Getting the card
Being a game champion
Ulysses was on the list for the colonoscopy for two years. In Canada, waiting for non-urgent procedures is common. He was 65. He knew there were a few colorectal issues in the family. And sure, there were interim diagnostics he could play at if he noticed anything during the wait. None of them are definitive. And there were no symptoms.
At last the day came round. On a lovely morning in May he headed down to the day clinic for his appointment. He'd shat his brains out the previous evening. Sitting in the well-appointed reception, holding his modest file, sun streaming over his shoulder, he looked over at other similar men, all sitting forward, all a little anxious. A thought just drifted in… what if they find something?
Game cards
If you’ve watched soccer, you know there are two sanctions a referee can impose on an errant player – two levels of penalty that can potentially cut into a player’s game time. Let's say a player blatantly trips another. The game is halted. The referee faces the player so there's no doubt in the recipient's mind. A card is pulled out of the ref’s pocket and held before the offender. A Yellow Card. The ref writes the player’s name in his little black book. The meaning? They’ve been caught out. One more error and they’re out of the game.
If it's an egregious rule-bust, then it’s a Red Card. More serious, the consequences are severe and immediate. Game over for you, buster. Off to the showers. No appeal. No alternatives. You're done.
It's inevitable. You're going to get clipped.
There's no getting through this life unscathed. One day, something unexpected is going to intrude on your well-oiled life and throw it all for a loop. In the last quarter of your match – I mean the match that is your life – you're going to get a Card. It will come from a strange quarter. It’s never pleasant.
Getting a warning – a Card – really upsets your assumptions and expectations for how your life is going to work in future. Cards can be Yellow or Red, come singly or in groups, and in all sorts of forms: serious illness, sudden job loss, financial market turmoil, physical or mental disability, natural disasters, identity theft… you name it.
You can expect them more at this stage of life. It's part of the territory. They arrive unannounced, sometimes sneakily, hit you like a ton of bricks, and destroy your personal assumptive world. They can happen directly to you, or to your partner, a close family member, lifelong friend… but the impact is the same. You're drawn into an unwanted vortex and you have no choice but to deal with it. Sink or swim.
A Yellow Card? You’ve been warned, and better do something about it. Some people are defeated, and nosedive. Others rise, fight back, lose some of their former capacity but live rich later lives on bonus time.
A Red Card? It’s an ending, just as in soccer. A terminal diagnosis, your life will soon end; time to put your affairs in order.
Here are a few stories of ‘Ropers’ – those of us who’ve let go of the rope (or are about to) – and their Cards.
Yellow Cards
Charlotte is a vibrant, irrepressible 65-year-old. Tall, elegant, always well turned out, today in a black blouse with frills around the neckline and well fitted white slacks. She married Adam a few years earlier, after a whirlwind courtship.
We were having a latte at Essence Café, sitting in the sunny plaza outside the glass veneer of an inner-city office building nearby her condo residence. After the usual pleasantries, I had to figure out what was disturbing her usual positive mood.
“What is it, Charlotte? What’s up with you?”
“What do you mean?”
“You’ve got just a tinge of down. I don’t know what it is, but something’s bugging you.”
“Everything’s fine.”
I knew her better than that. She is incisive and emotionally very intelligent, maybe from years in her position as HR Director. She and I have had some intense times, mostly in workshops, so I knew we were capable of greater depth than we were exercising just then.
“No, it’s not. Something is troubling you.”
She rocked back a bit in her patio chair and looked at me straight on, “Can I speak candidly?”
“Come on, Char. With our background? Of course you can…”
“It’s Adam. I think he’s doing drugs. I think he’s into cocaine.”
That moment of revelation hung in the air while I took it in.
“Adam? He’s such a straight arrow… isn’t he?”
“I always thought so. But you know the stockbroker world, some pretty high-rollers. He hangs out with them and lately I’ve run into some disturbing signs. I think he’s been influenced by a couple of his flashy friends. For the worse.”
“What have you seen?”
