After the Fog

I was at my PCP's office last week and shared with her the gray fog depression that had wrapped itself around me. After ascertaining that I was stable, my doctor said, "And let's not overlook that it's wintertime and that can add to depression what with the grayness and cold."

I burst out laughing. "Winter is my 2nd favorite season," I said. "Not a factor!" 

Melissa didn't miss a beat. "You just always have to be different, don't you?" And then we both laughed.

In the last few days, the gray fog has disappeared. Disappeared, not just moved over to the side to descend upon me again. I feel I am back to my non-depressed self with a normal (for me, given Melissa's observation about me never being "normal") range of emotions. 

And it does not surprise me one bit to say that I owe this lifting to—what else?—books, two that I just read and one that I am finishing shortly. 

The first is Tracy Kidder's latest: Rough Sleepers: Dr. Jim O'Connell's Urgent Mission to Bring Healing to Homeless People. I am a huge Kidder fan from way back and this book is no exception to his superb eyes, ears, and pen in capturing the story. Kidder's portrayal of a doctor whose career has been dedicated to treating homeless people in Boston is stunning and I heartily recommend it.

Besides the sweep of the story Kidder tells, a tiny piece that captured me was a retelling of the story of Sisyphus, condemned in Greek mythology to push a massive boulder up a steep incline to place it on top, thus freeing him from the ordeal, only to see the boulder roll down and away just as he reaches the summit, dooming him to start all over the next day. Dr. O'Connell, however, talks about a reinterpretation of the tale by existentialist writer Albert Camus: "The struggle itself toward the height is enough to fill a man's heart. One must imagine Sisyphus happy."

Sisyphus happy. Oh, oh, oh.

Upon finishing Kidder's book I began HumanKind: Changing the World One Small Act at a Time by Brad Aronson. I had brought it to one of Warren's rehearsals, along with the Kidder, knowing I'd finish the Kidder before the rehearsal ended.  I read the last lines in Rough Sleepers and opened the Aronson. How far did I get before I was in tears? Not far.

Aronson writes movingly and passionately about acts of kindness: some huge, many tiny, but all just acts of kindness towards others. How tiny? Just smiling at people as you pass them on the street or in a store aisle. What moved me deeply was the affirmation for me that small acts do make a difference. This book reinforced my commitment to tikkun olam (mending the world) and underscores what the Talmud emphasizes: the small acts, the small steps, are just as important to take as acts far beyond many of us (think of Martin Luther King, Jr.). We are not "excused" from tikkun olam because we cannot fix the whole world. Instead, the obligation on me as a Jew is, quite simply, just do it. Daily. 

After finishing Aronson Saturday night while Warren was at another rehearsal and concert, I began the third book, Class Cultures and Social Mobility: The Hidden Strengths of Working-Class First Generation Graduates by Paul Dean, a professor at Ohio Wesleyan University here in Delaware.

Oh my. 

Several years ago, I wrote about being a first-gen college student, about still identifying myself as a working class person, and about navigating life through that perspective. 

And now I am reading about those same realities, feelings, and issues in this new work. As I read, I am nodding my head in agreement at what Dean (who is also a first-gen) writes. I feel seen. I feel validated. And, just so you know, I was one of the many individuals that Dean interviewed, so at times I truly see myself. 

I truly believe these books are why my depression has finally lifted. Despite the larger matters that weigh on me (and have not gone away), I'm still here. And I am still mending the world, my world, in small steps and bits that matter. Camus had it right about Sisyphus: the joy was in reaching that summit every single day, then walking back down the hill to start again the next day. 

I can do that. 

Frugality? Therapy?

Maybe both?

I have been a longtime reader of Katy Wolk-Stanley's blog, The Non-Consumer Advocate. Over the years, she has more than once posted about her extending the life of socks and other knitted materials by darning them.

As I make known far and wide, I don't sew. I don't knit, crochet, or weave. I don't craft, period. Just not within my skill set. I admire those who do, but again, I can't do it. I can mend a tear or replace a button, but that is pretty much the limit of what I can do.

So why was I sitting last night mending a tear in a wool cap I wear often this time of year? 

One reason was because it is COLD outside. I walk a lot. A. Lot. And I need something warm and toasty that keeps my head warm.

Another reason was because the area in need of repair was small. The opening was about the size of my thumb. Okay, even I could do that. 

Another reason was sentimentality. My son Benjamin, about to turn 40, received this cap as a birthday present at, I think, a birthday party with friends when he turned 11. Or maybe 12. Whichever. The bottom line is the cap has been in my closet for years and I have worn it regularly for the last 20 or so. 

One final reason is that, although I do not knit or sew or other, I am married to a skilled, artistic, talented craftsman who has been making custom mallets for himself and others for decades. Decades? Like five of them. The keyboard mallet heads are wrapped over and over in yarn. As a result, the yarn was already in the house. All I had to do was ask.

So, there I sat quietly, mending, taking great satisfaction in taking care of a small task.

A small, concrete task.

A small, concrete task that I could focus on. Draw satisfaction from. Finish. 

