU OF FLOWERS THING’ THAT YOU ARE MARKETING FOR THE NEXT SIX MONTHS?
Thanks for asking! All the details are in this link here…
IS THERE A SARCOMA/CANCER BACK STORY THAT I COULD READ TO BRING MYSELF UP TO SPEED BECAUSE YOU PROBABLY DON’T WANT TO TALK ABOUT CANCER ALL THE TIME. THAT WOULD BE SOOOOOOOOO BORING AND REPETITIVE.
Again, thanks for asking! Yes. All the details of the two year plan are here in this May post and I am seventeen months into a twenty-four month plan, with the last two quarters being “market the ‘in lieu of flowers’ things”.
Everything in italics here is an intro. It is the longest intro in the history of the written word. If Guttenberg had seen this intro, he would have thrown up his hands in despair and never invented his printing press….thinking it would be way too much work to do the set up. If you drink, get yourself a drink: this is a long one. If you’re sober, make yourself a pot of coffee: this is a long one. Remember, proper hydration and kindness are the keys to life. As is a rock solid left hook.
My house went into escrow on March 11 and then days ago I moved into a pimped out Winnebago, where I can spend 30-60 days at a time in left coast states where my fixed costs can be locked in at $3K or less a month. This move may cause some to ask “why” and maybe postulate that I am on the run from the law (always a possibility) or that I have become a meth head (never a possibility….I am super bad with tools and rewiring things). I am neither on the run from the law, nor a meth head and this is the backstory on the move. I would prefer to tell my own story just once….. and I am going to tell it exactly one time.
This one time.
Feel free to come back to this piece as a reference, should I ignore calls, emails or texts about one of three topics: cancer, selling my house, or living in an RV. As an FYI, I will ignore all calls, texts and emails about cancer, selling my house, or living in the Winnebago.
I’ve been dealing with the former for quite a while and the latter two for ten months: they are not topics I want to discuss. If you have sarcoma questions, there are a bunch of links at the bottom and inserted photos. You can also use The Google on your own to look up “pelvic, grade 3 round cell dedifferentiated liposarcoma with lymphovascular invasion” and read whatever peer reviewed research you want. Stay the hell away from message boards, though….they are populated by the ignorant and the criminally insane. I have had thirteen surgeries in the past ten years and have avoided message boards like the plague because, again, they are populated by the ignorant and the criminally insane.
This is also a promo piece for my book, which ought to be done for Christmas, 2019. It may be unreadable drivel, it may be entertaining. We’ll see by the fall. Details on the book are roughly halfway through this piece, which Tolstoy would call “lengthy”.
I have had cancer for a while, the “a while” part length depends on how you slice the bread. It’s been 5 years if you count when the fatigue, the odd weight loss and gain & night sweats started back in 2014. That’s probably when the well differentiated liposarcoma started. It’s been 3 years if you count from when the dedifferentiation to round cell started and the hydroceles got bad. It’s been almost one year if you count when the pelvic tumor was removed and 8 months if you count back to the beginning of the 7 weeks of post-op radiation. It’s been a good long while while and I have had plenty of time to research, think this through, and plan out 2019 and 2020. Hence the “sell the house and move into an RV full time to get fixed costs down to where you don’t have to work.”. I am semi-retired as of last month with these fancy new business cards:
Regarding the three topics I have no desire to discuss: sarcoma, selling my house and the RV. Have you ever been on vacation to like, Key West, and when you come back during the first three days it’s interesting to tell your Key West stories at work………but then you want to just get back to work or talk about something else? Like the Cleveland Browns? So you don’t want to discuss Key West after a week or so? That’s how I feel about the cancer, selling the house, and the moving full time into a Winnebago.. All three topics now bore me senseless. I choose to not discuss those three items. I prefer to treat each of those topics like day eight of your Key West vacation. I will ignore all emails and texts and phone discussions about cancer because, no kidding, it bores me senseless by now. I spent a few days last month with a good friend who has known about this cancer thing since the beginning and we spent exactly .00003% of our time discussing cancer, how I feel, blah, blah,blah. We spent 99.99999% of the time discussing life, music, his family, my cats, the Browns, booze, how I have adjusted to being a monk, etc.
If you watched Randy Pausch’s video eleven years ago, the first five minutes are where I am with discussing cancer and how I feel about…not the least bit depressed or morose.. He does an excellent job explaining it: “we cannot change the cards we are dealt, only how we play the hand.” That is precisely where I have been for several years and throughout the last twelve months when things heated up.
Until this evening, there was a select group of 47 people who knew I have a high-grade sarcoma and they have all followed the rules. They did an excellent job keeping the information private. They know how I like to do diseases…..head down and mouth shut. I have done 2 colon resections head down/mouth shut, two wrist fusions that way, 5 spine surgeries that way and I have approached cancer the same way. The only reason I am sharing this now is I don’t want anyone to think I have turned into a meth head or that I am on the run from the law. Not that there is anything inherently wrong with being a meth head or being on the run from the law. This paragraph is not a pejorative paragraph designed to cast aspersions on meth heads or those on the run from the law. Or those meth heads who are currently ON the run from the law.
Those of you who were in the circle of trust until this evening….bravo to you. Thank you for keeping it between us and not bringing up cancer, selling my house, or the Winnebago for the last year. Good job!
In advance of any requests and despite my previous love for adventures, I’ll choose “pass” on spending the weekend with anyone. I didn’t spend weekends with anyone before I got sick and have no plans to start now. I sleep a lot. When I get tired, I go to sleep. Sometimes for half a day and sometimes for three days in a row.. I don’t want anyone around when I get tired because then I feel bad saying “go away” and I choose not to feel that old Irish (ex) Catholic guilt. Thanks in advance for wanting to get together for a weekend and understanding that I will most likely politely decline in advance. Unless you and I had a relationship where we made out and we had a lot of fun making out and you want to make out again for a while. I remain a fan of making out.
I have also chosen not to be one of those assholes like Lance Armstrong or one of my exes who runs around and screams at the top of their lungs that they have cancer or are a “cancer survivor” or that they “beat” cancer. That does not make someone special in the 2000s. Lots of people have cancer. Lots of people get cancer, get through it and then move on with their lives without yammering on and on about it all the time…..millions of people. Were it 1873, surviving some cancers would impress me. Not these days….95% of breast cancer, 99% of testicular cancer and 99% of prostate cancer is beatable these days. And no one “beats” cancer themselves…..their surgeons and their oncologists and their care teams do the heavy lifting. And Lance’s was testicular cancer which is like beating a really bad cold. Sure, it’s cancer, but the way he was running around screaming “I beat cancer” you would have thought he had a combo cancer of stage IV pancreatic cancer and Ebola. Or that he performed his own surgery and then came up with the chemo agents to use on himself. Maybe 17% of cancer folks ought to run around and tell people they have cancer……kids, so we can all support them……unusual cancers, so that we can raise awareness of them……and those who are terminal and doing something cool with it, like raising money for rare children’s cancers or adult cancers that do not get proper funding. Lance and my ex had no business running around screaming about their garden variety cancers. It takes the attention from the right places when people do that.
I digress. Here is the story. The one time telling of the story. You and I are not going to discuss it again. It begins in 1979 with my drunken Grandma Douglas then transitions into an interview with Natalie Imbruglia interviewing me about my sarcoma crap. Each and every question anyone might have about my type of sarcoma is in the Natalie Imbruglia interview. If you read through this and want to reach out, reach out about the Browns, puppies, the 2020 election, how women should be paid the same as men, etc, etc, etc. I don’t want to text, talk or email about cancer, my Winnebago, where I am living or selling my house. That horse has now been beaten to death, intentionally. This is a first draft, with little thought and no editing, like everything on Mind of Mully. Apologies to Strunk & White.
Oh, and I don’t want to hear about anyone’s cousin’s best friend who became cancer free by drinking only tea all day…mostly because I think your cousin or their best friend is full of shit. They never had cancer to begin with or they had a super easy stage I cancer that would have resolved itself on its own. Or they died exactly when the Kaplan Meier curve said they were going to die…..nine years after they got it. It was NOT the tea or the essential oils. I also don’t want a “fuck cancer” shirt. I believe cancer is a natural part of aging and besides, I don’t want to have sex it.
If you want to do something, buy “Misanthropes Guide to Sarcoma” when it comes out Q4, 2019 or Q1, 2020. Buy a bunch of them. Use “Misanthrope’s Guide to Sarcoma” at your book club. Half the profits will go to two animal rescue places that have been part of my giving plan for twenty years and the other half is going towards a foundation that will help the disenfranchised and the dispossessed in Pacific Beach, through a pastor dude I have been working with for a while. Here’s the cover. You can’t miss the cover: it is covered with pain pills and bourbon bottles.
Now THAT was a long damn intro. Onto the story.
We will begin with my mom’s mom….Grandma Douglas….and her affinity for both booze and discussing her real medical problems and any medical problems that she may have thought she had but did not have. Delivered with a lopsided grin and a stubborn sense of the absurd.
My Grandma Douglas drank a lot and by a lot I mean every day and all day. Grandma Douglas was a tiny woman, but she could drink her weight in booze. She could drink her weight in booze, plus my weight in booze, plus your weight in booze and my mom’s weight in booze. And my dad’s weight in booze: dad was six foot five inches and broad in the beam.. A mountain of a man. And anyone sitting near you while you read this? She could drink their weight in booze, too. Grandma Douglas could drink all of that weight in booze each day. Every day. If I wake up super hung over once a year from a long, long night of serious, serious drinking, my first thought is “well I may have drank a lot, but Grandma Douglas drank more than that every day and she lived to seventy-five…..so I am all good.” Grandma Douglas drank a lot.
Other than Grandma Douglas, Mulligans do not complain about our illnesses or surgeries. When we had holidays, all the children would hide when mom or dad drove to the east side of Cleveland to pick up Grandma Douglas. One of us was always chosen to join along on the ride and back then, the east side of Cleveland seemed like driving to China. It was far, far away and in that ride back with Grandma Douglas you would hear, for what seemed liked days, each of her maladies and what was being done (or not done) to fix those problems. When I was twelve, I made a pact with my parents to never complain about anything medical or discuss it incessantly. This is a pact I have kept through this very day. Unless you are speaking with your own medical care professional or a world-renowned person in that field, there is no need to drone on and on and on and on about what ails you or what surgery you just had done or whatever disease you may be dealing with. Head down, plow through. Other than Grandma Douglas, Mulligans do not complain about our illnesses or surgeries
Our family has always had plenty of cancer. We are chock full of cancer…..littered with cancer. My mom had colon cancer when we were kids and she was thirty-five, then got it again at around fifty-eight. She has Lynch syndrome…I do not have Lynch and this is in no way related to her genetic misfire. I have a translocation of the twelfth and thirteenth chromosome……a completely different genetic misfire. Then mom got stage II pancreatic cancer two years ago. My grandparents had cancer. Cancer in our home was as normal as pancakes for dinner once a week. Therefore, I’ve always believed that the question is not IF you will get cancer, it’s when. Do you get cancer at 36, 53, 78 or 103….. And when you do get cancer, you walk through it head down and don’t complain about it. Like when you pull a hammy. Walk it off and rub a little dirt in it. That is why you and I are not going to discuss cancer….because I believe everyone will eventually get it. Plus, we will have more fun discussing the Foo Fighters or why Tom Clancy writes awful books these days with bad writers or the outcome of the floods in Nebraska two months ago that no one is talking about these days. Our family has always had plenty of cancer.
I left my long-term job in 2000 with the goal of getting my PhD at UC Irvine, until the head of that program talked me out of it one afternoon by explaining to me that for five years I would make nothing and then for ten years after that I’d make 37% of what I was previously making. I immediately signed up for the Masters in Science in IT program at University of San Diego because the dot coms were hiring like mad and I had always wanted to be the dumbest person in each class in a master’s program. USD’s MSIT program fit that bill. I had time to burn before the MSIT program started so I went on a solo diving trip to Belize for a while, then I went to Nepal to learn both Hinduism and Buddhism.
The Buddhism lessons have always been useful, more so over the past three years. Buddha observed and taught that one of the three fundamental characteristics of existence is impermanence. Everything changes. Nothing of mind or matter lasts forever. Every single moment changes instantly into something else. Buddhism’s Second Noble Truth describes the principal cause of suffering. The principal cause of suffering is clinging. . . to anything at all. Buddhism has helped with letting go of Chez Mulligan and spending the next few years chilling with my cats in a Winnebago while reading and sleeping as much as I want.
To keep the fact sharing more entertaining, the rest of this piece will be told as if my twenty-year crush, Natalie Imbruglia, showed up in town unannounced and interviewed me for “Horse & Hounds” magazine. This interview should cover all the common questions about this sarcoma thing and the RV and the next two years.
I take an hour each morning and an hour each evening to read peer reviewed journal articles about high grade sarcoma, pelvic sarcoma, DDLS, round cell sarcoma, implications of a mitotic count of 40, implications of lymphovascular invasion being present, blah, blah, blah. Those two hours are the only two hours per day I choose to think about sarcoma. That’s why I choose to not have anyone else text, call, or email me about it. Literally, ever. Because those random texts or calls remind me I have a high grade sarcoma roaming around my body when I would rather be thinking about how I just had a great chest and tri workout.