“Well, once he came home from one of their bar nights really amped up. He was flushed and extremely talkative, for him. He seemed a touch manic, I don’t know... He was a little hard to handle, very amorous which is okay but this was a bit much. It was – well – out of character.
I didn’t think much about it, but then it happened again about two weeks later. He came home from a reception late at night and he was just wired – jumpy, energetic, couldn’t go to sleep. Restless, he paced around the house, eyes flashing. I knew something was off. He’s just not like that, usually wants to sit in his chair and doze off. We’re not that lively in the evenings, you know, getting old…
It happened two or three more times in the span of a month. I was getting… well, annoyed would be one word. And concerned of course. Then I found a bag of powder.”
“Uh oh!”
“I was taking his dark blue suit to the cleaners, and found it in a pocket. Almost like he meant for me to find it. I set it out on the top of the dresser. He knew I’d found it. I asked him what it was and he came up with a bullshit story – a supplement he was taking. Yeah, sure…I had wet my finger and touch-tasted that stuff and got a jolt! Right away I knew.”
Yellow card.
Charlotte’s life had taken a turn – a profound one. After a sublime five years with Adam, she suddenly found herself married to a stranger. She had a case on her hands and her awareness of it overshadowed her usually optimistic orientation to life. She hadn’t yet found a way to confront him, but I knew she would.
It was going to be profoundly altering, dealing with the dawning addiction of her spouse. Although still early days, these situations don’t usually have an easy, or simple ending. Her reality had shifted and she was headed down a road not of her planning.
How could Ulysses have known he was about to draw a Yellow Card, and launch on a long, strange trip?
He had come to the clinic on the understanding that he wouldn’t be able to drive home and may even have to stay overnight. When he learned the procedure could be done without sedation but be a touch uncomfortable, he elected to go ahead without being dulled, and go home afterwards. Good move.
It was late afternoon when he walked into the sanitized white medical suite fitted with video screens and a lab-like bed. He met Dr. Anthony for the first time, cool and crisp in his white lab coat.
“Lie on your side, please!” That voice continuing to be heard over a shoulder. Lubed. Scoped. Ulysses followed an internal tour of his own bowels on a colour screen in easy view.
Right away, there it was.
All were all looking at a dual lobed strange and crenellated lump clearly growing out of the bottom of a smooth undulating tube of oily muscle-like tissue. It looked like a cauliflower.
“Well, that's got to come out.”
“Go ahead.”
“No, it's too big to do that now. I'll take a biopsy.”
A little snipper intruded into the picture. The rest was anticlimactic, if distinctly uncomfortable. The denouement… not sedated, he was released into the spring sunset at 9 pm.
Word came down from his GP – benign. Bullet dodged! Follow-up with Dr. Anthony was set for September. Life resumed, but with a distinctively tentative flavour.
Ulysses and his wife Aline headed off to Italy, the time passing in a whiff of sublime countryside, easy touring and an intimate apartment beside the church at the top of a welcoming hilltop town. Barbera di Asti was on the table with dinners, and lunches were transcendent. He proclaimed to himself, “it doesn't get any better than this…”
“This is Dr. Anthony's booking secretary. We have to move up your follow-up appointment.” Hmm; an ominous cloud on a clear day. But okay. There was a big golf tournament coming up. Lots of summer still to be enjoyed…
Too soon, Ulysses was sitting in a tiny examination room, opposite that earnest face again.
“It's got to come out, Ulysses, as I said during the procedure. I know the sample was benign but this structure is one I've seen before and it definitely has cancerous potential (first mention of the dreaded C word!).”
Ulysses and Aline listened, subdued, trying to catch up to the import of what was being said. It was dawning on Ulysses that this was going to nick him – leave a mark. He had no idea of the impact yet.
“We’ll schedule your surgery a few weeks from now. You’ll be in hospital about a week afterwards, and it’ll be six to eight weeks for recovery. Then we'll know what else will be required. You won't be able to undertake any vigorous physical activity. Oh, and the nerves controlling sexual function run right through the area. It's possible they could be damaged.”
