Journal

Journal entry by Michael Bischoff

Short: I have a MRI tomorrow,haven’t noticed side-effects from chemo yet


Longer:

This past week I’ve been a little obsessed, biking over the Twin Cities, looking for pelicans.  Two years ago, I walked in a shallow lake with hundreds of pelicans, and I’ve been wanting to recreate that experience ever since. I saw a recent report that a bunch of pelicans had been in the river near an industrial part of St. Paul, but they weren’t there after I biked 15 miles to get there. I repeated this a few times, in different places, missing the pelicans each time, except some fleeting glances of them flying over. I can act similarly in chasing promising treatments for brain cancer. I keep pushing health professionals to look for new, possible treatments, even though they keep saying there aren’t any available that I qualify for.


Yesterday, on my way to pray with a friend, I sat next to the rapids of a creek close to his house, reminded that even when I don’t find the pelicans, what I need is available. Sitting next to the creek, it felt like there was a metallic claw rising up from my belly, reaching out from my chest, grasping for pelicans--and also grasping for a good MRI report tomorrow, and for close, growing relationships. I don’t like to admit to myself how strong my urge to grasp is, and how much desperation that can be underneath it. Even with terminal brain cancer, the longing I feel most intensely isn’t for a cure from the cancer, but for authentic, transformative relationships with people I’m connected with. Watching the rapids washed away the top layers of my grasping for pelicans and MRI results. Underneath those longings, there was still a restless longing for Intimacy, belonging, and living with purpose. And I still would love an encouraging MRI tomorrow!


My friend, Elizabeth, recently loaned me a book that helped me see my longing and grasping differently, Love is Stronger than Death, by Cynthia Bourgeault. In the book, the author describes a rather clinging, desiring spiritual friendship she had with a wise monk, as he was dying. The monk kept challenging her to release her grasping for him, and the author kept challenging the monk to lean into their connection.My interpretation is that our desire for closeness, even as we grasp for it, can be an essential part of our transformation and healing, if we combine the desire with ongoing practices of releasing.


After sitting by the creek, I met with my friend, Bob, to pray. We’ve done this every month for the past ten years. I need lots of ongoing practice releasing what I’m grasping for. This time of prayer, it felt like I was sitting in a hair salon, receiving a divine hair combing, slowly working on the tangles and knots in my spiritual hair.


This weekend in an interview with Atul Gawande, I heard him describe a study that showed that lung cancer patients who received palliative care, and did less chemo and fewer surgeries, ended up living 25 percent longer than the standard treatment control group. That paradox--that if we’re less attached and aggressive about our treatment, we might have better health outcomes, is one I think of often.


Right now I’m doing a less intense chemo than my oncologist recommended, but if I think that is the magic trick, that’s not less attached. I’m a desiring, grasping creature--just ask anyone close to me, or any of my health care providers who know how high maintenance I can be. But I’m going to keep watching water go past, praying with friends, and telling you stories about it all, in hopes that both the desire and releasing can be a part of a larger whole.


One larger whole that will be with me tomorrow, in the loud MRI machine and the nervous waiting for the results, will be all of you, and the care and engagement you’ve given me. In addition to tomorrow's appointment, I also have a second opinion appointment at the Mayo Clinic a week from tomorrow. And I'm working on a healing story event on June 10 that you're invited to. Thanks for your many forms of companionship.

 

Journal entry by Michael Bischoff

I took chemo pills each weekday last week. We know that my blood counts, especially my platelets, tend to go down when I take chemo. I'm getting blood tests twice a week to monitor this. Last Thursday, I was a little nervous when I did my first blood test after starting chemo, thinking that I might need to stop the treatment right away--but, to my surprise, the labs last Thursday showed that my platelets had increased a little, instead of decreased. I knew it could just be a blip in the testing, but I still felt celebratory about the increase. My white blood count also had an increase that surprised me. Today, I had another blood test--and my platelets had an additional small increase. It still could be a blip, but I'm still feeling celebratory. 

A peer reviewed study in Japan showed that participants in a particular kind of forest therapy had a boost in their immune functioning. In the past week, I spent two hours every day in the woods next to the river. I like to think that my time in the woods contributed to a measurable boost in my immune system, but I think there is another force that had a much larger impact on my immune system, the unknown. This week, the unknown feels like an active, intimate force that is available for partnership. 

No one knows why I'm alive and feeling good two years past the median survival for glioblastoma. We also don't know why I got brain cancer. Sometimes I'm tempted to think that I know what will happen, or that a doctor does. There have been multiple times now that I thought I would probably die within a few months. I was wrong each time. I want to be in humble, reverent, playful partnership with the great unknown, instead of thinking I know what will happen--not a faith that the unknown will always give me what I think I want, but a trust that it will always offer something offer something that can open us up more fully to life. 