Think about it this way. Let’s say your wife left you after cheating on you with the mailman. You came home from work early one day because the new “US” magazine was being delivered and there in your carport, your wife and the mailman were making the beast with two backs against his mail truck. And let’s say you got through seeing that, divorced and moved on. But then I started texting you and emailing at random times throughout the day about other people’s wives cheating on their husband with the mailman or asking you if you had gotten past your wife banging the mailman. See how that would make you think about your wife banging the mailman when you got the text or email? Also, no need to ask how I am. I’m fine. Ridiculously fine and extremely happy. When I am no longer fine the web site I have already made for my funeral will pop up and you’ll know I am dead. Then, you can come to the party 120 days later and trust me, it will be one hell of a party. It’s been planned for months.
Here is a list of some other things we could email, text, or talk about. The Browns, the Cavs, the Indians, your kids, my cats, the ocean, Robert Frost poems, your job, the 1099 work I plan on doing, surfing, music, concerts, a good book you read, a good book I read, a book that both of us read, that awesome person you married and/or are dating, that asshole you married and/or are dating, a great new restaurant where you ate, how the keto diet is bullshit and is pretty much a recycled version of the Atkins diet, how essential oils smell good but do nothing else, how great Mayor Pete is, what you thought about Goldwater’s masterpiece “Conscience of a Conservative”, a trip you plan on taking, a trip I just took, our favorite types of dogs, how much Wednesday sucks, the advantages to outsourcing all your laundry. That’s just off the top of my head. There are several trillion other topics for us to discuss that have nothing to do with sarcoma, selling my house or my RV. Let’s stick to those.
Natalie Imbruglia’s fake questions are in bold below. My answers are in non bolded script. All hail Natalie Imbruglia.
You’re a little late……
I thought we were meeting at 7 p.m…..it’s 6:55 p.m.?
No, I was riffing on my song, “Torn”…”you’re a little late, I’m already tooooooorn.”
Oh, I get it……” the illusion never changed….into something real….I’m wide awake and I can see the perfect sky is torn”, yadda yadda. Good one, Natalie. OK, let’s move this along. I have things to do and people to see. Your time to charm me was 1994 to 2000 and 2007 to 2017, Natalie…when I had the time to date and had the hots for you. These days I am a reborn virginal monk eunuch. Nice try, though.
How are the cats?
Well, you know…they’re cats. So they’re dicks. Running around, finding dick things to do. Cats are dicks.
So, any new scars? I like scars.
Oh, yeah. Lots more. My abdomen now looks like the shark from Jaws had me as an amuse-bouche and then spit me back because I tasted too bitter. Along with the previous abdominal scars from the two colon resections and the anterior lumbar interbody fusion, I have four more from this July surgery….a pretty bitching 12-inch scar that goes from my belt line to my nether regions on my pelvis, a new 10mm one above that from where they did the high ligation of the spermatic cord, a couple three-inch ones and then all the scars from the radiation burns that got infected. My abdomen and pelvis look, to me anyway, like those lepers from the first “Papillion” movie with my hero, Steve McQueen.
However, as my other hero, Shane Falco, said in “The Replacements”….”pain heals, chicks dig scars, but glory is forever……”
If you don’t mind looking at surgery photos, Natalie, this French peer reviewed article on spermatic cord sarcomas has excellent photos of exactly how they cut me open last summer. Good stuff:
Avert your eyes, if you’re not into surgery photos. Those of you who have worked with me will have no problem looking at this. They did it open because it was well integrated into the spermatic cord and surrounding tissue, so this was the incision that had to heal…waist line all the way down:
Then, this was what healed from July on……well, “healed” because when you deliver almost 70 Gray of post op radiation to an incision that size, it sort of inhibits the whole healing process:
I’d say it’s pretty well healed now. Lots of scar tissue and that scar matches the other seven scars from 2010 to 2017, so it looks pretty cool.
So you have a lipoma?
No Natalie…I had a liposarcoma. Completely different animal. Lipomas are not cancerous and are usually harmless. Liposarcomas are tumors that arise in the body’s fat tissue. Sarcomas are relatively rare, affecting only about 10,000 people each year in the United States…. sarcomas are rare…..liposarcomas even rarer……and a dedifferentiated round cell liposarcoma in the spermatic cord happens maybe two or three dozen times a year globally. Say, 24 cases in 8,000,000,000 people. If you looked up peer reviewed research on round cell spermatic cord sarcomas, there are fewer than 200 reported cases in all of the literature. They peer reviewed pieces generally start like this here.
Prognosis of sarcomas follows histology from the path report, Natalie. Histology predicts most everything. As does grade, location, size, mitotic count, necrosis, proportion of the tumor that was round cell (“bad” is 5% to 25% round cell) and whether or not the tumor had invaded the vascular system, because sarcomas spread via the blood. My tumor was in the pelvis, had an extremely high mitotic count (40…..”high” is 10), has lymphovascular invasion, was a round cell dedifferentiated liposarcoma with virtually all of it being round cell and it was greater than 5cm. Six swings and six misses. Hence the early retirement.
If you want to use the Google to do your own research, it’s important to know that you have to perfectly match the histology and path data. Mine is/was a grade 3 round cell dedifferentiated liposarcoma with lymphovascular invasion present, necrosis, and a mitotic count of 40. On the spermatic cord….in the pelvis. The reason that is important is that DDLS in a lower extremity behaves completely differently than DDLS in the pelvis. A low grade LPS behaves completely differently than a high grade DDLS. Nothing that you read on pelvic leiomyosarcoma is applicable to pelvic DDLPS. A round cell DDLPS is completely different than a spindle cell DDLPS…and so on and so on and so on.
Can you offer any deep dive details on what a high grade, round cell dedifferentiated liposarcoma is and how it behaves?
Sure…..below is a pretty good 5,000-foot summary from a text book, not a message board. As mentioned previously, message boards are populated by the ignorant and the criminally insane. I have been in med-surg my entire life and no medical professional has even said in the middle or a case in the OR “so, I was on this medical message board last evening and helped out this patient. Avoid medical message boards for the rest of your life. Or, you can look through these slides.
Different types of Liposarcoma have been described depending of their histology, including; well-differentiated liposarcoma (40%), myxoid liposarcoma/round cell liposarcoma (30%), pleomorphic (15%) and dedifferentiated liposarcoma (5%) each with different clinical behavior. Well-differentiated liposarcoma is commonly referred to as an atypical lipoma or low grade liposarcoma.
Dedifferentiated liposarcoma is the least common subtype of liposarcoma and usually arises from a well-differentiated liposarcoma (WDLPS). Dedifferentiated liposarcoma has also been defined as an atypical liposarcoma that progresses or changes over course of time with variable histologic grade. This is essentially a low grade liposarcoma admixed with a high-grade spindle or round cell sarcoma. These tumors occur mostly in adults and tend to behave far more aggressively than a low grade well differentiated liposarcoma. They arise most commonly in the retroperitoneum or pelvic region.
5 % of Liposarcomas
• Most commonly occurs in patients over 50 years old
• No gender predilection
• Commonly on deep soft tissue of retroperitoneum and proximal extremities
• Progresses from WDLPS and their presentation is more frequent after a recurrence of WDLPS.
• Up to 17% of well differentiated LPS progresses to DDLPS
• Painless enlarging mass
• Can attain a very large size
• Far more aggressive than WDLPS.
• Metastasis rate, range from 63% to 97%, depending on the dedifferentiated portion, mitotic rate and histology. Sites
• Lower extremities
• Upper extremity
• Between 13 and 47 % of patients present with metastases. Up to 87% of high grade patients will have a metastasis.
• Grade 3 DDLPS has 17-31% of overall chance survival at five years
• Location, grade, histology and mitotic count are the most important prognosis factors.
The most reliable means of obtaining local tumor control is by wide surgical excision. In cases of positive margins re-resections should be considered
option whenever possible.
• The response rates to chemotherapy of DDLPS are extremely low. Some studies show that chemotherapy is not useful as a part of the treatment and the majority of DDLS tumors are 100% chemoresistant.
“Liposarcoma is a malignancy of fat cells and represents the most common form of soft tissue sarcoma. It accounts for approximately 5% of all sarcomas. The prognosis varies depending on tumor site, size, grade, and histologic subtype. The World Health Organization recognizes five subtypes of liposarcoma: well-differentiated, dedifferentiated, myxoid, round cell, and pleomorphic. Patients with a low grade and well differentiated sarcoma have a relatively good prognosis with a five-year survival rate of 85%. Conversely, patients with a high grade tumor (e.g. dedifferentiated sarcoma) have a very poor prognosis with a five-year survival rate of 18-21%. Dedifferentiated liposarcoma (DDLPS) occurs when a low grade tumor changes and newer cells with higher grade arise in the tumor. Dedifferentiated liposarcoma is frequently found in the retroperitoneum, pelvis and the extremities (arms and legs). The etiology and the exact mechanism of dedifferentiation remains unknown. It is, however, thought to occur spontaneously due to certain chromosomal abnormalities”
So there are not many of these, then?
It is an unusual sarcoma, Natalie…hence the lack of research and dollars invested in clinical studies. To put it in perspective, prostate cancer has roughly 110 cases per 100,000 men each year. The number of deaths would be 20 per 100,000. The number of round cell DDLPS sarcomas is 3 cases per million per year and the number of round cell spermatic cord sarcomas is 18 per 300,000,000.
Number of new cancer cases diagnosed per year in US: 1,735,500
Number of new breast cancer cases diagnosed per year in US: 270,000
Number of new prostate cancer cases diagnosed in US per year: 238,000
Number of new sarcoma cases (all 800 types) diagnosed per year: 10,000
Number of genitourinary sarcomas per year (5% of STS): 500
Number of DDLS spermatic cord sarcomas diagnosed per year 28
Number of round cell DDLS spermatic cord sarcomas per year 6
This peer reviewed piece from MD Anderson is why there is not a rock solid protocol for spermatic cord round cell DDLPS. That’s one of the top cancer hospitals in the galaxy and they had 32 cases in 42 years. It’s tough to do a lot of research when your “n” is super low.
Sarcoma itself is an odd diagnosis, then the location of mine……pelvic, integrated into the spermatic cord…..was rare, within the “location” distribution. Of all the locations where sarcomas appear, the male genital area has the lowest proportion.
What did you have done?
Well, the first surgery last summer was to get rid of the tumor. I had a radical right orchiectomy when my doc did a high ligation of the spermatic cord north of the inguinal canal and then a wide dissection all the way down my pelvis, leaving a bad ass scar that starts at my waist line and ends just north of my special purpose. Then, because it’s attached to the spermatic cord and needs blood flow from the vein and artery removed, he took my right ball…leaving the right side of me like Varys from “Game of Thrones”. However, the left side of me remains as randy as Prince Oberyn. The alive Prince Oberyn….not the crushed in head Prince Oberyn.
Then I had a shit ton of post op radiation every week day for weeks and weeks and weeks (August 25 to October 29) and that burned the crap out of my pelvis. Those burns got really infected starting in September and you cannot knock out an infection while getting radiation, so I spent October 30 to the end of November in and out of the hospital trying to get the infections under control. The infections were pretty awful from October 1 to December 15: you cannot knock out an infection when you are also irradiating that area every day. It smelled like I had a dead raccoon in my underwear. I would be sitting at my desk working and look at the cats and say “did you fart….what the HELL have you been eating……old baby diapers filled with sewage and old curry?” and they would look at me and nod down at my crotch and say “not it, pal…..not it…..” The infection got knocked out in December and I was pretty much fully healed by February 1. Pelvic radiation is an interesting beast. It also makes you crap your pants and that is a whole chapter in the book. Artfully crapping your pants…a topic seldom covered in school, by your parents, or by most major religions.
I also spent most of the fall and winter with these three therapists here. Getting therapy and making sure my brain was well taken care of while the burns healed.
I heard you sold your house. You should not sell your house!
That’s not a supportive thing to say, Natalie Imbruglia. That’s like asking a couple with fertility challenges “when are you going to have kids…..oh, my….your life is not complete without kids.” I love my place….it took two years to get to a place where I am comfy selling it. Now, if you want to prepay the mortgage and the HOA fees and the special assessments and such for me for a year, I’ll stay. I’ll need that pre-paid for six months, please.
I loved my home and had been there twenty-six years. I planned on living in my townhouse until I was 203, because many of us Irish people are immortal, much like Star Lord in “Guardians of the Galaxy”. He is clearly Irish. It took a long time to decide to sell Chez Mulligan and I do not want to discuss selling it, Natalie.
My company was super supportive while I went through surgery and a full fall of radiation and the hospitalizations for the burn infections after radiation ended. Working full time wore me out. I’m not doing it again as this recurs. Selling the house allowed me working capital to not have to work when this comes back, which it will. That’s a full stop on the house selling topic, Natalie…let’s move on.
Sorry about that. Have you made any lifestyle changes?
Yes. I have started eating bacon with literally every meal and sometimes in between meals. Sometimes I’ll set an alarm, wake up at 3 a.m. and eat some bacon. And although I quit smoking thirty years ago, I may decide to take it back up in the fall and hope to get up to five packs a day by Christmas. Because….why not, and smoking is fun because….again…..why not. I may start tanning in a tanning booth six or seven times a day and might also insulate my Winnebago in asbestos.
