Originally the title of this post was “34.25 Signs You Might Be an A-hole.” I was, quite unselfishly and humbly I might add, going to provide a quick and easy way for people to recognize those a-holes living among us. What a guy! What a noble calling! What a rubric for negotiating modern life! What an…
But then I got to thinking (which is usually not a great idea but in this case it worked out okay)…
What an a-hole.
I mean how is it that I can lay claim to even a modest degree of proficiency in the subject matter; and so smugly produce a list?
Make no mistake the first sign, as in #1 in the list below, is there for a reason.
So, anyways, I changed the title temporarily of this post to “34.25 Signs I might be an A-hole.”
That seemed a better title for awhile…
But, needless to say, I changed the title back.
I’ll give you 34.25 chances to guess the reason why.
34.25 Signs You Might Be an A-hole
Whenever you are thinking you are not really an a-hole, then you probably are one, so sorry
If you are convinced that somebody else is an a-hole, then its possible you could be one too (also sorry about this)
Whenever you are overly sorry, that’s a perhaps a good indication you are a sorry a-hole
If you are speaking ‘passionately’ and it has suddenly gotten very quiet in the room, you might be tangling with a-hole-ish behavior
When you get done speaking and no one is looking at you, chances are good that you are an a-hole
If somebody just whispered, ‘What a total a-hole’ under their breath, that’s probably not a good sign either
Whenever you feel compelled to prove how much you know or how right your opinion is, then hot-dang, get yourself a ‘I might be an a-hole’ t-shirt son
If you are driven to talk about something you have little or no knowledge about, then you might want to convince yourself you are an a-hole first
If somebody just texted their friends while you are speaking, ‘can you believe this a-hole??? lol’, then the prognosis is likely “un-good” as far as you and the title of a-hole are concerned
If you go to the DMV to get your custom license plates and the clerk says ‘How about ‘A.H.O.L.E’ instead? That could indicate you might want to have A.H.O.L.E. stamped on your forehead
If you just got done calling someone else an a-hole, you might want to check your own nether regions
When education, name, birth place, place of residence, team, employment status or position, relative wealth/poverty, race, political opinions, suffering or success, religious or spiritual opinions make you better or “righter” than some other a-hole, you may be displaying classic a-hole symptoms
When you use words like “truly” or “sincerely”, that could be a bad sign of a possible a-hole outbreak
When you feel like you have been waiting ‘long enough’, you might not have to wait much longer to prove you are an a-hole
When you find yourself judging a-holes for being too judgmental, that’s can be a sure sign of a real a-hole move
Whenever you are 110% correct, you are usually 100% a-hole
If those a-holes are 110% wrong, you are probably not 100% non-a-hole
When you passed a lie detector test, even though you were lying, congratulations! You may have passed the a-hole detection test
If you take another lie detector test in which they ask if you were lying on the first lie detector test, and you pass, you may have just been proven ‘guilty’ a-hole
When you insist on being called a doctor even if you have a PHD and that’s not really the cultural norm, this could be considered pseudo-a-hole-ish behavior
When you feel its your mission to change a cultural norm, however insignificant or popular and/or benign, you might want to check your nether regions
When you just have to say something even if its going to shatter someone else’s feelings/stature/pride/position, just because you know ‘its the right thing to do (for them of-course)’, then you are probably about to be wrong and they will probably be right later when they call you an a-hole
If your wife prints out this list, laminates, and sticks a copy in your wallet, then you are probably, literally a card carrying member of the a-hole fan club
When you discover your laminated, a-hole card in your wallet and ask yourself, ‘Now why did she stick that in here?’ then, ladies and gentleman, the a-hole may have just entered the building
When acting like an a-hole, you pull out this card and can’t find a single thing to relate to, rip the card up and swallow, digestion might be your only chance at uncovering your true a-hole self
If your wife gives you a glass belt buckle for Christmas and says, ‘Here now you can see where you are going,’ you might possibly get accused someday of being an a-hole
When you write a heated email and use lots of these and those and them or even this, thiscould suggest you are in an a-hole state of mind
If you are wondering if you should send the aforementioned e-mail, you might want to wrap yellow ‘Caution – A-Hole Line – Do Not Cross’ around your work space
If you send it anyway, um, you may have just crossed the border into A-hole-ico-land
When you use too many “you”s in sentence, YOU might be an a-hole
When you use too many “I”s in a sentence, that can be a measure of a-hole-itis
If you use the term ‘a-hole’ instead of asshole in a list like ‘34.25 Signs You Might Be an A-hole’ because you want people to think you never actually use the term asshole cuz like you are too evolved a person to swear anymore, then your a-hole certification has probably not expired
If you can’t think of anything nice to say but you say it anyway, well…c’mon man what would your Mother say man?
