INDEPENDENCE DAY

No, this is not a repeat of a recent post- just some homophony at play. This post is about the Arbor Graduation ceremony that we attended yesterday.



For that occasion, Nicholas got dressed up in his best duds, and he could not contain his excitement despite not napping that day. Principally, he was excited because his Senior buddy named Alex would be graduating that day. As I have mentioned previously, every younger child at Arbor is matched up with an older student, and the kindergartners are paired up with an eighth grader, or Senior. Today was the last day for the Seniors to say goodbye to the school and for their little buddies like Nicholas to say goodbye to them.

To say that Graduation Day is the event of the school year would be an understatement because each Senior and his/her mentor has the opportunity to discuss his/her Senior Independent Project and to address the school for several minutes. The speeches are not pre-screened and often come straight from the heart. In many cases, the Seniors give a shout out to their buddies, which always elicits strong emotions.

Alex was one of the last students to present, and his was arguably the most emotional. His address in its entirety is shown here. Yes, Alex is only 13 or 14. Afterwards, even I had a few tears in my eyes after hearing what Arbor had meant to Alex and how Alex hoped Nicholas would have the same experience.

After the ceremony, we found Alex, and I gave him a big hug. I told him I was proud of him. I thanked him for what he had been for our son- a role model, a friend, and a compass in a new world for our son that was often unfamiliar, sometimes scary, but always loving. I told Alex that if I could ever be of help to him, I wanted him to let me know. He smiled and nodded and gave Nicholas one last hug.



As we boarded the bus that carried us back to the parking lot, I saw a man that bore a striking resemblance to Alex. I asked him if he was Alex's dad, and the man confirmed that he was. I told him he had a wonderful son, and he asked me how I, too, had come to discover Arbor for my own son. I said it was from word of mouth but that the words I had heard did not do justice to the school- perhaps the single best gift my children may ever receive...

WHAT I WANT TO BE WHEN I GROW UP

One of the funnest parts of my day is when Cate comes down after she wakes up to eat breakfast with me. We are generally alone because Nicholas usually plays upstairs before coming down and Kathleen is usually upstairs getting ready.

After I get Cate set up in her high chair with her vitamin, cup of milk, and oatmeal, we talk about a lot of things. Sometimes, I have the camera ready. Last night Cate volunteered to Kathleen that she wants to be a doctor when she grows up. I had never heard her express such a sentiment, so I decided to ask her about it this morning.

I promise not to hold you to this Cate, and I will understand if you decide to do something else. However, you are one of the smartest and kindest people whom I have ever met, and you would make one hell of a doctor someday, kiddo!

INDEPENDENTS' DAY

This month the kindergartners and first graders in Nicholas' class all presented their independent projects. Yes, you heard it right- independent projects.

For this assignment, each child selected a topic he/she was interested in, researched the topic, and then prepared an oral presentation complete with visuals. The only requirement was that the child found the topic interesting.

Topics ranged from Michael Jackson, to Atlantis, to the Portland Timbers. Nicholas selected the subject of "Stringed instruments from around the world." No doubt he chose this subject because of his music lessons and his love of music.

We bought a large piece of poster board for him to work with and construction paper for the various topics. Nicholas checked out several books about musical instruments, talked to his music teacher Laura at school and his ukulele teacher Jan, and consulted Wikipedia on my Ipad with my help.

Nicholas decided to focus on four stringed instruments and included information on when these instruments were first invented, where they were invented, how many strings each one generally has, and the name of a famous player.

Nicholas also played a song he wrote called "Singing on a Checkerboard" for the class that was a big hit!

Afterwards, he took questions and comments.

I was amazed by his poise, his confidence, his expertise, and his independence not only during the presentation to the class but also in the preparation of this project. Yes reader, he is five and in kindergarten.



I can only imagine what he will decide to do next year and what his eighth grade "Senior Project" will be. Regardless, this year's act will be tough to follow!

LAST DAY OF SCHOOL

Yesterday was Nicholas' last day of school. It is hard to believe how quickly this year has flown by and how much Nicholas has grown in every way- physically, mentally, and emotionally. Here are some highlights.

Nicholas can read, write, solve equations, and express his feelings in painting, poetry, or pottery. He is confident and looks people, including grown-ups, in the eye when he talks to them. His passion when discussing his interests is uncontainable. His encyclopedic knowledge now extends beyond animals to instruments and all things Star Wars (FYI, if you are wondering what to get him for his birthday next month, the answer is Star Wars).