I bought four new pair of various models of UGG boots in the first quarter and sixteen pair of comfy pajama bottoms and plan on dressing like and living like The Dude from “Big Lebowski” for the next year. Because I have a lot of scar tissue in my pelvis around my belt line, regular pants and belts hurt and, most important, because The Dude abides. “I don’t know about you, but I take comfort in that. It’s good knowing he’s out there. The Dude. Taking it easy for all us sinners.”
Oh, and I pretty much give the cats treats whenever they ask for them these days. Several thousand times a day. Good thing I did not procreate because had I procreated I would probably be saying to the kids “well, we NORMALLY do not condone crack smoking and heroin use in the house, but we may have limited time together, so you do what makes you happy…..I want to see you guys smiling.”
Do you have a bucket list?
Nope….I don’t have one. Now that I have got to hang out with you, Natalie Imbruglia, I have done everything I have ever wanted to do. I have lived a purely hedonistic, selfish life for decades and have no sort of bucket list. I am good to go whenever. I’ve been to forty-seven countries on five continents and all fifty states, which is pretty good for a kid from The Land of Cleve. I have been fortunate enough to throw around “I love you”s with some ridiculously cool women and have also been fortunate enough to have a stable of brilliant and hilarious friends. I could have been hit by a bus five years ago and still have
And for the love of whatever deity there may or may not be, Natalie Imbruglia, don’t ask people with cancer if they have a bucket list. It’s trite. Like asking a new parent if they are getting enough sleep. Don’t be trite, Natalie. The world does not embrace trite.
Final note on “bucket lists”. Everyone’s theoretical list should be identical….one line….”to have loved and been loved”. That’s it. As mentioned previously, I have been able to do both of those: those boxes are checked with a thick black Sharpie, making me good to go…whenever I choose to go.
Speaking of deities, I will pray for you
No need, Natalie…..I’m good….I have science and medicine and such. More importantly, the corollary of what you said would have to be true. If you believe whatever deity you believe in can cure cancer, then that deity also probably GAVE the cancer. I find it hard to believe that any potential deity would either give someone cancer or remove the cancer…..so no need to give me any of your prayers. Save them for the disenfranchised and the dispossessed. Same them for those who get shot in schools……just kidding….prayers do not stop people being shot in schools. Tightening who can have guns stop people from being shot in schools.
Why did you keep this on the down low for so long?
Good question, Natalie Imbruglia. A couple reasons. First and foremost, for the first couple years I had no idea what it was….thought it was Hodgkins lymphoma for a long time because of the night sweats, the fatigue and the unexplained loss. But there was also unexplained weight gain….I’d swing 30 up and 30 down for no reason. Same 2100 calories a day, same mostly vegetarian diet, same 90 minute work out. I’m data driven and did not want people guessing and suggesting essential oils would cure me.
Then, when we knew it was a high-grade sarcoma, unless someone was a world-renowned sarcoma specialist or an oncology surgeon, there was no reason to discuss it with anyone. I told some, but not all, of my work colleagues because I was unable to travel from July through the end of November. I told my family, but only after we had the fourth opinion on the path report. I told my close friends who live in the medical/surgical world and are not going to ask “did you think about holistic treatment for your grade 3 round cell sarcoma with a mitotic count of 40”. That is tantamount to suggesting they jump off a tall building.
And I told those who I was fortunate enough to throw “I love you” back and forth with over the last forty years. Except the girl at Catholic summer camp in eighth grade because I never got her last name and forty years later I am beginning to doubt if that was true love. It sure felt like it at the time. And I told my dry cleaner because we are tight and the people at my UPS store where I get my mail because we, too, are tight and I trusted them to keep this on the DL for the last few years. Hmmmmm…and three random strangers I knew I would never see again. And my realtor and the people at the RV place….I emailed them in October when this plan to sell the house and move into the Winnebago Sightseer 36Z went into motion.
A grand total of forty-seven people from April, 2018 to April, 2019. Over the past forty-five days I have told another dozen, in anticipation of finishing up this piece here. That’s how I parsed each and every question that might be asked: I would jot them down as they came.
I told the Pan-duh-Beeeeeeear because he has an advanced degree in round cell DDLPS research. He’s been helping out.
Most of all, I told people who I knew would not share the story, because it is my story to tell to whomever I choose, when I choose. Which is now. I carefully chose people who really know me and know that I have no desire to discuss cancer all the time or talk on the phone. I hate talking on the phone for more than three minutes. If you tell people you have cancer, all of a sudden your phone starts ringing nonstop and people want to yammer on and on about cancer…which is a pretty boring topic. Having to talk on the phone for more than three minutes or having to talk about the same damn thing all the damn time is actually, in my book, worse than the cancer itself. Imagine having the SAME conversation four hundred times.
Finally, one of my pet peeves is when I see people co-opt someone else’s story on their social media, Natalie Imbruglia. When I see someone post “just found out my friend Bob has cancer…..oh my.” It makes me throw up in my mouth. Unless Bob specifically said “hey, go ahead and post aboutmy disease on your social media, odds are you’re trying to get some attention. If you need some attention, get a puppy. The fewer people I told, the lower the odds that someone chooses to co-opt my story, which I don’t even want to share. Were it not for worrying about people thinking I all of a sudden got hooked on meth, I would not even share this
We have heard tell of a book?
Definitely. That is why we are here! I’ll be finishing “You Walk Him & Pitch to the Rhino: A Misanthrope’s Guide to Sarcoma” some time in 2019 and get it published in time for Christmas. There are a ton of first-person books on dealing with cancer that are all “rah rah” and “turn to prayer” and stuff like that, meaning the “sarcastic and snarky” niche is wide open for me. Grand canyon open. You want to hear about my sarcoma? Buy the book when it comes out.
And….what’s in it?
If you have ever read Dimitri Martin’s “This is a Book”, it’s a lot like that. There is one chapter that is all Venn diagrams and no cancer content. If you are a fan of Venn diagrams, as I am, you’ll agree that each and every book needs a Venn diagram chapter to break up the book. For example, most people believe the Bible is the best book ever written. You know what would make the Bible better? Venn diagrams, right between “Judges and “Ruth”. The Old Testament is dark and scary: you put some Venn diagrams in there and BOOM….people will want to read the Old Testament. Venn diagrams would make the entire monkey and the man with the yellow hat series better, they would make the Hardy Boys mystery novels more interesting and they would greatly add to the “Game of Thrones” books. Think of Tolstoy’s “Anna Karenina”, the desperate showdown between Anna and Vronsk where she has flung herself under a train in morphine-fueled despair and we are left wondering how this impacts her brother Oblonsky, his wife and her best friend Dolly. You know what would make that section less….desperate? Less dark? Venn diagrams. Venn diagrams make everything better.
Then, of course, there are the things no one ever talks about. Like crapping your pants.If you get high doses of pelvic radiation, odds are you are going to crap your pants at some point. If you get high doses of post op pelvic radiation and you’ve had two colon resections before the cancer diagnosis, you are definitely going to crap you pants and there are no other books that discuss how to properly and artfully crap your pants during radiation. This book does that, with aplomb. And dating. And how you should not act like at asshole from “PS, I Love You” and come back to haunt your ex every ninety days with love notes….just when they got over you. You are dead: leave your ex alone, for crying out loud. Let them move on and get laid. It may be the finest and most practical first-person cancer book out there. It has real information and the proper amount of sarcasm and snark.
Here is the book cover. I like it. Bourbon, half my hospital wrists bands from 2016 to 2018 and lots of pills. Captures the essence of 2016 to 2018: the only thing it is missing is a cat.
How did you come up with the title?
Well, Natalie, I had to wait a long, long time to get the path report back: it counced around for a while. So my surgeon calls and tells me that he wants me to come in and I say “dude, just tell me what’s up” and he walks me through the histology, the grade, the mitotic count, the necrosis, the lymphovascular invasion, yadda yadda. And as he is doing that I am taking notes and looking up the Kaplan Meier curves.
After we hung up, I had a screen full of Kaplan Meiers and I looked at the cats and said to them “you’ve got to be joking…..”. Then I copied the elevator scene from “Hot Shots” and replied “no, if I were joking I would have said ‘what do you do with an elephant with three balls? You walk him and pitch to the rhino.” The cats neither got the joke, understood the movie reference or cared about the Kaplan Meier. Because they are cats.
Then, I have an MDM2 amplification and a pretty significant CDK4 amplification, so that generates curves like this……..
And it was relatively clear from the beginning that chemo does not work on DDLS, which makes drawing the wire diagram on “should I try chemo” super easy to draw. You just draw the box “will it work on DDLS?” and then just one branch off of that to “no”. Then you move on. Makes it super simple to make choices based upon that.
You get the idea……The Google has plenty of these. Just stay the hell away from sarcoma message boards. Like all medical message boards, they are populated by non medically trained morons. Like Jenny McCarthy and her anti-vaxxer/pro plague friends.
Any fun radiation stories?
Sure. There’s a whole chapter of good stories in the book, aside from the chapter that is dedicated to crapping your pants artfully. Pelvic radiation, especially seven weeks of it, is interesting. Because of the other things that are near there. Like your private parts. And your legs. And your colon. And your bladder. But just the one story here….the story about how I got a smoking deal because of my Amazon Prime membership.
Three weeks into seven weeks, I noticed that even after relocating my private parts to the left after laying down in the machine thing…which was really just a mental thing and didn’t matter to the radiation machine, I got a great idea. A lead jockstrap. So I ordered a jockstrap that came with a cup and a sheet of 3’ by 3’ lead on Amazon. Called Stevie JC, asked him to stop by over the weekend with tin snips and we were going to make me a lead jockstrap. On Friday, when the radiation techs asked me what I was doing over the weekend, I replied “making a lead jockstrap”.
They explained that while I was free to make myself a lead jockstrap, since I was adding something to the field, I would have to have a new planning session done and that would take a week. And they would have to resubmit to Blue Cross and that might take another month. Since that would have screwed up my schedule of Aug to Nov (radiation), November (heal) December (heal), January (get house ready to sell), February/March (sell house)…..I didn’t make the lead jock strap.
If you’ve never ordered a 3’ by 3’ lead sheet, you cannot appreciate its weight. It weighed 43 pounds. Amazon shipped it next day because I am a Prime member. Meaning this not story about a lead jockstrap, it is a story about how last fall I more than made up for the Amazon Prime membership fee in a single transaction.
Anything you have found annoying?
No. I didn’t really tell anyone, so I didn’t have to hear all that “you’ll beat this” horseshit. Although, as an aside, saying “you’ll beat this” or “you can’t just give up” are two of the things not to say to someone with a rare, chemo resistant sarcoma. Neither of those is up to the sarcoma patient…..they are up to the histology of the sarcoma and the chromosomal translocation. I’d pretty much avoid those with any cancer patients, but you do whatever makes you happy, Natalie. Here is a pretty good primer on how to deal with sarcoma patients.
Regarding the “you’ll beat this” horseshit. I’ve said it for years and I’ll say it again here to you, Natalie Imbruglia, there are two things to say to anyone going through a cancer thing…these two things:
Can I do anything for you?
If there comes a time you DO need anything, will you call me?
That’s it. Full stop. None of that “you’ll beat this” crap, none of that “stay strong”, none of the prayer things, unless the person is religious. Think through that behavior of saying “you’ll beat this thing” to someone who is not going to beat it……then you put it on them. When they’re on their death bed, they may be thinking of you saying “you’ll beat this thing” and think to themselves “man, I sure fucked up and let so-and-so down because I did not beat this thing.”
Here’s a quote from a pediatric oncologist who deals with cancer every hour of every day:
“Fighting/war language is not helpful when you are talking about cancer. If you set yourself up for a war with cancer and it doesn’t respond in the way you had hoped, or it relapses, then you have to talk about “giving up” or “throwing in the towel.” If a person dies, it doesn’t mean that cancer “won.” Instead, if you frame it differently from the beginning, you can allow someone to change the goals of care in a dignified and courageous manner.”
I chose my goals of care and explained them to my doctors and family. I wanted to get through the surgery, get through the post op radiation, then heal and see how rapidly it came back. Then…get rid of most of my belongings, sell the house, quit working full time and have a year or two of unfettered “retirement”. I have executed on all of those, Natalie and will continue with the unfettered retirement through the relapses, on my terms.
If you watched “Top Chef”, you are familiar with Fatima Ali. She died of Ewing’s sarcoma earlier this year. My first two path reports in August, 2018 came back with “Ewing’s-like round cell soft tissue sarcoma” before being properly interpreted by Sloan Kettering in September. While I do not have Ewing’s and mine is not bone, it is a kissing cousin of Fatima Ali’s, which is to say that it is unpredictable in when it comes back and sometimes when it comes back it takes you out fast. That is why I am choosing to run this offense for the rest of 2019 and 2020. This is my version of “fighting” and this is the goal of my care: to do whatever the hell I want to do every day for as long as I am able.
Quote from a doctor who went through cancer herself who got sick of people saying “you need to fight” to her:
“I can tell you that I just glazed over when people said to fight. It was one of the most passive times in my life—just doing what was recommended. I needed fortitude, resolve and support…but fighting was way out of my capability…Every person experiences cancer in their own way. Insistence on “fighting” is not respectful of the patient’s right to make decisions that they choose.”
None of that “have you tried a cleanse?”, “have you looked into holistic healing?” or any of that crap, either. Unless you want that person to die. If you actually WANT that person to for sure die. suggest that they look into holistic therapy for something that actual medicine works on. If you break your leg, do you call a shaman? If you cut an artery, do you look into yoga for that or rub essential oils on the cut artery? No. You find a damn doctor…… James Fell wrote this excellent piece: “shut the fuck up about your bullshit cancer cure” about that topic.