If somebody calls you a ‘Mass-hole’ because A-hole is not a big enough term to describe you, then you might-could-possible-be a real a-hole of the real a-hole variety
.25 If you tack on .25 to a “34.25 Signs You Might Be an A-hole” list to try to be “cute” or get attention or who knows why, they might soon be welcoming you to A.A. (A-holes Anonymous) club
Of-course, there is a difference I think between ‘being’ and ‘acting’ like an a-hole. And of-course, anyone that uses ‘of-course’ in a sentence might be accused of a-hole-holic behavior (I can’t stop; this could of-course be #35) someday. But anyways…is that really true? Are being and acting a true distinction? There was a time in my life when I thought intentions mattered. There was later a time in my life when I realized intentions didn’t matter; it was the actions that counted. But now I think its somewhere in between. At least I had those good intentions, like a seed. They were however un-realized, at least, present. Though perhaps the longer intentions went un-realized the bigger the a-hole becomes. Anyways, I have diverged a little here from something somewhat comical and truthful or maybe tragic (all maybe the same?), to a more serious subject.
This means there has to be time for one more…
#36 When you are that guy that takes something relatively fun and light and makes it kind of morbid or self-reflective, that may be a sign you have stepped into yonder a-hole territory.
I mentioned during my last post that I’m grateful for the advice Susan Steel provided when I was first diagnosed with Stage IV melanoma. As I was running and thinking about this the other day, I realized that the way in which she delivered the information, in hindsight, was also quite exceptional.
For one, Susan never told me what to do. This, as some of my friends and family might surmise, was probably a wise decision. 0-; Instead she gave me a mission which I could either choose to accept or deny; but in either case the phone would self destruct in 5-4-3-2-1.
In this manner Susan led me gently in the right direction and taught some lessons which I still use to this day. I thought sharing some of these ideas might be valuable to my fellow melahomies reading here; or to a anyone facing medical spaghetti junctions in the road.
It was all kind of black hat-ish in hindsight. Susan practically whispered about a paper she’d recently obtained from a prestigious and well attended summit of melanoma researchers and oncologists in Chicago, fall of 2012. I admired her pluck – inserting herself in conferences and conversations where only doctors and phd’s feared to tread. She told me how, in many of these meetings, she was the only patient advocate, sometimes wanted and sometimes not.
I imagine her stepping up the microphone amidst a room full of cold shoulders in white jackets.
“And your name is?”
“Steel, Susan Steel,” she’d say and then lay down a heady dose of common sense or irony designed to make people think…which isn’t necessarily practiced in any professional organization, let alone medicine.
Anyways I had just finished describing my plan which included enrolling in the combinatorial BRAF and Mek inhibitor clinical trial. Susan, in so many words, suggested I might want to reconsider my position.
I thought it was odd how un-enthused she received my plan.
“I’ll send you the pdf, and we will talk on Monday,” she said, “oh and please don’t tell anyone I gave this to you” and hung up.
That was a Friday, the end of our conversation, and though I didn’t know at the time, it was a test.
The paper turned out to be a fat paper of papers, boiling over with a couple hundred pages (at least) of medical jargon… enough jargon to inflict eye-roll-back-disorder and a coma like state of duh, within seconds of reading. But I was “in”, committed, and otherwise motivated. Besides if I could get through Heidegger, Joyce or Foucault or those thousand page engineering books without blowing my brains out (yet), I could do the medical foo too.
