Back in college, I read a lot about Zen Buddhism. I especially appreciated koans, short stories or sentences that initially seem paradoxical. Koans are a learning tool intended to alter our perception of reality. I considered koans a safer way to alter my perception of reality than the chemical options in the college environment of the 1960’s. One I recall has particular significance right now.
A student asked his Zen master to give him good news. The master replied, “Grandfather dies, father dies, son dies.” The student objected, saying he did not find this to be good news at all. The master explained it is always good news when the grandfather dies before his son, and the father, before his son.
My brother, my youngest brother, was recently diagnosed with Acute Myeloid Leukemia or AML. He went to the doctor on a Monday because he thought he had the flu or a bad cold. Instead of walking away with a prescription for an antibiotic, he was checked into a room after being told he had acute leukemia and that the doctors would need to do some tests to determine just which type so they would know how to treat it.
I had heard about leukemia before, of course. But I didn’t know how many types there are. All leukemias are either acute or chronic. Acute leukemia develops over the course of weeks or months, not years. For this reason his doctor told us that if they did nothing, my brother would live only two to four weeks. I had no idea leukemia could progress so quickly.
But knowing that a case is acute or chronic is just the first step. All leukemias are further divided into lymphocytic or myeloid. And these two types of leukemia behave differently in adults than they do in children. My brother is 51, not a child in age but younger than the typical age at which AML develops, typically over 65.
Even after determining my brother’s leukemia is AML, not ALL, more tests were needed to determine if a bone marrow transplant was necessary or if consolidation chemotherapy treatments would be sufficient. Now I don’t want to sound like I think any form of chemotherapy is a simple solution. In order to kill the bad white cells, chemotherapy has to kill all the white cells, dismantling the patient’s immune system. And that means the patient is at risk for the slightest infections. But a bone marrow transplant is a pretty scary next step because it can’t be done just anywhere. My brother will have to travel to the University of Minnesota for the surgery. And first, he has to get well enough for that trip.
All of this is making me aware of the assumption I have subconsciously carried with me — that death would come to our family in the same order as our births. Grandfather dies, father dies, son dies. I had even joked with my youngest brothers that they were going to have to put together the eulogies and obituary for me because I’m the oldest, so they’ll have to watch me pass first. It is particularly difficult to watch my youngest brother, 10 years younger than I am, the one I bonded with because he came home from the hospital three weeks before his twin brother had gained enough weight to come home, as he struggles with a serious health condition. But when I watch my father, I can only imagine how much harder it is for him.