And for the love of whatever deity there may or may not be, unless you are married to that person, it’s none of your damn business what treatments they choose to get or what clinical trials they may want to look into. You know what’s expensive? Clinical trials. You know who knows that clinical trials may exist? People with a cancer thing going on and their doctors.. You know when they know that? The first day they sit with their doctor and discuss their cancer. You have two questions you can ask. These two, Natalie Imbruglia. Write them down:
Can I do anything for you?
If there comes a time you DO need anything, will you call me?
And while I can only speak for me….don’t force yourself on anyone. These days I like to sleep a lot and can only be “on” for maybe an hour or two. And the radiation destroyed all my pelvic lymph nodes from August to November last year, so I get pretty bad pelvic lymphedema that comes and goes. When it comes, it makes my scar tissue hurt and the only way to get it to go down is to lay down…..and if I am solo I can lay down whenever the hell I want. Plus, I like to do pain in private and I still have a lot of pelvic pain. I let the cats around during the pain….I’m cool with them seeing it.
So when you leave here, Natalie Imbruglia, don’t invite yourself back for a weekend, or even a night. I make my plans day to day and it makes me oddly uptight to hear “well, then, we NEED to spend a weekend together.” No we don’t. We have had plenty of weekends together….let’s just remember those in a positive fashion.
Well that was quite the soap box speech, Dan
Yeah, well, I am opinionated. And ridiculously verbose.
And your baby blues make this room pop.
Thanks, Natalie Imbruglia.
You seem to be having a good time with this.
Indeed. I always have a good time, Natalie. You would have known that years before now had you accepted my invitation to dinner. I’ve laughed about this as much as everything else in my life. In fact, I made my radiation thingie into a cat bed and Ceeeeeeeatie loved it. Check it out.
And Steve and I had a wake for my spermatic cord and right testicle after he picked me up from the hospital last July. At the West End. That was a good time. And there was cake.
Oh, and he visited me in the hospital in November and brought me booze. I can always count on Steve to bring me booze when I am hospitalized.
My cousin’s friend’s uncle had cancer: do you want his number? And he used essential oils and CBD oil to cure it. You should look into that.
Oh, I know you know someone who had cancer, Natalie Imbruglia. We all do. We all know someone who had cancer and now does not have cancer. And we all know someone who had cancer and died from cancer. No need to tell me about who you know that had cancer. I know PLENTY of people with cancer, in fact, I have had cancer for quite some time, and I know me.
And your cousin’s friend’s uncle did not “beat” cancer with CBD oil or essential oils. Your cousin’s friend’s uncle either never actually had cancer and he/she lied about it……or…..your cousin’s friend’s uncle had an easy cancer to get rid of (like stage I or stage II breast cancer….or testicular cancer…..or something that has a 99% cure rate in stage I or stage II) and the surgeons and oncologists took care of the problem and THEN your cousin’s friend’s uncle spread essential oils all over their body after it was already gone, because they are an idiot. I don’t need to hear about anyone’s cousin’s friend’s uncle and their miraculous cancer cure. Thanks, though…..I’ll stick with science and medicine.
That’s why I have not told anyone for a long, long time. I don’t have time for that crap, Natalie.
And I have read virtually 100% of the peer reviewed journal articles on male pelvic sarcoma, urogenital sarcoma, DDLPS, round cell DDLPS, prognostic aspects of grade and histology, yadda yadda yadda. And highlighted them. And cross referenced them with their bibliography and reached out to the authors for updates. I have had plenty of time to do the real research, Natalie: I do not want to speak with your uncle. Unless he is a world class pelvic sarcoma researcher.
That’s just one folder. There are three (3) folders of research. Tyrion is good at drinking and knowing things. I am good at drinking and looking up and interpreting peer reviewed research. And, of course, not a single screen grab from a message board. Because message boards are chock full off bullshit. This folder here is just from January this year to today:
Are you going to die?
We are ALL going to die, Natalie. That’s the way things work. Except Thor…although I think he can die, too. I’ll have to check on that. With the way I partied in the 1990’s and the way I drive and the solo trips I have taken to countries in the middle of coups, it’s a wonder I made it to 53. I count everything from 2002 on as bonus years. Icing on the proverbial cake, Natalie Imbruglia.
If you want to know the probabilities, this graph is pretty good. Histology, grade, size and location are all predictive. On this graph, mine is the DDLPS Grade III…the bottom line. 40% of people die in the first year, so I have beaten 40% of the peeps with this…winning. 60% are gone in the first two years, if you average all the studies and input histology, location, grade, yadda yadda.
As stated several million places in this piece, I believe wholeheartedly in medicine, science and peer reviewed research. If you average out everything, the sharp drop off is by the end of year two, then it levels off and you have roughly 5% of people alive at 5 years. So I am going to treat the next two years like I am retired…do whatever I want to do, whenever I want to do it…..and then at the end of 2020 we will see where we are. here are some more numbers:
So, what’s next medically?
Nothing, really. For the most part, round cell DDLS is chemo resistant. There’s one chemo agent that “works” on it and the italics are intentional. “Works”, meaning it “works” in 8% of those who take it. So you feel like crap every single day…day and there’s a 92% chance it will NOT “work”. You won’t know if it “works” until, like, six to eight months into the treatment and we are talking about an overall survival of eight to twelve months when the mets start getting really active. Oh, and when it “works”, you get an extra couple months…..two extra months to feel like crap each and every day……..so, I’m not doing that. I’m done. I am not going to choose to feel like crap every day for 6 months to get an increased PFS or OS that is measured in weeks, not years. I’m done. Most important, I am utterly at peace with that choice.
Below is a typical paragraph in a peer reviewed article on chemo for round cell DDLS. Lots of toxicity, response rates lower than 15% and super low impact on time to progression. You may as well use essential oils. See what I did there?
“Because of the significant toxicity and limited response rates of doxorubicin-based combinations, efforts have been made to find more effective and less toxic alternatives. In clinical practice, an often-substituted alternative to single-agent doxorubicin is liposomal doxorubicin, which offers similar response rates but a favorable toxicity profile. In a phase II study comparing liposomal doxorubicin to doxorubicin in soft tissue sarcoma, liposomal doxorubicin showed decreased adverse events including less myelosuppression and cardiotoxicity (Judson et al., 2001). Response rates were similar between the two arms (14% in liposomal doxorubicin vs. 12% in doxorubicin, excluding GIST cases), although this study has been questioned due to the relatively low response rates to single-agent doxorubicin. Median time to progression was slightly improved in the doxorubicin arm compared to liposomal doxorubicin (82 days vs. 65 days, no p value reported).”
Interpreting that…the “standard of care” works in 12% of people. In that study, versus the “standard of care”, it worked in 14% of people instead of 12%. In my thirty years in surgical, with many years of using or running teams that did peer reviewed research, numbers like that would get you laughed out of the room. “Good” numbers in a study are “it worked in 75% of those in the study”. And extra 2%? That’s laughable. And the median time to progression increased when it DID work by 12 days. 12. Days. That is what passes for “works” in my histology of sarcoma.
Given the DDLS histology high grade and location, there’s a 93% probability it will return locally in my pelvis in the first two years. Given the histology, grade, mitotic count and lymphovascular invasion noted on the pathology report, there is an 87% chance it will metastasize. Given the round cell component, it can metastasize to the lungs, bone or soft tissue. So we’ll just wait for that and make some decisions at that time. Until then, I’ll be reading a lot, drinking good bourbon and getting some sleep. This is my Mayo care plan that I am working through, given the chemo resistance of the round cell DDLPS:
In order to execute on that care plan, I sold Chez Mulligan and moved into a thirty-seven foot Winnebago full time on May 1 to get my costs down to a far lower, fixed amount. I’m not looking at it as any type of adventure. I am looking at it as a place to relax and the only thing you can live in with three cats while keeping your fixed costs less than $3,000 per month.
You getting buried or burned?
Great question……burned, for sure. That’s all planned out. In fact, I spent since last fall lining everything up and it’s going to be an excellent party. Funerals and memorial services are for the living and this one will be world class. Since the party will be in San Diego, it will be a Saturday…… 90 to 120 days after I kick the bucket so as to allow people time to plan a good little weekend vacation. Everything is all dialed in and paid for already…..so people just need to get to San Diego and then have a good time.
And I already had the urn made. Well, the urn container. My ashes are going into that great big Bulleit bourbon bottle…a bottle that I already drank. And I found this guy in Kentucky to make the box for the urn and had him put my favorite Archpoet lines on it. These ones:
Meum est propositum in taberna mori,
ut sint vina proxima morientis ori.
tunc cantabunt letius angelorum chori:
“Sit Deus propitius huic potatori”
Which, loosely translated, is:
“My purpose is to die in a tavern,
so that wine might be close to my dying mouth.
Then a choir of angels will happily sing,
“May God be merciful toward this drinker.”
Turned out pretty good: the photo below is the exact Bulleit bottle and the box. Fire up will be at Latitude 32 on Cass Street, then the church service will be at PB Christian (a block from Latitude 32) and then there will be two busses to take people to the after party at the San Diego Museum of Man, where there will be more surprises. Three days after I kick the bucket my friend Steve will publish the web site that is already built and then people can make their plans.
Back to your question. Burned……definitely burned. I’m still trying to make friends with someone who works in a B-52 because I’m putting some of the ashes in these tiny half note things and a dozen of my friends who love music as much as me will be tasked with bringing a small part of me to concerts for the next few decades. But I would love to have someone who works on a B-52 and circumnavigates the globe take the rest and on a trip sprinkle just a little bit of ashes the whole way around the world……that way I will be EVERYWHERE. You know anyone?
Sadly, Dan, I do not…..but I will ask my friends.
Thank you, Natalie Imbruglia.
Anything anyone can do for you?
Yes. For the love of god, STOP….SHOOTING…..VERTICAL……F*CKING…VIDEOS. Just stop. Never, ever, ever, ever shoot a vertical video. I don’t want people to start checking themselves for cancer and such, I just want them to STOP….SHOOTING…..VERTICAL……F*CKING…VIDEOS.
When you record a video with your phone, turn the damn thing horizontal. It is meant to be horizontal when you shoot video. I don’t give a damn that it looks OK on your phone, when you put it on anything else that is NOT your phone there are gray bars on the left and right when you do it wrong. Those gray bars are the universe saying “hey, *sshole….quit shooting vertical videos….they look like crap.”
If I could get everyone to turn their damn phones in the correct orientation….horizontal…while shooting videos for however long I have left, be it one year or three, that would make my years more comfortable. Then I will not have to click on “hide this post” every time I see those stupid gray bars framing a video on FB”. And I won’t have to yell “TURN YOUR DAMN PHONE SIDEWAYS TO SHOOT VIDEOS…..IT LOOKS LIKE CRAP WHEN YOU SHOOT VERTICAL VIDEOS” at my Mac.
Fewer people will die of cancer if everyone stops shooting vertical videos,
That statement is as true and saying that diet, yoga, essential oils or any of that other holistic crap will cure sarcoma or most cancers. And has as much data to back it up. I lied. Fewer people shooting vertical videos will not cure cancer or prevent cancer, however, it will prevent stupid gray bars on the right and left sides of posted videos on social media.
Oh, and elect a woman as President in 2020, for crying out loud. It is ridiculous that we have not elected one yet and given statistics and medicine and science and such, this is probably my last chance to see a woman take the oath of office. So, quit shooting vertical videos and elect a woman as POTUS. I have everything else under control.
I was just kidding. You said up there that you didn’t need anything.
Game, set, match, Natalie Imbruglia.
Anything frighting about the last few years?
No. Not so much. As we discussed earlier, we’ve had a lot of cancer thingies in our family and the outcomes are pretty well binary……you live or die…..and I am quite comfy with either of those. I never bought into that “hell is a possibility” as an afterlife thing so there’s no fear there.
There is one thing I am extremely afraid of, though.
And what is that, Dan?
Bears, Natalie Imbruglia. Bears. Bears will fucking kill you.
What sort of RV are you living in?
I researched all last fall and winter and decided I wanted one with a king bed, two bathrooms, plenty of televisions, a residential fridge (I eat mostly fruits and vegetables) and one with an open floorplan. I ended up purchasing a 2016 Winnebago Sightseer with 15,000 miles….so all the bugs were already worked out. Here is a walk through video of it.
Then, I had the RV place put in the best DISH on top and the top of the line 4D receiver and repeater, because I plan on watching just a shit ton of TV. And I had a company up in Anaheim replace all the furniture inside with brand new leather furniture. This is what it looks like now. It’s a most excellent transient Chez Mulligan.
Where are you going next in your RV?
Wherever I want. I am not planning it: I am simply choosing a place where I can stay for 6 to 8 weeks in a row that is pretty and has full service hookups and I can walk to town and to a gym. On the west coast, near something pretty, be it a mountain or an ocean and only in CA, OR, NV, UT, AZ or ID. Just those five states. Then, five weeks into that trip, I’ll pick the next place. There is no agenda and I don’t want to be asked what the plan is,. There is no plan….that is the plan. I want to live in the present and also don’t want to answer the same five questions over and over and over.
