A Movable Feast

Since we arrived back in New York from Paris about a month ago, I have taken advantage of my unscheduled interlude by eating lunch with one or more friends almost every day and attending some sort of party or dinner with Susan and one or more couples almost every night. The only ill effect to report from all of this activity is that I had to take all of my trousers to the tailor to have them let out an inch. 

Meanwhile, I have continued to go either to physical therapy or to the gym almost every morning, and I have steadily regained energy, strength, and flexibility. Although the surgeries and their complications have left their marks, I am in good spirits, eating and drinking con brio, and feeling remarkably well as I look forward to making plans to spend time in the New Year with other family and friends. 

On Monday morning, Susan and I will head south by automobile. We will divide the driving in our usual fashion: She will drive; I will read. She can't read in a moving vehicle, and I can't stand to waste time. If the snowplows do their job, we should arrive on the 23rd in Ponte Vedra, Florida, where our son will join us in a Christmas-time visit to my parents. The next morning, we three will drive west from Ponte Vedra across the state to St. Petersburg, to spend Christmas Eve and Christmas Day with Susan's father and one of her brothers, Tom, his wife, Judith, and their son, Nick. 

On the 26th, Susan and I will travel partially back across the state to Ocala, to visit friends and horses, including Statesmanship, the most successful horse that we have, to date, ever raced (in partnership with Mike Rankowitz and the late Peter Karches). Thanks to the kindness of our friends, Jill and John Stephens, Statesmanship is now a happy Florida retiree.

We will wend our way up the Atlantic coastline, visiting people who currently cannot easily travel:  a friend in Charleston; my aunt, Lucy, and an unrelated couple in Virginia Beach. We intend to arrive back in New York City on New Year's Eve.

Before I retired at the end of last year, Susan and I had intended to take more advantage of New York than I had ever had time to do while working. We had envisioned spending leisurely lunches at fine restaurants before heading off to museums. 

My extended interlude should enable us to realize a bit of that retirement dream. During the first week of January-- always a quiet week in New York, with everything available on short notice-- we are going to pretend that we are foreign tourists in New York. Today, I made luncheon reservations at Bouley, Aquavit, Le Bernardin, Jean-Georges, and Eleven Madison Park. Tomorrow, we will pick concerts and plays. We won't decide now on museums: I can't think of many more pleasant topics to save for luncheon conversations than discussions of which exhibits to visit that afternoon.

I wish for you a happy and healthy New Year!

Hallelujah!

From August 22 through September 12, 1741, George Frideric Handel composed in London a rough score of Messiah, consisting of some 250,000 notes written with quill pens. (Presumably, he wasn't spending much of his time during those 24 days watching television or on the internet.) One of the earliest performances of parts of Messiah in the New World took place in October of 1770 at Trinity Church, at the same location at the foot of Wall Street currently occupied by Trinity in its second reconstruction consecrated in 1846.

Handel conceived of Messiah as an oratorio to be performed during Lent, just prior to Easter. In recent years, performances of this retelling of the life of Christ have become part of the Christmas tradition. Often such Christmas-season performances consist of "Part One, The Prophecy and Birth of Christ Our Redemption," including only the Hallelujah chorus from "Part Two, Redemption's Cost: The Passion of the Scorned, Suffering Lamb; His Resurrection and Ascension," and omitting entirely "Part Three, Redemption Fulfilled; Thanksgiving for the Defeat of Death." 

Christmas-time performances of the entire Messiah have become critically acclaimed and popularly anticipated annual events at Trinity Church. This year, two performances were scheduled: one for yesterday afternoon, which Susan and I attended; another for tonight. Prior to yesterday's performance, an uncomplaining line of people stood in a cold rain, occasionally moving forward a step, waiting to squeeze through the one open door to pick up tickets purchased on the internet-- or even in mostly vain hope of being able to buy tickets-- at a table staffed by distracted volunteers. When the performance began, I doubt that there was an empty space in a pew or an unoccupied folding chair in the aisle (where we sat, near the front) of this beautifully proportioned, perfectly maintained, Neo-Gothic church. 

This year, Trinity Church's Messiah is sung, as it has been for many years, by the Trinity Choir, accompanied on period instruments by the debuting (in current configuration) Trinity Baroque Orchestra. The guest conductor is Jane Glover, Music Director since 2002 of Chicago's Music of the Baroque and now also Artistic Director of Opera at London's Royal Academy of Music. Yesterday's performance was broadcast live on WQXR 105.9, and tonight's will be recorded and available on video at trinitywallstreet.org. 