There was actually, I found, a certain amount of treasure hunting involved once I got started. As a newbie to that world I didn’t understand all the terminology but wanted to unlock its secrets nevertheless. That meant wading through stuff like this:
…9x11mm ill-defined and spiculated nodule with surrounding ground glass density (aprox 1mm larger than previous scan) in the superior segment of the right lower lobe. Primary differential consideration is primary lung neoplasm although active fungal disease could have the same appearance. Biopsy should be considered. (air bronchograms extend near the margin of the nodule but definitely do not extend through it)…ad infinitum…Cha-Chink-BOOM!
Luckily, most papers in this collection had introductions and conclusions and the conclusion I eventually arrived at was that doing the BRAF and Mek1 targeted therapies was not advised, yet. The melanoma megla-maniac-minds recommended instead, as in my case, that a “low tumor load” (my condition at time) was a better fit for immune therapy. In such cases there was some measure of time to see if the intervention would work. The targeted therapies such as BRAF and MEK1 could, in turn, be kept in reserve as a last ditch effort should the immune therapy fail. As I recall, @ 70% of people experience good results with targeted therapy.
However, after 6-12 months almost all (the paper discussed) patients develop a resistance to the treatment. Even though my original plan was novel, in the sense that they were combining BRAF and MEK1, the collective wisdom was that patients doing this would eventually develop resistance. So perhaps the best course, they suggested, was to go for an immune therapy. These carried a much lower success rate but, when they do work, can result in longer lasting or “clinical” outcomes. If these fail, I could then go with the original plan which had a higher short term success rate but more morbid long term prognosis (Note: new studies have shown that even when somebody develops a resistance to a targeted therapy, sometimes they can be reapplied or re-tried with success; if interested, google “re-challenge” and “braf inhibitor”).
Okay, so if you are still reading and that last paragraph did not cause eye-roll-back-disorder or a catatonic state of duh, what’s my point? The point is being informed was my job. Despite a strong desire to have somebody of authority (Susan, the doctors, Somebody dammit) tell me what to do, I had to make a decision on my own. As I’ve shared/whined in the past it can be agonizing how little doctors actually participate in the decision making process. This seems in direct proportion to the severity of the diagnosis. Anyone that is hoping for a authoritative direction when it comes to dealing with advanced stages of Melanoma may be in for the same comedy of disappointments (kind of ironic or maybe pathetic though that I whine about this when all but stated above I don’t like being told what to do). So, either I could educate myself and try to make the best decision…or not.
But, as Susan guided me and lived her life by example, it was my job alone to do this, 1 billion pages of medical highfalutin lingo be damned;or even the doctors and clinical trial process be double damned for that matter. I mean, some of the same doctors that had signed/contributed/read/reviewed the aforementioned super duper topic secret paper of papers and attended the all mighty seminar, were the same ones who with a straight face recommended that I do the first clinical trial. Sure, do the targeted therapy Monseigneur Guinea Pig, even though we think that immune therapy is probably your better long term option…alright, alright this is getting a little carried away…don’t think there was some mass conspiracy, a plan by the man to keep a poor melanoma patient down. True there are a few idiots and a-holes out there (have had a few appointments with some of them…as someone intimately familiar with idiocy and a-hole-ness, I feel qualified to recognize one…hmmm…feel the topic of my next blog coming on). All rambling aside, there are indeed some serious flaws in the clinical trial process (great blog post on this subject here, see chaotically precise, The Problem with Clinical Trials) and, okay dead horse being beat um deader here, my job is to be in the know bro.
Lesson two came next. I got a list of doctors across the continental US to go see. I didn’t have to see all of them, but at least some were, um, highly recommended. Why? First off, and as I’ve said before as if it were my own (now you know even more that I have no original thoughts), these were melanoma doctors that specialize in melanoma patients using melanoma medicine. Nothing against the vanilla oncologist, but this makes more sense. They are in the game, every day, taking lay-ups, practicing free throws, and hopefully getting in a few slam dunks on melanoma.