The five off limit questions for forever and ever are:
1. Where are you now?
2. Where are you going next?
3. How long will you be there?
4. How are you feeling? (awesome)
5. Are you SURE you don’t want to try chemo or look into holistic? (positive….neither will work).
I am headed first to Kanab, Utah…..you can look it up on The Google. For years the Best Friends animal sanctuary has been part of my annual giving plan and I am going to volunteer for six weeks there, rotating through doggies, cats, horses and pigs. Selling the house made me miss foster kitten season for the first time in twenty years, so I’ll make up for it at Best Friends.
After that I will pick a new place on the left coast every six weeks or so with Reliable driving my house for me and me driving the Dodge. Cats ride with the driver in the Winnebago…..I drive on ahead, as fast as I want, stopping whenever I want. Again, with no plan. And only on the left coast. Only qualification is the campground has to be close to a gym, near an ocean or mountains and it has to be full service and uncrowded. Misanthropes hate crowds.
Are you comfortable driving a thirty-seven foot Winnebago?
I have no intention of ever driving my RV. I am outsourcing that and found a great company made up of retired police officers. I pay them, they show up and drive the RV and the cats while I head out in advance in my Dodge. The Dodge goes 100 to 160 mph on the open road: I doubt very much the Winnebago ever gets over 60 mph. I am outsourcing and I love the company to whom I am outsourcing the task. They are utterly fantastic people.
You know they are not that hard to drive.
Don’t care. Made my mind up months ago to outsource the RV driving: plan your work and work your plan Natalie Imbruglia,. I don’t ever want to get good at driving an RV and I don’t have to get good at it. It’s simply a place for me to live at a super low fixed cost, four to six weeks at a time, in random places I choose on the left coast. You do you and I’ll do me, Natalie Imbruglia.
Can I come spend a weekend with you or ride around in your RV with you?
No. That’s not on the table for anyone and will never be on the table for anyone. As big as my crush has been on you for 23 years, Natalie Imbruglia, I don’t want to spend a weekend with you. I get tired pretty easy and really don’t know what my energy levels will be from day to day, so I am not going to spend “a weekend” with anyone. In order to go out with friends for a night, I generally nap for 4-5 hours ahead of time and if we are out past 9 p.m. I’ll sleep for two days after.
As for riding around with me, when I was married to Penny I would go to a different floor of the townhouse to pee……..I have level four stage fright. There is not an ice cube’s chance in hell that anyone is driving around with me in my RV or staying with me in it, despite the fact it has two bathrooms. The RV has one purpose: get my fixed costs down to $3K a month so that I can sleep whenever I want. It’s not an adventure mobile for group road trips. Misanthropes avoid group road trips.
It’s kind of you to ask, Natalie, but it makes me uptight to have to keep saying “no” to people who want to spend a weekend with me and I’d rather not keep having to say that. And I’ll also say “no” when people say “oh, if you’re tired you can just sleep…it won’t offend me” because it’s going to make me feel guilty if someone comes to visit and I feel like crap at that time. Irish Catholic guilt: the worst kind of guilt. So….no…..and thanks for asking.
We should have a party in your RV!
No, Natalie, I will not be entertaining in my RV. The RV is set up for me and my cats to have quality time together and for me to relax and sleep. It is not a party venue. I am worried only about one thing…my cats escaping the RV. They are chipped and have collars, but they are crafty. Plus, cats are dicks. I know for a fact that if only Daniel C Mulligan is going in and out the door that no cats will escape: however, I do not trust anyone else to make sure my cats do not escape. Therefore, I will not be entertaining guests in the Winnebago.
Anything else you’d like to share?
Just a summary on moving forward. I believe in science and outcomes-based medicine…..which is to say I think holistic things are complete bunch of crap. If research is unable to find some sort of gene suppression therapy down the road, charlatan “holistic” morons certainly are not going to come up with cures for sarcoma. I had the following rules with my sisters and the small circle of friends with whom I have shared over the past 18 months and these are the rules. I’d like everyone I know to please stick to them.
Some folks have said “I’d like to join you in your RV.” As mentioned above, I will always respectfully say “no thanks” to that request one hundred percent of the time. When I was married and had to go to the bathroom, even number one, I went to the floor that my wife was not on. The RV has two bathrooms, on the same level, sixteen feet apart. I do not want stress when I want to go to the bathroom. I’ll be spending 100% of my RV time with my three cats, living a monastic, non-dating, eunuch-like, single life. Hence the name of the book…..”a misanthrope’s guide”. Plus, as we discussed earlier, the RV choice is not for adventure, it is the single best way for a person to reduce their fixed monthly costs to a minimum. Had I not married, I would have spent the next two years on my deck in la Jolla, reading books, drinking bourbon and smoking pot.
There are high grade sarcomas that do not respond to chemo or radiation.
This is one of those sarcomas
Yes, I’m sure.
Super sure…..I have done two years of research and I am super good at research.
Those two years and the research have made me super comfy with this whole thing. Zen even.
It’s not my job to make anyone else feel comfy about it, so that’s on you to do yourself, Natalie.
There is no “what is next”…….because there is nothing else to do that will actually add to overall survival.
Please don’t ask “now what”. It’s sort of rude and none of your business.
Don’t suggest “holistic” crap. You may as well tell someone to hold their breath under water for eleven minutes. Same outcome. Fastest way for a cancer patient over Stage II to die is ignoring medicine/science and going “holistic”.
Here are some more links. If you feel like using The Google, again…..sarcomas are a super heterogenous group and you have to only apply things that are the same. Grade 3, dedifferentiated round cell liposarcoma of the spermatic cord with lymphovascular invasion…..it had a mitotic count of 40 with necrosis and it was roughly the size of an orange….6cm X 5 cm X 4 cm. And the round cell component was roughly 90% of the tumor: “no well differentiated liposarcoma component is noted” (fourth opinion…from Sloan Kettering….September 3, 2018). It was mostly all round cell.
It started as a far smaller well differentiated liposarcoma in 2015 with the primary presentation being testicular hydroceles. The 2018 tumor was removed with a radical right orchiectomy, high ligation near the inguinal canal. All questions are answered above with deeper links below….. and if you have any more questions, The Google is waiting for you.
Best experienced with Neil Young’s “Keep on Rocking in the Free World”. Feel free to right click the link below to open the tune in a new browser window. That instruction is for my mom…..who would have clicked on the link and missed the actual writing…….
(Written from November 9, 2016 through January 19, 2017)
The first three weeks of November were crappy. First, the Indians lose Game 6 and Game 7 of the World Series. Then, slightly less than half the nation votes in an orange colored, poorly qualified person to the Executive branch. Then, Leonard Cohen dies. The only thing that would make that three-week period worse is if the world ran out of bourbon. Which is why I penned a letter to America and some of the groups in America on various plane rides across this great nation.
This is why we cannot have nice things.
Dear Coal Miners:
As you may have seen, 6 days after the election, Mitch McConnell (he’s the guy who runs the Senate, in the event you only follow politics when someone lies to you and gets you all riled up in a Presidential race) has already said……and I quote……”bringing back coal jobs is a private sector job….not a government job.” His words. And, by the way, the words of everyone else for the last 12 years. Coal did not go away because of President Obama or even President Bush. Coal jobs went away because coal had a solid run from 1843 to 1983 and now is no longer the best energy source. Period. Not a single one of you is going to get your job back. He was full of shit. It is a motif……like that whale in the book about the old guy and the whale. Bullshit…..a motif.
You saw that Kanye West was at the orange guy’s towers there in NYC, right? It was all over the news. Do you know why you have not heard that same orange guy say a thing about coal jobs or have anyone involved in coal jobs in for a visit? It is not because the news outlets missed the coal meetings……
It is because the orange dude lied to you. Like he lied to his first two wives when he said “to have and to hold until death do us part.”. You know what liars do? The lie. That’s why we call them liars. You got snowed. You know what would have been the same thing on the Democrat side? If Hillary had stood in front of crowds and screamed “I am going to bring back the biplane and regular gasoline cars!” You would have said, “whaaaaat the hell is that? That’s not possible” Same thing with the coal jobs. You got bullshitted. Get used to it.
You got bullshitted as well. You know whom TPP would have helped? You. One of the main beneficiaries of TPP is US agriculture. Don’t believe me? Use The Google and hind the October 16, 2016 article that was on the front page of that liberal rag the “Wall Street Journal”……Google the following…..in quotations…”wall street journal TPP farmers” and it will be your first search result that pops up. Go ahead and read through that. See? That’s why you ought to read edited newspapers BEFORE you go to rallies and get all riled up about them damn non whites who are over here stealing our jobs.
Oh, and those of you farmers who use migrant workers to plant and then bring your crops in in the Southeast….keep in mind that in those two years that Alabama and Georgia outlawed migrant workers, they lost hundreds of millions in revenue. So they changed the law. Because we NEED migrant workers. Proof source? Of course I have a proof source. I do actual research.
And the guy who just got appointed to be Secretary of Agriculture? He used to be a Democrat…until he flipped when being a Republican made it easier for him to become governor in Georgia. Which means he has no character. And when they had a drought in Georgia back in 2007, he got a bunch of people together and they did a……..wait for it……prayer circle to make it rain. Yep. No…..no, it did NOT work. I am as shocked as you are.
Dear Steel Workers:
This may come as a shocker given the pervious two paragraphs……but here goes. You got snowed, too. The dude who was named as Secretary of Commerce….you know how he made HIS money? Wait for it……….wait for it………he is a vulture investor who purchased steel mills, fired people, then sold those steel mills to the Chinese. Guess what the Chinese did with the steel mills? They poured capital in, modernized them and doubled the US workers in them. No. Just kidding. They closed them and put people out of work.
Don’t believe me? Here is a 2004 article. That was 12 years ago, From well before he was named Sec Commerce.
Soooooooooo, four weeks ago, and for 15 months before that, it was “I’m going to create so many jobs for you steel workers and coal miners. Now, he has hired…..as Secretary of Commerce…..one of the people who is supposed to help CREATE jobs…..a dude who made his billions buying distressed businesses and firing the workers. You didn’t see that coming, did you? You know who DID see that coming? Anyone who has ever looked into how the orange dude has run his companies for the last thirty years. Those of us who read things and do our homework. Wilbur Freaking Ross. Hahahahahahahahahahahahahahaha.
Dear African American Friends:
First, let me rewind this back……to an apology first about slavery….then an apology about Jim Crow from 1920 to 1974 (or longer in some places……like up until today) and then……about the whole mass incarceration thing that was sort of the same thing as slavery and Jim Crow. And now what does white America deliver to you?
A dude whose FATHER marched with the KKK in 1927 and was fined for failure to disperse while marching with the KKK. A dude who helped his daddy discriminate against people of color in the tenements they owned from 1972 to 1978. A dude who walked off a plane in Nevada earlier this year, walked up to the microphone and yelled “where is my African American? (scans crowd)……THERE’S my African American!”. A dude who says “THE blacks” because you KNOW he has used a completely different word for the previous 70 years when talking about non-Caucasian peeps. A racist will be in the White House.
And he will be surrounded by racists, too. Shocker. Jeff Sessions? He said that the thing that bothered him about the KKK was that they smoked pot and was considered too racist for a federal judge position. Now he is AG. Bannon? White nationalist……always has been and always will be. Pompeo? Another racist…..called President Obama an “evil Muslim, Communist, usurper.” Yep. A racist surrounding himself with racists? Shocker.
From the bottom of my heart……sorry about that. I have your back. Everyone I know has your back.
Dear Koch Brothers:
Look…..you got your little puppet into the head position at the CIA. Yes, we are all aware that you have been the money behind Pompeo since the beginning. Like “Trading Places” or “The Manchurian Candidate”.
And you got another puppet……. for Sec of Energy……
I liked the “Trading Places” evil brothers a trillion times better than you. Mostly because Eddie Murphy was funny back then. I miss the funny Eddie Murphy. It’s like his genes turned off the funny gene in 1998. That’s a shame. In any event, you two suck….despite what your happy little Koch commercial on CNN say. The earthquakes in Oklahoma that were NOT there before fracking tell a different story than the blonde in your Koch commercials.
Dear Anyone Who Pays Taxes:
Did you see the next tax plan? It’s a good one. If you are in the top 1%. Now, if you’re in the middle class, especially if you are in a family with three or more children or a low or moderate earning single parent, you are going to pay MORE. You didn’t actually believe him when he said you were going to pay less, did you. Man, you are gullible. The dude who told the truth about the tax plan was Bernie Sanders. He looks completely different. Bernie is not orange.
In any event, if you don’t earn more than $576,000 per year, you’re going to pay more. Suckers.
Dear People Who Made the Movie “Bad Santa”:
I see your movie several dozen times around this time of year. Great flick. Thanks for making it. Here’s my problem with your flick, though. I cannot suspend my disbelief when the bad Santa character has the romantic fling with the good-looking bartender. There is NO chance that bartender would make the beast with two backs with a nasty, smelly homeless drunk. Nope.
Dear Richard Nixon’s Ghost:
Remember during the Pentagon Papers scandal when you said; “we should quit making heroes out of people who steal other people’s secrets and then publish them in newspapers”? Dude…you should have seen Wikileaks. And Russia. Remember how you hated Russia and How Reagan hated Russia and how everyone hated Russia? I still hate Russia. Guess who does NOT hate Russia. Seriously. Go ahead. Take a wild guess……
Dear Steven Seagal:
I see Putin gave you a Russian passport. There was a photo of it in the paper this morning. That shirt you were wearing in the photo made you look fat. Or, rather, your eating habits and lack of working out made you look fat in that photo. One or the other.