This past weekend, during one of my forest times, it was the first day this year above 70. I was next to a small lake. Each log in the lake was covered with turtles, sunning themselves. I'm attaching a photo of a dozen of them on one log. After months of a frozen lake, they must've been surprised it was suddenly sun bathing weather. I want to be as welcoming of the unknown as they were. 

As the eager turtles were climbing on to and falling off the crowded log, I played the attached Cloud Cult song for them, in honor of their exuberant, communal relationship with the unknown: 

May you find faith in the Great Unknown. 
Lay it all down… in a calm, safe space. 
And if the dream doesn’t come… just wait 

Journal entry by Michael Bischoff

Tonight I took my second chemo pill of this round. It is early in my treatment, but I'm not feeling side effects from it yet. Yesterday and today, I took a short retreat, as a way of welcoming the chemo and this next round of healing. I wanted to re-affirm that the river is my primary treatment, and welcome chemo as a compliment to the river, helping wash away anything that is getting in the way of life moving freely.

I've always had a strong wanderlust. Since my diagnosis, I've cancelled trips to Israel/Palestine, New York, and Boston because of health changes. For this retreat, I took a bus 15 miles up the Mississippi River, and walked and sat by the river, focusing on shorter adventures.

Near the end of the first day, after walking several miles, I was hungry, my phone battery was about dead, and it was starting to rain. I was a little lost, and I felt confused about why I was wandering the suburbs by myself. By that point, I had wanted to be settled into the airbnb I was staying at, having quiet time to be able to take my first chemo pill in a peaceful, intentional way. About that time, eight wild turkeys walked across the sidewalk in front of me, gobbling, squeaking, and dragging their feathers against the concrete as they passed me. After they passed, I made it to my airbnb, with some Chinese take-out I picked up along the way.

I texted a few friends, told them what time I was going to take the chemo, and asked them to join me in the intention that the chemo compliment the river in washing away what is in the way of life and love.

In praying recently with my friend, Christopher, he had the image of an open, expansive field in front of me. Out of silence with my friend, Beth, we agreed that my job now is to let the Earth and river blend with my body. I welcome the open field of possibilities in front of me, and welcome the blending with the land and river now, and not just after I die.

It is fortunate that the river is my primary treatment, because I might not be able to do chemo very long. My platelet count is close to being low enough that I can't do chemo. My platelets are still damaged from the previous times I've done chemo, and they dropped a little this past week, maybe feeling afraid of this next round of chemo. In preparing for the chemo, I made a commitment to myself to increase my dose of time at the river from at least a half hour each day to at least two hours per day. As the chemo dose might need to go down, the doses of other forms of healing might need to increase.

I welcome your help in surrounding the chemo with that expansive field of possibilities.

Journal entry by Michael Bischoff

I decided today to start Temodar, the chemo pill that I’ve done before, and that the Mayo Clinic oncologist recommended for me now. I also decided not to do the more intensive kind of chemo that my primary neuro-oncologist recommended. There are some clinical trials in other locations that I also decided not to pursue right now.


In the absence of medical consensus or a standard practice for my situation, it felt like more of a heart and Spirit decision.


Sometimes in this decision making process the reality of love as the foundation was so clear and immediate. Other times it felt like I was spinning and disoriented, unsure of the reality or accessibility of that foundational love. Sometimes, I couldn’t tell the difference between magical, delusional thinking, and a healing act of faith. I need many reminders and re-orientations back to the foundation. This weekend I sat in silence at different times with Christopher, Bruce, Nancy, Beth, Jenny, and Isaiah, and each time I felt that re-orienting. My friend, Wendy, left a beautiful comment on my last post here, about the shift she experienced from tears about what my family is carrying to a tender smile about the ways we are “abiding in a field of great love.”


When I was more grounded in that field of great love, it was clear that the decision of which chemo I do isn’t the most important question facing me. At one point it was very obvious how closely great love was working in partnership with my friend/doctor, Peter, and how fully I could trust and surrender to that. Not that it is all up to Peter, but it is all up to great love and Peter is one beautiful vehicle for that.


I usually need to stay focused on listening for and taking the one next step toward healing and love. If I try to see too far, I usually stumble. I know in chess and many other places, it is quite beneficial to plan several moves in advance. In matters of the Spirit, I don’t have this gift. I trust there is a larger force of cohesion weaving the steps toward love together.

Last Friday, when my neuro-oncologist asked me, in a pointed way, which chemo I wanted to do, so we could get started on it the following week (now this week), my response was “I want talk to Peter.” That wasn’t answering the question he asked me, but I knew it was the next step. Then after talking with Peter, I knew I needed to spend a lot of the weekend sitting at the river. At the river, I realized I needed to write my neuro-oncologist another letter, about how difficult the meeting with him on Friday was for me, and the kind of partnership I was asking for with him moving forward. I empathize with him for having to deal with my repeated, emotional letters. Then yesterday, the next step was meeting with another neuro-oncologist at the U of MN to talk through the options with her. She and I talked through multiple possible steps, and I started feeling lost and overwhelmed again. She’s wonderful, and my confusion in that meeting helped me return to the one next, simple step, which Peter had already affirmed. I’ll start the chemo pill with my current neuro-oncologist, and adjust as we go. It is less toxic than the other treatment options that we’ve considered, and has the most research behind it, even though it doesn’t promise long-term impact.