To my tone-deaf, untutored ears and dim vision, yesterday's performance of my favorite"Christmas music" was completely satisfying: expertly and charmingly conducted and performed, in an appropriate and sublime space. Not only did a number of the sopranos, altos, tenors, and basses take turns singing the solos, but also the facial expressions of the entire choir were consistently appropriate to the passage at hand.  The orchestra not only employed period instruments, but also it was sized as sparely as the ones for which Handel had composed Messiah. A medium-sized church, Trinity's undistorted resonance flattered the enunciated words in the lovely voices of the singers and the precise and spirited playing of the musicians. 

In spite of the solemn nature of Parts Two and Three, it was manifest that not only the members of the audience, but also the singers, musicians, and conductor were excited, proud, and happy to be part of this august occasion. Amidst the audience's still thunderous applause, we filed out, pulling on our coats against the cold and rain, crossed lower Broadway in winter's early darkness, walked down the stairs into the subway, and thence home. My Christmas season, my favorite time of year, had begun.

Hallelujah! 

 

At the Cafe d'Alsace

Last night, at the Cafe d'Alsace, our host acquainted us with these lines from "The Kasidah of Haji Adul El-Yezdi," by Richard F. Burton:

                                         

                                        Cease, Man, to mourn, to weep, to wail; 

                                        enjoy thy shining hour of sun;

                                        We dance along death's icy brink,

                                        but is the dance less full of fun?

Avastin

Recently, I heard that Avastin is the leading cancer drug in the United States, as measured by dollar sales. On November 24, Britain's National Health Service announced that, as a result of a cost/benefit analysis, it will not make Avastin available to patients like me with metastatic colorectal cancer. Avastin is an anti-angiogenesis drug: Avastin shrinks the blood supply that tumors create to feed their rapid growth. When I go back on chemotherapy, I will probably receive Avastin in conjunction with the same cocktail of poisons, FOLFIRI, that I received when I was on chemotherapy previously. Although Avastin does not have subjective side effects, its rare physical side effects include cardiovascular events and stomach perforation.

Britain's National Health Service rejected the use of Avastin even though, in conjunction with chemotherapy, Avastin shrinks tumors in 78 percent of patients with my condition. That benefit sounds pretty impressive until one considers, according to what I read on the internet, that it translates into median survival of 21.3 months, as opposed to 19.9 months without Avastin. A modest improvement in median survival does not of course mean that some patients do not benefit significantly from Avastin.

Given our society's many needs and the budget deficit, should Medicare pay, as it will, for my Avastin? Although I have not attempted to follow all of the twists and turns of the healthcare debate, I do not think that the cost-containment proposals currently under discussion by our politicians in Washington include consideration of eliminating Medicare payments for things like Avastin (especially, one could argue, for folks who could afford to pay for it themselves). Until our nation has completed the squandering of the U.S. dollar's status as the world's reserve currency, I wonder if our politicians will have the temerity to suggest to us, the American people, that we will have to accept that there are painful limits to what our country can afford, whether it be for medical care, other entitlements, bailouts of businesses, pork-laden stimulus programs, or some notions of national defense?

But Not Today!

A friend says that my attitude reminds him of a man's who says to himself, "They've got me. But not today!"

The Joke

I fear and respect my opponent, the cancer that constantly gains ground against me, within me. And yet, is not the joke on it? When it kills me, it too will die. So it can't beat me in our death struggle: At the end of the day, we will go out together.

Interlude

This afternoon, I had an appointment, scheduled about a month ago, with my medical oncologist, Dr. Leonard Saltz.  The purpose of the appointment was for him to determine whether, given my objective of maximizing the quality of my remaining days, I could continue my respite from chemotherapy through the holidays. Because I am feeling so well, I was pleased but not surprised when he agreed that, unless I have a turn for the worse, I can extend my holiday into January. 

As I write this entry, I realize that I may never again be as free of pain, or as energetic, or as able to taste food and otherwise enjoy life as I am now. During this interlude between the miasma of the surgeries and their complications and the renewed poisoning of chemotherapy, I hope that I can keep the perspective of finiteness in the forefront of my mind from moment to moment in the precious minutes, hours, and days ahead.