Ever read a book where a sentence or a sentiment or a concept leaps off the page and grabs you? That is not an uncommon experience for me and it happened several weeks ago when I read Rabbi Angela Buchdahl's stunning memoir Heart of the Stranger. She ends each chapter with a mini-sermon ruminating on a Hebrew word and its importance in Judaism. The word at the end of one chapter was simcha (joy) and she reflected on the importance of finding joy even in the midst of hard times and sorrow and depression. 

Buchdahl quotes Søren Kierkegaard: "It takes moral courage to grieve, it takes religious courage to be joyful." She then write about Hasidic Rabbi Nachman of Breslov, who struggled with depression and wrote that even when one did not feel happy, they should act happy and "genuine joy will follow."

That was not the part of her writing that caught me. It was her discussion with Alan Schlechter, an NYU professor, and his observation that Nachman's response is a major therapeutic tool in treating depression and is called "behavioral activation." "The method insists we start doing the things that bring us joy, even if they are not making us feel the way they used to. In the doing, the feelings will change," he told her.

Behavioral activation! That is where I leaped off the chair. Well, leaped figuratively. What I actually did was grab my Chromebook and Google "behavioral activation." Within a few minutes, I was looking at a sample worksheet and burst into laughter. The first page was suggested activities, the following pages contained a log to chart one's activities and to assess how one felt after a week of such deliberate actions.

My laughter? I have been treating myself by behavioral activation for weeks now, without knowing I was doing it. Small, deliberate tasks. Running an errand. Cleaning up the kitchen. Organizing the paperwork messes that pile up in my study. 

And mending a hat that came into my life years ago.

And after 21...

Dr. Timothy D. Moore (okay, so he's a little older now
and the hair has gone white but this captures his great smile)

Before yesterday, I had been tossing around a bunch of topics about which to write, ranging from food to community to moving through the grayness I seem to have been wading in this fall to it being Biscotti Season again. But then I was told some news that made me catch my breath and I woke up this morning thinking I have to write about this.

Yesterday we saw my oncologist of 21 years, Tim, for what has become a pretty routine every-three-months check. After coming into the examination room and asking me how I was doing (fine), he sat down, pulled his stool up close, looked me in the eye, and said, "You have heard, haven't you?" 

Heard what?

Tim is retiring at the end of January. And I hadn't heard because at my last appointment in September, he was unexpectedly rounding in the hospitals, so he was not there to tell me himself. 

Tim? Retiring? What?

While I knew that his retirement was possibly/maybe/probably on the horizon, it is one thing to know this "may be happening" in the future and quite another matter to hear a date definite said out loud. He said there were two hematologists at Zangmeister that he was passing his patients to and that he made the choice for one who he thought would be a perfect fit for me. After talking about her background and experience, he added, "The first thing she will say when she meets you is "You've had myeloma since 2004? What?!"

Don't get me wrong. I am very happy for Tim and his wife, who I have met several times. Over the years, our talks have ranged far and wide; I know of his family and travels and I am thrilled that they can now spend more time seeing and traveling and being with friends and family. I totally get moving on from a lifetime of practice. 

But all the same I was shellshocked. Tim is turning 71 this spring. I never expected to outlive his practice and I am so grateful I have. But dang!

Warren had the best response when we talked about it later yesterday and again this morning. He pointed out that, for me, this is an ideal time for Tim to bow out. I have not had treatment since August 2023 and my myeloma has stayed flatlined since then. That is way better than me being in the middle of yet another course of treatment or worse. And Warren is right.

I meet my new oncologist in March. And I know I will continue to cross paths with Tim from time to time. "You know how to reach me," he said, and he meant it.

Tim and I have had 21 years and one month together. I still remember what he said the very first time I met him: "Don't look at statistics for myeloma. Every patient is different." (The survival statistics for myeloma in late 2004 were bleak, to put it mildly.) I also remember what I said to him that first appointment when he told me just from my blood tests alone he knew I had myeloma: "F*CK," immediately apologizing to him because I didn't know him well enough to talk like that in front of him.  I recounted that story yesterday and we both laughed.

In 21 years, Tim has been there leading me through treatments, directing my oncology care—everything. He himself did my first few bone marrow biopsies, marking the insertion spot by pressing down hard on my hip with his medical school ring to imprint my skin. Tim is the one who said to me, over a decade ago, that he wanted me to go to Mayo Clinic for a second opinion, because he was stumped at what he was seeing in me versus seeing in the labs and wanted me to see a specialist. I am still grateful he had the intelligence and the humility to do that. 

We finished the appointment talking about everything from Mayo Clinic to Class B RVs to Beethoven to how much myeloma treatment has changed since Tim and I first met. When all three of us stood up to say goodbye, Tim and I gave each other a tight hug. 

Back in May 2022, I wrote about The End of Your Life Book Club, Will Schwalbe's memoir about the books he and his mother read and shared together in the last months of her life as she dealt with the cancer that was killing her. Schwabe wrote about the hug his mother's oncologist gave his mother at the next to the last appointment, knowing the death was not far away. I wrote then that I had not a farewell hug from Tim yet, but that day was out there.

Well, that day was indeed out there and now I have had that farewell hug from Tim. But for a most wonderful reason. And for that I am more than grateful.

Thank you, dear Timothy, my doctor, my oncologist, my friend. It's been a great trip.