What’s more, as Susan taught me, I was building my network of contacts. I might need the full team if I was in the this fight for a long time. And I since found, just as she taught me, that not only was it important to find the right, specialized doctors; but I might need to call or email all those doctors on the list with questions or additional treatment options. Making an appointment and showing up on their doorstep at least once, makes it a lot easier to get a hold of them, down the road, with questions, again. These are some good dudes too and they get back right away; this because all the good melanoma doctors are on major pharmaceutical grade methamphetamines and they don’t sleep (but its okay because, um, their doctors and these specific meds are non addictive, really).
Wonder if I should crank call one of them now?
Or maybe offer a joke?
Joke about NASA, Full Of Bright People
Three men were in a NASA conference room to decide how to spend $10 billion.
“I think we should put our men on Mars!” said the first man.
“Ooh, good idea,” said the other two.
“I think we should put our men on Venus!” said the second man.
“Ooh, good idea,” said the other two.
“I think we should put our men on the Sun!”
“How are you going to do that?”
“Easy. We go at night.”
Anyways, when it comes to medical decisions your mission, or Susan will come back and haunt you up, should you choose to accept is:
Never tell me what to do… or call me Francis for that matter…or I kill ya. I suspect Susan would have too.
Be informed, read stuff, even if you are scared or feel inadequate to do so; or, as they advise in other circles, if you can’t do it find a friend who can for you
Realize I know something about a-holes and might blog about this next, you might want to skip my next post
Seek out the good doctors and build a relationship or team of them to call on…never know when you need a good post up guy or three point shooter
Remember that the good doctors take lots of uppers and don’t sleep at night so its okay to email or call them and don’t worry because they are doctors and they won’t get addicted but you will man so like cut that crap out and like ‘Just do it’ …ah, that is, I mean be like Nancy not Mike and ‘Just Say No.’
The following quote arrived in my inbox today and it made me think, again, of Susan Steel.
“The most beautiful people we have known are those who have known defeat, known suffering, known struggle, known loss, and have found their way out of those depths.”
Elizabeth Kubler Ross
We’ve been thinking about her a lot over the last few days, since hearing the news she passed away. For those that did know her, she was a long time Melanoma survivor who started, among her other accomplishments, the Skin of Steel foundation. She was not only an intimidatingly smart and perceptive woman, she had a huge heart for us sick melanoma folk, a real spirit for family (I could totally relate to her desire to see her kids grow up and fight like a mofo to try to make that happen), and an awesome sense of humor. What’s more Susan was a tough as nails customer when need be…10 years ago when she got diagnosed there was almost no hope for us, yet she survived and helped a ton of people in the process. You can read more about her compelling story here.
Besides saving my life with her initial advise after I got my Stage IV Melanoma diagnosis, Susan pointed me towards a number of things:
When you get a tough diagnosis go to the experts. For instance, if you have melanoma find the melanoma docs. A general oncologist might see 1 or 2 melanoma patients per year. A guy like Omid Hamid in LA at the Angeles Clinic sees a couple of hundred, besides having a vested interest and passion for fighting this specific malady. It stands to reason that the quality of care (as expressed by knowledge, intent, access to the latest treatments/ideas/approaches etc) is probably going to be higher. So, if you can do it, seek out the experts. Its worth the effort.
There is power in applied information sharing. Simultaneously amazing and tragic, the medical and pharmacological research communities do not share information very well. More than 50% of the findings gathered during clinical trials, for instance, are never publicly disclosed. Say what you want/draw your own conclusions about this and the closed nature of this system, Susan set out to do something about it. In her typically astute way, she saw a real opportunity to take a bite out of this close door problem. In particular, she saw how tissue banks where dramatically moving forward research in breast, colon, lung and other cancers, leading to new effective treatments. So she took the initiative to start SOS with the expressed purpose of doing the same for the fight against melanoma. Someday, when the cure(s) are prolific there could be one named after her.