During this interlude, my major time sink is spending a couple of hours a day in either physical therapy or at the gym. But I think that this expenditure of irreplaceable time is worthwhile. I am given to understand that patients with advanced cancer not only feel better, but also may live significantly longer if they follow a program of vigorous daily exercise. In my situation, I know of nothing else that does not require a tradeoff of quality of life for quantity of life. The exercise also seems to be helping me to rebound physically from the two surgeries and their complications. 

Moreover, I experience a considerable psychological boost from doing something active to fight back. While I know that the cancer is winning and will kill me in the end, struggling against it feels good. If, today versus yesterday, I can lift more weight, stretch over a wider range, and go faster, longer on the cardiovascular machines, am I dying? When I have added more weight to the bench press and am completing the last of the repetitions that I have assigned myself, as I did today: In that moment, I have won. I have won!

As you probably infer, during the more broadly defined interlude between diagnosis and death, the time-consuming writing of this blog is, for me, another way of struggling, of fighting back.

Mob Scenes

One night a couple of weeks ago, while we were in a taxi in Paris halted by a surging swirl of yelling, flag-draped, Algerian soccer fans on foot and leaning out of honking automobiles, my mind turned to other mobs in which I had found myself surrounded. Two such scenes had temporarily seemed similar to me to the one in which I found myself in Paris.

Spring is a season particularly conducive to rioting (many of us at Princeton rioted at the onset of spring during my sophomore year). On May 1, 1976, our family was on holiday at a resort in Puerto Rico. Before driving into San Juan for dinner, my wife and I watched the Kentucky Derby on television with especially keen interest. The favorite in the race, Honest Pleasure, was (and remains) the shortest-priced favorite in the history of the Derby. He was trained by the trainer of our horses at the time, Leroy Jolley, and we had watched Honest Pleasure develop from the beginning of his two-year-old season. But Honest Pleasure was upset that day by a horse named Bold Forbes, a supposed sprinter that "stole" the Derby  by taking the lead at the beginning of the race and holding it to the finish. As it happened, Kentucky-bred Bold Forbes was not only owned by a Puerto Rican, but also had begun his racing career in Puerto Rico. On the way into San Juan after the race, I soon had to halt my car because of the exuberant crowds in the streets, on foot and in cars. It took hours to make our way into San Juan. I had had no idea that horse racing was so popular in Puerto Rico or that the populace was so proud that a top horse was owned by a Puerto Rican! 

The next morning's headlines in the local newspaper were all about the previous night's huge May Day Communist demonstrations.

On April 29, 1992, I flew from New York to Los Angeles for board meetings of the two Santa Anita Companies, both listed on the New York Stock Exchange-- one company conducted racing at the racetrack owned, along with other real estate, by the other, a real estate investment trust. My flight arrived about 9 p.m. California time. I got in a taxi, gave the driver my destination, and dozed off. I was jolted awake with when the driver slammed on brakes. We were surrounded by men and women peering into the taxi, their arms loaded with merchandise. My adrenaline pumping, I noted that we were on a local road rather than on a freeway and that there were no other cars on the road; that some of the stores around me, including a liquor shop, were in flames; that my driver was African- American, which struck me as potentially a good thing, as the members of the mob looked African- American as well; and that the doors to the taxi were unlocked. I quickly decided that it would not be a good idea to show fear by trying to lock the doors. The crowd seemed more exuberant than angry. They didn't seem to want to harm the driver, and I couldn't see why they would want to put down their armloads of television sets, clothes, and whiskey bottles to bother with me. Slowly, the crowd in front of the taxi parted; and slowly, the taxi started forward, gradually gaining speed. I asked the driver what was going on, and he told me that the police officers who had beaten Rodney King had been acquitted. As I surveyed the burning buildings along La Brea street, I asked him where the police were. He replied that the police were afraid to come there, which did make me wonder about his judgment in choosing our route. After checking in at my destination, I went to my room and turned on the television set. City Hall, which was right next door to where I was staying, was under siege! During that night and the next two days, 53 people were killed, 2,383 were injured, and there were some 7,000 fires. 

That summer at Saratoga, I was dining out on my tales of the Los Angeles riot. At a party, the late Joe Hirsch, the dean of racing writers, asked me where I had been staying in Los Angeles that night. 

"Well, Joe, I was staying at the California Club." 

"Oh then, you couldn't have been safer, Charlie." 

"What do you mean, Joe? You know that the California Club is a ground- floor building, and there is just one employee on duty at night." 

"Safest place in the world, Charlie. You know perfectly well that the California Club would never permit anyone to enter who wasn't wearing a coat and tie!"