MID-LIFE

Last week I celebrated my 38th birthday. This means that I am theoretically at mid-life since the average American male life expectancy is 76. Therefore, this seems like a good time to reflect on the mid-point of my life to date and on this age.

Nineteen years ago, I was a college sophomore. I had decided that I wanted to be a doctor and was majoring in Biology. However, I still had an MCAT to take and numerous courses to ace. Somehow things worked out, and I got in. I am now a physician-scientist and spend my days trying to understand prostate cancer and how to improve the lives of men with this disease.

Nineteen years ago, I was out of shape and did not exercise regularly. Since then, I have run races of every distance from a marathon to a 5K and finished in the top three in my age group several times. I took up soccer last year and can safely say I am no longer the worst guy out there.

Nineteen years ago, I was rather unconfident and had yet to achieve much personally. I had dear friends, but I had not met many people like me. It would have been easy enough to say that I was wrong and the world was right, but I never believed that. Not for one instant despite numerous failed romantic overtures and other false starts. I suppose one could say I had no shame or that I believed that no challenge was too great to tackle. This is a trait that remains with me today and that has served me well.

I ultimately fell in love a few times and spent time with a few individuals until I met my wife. It is hard to believe that it has been eight years of marriage. Do I have eight more in me?

What words would I use to describe me now?

Particular. Driven. Efficient. Critical. Caring. Passionate. Indefatigable. Perturbable. Impatient. Sincere.

Not all of these words are complimentary, but they all describe the person whom I am today at 38. Only about half of them would have described me at 19, and it will be interesting to see which ones describe me at 57 or 76.

I believe that we are the sum of our experiences and that the people who have entered our lives, no matter for how long, shape the people whom we will become. This means that we also influence the development of those around us, and I try to remember that when I am around those pictured below. In their young selves, I already see much of myself: guileless, caring, and intense.

I have no doubt that I will continue to change and that my kids, my family, and my friends will be a big part of that. Here's to another 38 years... I hope!

PROFILES IN COURAGE

I used to think I was a brave and well-equipped kid... until I met my two kids. I am constantly amazed by what they are capable of doing by themselves by comparison to my readiness at their ages. I guess that is probably because they have to be more self-sufficient with two parents that work like mad.

Nicholas wakes up everyday at 6:30 AM. This summer he has been going down all by himself 2 flights of stairs to a dark first floor and dark basement. He is able to turn on the TV and settle in for a cartoon marathon. Additionally, he is not afraid to try and learn new things at which he does not excel- music lessons, soccer, swimming. I, by comparison, was afraid of the dark for much, much longer and do not have his adventurous spirit.

We recently pulled Cate out of her former daycare because it was imploding. We looked at many different schools, and the Montessori school we were most interested in did not have a spot. Therefore, we enrolled her at a daycare nearby. Of course, one day after starting the "new school," the Montessori school called to say they had a spot. So... Cate went to visit her "new new school" and met with her "new new" teacher and carried out a lesson, or task, with her. It was a very formal and structured task quite different from the free-form play Cate is used to. However, Cate was calm and composed and nailed it with aplomb!

I love these kids beyond words not only because they are my own but because they do and know so much. Our lives are more challenging because of them, but are lives are also much more full and fun because of them.

Here's to Cate and Nicholas! These kids are more than all right. They're brave and their grrrrreat!

LOVE IN THE TIME OF CANCER

Today, I saw several patients in clinic. Many of these men were accompanied by their wives. One man in particular who was a former music teacher was the most memorable not only because of his history but also his story. He had surgery for prostate cancer in 1996, and despite that his PSA blood test became abnormal. This meant his cancer had come back. He received radiation in 2005, but his PSA blood test became abnormal again in 2010. He came to see me because his PSA was rising.

The good news for him was that his cancer was not visible on scans and was unlikely to show up during his lifetime because his PSA was changing so slowly. Because he was already 76, he was apt to die of something else and to die before his cancer could cause serious problems in the coming years.

As I asked him about his past history, I also inquired for how long he had been married to the woman by his side. His companion said that they were not married but that they were together. I then asked how long they had known each other. They both smiled and said since first grade.

At that point, I wondered two things- how could two people possibly stay together for that long and what were they smoking? The patient said that while they had been friends in first grade, they had largely grown apart and lived separate lives. Each married another person, and the patient moved away for many years. However, 15 years ago after he moved back, one of his friends "re-introduced" them. The rest is history, and she has been by his side through all of his treatments and recurrences and also many high notes.

Their story was inspiring and brought to mind one of the greatest love stories ever told- "Love in the Time of Cholera" by Gabriel Garcia-Marquez. I mentioned that to the patient, who said he had a copy at home but that he had never read. Why would he need to, when he had lived to tell his own tale!