Does Putin know you are not actually Casey Rybeck from “Under Siege”? You are the actor who portrayed Casey Rybeck in “Under Siege”….you have never actually been in the Navy. Did you know Putin murders reporters? And rivals? And took over part of the Ukraine two years ago. You fat ass commie sympathizing has been.
You are a Commie punk sympathizer. Ronald Reagan’s ghost is probably going to come haunt you…..every night……for all eternity. Because President Reagan hated the Commies and you know whom he hated more? Pinko sympathizers like you who take money from RT.
Dear General Mattis:
Thank you for taking that job. It is comforting to know that there is one person in that cabinet who is an “other directed” adult….not to mention the fact that you can kill several people at one time with your bare hands.
Dear Senator McCain:
If you want to punch the orange dude in the face a few times for mocking your military service, you have precisely 17 hours to do it relatively easily and with less of a penalty. If you need any help, call me.
Dear Everyone Who Believed Homeboy’s Lies About Taking Care of Everyone:
Here is a photo from three weeks ago of the top twenty-four (24) positions in the cabinet…with the veep and president spot included. Twenty-four positions. Of those 24 positions, precisely 4 of them (16%) of them are not men. Women make up 51% of the United States population and 16% of the orange dude’s cabinet picks. That’s a pretty big delta. Bet you feel kind of stupid if you held a sign at those rallies that read “trump loves women”. Or, maybe you were confused about what he loves them for. Clearly not for cabinet positions.
Back to those 24 positions. 2 of the 24 positions (8 percent) are non-white dudes.
That means that of those 24 positions, 20 of the nominees are……wait for it…….white men. 31% of the general population is made up of white men and 83% of the orange guy’s team are white men. Of those white men he pulled in, 73% of them are millionaires and billionaires. Less than 1% of the United States population is millionaires or billionaires. Which means that this proposed cabinet is the least representative cabinet since the late 1700’s. This cabinet actually looks JUST like the ruling class in the 1700’s when only land owning men could take part in government. Welcome to 1793, everyone.
And it means that all these morons who said they believed they were going to get something different and that this guy truly cared and that he was all about them got snowed. Which is not that shocking.
You know who we did not need to see on CNN all weekend after Castro died? Elian Gonzales. I don’t care what Elian Gonzales thinks about that Commie dying…..no one cares what Elian Gonzales thinks about that Commie dying. Well, there’s a good chance that Steven Seagal cares about that Commie dying. Because it looks like he is on some sort of treasure hunt where he collects dirty Commie passports.
You know how we know no one cares about Elian Gonzales? Because up until the time when Castro died, no one saw him or asked him any questions. You know why? Because he demonstrated his lack of intelligence by choosing to reject South Beach. If you’re not LeBron heading back to The Land of Cleve, rejecting South beach is insane.
No. No you cannot have any more money. You had plenty of money and you lost the election. Quit sending me emails. You cannot have any more money. I will; however, continue to give money to Applegate because Issa is a smarmy punk. Despite being from The Land of Cleve.
Hey, hey, hey…..how about this. How about in the NEXT Presidential campaign you make matching in-kind donations to food banks and homeless shelters. For example, if you and the RNC spend a billion dollars on the Presidential campaigns, you then also donate a billion dollars to hungry and homeless people.
You were angry that President Obama won the primary in 2008 and then you lost your way. Since then, you have lost over 6,000 state, local and national seats. You need to find your way, DNC.
Dear Pundits & People Saying “It Was the Economy”:
Bullshit. Cleveland’s Corey Kluber and Andrew Miller were an amazing MLB pitching combo in 2016 and have the stats and the wins to back up that assertion. Atlanta’s Matt Wisler and William Perez were awful in 2016…..they sucked….and the numbers and wins prove that out. Numbers & facts……facts & numbers.
The economy was dong crappy under Bush 41….we brought in Bill Clinton and grew the economy much like Ike grew it from 1953 to 1961. Then Bush 43 took the reigns and six years later the economy was tanking in a spectacular fashion. Then we brought in Barak Obama and unemployment went back down, jobs went back up, the stock market climbed to new record highs. And President Obama’s average GDP growth was twice that of Bush 43.
Anyone saying “it was the economy” is either a moron or full of shit. We just took out Corey Kluber and instead of tossing the ball to Andrew Miller, we threw it to Wisler and Perez. You got snowed if you think this new group is going to do better on the economy. That has not happened under a Republican in over thirty years and it sure as hell will not happen under someone who has bankrupted six companies. Bankruptcy means failure. Bunch of racist, misogynist morons is what it was. Period.
Dear Disenfranchised White Voters:
Dear Anyone Who thinks Gerald Kushner Ought to be Involved:
His daddy Charles Kushner, a multimillionaire real estate executive, philanthropist and one of the top Democratic donors in the country, was sentenced in 2005 to two years in federal prison after pleading guilty to 18 counts of tax evasion, witness tampering and making illegal campaign donations. Apples…..trees…….
In June of last year, then Republican presidential hopeful Donald Trump received his first—and one of his only—endorsements from a publication. It came courtesy of The Daily Stormer, a neo-Nazi and white supremacist website. The Daily Stormer’s stated goal, according to founder Andrew Anglin, is “to ethnically cleanse White nations of non-Whites and establish an authoritarian government. Many people also believe that the Jews should be exterminated.” In the wake of Trump’s shock victory, Anglin suggested to readers that they should troll pro-Clinton liberals into committing suicide.
As if that weren’t enough, Trump also received endorsements from the American Nazi Party, whose chairman believed a dt victory would present “a real opportunity” for the white nationalist movement, as well as “The Crusader”, otherwise known as the official newspaper of the KKK. And over the course of the campaign, both dt and his eldest child of the corn…..donnie Jr……shared anti-Semitic memes that originated on neo-Nazi message boards, while matching bad haircut children of the corn (and rejects from a drug fueled orgy scene in the vampire movie “Blade”) sons donnie jr. and eric did actualy interviews with five white nationalist-affiliated outlets.
The Trump camp’s seeming embrace of the white nationalist movement, and their utter refusal to condemn any and all anti-Semitism spread in Trump’s name, is particularly puzzling when you consider the fact that Trump’s son-in-law Jared Kushner, who some dt advisers have called his “real campaign manager,” is an Orthodox Jew. It’s even more baffling when you take into account how dt’s daughter, Ivanka, converted to Orthodox Judaism to marry him. How challenging would it be to craft a press release that disavows all support from white nationalist and anti-semitic groups and condemning their action? I could jot one of those up in eleven minutes. Twelve, if I got wordy. I always get wordy.
I miss you. I miss you dearly.
However, in a country where the majority believes angels are real things and then believes that because they BELIEVE angels are real it proves that angels are real…….facts get lost pretty rapidly, Just because YOU believe something does not make it a fact.
I’ll keep reading books. And fact checking. I will never lose my love of you, facts. Ever. I ordered these last week and will read them this week and get more next week. I heart you, facts.
Here’s a fun fact. In the last 10 years, both President Obama and Hillary Clinton received significantly more votes than the orange, misogynist guy:
President Obama, 2008: 69,498,516 votes. 365 electoral votes
President Obama, 2012: 65,915,796 votes. 332 electoral votes
However, that’s not the best fact. The best fact is when you proportionately compare the orange misogynist guy’s popular vote total and electoral college totals to all the winners previously, you see that he is one of the least winningest of the winners. Which is pretty fun.
Dear Starbucks Employees:
I saw that whole “people having you write dt’s name on their cups” thing because of Howard Schultz. Which is pretty amusing because that means they’re giving Howard Schultz between $3.80 and $6.40 every time they protest against him. That’s a pretty good deal for Howard Schultz and Starbucks investors.
Here’s a suggestion…and one that’s not going to hurt you because those morons aren’t coming back anyway. Instead of writing dt’s name on the cup, write the last name of a famous feminist, a famous civil rights person, a famous LGBT rights person, or a famous Muslim author. Here are some names to get you rolling………Naomi Wolf, Abu’l Hasan Mihyar al-Daylami, Oscar Wilde, Tennessee Williams, Azar Nafisi, Truman Capote, Alice Walker, James Baldwin……..there you go,. Knock yourself out.
Or, you could put the tally of the tally of the number of bankruptcies each has and that would still include the dt name. You could scrawl “Howard Schultz: ZERO bankruptcies……dt: SIX bankruptcies.” on their cup. That would be pretty fun, too.
You know that infrastructure plan that was discussed during the election and in depth from November 9 to today? Do you think your President knows that was Democrat plan that was shot down seven (7) times by your Republican controlled Congress? You know that paid maternity leave and equal pay for women plan dt discussed during the election and the same plan that his team says they want to get done in the first six months? Do you think he knows that is a Democratic plan that the Republican controlled Congress shot down five (5) times?
You know all those global trade deals that he wants to swap out or switch out? You know that’s been the Democratic party’s platform for a while, right? Your heads must be exploding. Or……you are like me when a large pizza with bacon and onions shows up. Super, super happy that a large pizza with bacon and onions just showed up, but also super, super unhappy at what that’s going to mean for the next month in terms of extra cardio and 1600 calorie days to make up for eating the pizza with bacon and onions. That’s tough. I don’t feel for you, though.
You know that whole “put America first” thing? You know what book that is contraindicated in? The Bible.
And you know that whole “taker versus maker” thing? I voted yes on proposition 55 in California that is going to keep my tax rate at 13.3% for 2017. You know why? Because that money is going to the kids…….it keeps schools going. And it keeps the budget balanced after that slap dick with no previous experience…..Arnold S…tried to burn the state to the ground. You know what Christians do? They think of everyone else and THEN they think of themselves. They also call people like Arnold and the dt slap-dicks. Yep.
Dear LGBT Friends:
Because some of you pointed me at Pence 20 years ago, I have been following the dude. He hates you. You know who else hates you? Giuliani. You know who else hates you? Gingrich. You know who loves you? I love you.
Recently, Matt Hennie…..owner and editor of Project Q wrote: “Republican lawmakers in Georgia are itching for another fight over anti-gay ‘religious freedom’ legislation and are now exploring breaking their bigotry into bite-size pieces and passing several bills,. After all, Republicans have an insatiable appetite for anti-gay bills.”
You have my word that if anyone fucks with you over the next 4 years, all you have to do is call me, leave a voice mail with their name and address and I’ll stop by that persons house with a sock full of quarters and I will beat the living shit out of that person. Pinky promise. The overwhelming majority of we straight peeps love you and we have your back. I can’t say that everyone else will resort to barbarism and violence against those who screw with you…….but I will. Hell, yes. I like to beat the crap out of closed-minded bigots.
Dear People with an Accent:
See the last paragraph. Substitute the word “racists” for bigots. We Irish especially have your back. We got here between 1845 and the early 1900’s and faced the same sort of crap….”the Irish are happy, lazy, stupid, with a gift for music and dance.” And they were criminals. And drunks. I have multiple pairs of socks and two whole jars full of quarters. Whenever I get home from a trip….be it to the super market or a plane ride, I throw all my change into those jars. Lots and lots and lots and lots and lots of quarters.
Dear Anyone on Medicare:
Sorry that Medicare is about to get gutted. Those of you who voted for the GOP candidate and are on Medicare…..you didn’t really do your homework, did you? See, Paul Ryan has wanted to gut Medicare for three years and has put it in the same basket for three years as the ACA. It is a completely different animal, yet he is tossing them in the same pen. He HAS put them in the same pen for three years. More than three years, actually. He started talking about replacing Medicare twelve years ago.
And now…..well now he has what he needs to gut Medicare. He has the legislative and the executive branches from 2017 through 2019. You didn’t think about that one when you voted, did you? Next time…..do your homework. If you don’t die first. From not having your Medicare coverage.
Dear Democrats Who Did Not Go Out to Vote:
Did you get all pissy when he announced that alt-right batshit crazy Bannon was going to be representing the nation in the White House to determine strategery? Did you say “hey…..that’s the guy who is documented in the court papers during his divorce as saying that he hates Jews and did not want his children attending a school with whiney Jew kids!” That guy. The guy who is the voice of white power. Did that piss you off?
Yeah….well…..as you can see, that was YOUR fault. The dt received less votes than McCain and less votes than Romney, but you didn’t go out to vote. Thanks. Jackasses. (see the chart above again……..)
Dear Democrats and Indies Who Only Pay Attention Every Fourth Year:
As an FYI, this has been going on since December, 2008, when we elected the fist African American President. It has been an eight year….successful…..offense that began with “meh….you never know what that black dude is going to do so we need to TAKE OUR COUNTRY BACK from those non-white people who are trying to steal it from us. Like we stole it from the Native Americans from 1680 through yesterday.”
Well….not the last line. But the first one for sure. And it worked. They went from 22 Governor positions to 33 and took control of state legislatures in 16 states and you know what those legislators did? They changed the voting rules! Yep. That whole “take our country back from the black dude” started eight years ago
Hey there, ass-hat. How you doing? You know what I remember that no one else does? I remember that back in 2000, you cheated on your second wife (you had also cheated on the first one) and had the police drive your mistress around. And you used NYC money to pay for part of your mistress’s apartment and all of her security. That’s how Dinkens beat you.