The field of great love, that all of you help cultivate, is what is most important to me, both in seeking physical healing, and in healing while dying.

 

Journal entry by Michael Bischoff

I just got back from meeting with my neuro--oncologist, Dr. Trusheim, to find out the results of the MRI I did yesterday. This was the first time that my son came with us to an appointment with him. It turned out to be an intense one, both in content and style. 
 
Yesterday's MRI showed that the area of concern from last month was "a little wider" and more prominent. Dr. Trusheim was pretty confident that the growth contained cancer cells and definitive that "it is time to do something," meaning to start some form of chemo within a week. 
 
Two weeks ago I went to the Mayo Clinic for a second opinion, with an oncologist I trust and have seen twice before. That oncologist and Dr. Trusheim disagree both about what treatment is best now, and also about their interpretation of my past recurrences. Today I felt like I was in the middle of their argument, at a time when I was feeling shaky and sad. I'm grateful for them both, and I trust that the information and recommendations will settle and become clearer, especially in talking with my doctor/friend, Peter, who is coming to our house in a couple hours. 
 
This past weekend, our family took a hike and had lunch at our favorite pizza restaurant. At lunch, I told them that on our hike, and other times, I sometimes felt left out from the family because I was walking slower and having trouble keeping up with them, and because my hearing isn't great so I couldn't hear many of the things they said. I told them I felt more sensitive about it because of my fear and anticipation of dying and being left out of the family and unable to contribute to the family because of that. After I said that, my thirteen year old daughter leaned over the pizza in between us and said, "Dad, you will always be a part of the family." 
 
With my daughter's healing message, and my son's affection after sitting through the hard meeting this morning, I know that all shall be well. It's also scary. This weekend we'll be researching, praying, and talking about the options. Stay tuned. 
 

Journal entry by Michael Bischoff

When I woke up this morning, the first thing I said to Jenny was, "seeing your inner world as a colorful landscape to explore makes having a terminal illness a lot more fun." After I said it, I realized that sentence sounded pretty weird, but I still liked it. It reminded me that I believe that there are many secret, Narnia-like doors in that landscape, that can lead to other inner and outer worlds.
 
I also realized that part of of what gets me in trouble is that I see everyone's inner life as a landscape to be explored, and I sometimes have trouble respecting the "no trespassing" signs in other people's landscapes. Sorry to those of you whose inner privacy I've violated.
 
After those thoughts, we headed to an appointment with my infectious disease doctor. I was hoping he'd say that I could stop taking the strong antibiotics that I'm on, but instead, he said he thought I should keep taking them for at least another month, maybe longer. There isn't a way to know if the infection in my spinal fluid is gone other than to stop the antibiotics and see if I have infection symptoms, like fevers and headaches, return. He doesn't think this is worth the risk.
 
Since my seizure a week and a half ago, calculating risk has become a larger part of my inner world. I'm often thinking of what would happen if I had a seizure for each thing I'm doing, where I might fall, and who might find me. It hasn't stopped me from taking risks, but I continue to adjust. I'm very grateful to friends who have accompanied me to the river and kept a supportive eye on my solitude.
 
This afternoon I walked a few miles by myself to my brain tumor support group, knowing that it was a risk, both from a possible seizure, and the generous amount of ice on the outer landscape. I wore my bike helmet, mostly to make myself feel a little better. I also felt a little giddy for the chance to walk by myself in the cold rain. One of the inner changes I enjoy watching is the ways limitations can sometimes create the feeling of more space.
 
I haven't driven at all in the last two years, partly because of the seizure risk, and also because of my reduced peripheral vision. I'm less willing to take risks that could easily harm others. When the ice melts, I'll have risk assessments to make about biking. 
 
I haven't had another seizure in the week and half since the first one. My next MRI to look for changes in my brain is on April 4.  And each day, with the help of observant and compassionate friends, I'll keep doing my own explorations of the inner landscape, looking for opportunities for healing. 
 

Journal entry by Michael Bischoff

This morning, I had a short meeting with my neuro oncologist, and the conclusion was that I should not start any new treatment now, but come back in 4 weeks for another MRI and appointment to re-assess then. 
His best guess is that the ambiguous area on the MRI is inflamed from the radiation, not cancer. Even if it isn't tumor, he probably wants to treat it with Avastin or steroids to reduce the swelling, since the inflammation can still cause brain injury, even if it isn't cancerous.
 