Whoa! The implications were starting to pile up. No exercise. Low energy. Out of action for eight weeks of the fall business run. And no sex. Maybe forever?
Yellow Card.
Ulysses' life agenda had been totally supplanted at one stroke... he was clearly no longer on the trajectory he’d followed so joyfully, so heedlessly, so freely earlier that glorious year.
Charlotte, never one to just let irritating matters lie, had been busy.
“I’ve got it all organized. Except I need you to come for the intervention. The psychologist says we need all the people who care about Adam to be there.”
“Char, you’re a little bit ahead of me here. What is happening?”
“It’s an intervention. As many people as possible are going to confront him next Thursday.”
“OK. What’s going to happen?”
“I’ll take the lead, and start to break any illusions that he doesn't have a problem. I’ll tell him what I know, that I'm fed up with it – maybe nicer words – and that something must be done. The rest of you will back me up, and be a united front so he can’t deny the facts. Then the psychologist will open up the avenue of rehab at an addictions center… it’s all set up.”
“OK. I hope they have good food! You know Adam. I guess the possibility of good wine is off the table, so to speak.”
Charlotte guffawed, “You got that right! See you Thursday?”
“You bet. It’s not my favorite thing to do, but for Adam, I’ll be there. Where exactly do you want me to go?”
As autumn neared, Ulysses couldn’t help but brood over the oncoming surgery and recovery. He would be out of the picture at a critical time, just as everyone was getting back to business. Not good; money and work imperilled. And if he told his clients and friends, he would change from being a man seen as part of the future – a ‘player’ – to ‘cancer patient’… Not someone to be counted on in serious company building efforts, as he had been for many in the past. He worried he would be perceived as being on his way out.
Not just that. Cancer. Not a mild form. His capital ‘C’ diagnosis still held the connotation of a death sentence. Not a Red Card yet, but significant for sure.
His status had changed. Soon he’d be a defective, limited person. No energy, no golf, no zip for work. Ulysses saw this totally new estate suddenly take up a major portion of his horizon.
What now?
Anticipating a life without a Card is not realistic. On the other hand, living as if its arrival in imminent isn’t either. You can't mope around because something is going to happen someday. Life is made of challenges; how you take them on makes all the difference.
It may be part of the way forward to dig down through the rubble of potential despair to the rock underneath. It’s a plus if you've had a hard look at who you would be and what priority your life would have if so confronted.
In the past, Ulysses had a major part of his business life melt down. It happens. He had taken a close look at retirement options. After a little experimentation, he decided to fight back, reinvent his business and re-establish himself. His maxim for his new era: "I'm not going to be counted out. I'm staying in the game." And he was enjoying unprecedented satisfaction under the new banner. It had all changed in one clinic visit.
That's how it is when the Card lands. Illusions of mastery, control and direction over one's life are blown to hell. The new reality scrubs your nicely ordered plans. Getting over that and used to it becomes the whole story. Well, almost.
The phone buzzed late that winter eve. I was lounging back in my office chair, feet up on the credenza, looking out at the lights of downtown. I pulled the iPhone out of my jacket pocket and looked down to check the provenance of the call. It was Charlotte; I slid the button sideways.
I held the phone up to my ear, said hello… and nothing. Then a soft sobbing.
“It’s Charlotte...”
“I know. What’s happened?”
“It’s Adam. He… he's gone and died on me.” A torrent of tears.
“Oh no, Char. That’s awful! How?”
“Well, he’d done really well after his stint in the center. Came back clear and was kind of back to his old self. But I guess it didn’t hold.”
“I’m guessing he got stoned when he got together with his old crew and ended up on the wrong end of a bridge abutment. The police said he must have been doing over 100. Died instantly, so that’s a mercy.”
The tears flowed and consolations were attempted. But there was no doubt.
Game over for Adam. And a much more significant Yellow Card for Charlotte.