Any d-bag who would cheat on two wives will cheat on anyone else in the galaxy. Everything that comes out of your mouth is a cry for help. Step in front of a cab, please.
How’s that job with the new administration going? Whoops.
Dear Southern Poverty Law Center:
Thank you for tracking the uptick in racist activities over the last few months. Damn shame isn’t it, when people feel like a candidate’s actions and what they articulate justifies the racist things they have kept in the dark for years?
Keep doing what you are doing. We have your back.
Dear Racists & Bigots:
Technically, you get to say whatever you like in the United States. I have a new thing on my “to do” list for 2017…..I’m going to keep a list. And if you do something racist or bigoted, I am adding your name to that list. Then, one night around 9 p.m., I’ll ring your doorbell and ask “are you so-and-so” and you’ll say “yes” and then I will smack you in the face with a sock full of quarters and then break one of your kneecaps with a tire iron.
It will sort of be like that robot in “Hitchhiker’s Guide to the Universe” that visited homes and insulted people. Except I will break your nose and your knee….leaving a note behind that says “done because this ass-hat was a racist.” Yep. Keep that in mind.
You’ve clearly got “your guy” in office now. I had some fun with friends the past six months by asking the following questions, in the following order. “How many times was Mitt Romney called a racist or confronted with his racist comments?” “How many times was John McCain called a racist or confronted with his racist comments?” “How many times was Bush 43 called a racist or confronted with his racist comments?” “How many times was Bob Dole called a racist or confronted with his racist comments?” “How many times was George H.W. Bush called a racist or confronted with his racist comments?” Then, I allow that to sink in for a bit.
PS: If you have begun at least a single sentence with the following six words one or more time in the past 10 years…..“now, I’m not a racist, but….”, guess what? Get it? You know who has never had to preface a statement with “now, I’m not a racist, but…..”? Anti- racists.
Dear Pamela Ramsey Taylor & Beverly Whaling:
Enjoy your job hunt, you ignorant pieces of white trash. I don’t hit women, so you are safe from the previous section. However, you may want to tell Mr. Ramsey and Mr. Whaling that if I am ever close to Clay County, I might just stop by and visit them. I have no problem smashing them in the face with a sock filled with quarters. Because they are dudes. Dudes with awful choice in wives. And not just because you are extremely obese with a bad haircut, Pamela Ramsey Taylor…..because you are an ignorant racist AND a lover of fast food.
Dear Edited Newspapers:
Thank you for fact checking….especially “Washington Post”. Those of us who appreciate fact based news stories appreciate your rules….the rules that say you need multiple proof sources and those proof sources cannot be an Albanian web site that made something up out of whole cloth.
Keep it up. You are the fourth estate and important for a reason. Honorable men have no fear of edited, fact finding press corps. Dishonorable men live in fear of you on a daily basis because you are the general public’s path to knowledge. Richard Nixon hated the press and then he REALLY hated the press when Woodward and Bernstein ferreted out the Watergate thingie. The whole Watergate scandal had died down and Nixon (et al) had done a fine job of getting everyone else to pay attention to a different shiny thing in the other hand when the Washington Post blew it wide open. Absent the Washington Post, no one would have known how dirty Nixon was. The orange guy will be the same way…….keep turning over those rocks.
Keep it up, edited press. Keep it up.
Dear TV Media:
Part of whatever stupidness happens over these four years is on you. In fact, batshit crazy fake general Flynn having a job in the White House as of today is on you. You treated dt as a circus show to drive ratings and then you KEPT doing it. Not one time did you actually hold him or his team accountable for the things he said. Had Bush 43, Mr. McCain or Mitt Romney said any of the horrible or batshit crazy things the dt said, you would have held them accountable.
CNN. You are dead to me. That 30 minutes you gave him…uninterrupted….after the first GOP debate was disgusting. You know who had better ideas on that stage? Rand Paul, Marco Rubio and John Kasich. Did any of them get 30 minutes with you? Nope. That was when he made the M.K. blood comments. Did you shut him down the minute he said that, like a responsible news organization would? Nope. You did not call him on the blood comments and kept on going with the circus show for the next 21 minutes. You are TMZ now, CNN. You are dead to me.
Jon Stewart said this the other day: “Stories that were sent from a Macedonian teenager to grandmothers’ email accounts didn’t sway this election. News organizations that lost their credibility and authority because they were not careful enough about introducing toxic and poisoned information and laundering it into a system devalued the authority of real supposed news sources, to the point where people are frustrated enough to elect a man who stands for what he stands for.”
There were plenty of non-Fox news shows that propagated incorrect information and fact-less stories. Moreover, someone must have made it a law last summer that all talking heads must begin every sentence about HRC by saying “HRC, the person many people do not trust” when the more appropriate intro would have been “HRC, the most qualified person to ever run for President”….or….”HRC, the one candidate for President who has spent virtually every week since college graduation figuring out how to help people not named HRC.”
You’re all dead to me. Except BBC, C-Span and local public
Dear Fake News Spreaders:
You are idiots. Mouth breathing, simpleton, dullards. If you spread the fake stories that the Clintons stole the Haiti money? You. Are. An. Idiot. You are stupid. You know what happens when you don’t research the back-story and make sure that the story is real before sharing this crap? This happens. Someone even more dumb than you, with a gun, follows up on it.
Don’t be a mouth breathing, 67 IQ, simpleton who spreads fake news stories. Multiple source verify……….
Dear Bernie Supporters:
I love the guy, too. However, he could not have won. That answer “everyone is going to pay a little bit more” would never have worked….ever…in a general election. What would have worked is this: “everyone is going to have some extra money in their pocket at the end of the day….except those bastards who have been hoarding the money since the rebound began in 2010. Those bastards who have been sitting on 2.3 trillion in cash instead of adding job? THEY’LL be paying more.” That is the more accurate answer and the one that would have won.
All of Bernie’s plans were very, very similar to our best President…..Ike. I like Ike. And Bernie has only been a Democrat for one and a half years. As much as I love the guy, he’s not actually a Democrat. You know who could have won? Biden. Biden could have won. Yep.
Dear Joe Biden:
You complete me. You’re 57 in your heart and soul. You can run. See you in four years.
Dear Senator Rubio:
Thanks for changing your mind and running and winning again. Your presence in these confirmation hearings has made the past two weeks bearable. Thank you, again and please be the first Republican ever to force a primary with a sitting President. It will take roughly 200 days for everyone to say “this person is a moron……man, we screwed up by not choosing Mr. Rubio.” That’s when your campaign coffers will begin to overfill.
Dear Bernie and Elizabeth Warren:
Keep it up. Keep it up. Please, for the love of God (the real one that most Christians pray to…..not the one the orange guy claims to speak with), keep it up. President Obama had roughly 40M people screaming “take our country BACK” (with the implied “from that black guy”) from January, 2009 through yesterday. It is A-OK to start yelling “take our country back” with an extra…..out loud….”from that orange guy” each and every day. Because precedent was set from the minute the tea baggers started screaming “one term…..one term……one term….” In January, 2009. Apparently there is absolutely nothing wrong with being utterly obstructionist.
Dear “Repeal and Replace the ACA” People:
Did you read the textbook in civics class? There was a pretty important part in there that you may have missed. In order for the Senate to repeal and replace the ACA, you need 60 “aye” votes in the Senate. Which means that those who want to take healthcare coverage away from tens of millions of Americans have to convince at least eight (8) Democrats that they, too, want to take healthcare away from tens of millions of Americans.
If you are actually interested in a subject and wholeheartedly behind it, you may want to research it. For example, let’s say you want to learn banjo. You may want to read up on Earl Scruggs and the history of bluegrass…….then you may want to draw out all the different rolls and chords and such. Do the work. Same thing applies to learning legislation. Get to know how it operates if you are screaming “repeal and replace’ for a year. You embarrass yourself when you don’t know how the system works.
Dear Evangelical Christians:
You’re kidding, right? That guy? THAT guy? Hahahahahahahahahahahaha. He hasn’t seen the inside of the church in years. He’s about as far from Christ-like as you can get. Let me know how that turns out for you. At the very least, you could have said “you know what…….even though she goes to church every day as Methodist and actually quotes scripture…..but we disagree with the 67% of the United States who believe abortion should be legal and safe so we are going to pretend that the orange guy is a Christian.” I could understand that sentence. Even with the run ons.
You know what HRC has said for decades……decades….about her faith? That she learned the teachings of Jesus and applies it to her helping the poor and down trodden…..”Because it sure does seem to favor the poor and the merciful and those who in worldly terms don’t have a lot but who have the spirit that God recognizes as being at the core of love and salvation,”
The guy you chose worshipped at Gordon Gekko’s church.
Don’t worry about the internment camps. There are roughly 64,000,000 of us who would burn down anything like that as it was built. We got your back. We love you.
Don’t worry about the whole “register as a Muslim” thing. Aside from being wholly unconstitutional and against everyone’s civil rights, if that were to be done, roughly 70,000,000 of us would register as Muslims. Just to fuck with The Man and show solidarity with you. We got your back. We love you.
Dear Millennials Out Protesting in the Street:
How do you feel about your “protest” vote now? A third of you voted for a third party and you’re shocked and angry that this guy won? Seriously? Have you not attended the logic classes at college? You’re wasting your mommy and daddy’s money.
You know what would have taken LESS of your time? Voting for HRC in the first place. Do they still teach you math? I added up the Gary Johnson and Jill Stein votes in the swing states that matter and if you take the proportion that would have gone to HRC, she wins. Because of your “protest” vote. You know Stein is a climate change denier, right? You know that Johnson’s running mate spent the last month of the campaign looking straight into cameras and saying “don’t vote for us….vote for Clinton.” That should have been a cue for you.
However, stay out there in the streets. Keep it up. Get involved in local government. Stay active in the non-Presidential years. Keep being the riot that is the rhyme of the unheard. Read “The Federalist Papers”, get comfy with the entire Constitution, subscribe to both the “Wall Street Journal” and the “NY Times”. Read the “National Review” every once in a while for a different perspective. Vote in every election. Remember that every election has consequences.
Dear Kid Rock:
Thank you for making punk rock……and mixing it with the hip-hop……and thank you for getting us higher than the treetops. Thank you for making southern rock……and mixing it with the hip-hop. You’ve got money like Fort Knox. You have forever been the Kid Rock. Forever.
Dear President Obama:
Thanks for saving the car industry and getting unemployment rates back down under 4.6%. And for adding 9,265,000 jobs since you took office. Bush 43 added 1,300,000 jobs in his 8 years. Less than you.
And thank you for getting the deficit from $1.3 trillion in 2009 to $438 billion right now. And thank you for getting the deficit as a proportion of GDP from 9.8% to 2.5% during your 8 years. That’s about to be blown up, you know. Every gain you made in reducing Bush 43’s deficit over 8 years will be ruined by the tax plan and the spending plan I read last weekend. Just like Bush 43. This appalls me as a fiscal conservative.
And thanks for not using tweets to converse. You know why I am not on Twitter, Mr. President. Because it is base and pedestrian. Those who use it as a primary conversing tool are base and pedestrian. Have you ever read Alexander Hamilton, John Jay and James Madison’s “Federalist Papers”? They are a work of art. You know who would NOT be on Twitter? John Jay, Alexander Hamilton, and James Madison. Because they were not pedestrian. They were brilliant.
You were an amazing President. Thank you.
Dear Michigan and Ohio:
Were you aware that President Obama and the Democrats in Congress saved your asses in 2009 and 2010? Despite Bush 43 being in charge during 2007 and 2008 in the largest financial collapse since 1929, many of the Republicans voted AGAINST saving the automobile industry, or at the very least bitched about it for a few years. You know how you not only didn’t collapse, you are now thriving? That’s because of the Democrats and President Obama. Think how bad it would have been without the bail out.
Remind me not to lend you $20 when you need it. You have a short memory.
PS: Flint, Michigan. Flint. Republicans did that. Let me know how the next four years works out for you.
You just got the largest non full war time budget in the history of our country at $611 Billion……..with a “B”. The highest military budget before this one was $643 Billion,….with two full wars going on at one time. Ike is rolling over in his grave and wagging his finger and screaming……”I WARNED you about that………”
Ike…..we spend more now than the next seven countries combined. Combined.
Dear Mayor Betsy Hodge of Minneapolis:
Congratulations on keeping your city a sanctuary city. That’s not really a word, though, and let me tell you why. It is absolutely not “illegal” to cross the border and remain here. That is not a crime. You cannot look up that crime….because it does not exist. Under U.S. law, that action (crossing the border and remaining) is not a crime and those who do it are not criminals.
Have a look out here at California. The largest spike in immigration to California took place under Bush 43 (shocking, eh) and maintained the same rate until the final two years of the Obama administration. The crime rate (especially the violent crime rate) declined each of those years in Los Angeles and in the state. We do a splendid job of getting along with new friends. Yep.
Dear K.A. Conway
I just saw you on “Meet the Press”….Chuckie Todd asked you about this “thank you” tour where your team is doing a six-week, extended touchdown dance. In the states that your team carried. Chuck asked you if the orange guy meant what he said on November 9 when he said
California, that state you’ll be avoiding like the plague on this touchdown dance tour, has the largest and most successful economy in the United States. It’s also the largest state in the nation. You may want to pop on out here…..maybe we can teach you guys a few things.
