Cancer and the Art of War

Cancer and the Art of War

Pondering Cancer and the Art of War

I first saw my cancer though the eyes of my son. Three weeks of coughing had continued to get worse. Alex, needy as always, slept in my arms, refusing to sleep in his crib. I awoke both of us with a gut wrenching, gravely cough‐wheeze. Instead of startling, or crying, I look down and saw in the face of my son a look of deep concern and compassion, deeper than I had ever seen on an adult, with an understanding far beyond his nine months. Seeing that look I asked myself “I wonder if this is worse than I think. How can he know?” A week later they found the mass in my chest. It is the size of a soda can, wrapped around my heart like a glob of concrete fired from a canon.

Yesterday I was formally diagnosed with Hodgkin’s lymphoma. Memorial Sloan Kettering found it on the needle biopsy, a test run by an Asian doctor dressed, not in a doctors white robe, but in a classy blue Chinese dress. This stood out to me, as almost every aspect of Memorial Sloan Kettering has, that nothing is done quite as normal, everything seems to have a class and art to it you would never expect in a hospital.

I watched the ultrasound as she guided the need into the lymph node, a node that had been marked as glucose hungry by the PET scan. Either she was skewering the topmost cancerous lymph node, or she was impaling my body’s first line of defense: both an active cancer and an active correct lymph node appear the same on the PET scan. I was wondering if my lymph node was about to be a friendly fire casualty.

It wasn’t friendly. It was the topmost active cancerous lymph node. The last in a series of “hot” nodes that start near the back and bottom of my heart and climb like a ladder of raisins up to my collarbone and neck, then across the top of my chest where all the important things are, like veins, and arteries, and my trachea. It had claimed all the territory it could, and now was seeking more, with little space left to go.

The tumor itself extends over much of my chest toward my right shoulder, but that area, having outgrown its food source, is dying a starved death. It was into this dismal mass of battles already fought and cells as casualties‐of‐war that the first biopsy’s had been done. There were too few survivors to interrogate. No useful intelligence to bring to those who would plan my counter–offensive. Not even a clue to the nature of the war that had been a waged—just casualties on a destroyed battlefield.

What tortures the pathologists had to inflict on this sample they will never tell, but it yielded its secrets. Hodgkin’s Lymphoma. A rarer, but treatable, cancer.

I have been put on Prednisone. It shrinks the lymph nodes and reduces the inflammation. On Tuesday I will be back at Memorial Sloan Kettering for an echocardiogram and then to meet with my Oncologist. I have been told treatment can be long, and difficult, but that Hodgkin’s Lymphoma isn’t just treatable, it is curable. Everything from radiation, chemotherapy, antibody treatments, viral treatments, genetic treatments, stem cell treatments, etc etc etc are all possibilities for treating Hodgkin’s lymphoma. On Tuesday they will tell me what they know, tell me what they need to know, and then begin to plan a course of attack.

Chemo is the most likely, as the same glucose consumption that made the lymph nodes glow in the PET scan, also delivers the poison. The lymph nodes are hungry, and their consumption will be their demise. Of course, this is working on the theory that it will kill them faster than it kills me, but a poison is a poison and I fear the casualties I will wreck amongst my good cells to destroy the bad. But, those have always been the calculations a General must make in war.

In preparing for this war, albeit a fight against my own rebellions body and not some external enemy, I decided to read through some classic strategy, Tsung Tzu, The Art of War. These quotes seemed applicable in my battle:

“Success in warfare is gained by carefully accommodating ourselves to the enemy’s purpose.”

― Sun Tzu, The Art of War

“if you fight with all your might, there is a chance of life; where as death is certain if you cling to your corner”

― Sun Tzu, The Art of War

“the opportunity of defeating the enemy is provided by the enemy himself.”

― Sun Tzu, The Art of War

“the wise leader’s plans, considerations of advantage and of disadvantage will be blended together.”

― Sun Tzu, The Art of War

“War is cruelty. There’s no use trying to reform it, the crueler it is the sooner it will be over.” -William Tecumseh Sherman

And so I go to war.


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