But Avastin can impede wound healing, and he wants to wait a little longer for the wound from my last surgery to heal before using Avastin. 
 
He thought that I might not have another seizure, with the increased meds I'm now taking to prevent them, but that I should be careful about doing things like walking alone in places away from people (my favorite hobby), so I would be seen if I did have a seizure. Rainer Maria Rilke says that one of the most important parts of love is to protect each other's solitude. Some friends have already volunteered to be my Secret Service, quietly watching over me while I'm in the woods. 
 
Rilke also has something to say about my waiting for an answer about what is next:
 
“Be patient toward all that is unsolved in your heart and try to love the questions themselves, like locked rooms and like books that are now written in a very foreign tongue. Do not now seek the answers, which cannot be given you because you would not be able to live them. And the point is, to live everything. Live the questions now. Perhaps you will then gradually, without noticing it, live along some distant day into the answer.” 
― Rainer Maria Rilke 

Journal entry by Michael Bischoff

A couple people told me when they saw that my last updates here after my seizure were straightforward, without my normal philosophical embellishment, they knew something might be wrong. I went home from the hospital after just a couple hours, but I was wiped out the rest of the day, either sleeping or nauseous. When it was 6 pm on Saturday, I didn't even know if it was morning or evening. Today and yesterday have felt much easier.

With seizures now a part of the landscape, I'm re-calculating risk for things like solo walks to the river. My doctor/friend, Peter, stopped by yesterday and provided some helpful context and reassurance. This morning, we called my oncologist and moved up the appointment I had there for next week to tomorrow, when we can talk both about both the seizure, and the next round of treatment for the cancer.

At the same time I was in the hospital, there was a healing story event I had been planning for months with others. My hospital trip kept me away from enjoying and completing what we'd planned. I'm grateful for the ways Hanna, Mari, and others stepped in to pick up the pieces I dropped, which pains both my over-developed sense of responsibility and my disappointment of missing my kind of fun. I imagine that could be one theme of this stage I'm entering--doing even more trusting in the web of relationships that hold me.

Saturday morning, I was lying in bed talking with Jenny. The next thing I knew, I was on an ambulance on my way to the hospital. Life can change quickly. I'm so grateful to be in Jenny's arms when it does. I'd rather not scare her so much, though!

Journal entry by Michael Bischoff

This morning, I had a seizure when I was in bed. Cuddling with Jenny. It is the first seizure I've had, but not surprising. I took an ambulance, and now I just had an MRI, and we're waiting for those results. I have a little headache and nausea, but don't feel too bad. Stay tuned. I have a healing story event today that I'm bummed to miss, and Jenny was going to leave on a ski trip with friends, so those plans are changing.

Journal entry by Michael Bischoff

I found out yesterday that I have a brain tumor that probably needs surgery soon. Let the healing adventures begin! 

I've been having headaches for the past month, but both the neurologist and I were surprised when they found a tumor in an MRI this week. They did a second MRI yesterday, and I have a consultation appointment with a neurosurgeon on Monday. I'm guessing they'll plan a surgery within the next week or two. We don't know much about the tumor yet, including if it is cancerous or not. 

I have felt surrounded by loving support. I'm very grateful for that. I have felt scared, sad, and numb--but I have felt the love of friends and family more deeply than anything else so far. I welcome more of that!!

Physically, I'm mostly feeling great right now, with just a tiny amount of pain on the back of my head. 
An image that I'm holding is that this tumor has come with a message, asking me to slow down and pay attention in new ways. I'm also imagining that the tumor has served its purpose, and that, a couple days ago, it started to shrink. I haven't had any headaches in the past few days. I invite you to hold this image with me, of this tumor shrinking and melting in beams of love. 

As you may know, I'm quite into that spiritual stuff. I understand this journey as an invitation to become closer and closer in intimacy with God and the source of life--both for me and those I'm connected with. Sharing that path with me and letting me know of your journey is about the most supportive thing I can imagine. I also know many people I love aren't into the spiritual or religious stuff, and I look forward to welcoming love and support in many other ways too. 

I'm very grateful that you are with me on this adventure. Jenny and I will put updates on this page and also let you know ways to be supportive and connected.

Gratefully, Michael
Michael’s Story

Site created on September 25, 2015

I found out on Sept. 24, 2015 that I have a brain tumor. I had surgery the next week, and started radiation and chemo shortly after that. It is an aggressive kind of cancer called Glioblastoma, that requires ongoing treatment. We've created this site to keep friends and family updated. We set up another web page for people who would to give money to help pay the medical bills and also support our work and healing: https://www.gofundme.com/healing-for-michael-and-family (https://www.gofundme.com/healing-for-michael-and-family.   We) . We appreciate your support and words of hope and encouragement during this time when it matters most. Thank you!!

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