Waking up in recovery, Ulysses met his new closest friend – a colostomy bag – now hanging off his waist. As meds wore off, reality and pain set in. He felt a wreck. Trying to get back on his feet, learning how to handle and change his ostomy bag of shit, manage the portal bandage... He had to climb back into the picture. Or what? Give up?
A post-hospital visit to the surgeon: “We got good margins. But pathology shows evidence of cancer involvement. You'll have to do chemo and maybe radiation, six months. After that we'll come back and reverse the ostomy. It may take a couple of years after that to settle back to fully normal function.”
A meeting with the confident and fun oncologist: “Yes, you're going to have a combination: radiation and chemo. Five weeks of everyday radiation first, with chemo pills, then a three-week break, then four months of infusions every three weeks and daily pills.”
Nice, thought Ulysses. They don't beat around the bush, do they?
Ultimately, getting the Card forever changed his sense of himself. It cemented his marriage. It enhanced his appreciation of simply living. It dented his capacity for adventure. It impacted his income.
And Ulysses got great advice concerning the Card from a long-time fellow traveller and survivor of two bouts of chemotherapy. You can do this.
Ulysses’ good friend and former office mate Gene now lived in California. He would continue to live if he undertook horribly invasive stem cell therapy for his aggressive lymphoma. His regime called for three solid weeks in hospital, being brought to death’s door, then, hopefully, to come back.
Facing the unfathomable, Gene had a frank talk with a trainer who knew him well, “I don’t know if I can handle it…”
A pause; a long pause. Randy looked him dead in the eyes, “Gene, you can do this.” Another long pause. Then, a reset, right there and then.
“Yes. Yes, I can.”
And he did. Get through it.
Red Cards
Eleanor was the picture of health and involvement. She was fully into a vital existence, a veritable fireball of activity. Her career was long over but she was an ardent tennis player, an international traveller with husband Reg, a volunteer with the Muscular Dystrophy Association, having lost her sister to that disease.
It began with gut pain, incidental then alarming. Never a complainer, she commented on her discomfort to Reg a couple of times after a dinner out, and he found that surprising. The third time she called him to the bathroom where he found her sitting clothed on the toilet doubled over and groaning.
“C’mon, we’re going to the hospital!”
Begrudgingly she got into the car and went along to Emergency. Her pretense that she could just carry on masked something deeper – awareness that something was significantly wrong, and fear of facing it.
There was a short wait for triage, a range of blood tests, a CT scan. The news was delivered by a tired Resident trying to show compassion.
“You’ve got cancer. We’re not exactly sure, but we think it is pancreatic.”
Red Card.
Reg was heartbroken. He was willing to take her anywhere, do anything to help his companion, his lover, the mother of his kids, his wife. But he could not suffer for her.
For a while, the path ahead seems a bit foggy. It depends somewhat on the medic. These folks are fundamentally bio-mechanics and not always great at bedside. Most dish the bad news bluntly. In Eleanor’s case…
“You’ve got stage four cancer. There isn’t much more we can do for you.”
“How long have I got?”
“Eight months, maybe a year.”
Treatment options were laid out. All had poor odds and all were unpalatable as hell. She began the process of adaptation, but a Red Card is different in its finality. She grasped at straws for a short time. Dreadful options were explored, but not taken.
She tackled the big question: do you want to spend your remaining time in agony, undergoing experimental or painful and diminishing treatment of the ‘faint hope’ variety? Or, just head into the known future and accept what comes? Maybe take an option where you control your end game?
Part way along, Eleanor came to her own conclusion: “I’d rather die peacefully than go through much more of this.”
With full knowledge and resolve, Eleanor chose an interesting mix of alternative and traditional medicine. It gave her a dignified exit to limit suffering, and brought her known outcome to a definite close.
Reg saw the light going out of her. Not that he had any real say.
They lived in a state where medically assisted death was an option. Eleanor was in full possession of her faculties as she researched, then elected to go with it and kicked the process into gear.
There it was. Reg acquiesced.