Dear Governor Rick Scott of Florida:
Congratulations on keeping your state a bastion of racist white trash and racist rich trash. I remember that Columbia HCA perpetrated the single largest case of Medicaid and Medicare fraud when you were the CEO there. You scooted when you saw the walls were about to come down and now you are the governor of a white trash Mecca. Shocker.
You rock. We all have your back in every way as the misogynists try to get you back barefoot and pregnant in the kitchen. Not that you need us……I just wanted you to know that about 70% of us have your back.
My plan for the next 240 years is a solid plan. Since we white men dominated the legislative, executive and judicial branches for the first 240 years, we should make it so that women hold 90% of the elected positions for the NEXT 240 years and then 240 years from now, we split it up and women get 51% of the elected and appointed positions and men get 49%….so it is proportional.
If you see this sign in the marches over the weekend, that’s my sign. Well, one of 27 signs I have made. CVS ran out of white. So, I got pink. And Bulleit was on sale for $21 a bottle. That’s a heck of a deal.
I’m a math, facts and statistics person. California is the biggest state in the United States by a large amount and is the fifth largest economy in the world. Beaten only by the entire United States, China, Germany, etc. California’s GDP grew 4.2% last year….double the national average. HRC won California 62% to 33%. If you were going to extrapolate from a single state, you’d extrapolate from California. You know how we did it out here? We said “fuck you Republicans” after that moron Arnold destroyed the state. It’s time to say “fuck you Republicans” across the nation. Run the same offense they have been running for 20 years.
While I can appreciate the people who kindly said “we have to do what we can to support him”, that is certainly not how President Obama came into the White House. Hell, no. From the first day, there were Congress members saying “we are going to obstruct his agenda and make sure he is a one term President.” From day one. And President Obama won by far more than the orange guy. We obstruct and obstruct and obstruct and when the GOP complains we do the 1980’s drug commercial thing.
We look hurt and say “I learned it from YOU, dad……..”
I love you, but THIS is why we can’t have nice things. Keep on rocking in the free world…..
If you would like to hear the post election, bourbon infused Two Non Blondes version of “Keep on Rocking in the Free World”, here you go……
(I’m on a cross country flight watching “How To Be Single” while thinking about a conversation today with a female friend about a d-bag she just dumped. Which was similar to convos I have had with plenty of female friends through the years. I grew up with three sisters and keep a 50/50 ratio of “ride or die” friends…female to male. I’ve never tried to make out with a female friend because I would also not try to make out with a man friend. Friends are friends. No one should try to have sex with their friends. This is an open letter to all my single female friends. Print it out and put it on your fridge.)
Dear Female Friends Who Are Kicking Yourselves For Not Finding the Right Guy and/or Who Keep Trading in Morons for Morons:
Hey! How are things? How about them Browns? Can you believe all the horse crap with Johnny Manzeil? What a moron. Speaking of morons, I need you to raise the bar on the guys you have been dating. You are better than that. You deserve better than what Tinder is handing you through its algorithms.
And here’s the gig. If I thought you were an idiot, or a poor dating partner, I would by no means tell you otherwise. You know me. I am as subtle as a chopping block. If you utterly sucked as a dating or lifetime partner, I’d encourage you to take what you can get and take it as fast as humanly possible. I have done that.
You are smart. You are very witty and amusing. You’re an excellent person to bounce random things off of, like “should I buy a hot air balloon or simply rent one for a month” and “can I eat this (insert name of food stuff) if it looks like this?” You are beautiful. You are going to be a superb wife and an amazing mother. You don’t need me to tell you that….you know that. You most certainly don’t need the dude in the V-neck sweater with the new beard to tell you that. His opinion does not count.
I want to wake up many mornings throughout your next relationship and get a text from you that reads “(insert dude’s name here) left me a half gallon of milk in a cooler outside my door with a cute card and seven huge chocolate chip cookies so that I’d come home from work to that last night.” I want THAT dude to be your boyfriend. I want to read those texts and I want you to pay attention to the list below. I want your next boyfriend to go 9 for 9 on the list below. Print this list and put it somewhere safe in your house. Not on the fridge. If you put it on the fridge, some dude will see it, take a photo of it and just do this crap. You want someone to do this crap because they always do this crap. It’s Zen to them. This stuff.
He opens the doors. All the doors. All the time.
He acts mostly the same in months 7, 11,13, 27, and 39 as he did in months 1, 2, 3, 4, 5, and 6. Anyone can be shiny for 180 days. True character reveals itself in long lasting behaviors.
He brings you some damn flowers. Randomly and consistently
Same with greeting cards. Especially in months 7, 11,13, 27, and 39. And month 127.
He sings to you with vigor, regardless of his singing ability.
He brings cash with him. Everywhere. Men should carry cash at all times. Everywhere. Seriously.
He respects women. All women. All the time. In word and deed.
Those texts that you received each morning in the first 79 days are the same type of texts you receive each and every morning from day 81 to 623.
He understands that love is not an emotion…it is a decision you make each and every day when you wake up. He wakes up, looks at you, smiles and decides to be in love with you that day…more than the day before.
He’s A-OK with you being more smart, funny, or successful than him. This sort of goes with G; however, it can also be a stand-alone.
He is kind. Always. To everyone and everything.
That was a list of 11. Not 9. I wanted to see if you were paying attention. 11 is one louder. Always has been. Always will be.
I also want you to be with a man who surprises you on December 19 with a trip to New York City. I want him to throw you both on a plane, get a car service from JFK (La Guardia is just nasty…..and he should know that) and you go to a hotel where you will walk into the room and there will be a cheese plate set up and wine in decanters…breathing. Then, he will blindfold you in a limo and you’ll end up somewhere and he’ll walk you out of the limo and when he takes off the blindfold you will be standing beneath the Rockefeller Christmas tree. Then you’ll get skates and skate around…horribly…and laugh and fall. That’s the dude I want you with.
Dudes with sisters will always be superior to dudes without sisters. Hands down. Use that for ties. If there is a tie and they both have sisters? Choose the dude with more sisters. Unless you hate the sisters, of course. If you hate the sisters, choose the other dude. If you hate the mom? Leave. Immediately. Unless the mom is in prison and has a super long sentence because she robbed a bank with Patty Hearst or did some sort of bombing with the Weathermen.
And, for the most part, avoid these:
Dudes who wear V-neck sweaters. 87% of dudes who wear V-neck sweaters are d-bags.
Dudes over the age of 26 who go to clubs.
Dudes over the age of 17 who use emoticons in texts
Dudes who did not have a beard last year but have a beard this year. They don’t have a beard because they like beards…they have a beard because it’s trendy. If they had a beard because they LIKED beards, they would have had a beard five years ago. Seriously. Trendy dudes tend to be d-bags. Much like the women who bought tiny purse size dogs when Paris Hilton was the “it” girl. You would not want me dating a woman who bought a tiny purse dog because Paris Hilton had a tiny purse dog back then…I don’t want you dating some dude who has a beard now because beards are trendy. Ask to see a 2013 photo of them. Did they have a beard in that photo? No? Dump him. Then, use The Google to find the Dinty Moore commercial on lumberjacks. That’s a funny video. PS: Same goes for that new stupid haircut where the sides are shaved and the top is long. You know why you never saw that style before four months ago? Because it is a super stupid hair style. No one ever walked into a hair place ever and said “hey…keep it long on the top, but shave it on the sides using a 2.” Unless that guy is a super model, he’s a trendy d-bag. N-O…..”no” on trendy guys.
Dudes over 35 who accessorize too much. Like Johnny Depp or Dave Navarro. Unless it is actually Dave Navarro and Johnny Depp. You are not allowed to date Johnny Depp….he was not nice to Amber. Not at all.
Dudes who ever owned an Ed Hardy shirt, an Anarchy shirt, or a shirt with angel wings on it. Ever. Like, if they owned one when they were 19 back in 2007 and you see a photo from back then, I want you to leave that man and never go back. Trust me. D-bag is either part of your DNA or not part of your DNA
Dudes who expel gas in front of you intentionally…unless you are both locked in a trunk during a kidnapping. He should leave the room.
Age? Age matters. That stuff about “age is just a number” is a bunch of crap. In the row next to me right now there is a sixty something year old man with a thirty-something woman. And…..it’s gross. I am A-OK if you use an older guy or a younger guy for a sexual sorbet….a palate cleanser between things. Your range for relationships is 4 down and 9 up. No more and no less. You may put any other age into the chew toy basket and do with them what you like; however for relationships your floor is 4 years below you and 9 above. You are not allowed to change those numbers. No……we cannot negotiate on the age thing. Age matters. Period.
Finally, please keep in mind that all of us……you, me, Gandhi, Mother Theresa, everyone…….is a different person in the first 180 days. Don’t make any big moves (moving in, moving, marrying) in those first 180 days. Give it some time. I know, I know, I know…..he hung the moon and stars and makes you feel like you never felt before and he’s the perfect man. I get it. If that is the case, then he’ll still be that person on day 187 and you can move in with him on day 188. Lots of people show their true character after the first six months. I want you to be happy for a long time……take your time on the big decisions. If he is pushing for the move in or the marriage fast? Run. Run fast. Text me and I’ll meet you somewhere for a burger and introduce you to someone else there at the bar. As a sexual sorbet thing for the in between time.
That’s it. Again….you are beautiful, you are smart and you are funny. Take your time. Choose the right one because if you choose the wrong one, there is nooooooooo fucking way I am coming over for Thanksgiving.
This post was written in seventeen minutes after deboarding a MN to CA flight listening to the song below five times….looped…after hearing it while pulling into the Hertz car return in Bloomington, MN. Pull it on up and read you some Yeats……smoke rings, I know you’re going to blow some, indeed…….
Whenever I hear the Red Hot Chili Peppers’ tune “Can’t Stop”, Keats’ poem “Second Coming” inserts itself, mentally, in the middle of the tune’s musical parts. Because the two works of art are virtually the same. Except that “Can’t Stop” has John F singing off key as back up and I looooooove that part of the song. Because it gives me one single RHCP tune upon which I can sing backup.
Go ahead. Give it a try. Felix the Cat will keep you company. What’s in the bag? WHAT’S IN THE BAG?????? (said in a Brad Pitt voice).
None of your/our business.
Turning and turning in the widening gyre
The falcon cannot hear the falconer;
Can’t stop addicted to the shin dig
Cop top he says I’m going to win big
Choose not a life of imitation
Distant cousin to the reservation
P funk the pistol that you pay for
This punk the feeling that you stay for
In time I want to be your best friend
Eastside love is living on the west end
Knock out but boy you better come to
Don’t die you know the truth is some do
Go write your message on the pavement
Burning so bright I wonder what the wave meant
White heat is screaming in the jungle
Complete the motion if you stumble
Go ask the dust for any answers
Come back strong with fifty belly dancers
Things fall apart; the centre cannot hold;
Mere anarchy is loosed upon the world,
The world I love
The tears I drop
To be part of
The wave can’t stop
Ever wonder if it’s all for you
The world I love
The trains I hop
To be part of
The wave can’t stop
Come and tell me when it’s time to
The blood-dimmed tide is loosed, and everywhere
The ceremony of innocence is drowned;
Sweetheart is bleeding in the snow cone
So smart she’s leading me to ozone
Music the great communicator
Use two sticks to make it in the nature
I’ll get you into penetration
The gender of a generation
The birth of every other nation
Worth your weight the gold of meditation
This chapter’s going to be a close one
Smoke rings I know you’re going to blow one
All on a spaceship persevering
Use my hands for everything but steering
Can’t stop the spirits when they need you
Mop tops are happy when they feed you
J. Butterfly is in the treetop
Birds that blow the meaning into bebop
The best lack all conviction, while the worst
Are full of passionate intensity.
The world I love
The tears I drop
To be part of
The wave can’t stop
Ever wonder if it’s all for you
The world I love
The trains I hop
To be part of
The wave can’t stop
Come and tell me when it’s time to……
Surely some revelation is at hand;
Surely the Second Coming is at hand.
Wait a minute I’m passing out
Win or lose, just like you
Far more shocking
Than anything I ever knew
How ’bout you
10 more reasons
Why I need somebody new, Just like you
Far more shocking than anything I ever knew
Right on cue
The Second Coming! Hardly are those words out
When a vast image out of Spiritus Mundi
Can’t stop addicted to the shin dig
Cop top he says I’m going to win big
Choose not a life of imitation
Distant cousin to the reservation
P funk the pistol that you pay for
This punk the feeling that you stay for
In time I want to be your best friend
Eastside love is living on the west end
Knock out but boy you better come to
Don’t die you know the truth is some do
Go write your message on the pavement
Burning’ so bright I wonder what the wave meant
Troubles my sight: somewhere in sands of the desert
A shape with lion body and the head of a man,
A gaze blank and pitiless as the sun,
Is moving its slow thighs, while all about it
Reel shadows of the indignant desert birds.
The darkness drops again; but now I know
That twenty centuries of stony sleep
Were vexed to nightmare by a rocking cradle,
Kickstart the golden generator
Sweet talk but don’t intimidate her
Can’t stop the gods from engineerings
Feel no need for any interfering
Your image in the dictionary
This life is more than ordinary
Can I get 2 maybe even 3 of these
Come from space
to teach you of the Pleiades
Can’t stop the spirits when they need you
This life is more than just a read thru
And what rough beast, its hour comes round at last,