You can be a smart and strong, even when your sick. Susan traveled from Chicago to Colorado for the benefit dinner thrown by the Fay Family Friends (F3, https://www.facebook.com/search/top/?q=f3%20-%20fay%20family%20friends) even when sick, just weeks after getting another gamma knife treatment. She delivered a powerhouse speech and provided a huge jolt of positive energy and hope for our family just by showing up. She had an aura and power about her and was a true melanoma warrior bad ass.
Susan at Leland’s Benefit Dinner in 2012. Her beautiful daughter Sacchi pictured here too (far right)
Finally, I’m including a text from our friend Polly who, eloquent as usual, said this about Susan:
“Leland I am so sorry to hear about Susan. there is just no way for that not to be terrible and sad news. The reed I grab for is her everlasting fingerprints in so many lives and families- your own included, where she played such a pivotal role in finding a new way to be in this battle. I was part of an ad campaign once and it was called “on the shoulders of giants”, a term I don’t think was original – I’m sure it’s borrowed from something more well known then I am aware of; however, I think of that a lot —-she was a giant. Giant footprints left to follow.”
TGMP re-purposed one of my previous posts today. It was essentially about coming to terms with who caused my cancer – namely, me. It’s also, I hope, a cautionary tale for kids thinking that an obsessive/excessive tan (from tanning bed or otherwise) is a good idea.
What I didn’t say but want my boys to know is along the lines of the cliche-ish, ‘Its not how you look but who you are and what you do that’s important.’ Believing otherwise was my problem. God willing I hope I’m around to celebrate the zits on the boys’ faces when that time comes (and I know Sarah will undoubtedly enjoy popping them) while continue sharing these types of messages with them.
Here’s the cliff notes of what I want to say with this post to my friends with cancer, melanoma, brain tumors, myself (which is close to the number of people reading this blog), et al of you tonight, right now:
Don’t give up.
Even after cancer spreads through lymph nodes to liver, lungs and stomach in a few short months after diagnosis
Even when you get told you have 43 brain tumors and likely 6 weeks to 6 months to live
Even after you get unceremoniously kicked out of the clinical trial you’ve been doing, once a week, 1000 miles away, for the last six months
Even after 9 months of stereo-tactic surgery and immune therapy side effects gone wild
Even after you discover you actually had 98 brain tumors all along (not 43 tumors, this is an extreme version of a cranial “clerical error” 0-;) and “get to do” six more months of cranium drilling, tube riding radiation – yeehaw
Even after you to do brain surgery to remove one particularly nasty necrotic mother-bugger
Why? Because there is still a chance. There is man. Even if you are not feeling or believing that. There is a chance today. So don’t give up!
I know-I know-believe me I know- this is easier said than done. When you are in the middle of The Shat, it’s just not that easy. In fact I drove myself all up in and around crazy town, getting confused by all the crazy town street signs, all the crazy town people and crazy words and crazy arse music, worrying about the 1098 crazy things I couldn’t control. Eventually I had to give it up. Somehow or another the lesson of worrying or getting fearful and pissed wasn’t going to make anything better.
So maybe the message is: Give up don’t give up? I guess that’s right. Doesn’t really make a lot of sense at face value but whatever. But if we can live with other vaguely inept statements in the English language like “exact estimate”, “pretty ugly”, “only choice”, “seriously funny” or “clearly misunderstood” we should be able to accommodate “give up don’t give up” (however clunky the statement sounds).
There’s always the serenity prayer which does a pretty good job of summarizing the sentiment involved:
Lord, Grant me the serenity to accept the things I cannot change, Courage, to change the things I can, and Wisdom to hide the bodies of those people I had to kill because they pissed me off.
What a tic, that’s not it, please don’t mention that faux pas to my parole officer, case worker, psychiatrist, parents, psychologist, psychic, sponsor, friends, priest, minister, wife, kids, employer, cats, dog (especially the dog, she thinks so highly of me), here we go, sorry:
Lord, Grant me the Serenity to accept the things I cannot change, Courage, to change the things I can, and Wisdom to know the difference.