Some hard moments came while Eleanor talked with life-long friends, tennis buddies, fellow volunteers…
Her two kids, Gini and Felix, were completely riled up and immediately besieged her with advice gleaned from online sources. For the longest time, they simply couldn’t abide Eleanor’s choice. It was only seeing their mother’s resolve that forced them to let up, and begin to wrap themselves around the realities: it couldn’t be helped and it couldn’t be stopped.
Cards: extraordinary moments
Yes, you’re likely to get a Yellow Card, maybe more than one. It comes with the territory of living on into our 60s, 70s, 80s, 90s. It's like a tax on a long, well-lived existence. You can treat it as a trigger for a long, slow tapering off. Or pay up and move on to... more.
With a Yellow Card, our biggest fear is that this is The Big One, that the end is nigh and it’s the start of an unavoidable downturn.
Well, it isn't. There are better ways to frame the arrival of a Card. You're still armed with a drive to accomplish things. Recruiting that initiative, reviving that energy allows you to take a different vector and view the challenge as something other than a disaster.
Your Yellow Card grants you a spectacular gift of time to experience ‘space and grace’ after long innings of hard work. So, get a grip and carry on. It's not over until it’s over.
But, with a Red Card, it is going to be over. Soon.
How does one address the final transition? As with all difficult life passages, you can choose to face forward and take it on, or be dragged kicking and protesting feet first into the future. Either way, you’re making the trip.
A magnificent exit
Meeting Eleanor in that twilight was both sad and a revelation. Here was someone at the end of the trail, an end we will all meet, who radiated understanding, reconciliation, and peace. Through her medicated fog, she was still acute, and her self-appraisals were startlingly clear eyed.
Reg, too, grew spiritually through his slow adjustment to this unwanted turn. Platitudes from others were small consolation for his raw wound. Although accepted graciously, they seemed almost unintelligible and lame. He recognized that even though off target, they were well-meaning and came from a place of caring. Some friends just couldn’t bear it and didn’t come around. Some were very stiff and short in their formal goodbyes. It was as though they thought death might be catching.
Eleanor was a singular person, with her own way of tackling challenge. She scheduled a ceremony conducted by a leader in a discipline she believed in. She invited many people with whom she was close. The event involved several elements:
Eleanor showed herself to her friends, not wanting to hide away. Why do the dying do this? To hide? Shield others? Have people remember them as they were formerly? Eleanor tossed that convention out the window.
Eleanor allowed her friends to participate in this passage. All knew what was at stake. Most wanted to help. Fundamentally, how friends handled this was up to them. Some wanted to be there. Most were grateful to be included and behaved appropriately. Some shied away, not having the spiritual or physical capacity necessary to be present with the prospect of death. Some had the desperate, unfortunate need to advise, rather than accept. Eleanor took it all in.
Eleanor received love, regard, and the best of good wishes – all implicitly on the menu. She basked in this opportunity to experience the warmth of friends while still sensate. There was such generosity in this. Where else do we share expressions of regard, meaning, and affection for those soon to be departed? How much better is this to happen in life than at a funeral where the honoree cannot respond?
For Eleanor and all others present, this ceremony provided closure. It was a launch point for acceptance and grieving. Experiencing sadness was not to be avoided; it was fundamental to moving on. Ultimately, every attendee felt this evening was one of the most intense of their lives. Eleanor felt replete; this celebration had rounded out her life.
In the end…
My dad is 95 and still vital. The funerals are all over for him. He’s attended those of all the friends in his cohort. Some hit him harder than others. But he has manned up and, because he is a champion at managing loss, has often been asked to speak at the ceremonies for many of his contemporaries.
He’s a champion. It’s his prize for outlasting them all. He knows how to grieve, how to experience loss and grow to be a bigger presence with each loss – however hurtful.
Yellow Cards – he’s received a few. Each has taken something from him, but has also given him something. Scarred and touched, he carries on and faces each day he is given with gratitude and wonder.
A Red Card – when that referee stalks up to him, stares him down and holds up the dreaded signal – he won’t wonder any longer. He’ll know. And that’s good! He’ll get on with acceptance, and saying his goodbyes.