My Bucket List

Now that my physicians have moved from an aggressive treatment strategy with a goal of complete remission to one aimed primarily at palliation, I have been irresistibly drawn to contemplate those things that I have always wanted to accomplish or experience but have not yet achieved -- i.e., my "bucket list" (the things I want to happen before I "kick the bucket").


A recent film by the same name, starring Jack Nicholson (as a billionaire corporate executive) and Morgan Freeman (as a working class mechanic), effectively highlights both the allure and folly of frantically pursuing adrenaline-pumping experiences as a means of finding ultimate fulfillment in however many days are accorded to each of us in this fleeting life.

Always ready for an adventure (see blog entry of 2/14/09), recently I have been tempted to pursue some of the more exotic and crazy undertakings of my fantasy musings -- like hang gliding, sky diving, or even base jumping. (Please do not tell Linda!)

Honestly, I am not sure of the source of these crazy urgings, for I surely do not have an underlying death wish -- just an irresistible desire to soar like a bird :-) From the deck of our home on the Chesapeake Bay, I have watched with secret envy and awe as a phalanx of pelicans soar effortlessly overhead, then swoop to within inches of the breaking waves in perfect formation. Don't tell anyone (and please no psycho-analytic comments), but I have even been known to fly in my dreams with no more 'equipment' than my spread arms and pointed toes, swooping and soaring like those pelicans in endless weightless fantasy.

I am not sure what your ultimate fantasy may be, but one thing I have learned on this journey with cancer is that no flight of fancy or adrenalin-pumping adventure can compare with the sustained satisfaction and sheer joy of heart-warming and life-affirming relationships. This is also the conclusion that the protagonist in The Bucket List comes to realize after a frenetic pursuit of one adventure after another just as his new best friend succumbs to the irresistible ravages of his terminal illness.

And I am a man blessed with many such relationships, particularly those of family and close friends. For this I am enormously grateful and find myself relishing with greater delight than ever before. Watching soaring seabirds , fantasizing about my own effortless flight from some spectacular summit, or the realization of my wildest adrenalin-pumping adventure will never overtake the deep abiding satisfaction of holding my adoring grandson while roasting a marshmallow to golden perfection (see recent photo of Mark Daniel and me above), or guiding my youngest grand-daughter as she takes her tentative first steps, or walking hand-in-hand with my sweetheart in the golden light of the setting sun along the beach.

Interestingly enough, even Jesus appears to have had similar contemplations as He faced the end of His life here on earth: "...who for the joy set before Him endured the cross, despising the shame, and has sat down at the right hand of the throne of God." (Heb 12:2) I am pretty sure that the joy set before Him had little to do with the ability to fly or walk through walls or any such fantasy adventure, but rather the ultimate unbroken and intimate relationship with both His Father and with those He came to redeem (you and me!)

Would that my greatest passion will be to return such love in kind!

Grateful for each day,
Dr Dan

PS -- The recent head MRI shows progression of the brain metastases (including for the first time a sheet-like spread over the covering surface of the brain). As noted earlier, treatment options are extremely limited at this point. After much contemplation, prayer, and consultation with both family and doctors (including a physician friend who is director of a hospice service for one of my former hospital systems), I have decided (again) to decline whole-brain radiation. However, after a very difficult (all-night-head-in-the-toilet) initial experience with the chemotherapy offered by my current oncologist, adjustment in the sequence and timing of meds has happily resulted in much greater tolerance. Subsequent imaging studies, labs and visits will assess my response. I will assuredly update this blog as developments warrant.