And in the words of some immortal friends from another bunch of beloved crazy-pantsed people I know…’C’monnnnn Wisdom!’
PS. Am back to work after the holidays which gave me occasion – while waiting for code to compile or listening (attentively of-course) in meetings – to catch up on what’s happening in the world of melanoma research. Anyways this fairly recent summation of previous published research made me think of the above. I was reminded today of how low down I felt looking at the numbers, stats and treatment options three years ago. There was no encouraging kinds of research like this available. But, the interventions discussed in this article are in fact what I ended up pursuing:
It’s not like when you hear “you have six weeks to live” you start thinking “oh man hope I get to see that Star Wars sequel someday” but when you do find yourself in that position three years later it does kinda feel like unwrapping an unexpected or forgotten present underneath the Christmas tree.
We saw ‘Force Awakens‘ last Tuesday morning, along with rest of the known universes. While it wasn’t the near-religious experience of the first (okay the fourth) Star Wars at 7 or 8 years old (TOTALLY BLEW MY MIND), there were similarly strong feelings evoked.
Grateful was I.
Grateful to be getting to see #7, sitting down with a full tub of popcorn with Sarah, Mom, and the boys at 9am as the first strains of the SW’s Overture fired up.
And hopeful (I was) too. I mean maybe its not too late to become a Jedi?
Here I’m a little confused though. There’s so many choices, choices, choices.
It seems in addition to the Church of the Jedi’s various motions to become an officially recognized religion around the world, there are a number of sects popping up. Go figure! A religion with different strains popping up!
Here’s a sampling of what’s out there:
Argenteum Astrum – Facilitate, encourage, and promote the Jedi Order as a spiritual path through life. Our way is primarily based upon Buddhism and Hermetic Traditions & Principles. As the belief in Jesus defines Christians; How, we see the Force defines us as Jedi.
I believe in the Living Force Of Creation and all that is seen and unseen. I am a Jedi, an instrument of peace; Where there is hatred I shall bring love; Where there is injury, pardon; Where there is doubt, faith; Where there is despair, hope; Where there is darkness, light; And where there is sadness, joy. I am a Jedi. I shall never seek so much to be consoled as to console; To be understood as to understand; To be loved as to love; For it is in giving that we receive; In pardoning that we are pardoned; And in dying that we are born to eternal life. The Living Force Of Creation is always with me; I am a Christian Jedi.
Sounds suspiciously like St. Francis of Assisi paid a visit to a Jedi temple during his travels…
Anyways, we enjoyed the movie. And there’s been a lot of other gratitude inducing events over the last few weeks:
Another Christmas Eve dinner with our good friends the Avery’s (a tradition now, a few years in the making…traditions, like unexpected surprises, are equally righteous)
I turned 45 years old last week. Whoa Grandpa. Get out the Depends and knee sock garters.
I spent 2 weeks away from the salt mines for a staycation with family; and, with the exception of one night of extreme barfing, was a relatively pain and treatment side effect free experience.
Got good results from MRI last week. Thank you God. Brain is “stable.” Queue the running joke about brain and stability.
Speaking of running, Derek has decided he is now a trail runner. Nothing like crashing through Colorado foothills with your son and dog in crisp 15 degree weather. We did 8 miles over two days. Complete fun. Glad I didn’t face plant while capturing video.
This met with Elsa’s approval as well:
Played old school pond hockey ’til we dropped this week in Evergreen CO. Evergreen is ranked as one of the top 10 ice skating experiences (11 rinks + huge free skating rink) in the world. Seriously fun. Was every bit of a top 10 experience with boys.
Led to a true Christmas miracle.
Finally, circling back to the original topic, there’s an invasion of gratitude inducing, Star Wars stories, media, and other related pop cultural artifacts crashing around the internet like prolific space debris tumbling through a Hoth asteroid field.
Reminded me of the classic:
And I desperately want a few of these for our dinning or living room (not sure if Sarah will go for it)