There are people from his class whom he loves dearly and who love him dearly. These include not only his friends but his teachers Lori and Toby pictured below, whom he will have for a second year due to the mixed grade classes. Yippee!





The list of other changes is innumerable but all together positive. Indeed, sometimes it is easy to forget that Nicholas is still a little boy and not yet six years old. He constantly surprises and amazes me, and I have enjoyed this year immensely. I look forward to many more wondrous years ahead at Arbor, and I look forward to watching him grow into the boy whom he will become.

NINE MONTHS

This is not a post about the normal human gestation period in my wife or anyone else's wife for that matter. Nine months is the expected survival duration I quoted today to Mr. H, a 51 year-old man whose metastatic prostate cancer had exploded through two prior therapies.

Until last Fall, Mr. H had been working as a general contractor building houses. At that time, he found it increasingly more difficult to bounce back from a hard day's work due to bone pain and fatigue. He finally landed in an emergency room and was found to have a body riddled with prostate cancer. He was started on standard hormonal treatments and received palliative radiation therapy, but the benefit was fleeting. That is how he arrived in my clinic accompanied by his supportive ex-wife today.

We talked about his current symptoms, and we talked about the next steps: MRI of the spine to rule out compression of the spinal cord from his cancer, pain management, and chemotherapy. This naturally led to a discussion of his dire prognosis and what to expect.

I tried to tell him that the numbers we quote in Oncology are imprecise and that if I had a crystal ball I would be in Vegas at the tables. However, I also shared with him data from prior clinical trials that demonstrated that men like him live on average only nine to twelve additional months even with aggressive chemotherapy.

Understandably, he broke down, and he explained that he had two sons- one eight and another five whom he had not yet prepared for such bad news and with whom he still had much, much more to do. He said he had scheduled a trip to Lake Tahoe with them later this week, and he wondered if he could still go.

His condition was grave, and it was urgent that we start chemotherapy as soon as possible. However, I knew that his disease was incurable and that delaying his treatment by two weeks would make no appreciable difference to his cancer outcome but that it might make a significant difference to his boys and to him. Without missing a beat, I looked him in the eyes and told him to take the trip. I also explained that we had resources and strategies through our social workers to help him talk to his kids about his disease. Yet, deep down I knew that there were no easy answers for how to explain to his sweet kids that they were going to lose their dad.

We used a lot of tissues in that clinic room today, and no amount of time or experience makes these conversations any easier. Despite feeling emotionally drained, I was able to continue in clinic today for three reasons: 1) I knew that it was my duty to do everything humanly possible to make the care and experience of Mr. H and my other patients as optimal as possible in the face of cancer and such horrific odds, 2) I knew that my problems that day were nothing compared to Mr. H's and the rest of my patients, and 3) I knew that the only way to get home to my own smiling, innocent children was to forge on and grind that clinic out.



This afternoon, I was rewarded with many thank yous from my patients for the care I provide to them, and later this evening I was rewarded with with many hugs, kisses, and jokes from my own two kids. Only nine years with them would be unthinkable. Only nine months... well, that would be just plain cruel.

MY KIND OF TOWN... PORTLAND IS

This past week Kathleen and I travelled to Chicago for the annual American Society of Clinical Oncology meeting. Kathleen's sister Laura was kind enough to come down from Tacoma to help out and watch the kids at our house. This meant that we were on our own. Yippee!

On the first night, we met some friends at the Chocolate Bar in the Peninsula Hotel that has an all you an eat dessert buffet. The next day, we went to the meeting. However, we also snuck in an hour at the Art Institute of Chicago, one of my favorite museums of all time. There, we saw:


the "Chagall Windows"


Seurat's "Sunday Afternoon on the Island of La Grande Jatte"


and Picasso's "The Old Guitarist" among many others.

Another night, we had deep dish pizza at Gino's (forget about Giordano's) and saw the movie "Bridesmaids" that was absolutely hilarious.

On our final night, we again met some friends. First, we had small plates and cava at a fine restaurant called Avec and later went to a rooftop bar called C-View at the Affinia Hotel for drinks. What a night and what a week!

However, despite all the revelry and time for bonding, I missed my two little guys more than I can describe. I thought of them all week, and even kept a hand-written note from Nicholas in my wallet that is reproduced below.



Though no translation is necessary, it says, "Dear dad, I hope you have a good trip. Love, Nicholas."

While Chicago is a great town and while this vacation was great, home is where the heart is. Now that I am back in town with these two little people, there is no place I would rather be... than in Portland.