Seize the Monkey

Unless he is already doomed, fortune is apt to favor the man who keeps his nerve. The maxim from the ancient Anglo-Saxon epic Beowulf reverberated in my skull, over and over again like a mantra, until the words no longer made sense and were simply a collection of sounds. My breathing slowed and deepened; my mind felt calm. I felt far away from the isolation room in the bone marrow transplant ward, even though high-dose chemotherapy drugs dripped through IV tubes into a catheter implanted in my chest.

Minutes ago this was not the case, I’d been anything but serene; anxiety welled up inside my chest like a giant palm pressing on my diaphragm.

I watched the nurse open the plastic levers on the IV lines and prepare to exit the room. She stood for a moment to give me words of encouragement when she noticed the small stack of books on the wheeled tray near my bed.

“Beowulf? She picked up a translation of Beowulf with a photo on the cover of an ancient Anglo-Saxon war mask, its iron mouth smiling, and the spaces for a warrior’s eyes hollow.

“God Almighty, you should be reading something lighter, like War and Peace.”

“I can’t help it—Beowulf is my soul brother. You see, we’re both born monster killers.”

“Oh, I see.” She shook her head. I forged a smile on my face, hoping it looked grim and determined like the mouth on the iron war mask. As she closed the steel door to the tiny isolation room, signaling the beginning of the month-long transplant process, I scanned my surroundings.

Fifteen years ago the room was state-of-the-art, built specifically for the transplant procedure. At that time, the medical experts thought that any hint of a germ would be fatal for the patient after his blood counts dropped to ground zero. So they designed the room to resemble something out of the space program, a combination of the sterility of a “clean room” at NASA with the roominess of an Apollo space capsule.

The walls and ceiling were composed of aluminum sheets joined by riveted metal strips, all painted hospital white; the room itself was about 12’ by 12’ and perhaps 6 1/2’ high. The bed dominated the working space, leaving room for only a single chair, medical monitors and equipment, and the portable commode with its high back and arms for comfort (This would come in handy when diarrhea struck every 15 minutes).

A single window provided a view of the outside world, in this case the hospital parking lots. Its double-paned glass slightly warped the appearance of things and was dense enough to be bulletproof. Terrific—no assassin’s bullet would find me! I was really worried about that possibility…

Those were the old days; today the human contact is slightly less antiseptic. Today the nurses and doctors condom themselves with disposable gowns, gloves, and filter masks and bypass the screen entirely.

…Panic. Shallow, quick breathing and thoughts of death pinball through the mind. It’s that door—once the door clicks shut and the air no longer flows naturally into the room, the panic sets in. The noise of the compressor blowing filtered air into the cramped room increases the sense of claustrophobia and constriction in the chest.

Quickly--rip the tubes from your veins and escape into the corridor. They can’t hold you here! From outside you hear the sounds of the workmen’s tools as they modernize other rooms on this floor to accommodate future transplant patients.

Steal a hardhat and a pair of coveralls and escape into the working world...It’s Friday, and you imagine returning home after a long week of work…your sons meet you in the driveway, riding circles around the car on their bikes as you pull up to park.

But then, the scene switches. Several boys ride bicycles, including your two sons.

“What happened to your father?”

“He died.” The older boy answers, while the younger rides his bike in ever tightening circles.

“Was it in a war or an accident or something?”

“No, he got sick and died in a hospital.” Your wife comes to the screen door; her face puffy and her eyes empty, like the hollow sockets in the Anglo-Saxon war mask.

“This is agony! I don’t want to die in this place!”

Keep your nerve, man...yeah, easy if you’re Beowulf, the hero of my long-gone Anglo-Saxon ancestors, a superman who could tear the arms off monsters with his bare hands. But what if you’re me, Corporate Bob, a word-weaver, a man clever with people, but barely able to tear the arms off a Barbie doll? How do you keep your nerve if you have lymphoma cancer, when huge biceps and a washboard waist wouldn’t help you anyway?

Damn. I’m in for a screwing this time… This is my second transplant so I have the dubious advantage of knowing what to expect: Over the next few days, the chemotherapy will destroy my bone marrow and, with luck, all the cancer cells existing in my body. It also could destroy me by causing a heart attack, damaging my organs, allowing infections like pneumonia to arise, or killing me in numerous other ways.

The less lethal but uncomfortable side effects of the chemo could include rampant diarrhea, nausea and vomiting, fevers and chills, as well as complete fatigue and depression. In short, I am looking at what amounts to three or four weeks of a simulated cheap red wine hangover—one that could prove fatal.

Assuming I survive the chemotherapy, they’ll pour my stem cells (baby white cells harvested from my blood) back into me. These little buggers are smart: Just hang them off an IV pole from a bag that looks like watery tomato sauce and they’ll swim their way back into the bone marrow to recreate your immune system.

Of course, something could go horribly wrong, something mentioned in the release form I signed before the doctors began the treatment. Sometimes the stem cells refuse to take, or engraft properly, and you are left without an immune system. But not for long...

If the stem cells do engraft properly, you’re not home free. No, those nasty mouth sores prevent boredom from setting in. Once a patient’s white blood cell count dips into the nether regions, the mouth sores appear, raw, leprous wounds covering the tongue, the inside of the mouth, the throat and sometimes the esophagus. The pain is so intense that you cannot talk or swallow—never mind eat--without the help of a morphine derivative constantly dripping into you.

Control. I can’t lose my nerve... Okay, Beowulf, let’s step away from this scene and observe what is happening. My mind is a tangled jungle canopy, and thoughts careen through it like frightened monkeys chattering and swinging from its vines. I am under heavy stress and in a state of fight or flight. If this continues, the adrenal glands on top of my kidneys will continuously flood my bloodstream with adrenaline and other hormones.

In the short term this hormonal boost is a positive thing, as it gives humans the energy to handle extraordinary situations, like fighting a monster or escaping from its claws. But suppose the monster is within you, and you can’t fight or can’t run away? The hormones inundating you will overload your body’s systems and eventually burn you up.

Can’t have this! The combination of the cancer and the chemotherapy is enough to wear anyone down. Must seek a state of stillness so my immune system will allow the treatment to do its job without interference from my body. How? You know how…

Seize the monkey. The monkey in Chinese philosophy is the emotional mind that chatters unceasingly, cluttering the brain with questions, thoughts, fears and judgments that prevent a calm mental state. This monkey can be dangerous if you’re ill, because if the mind is in a state of panic, the body responds and triggers its panic systems.

How? With your breathing. The breath is the bridge that links the mind and body. By regulating the breathing with slow, deep inhalations from the bottom of your lungs you can seize the monkey, calming the emotional mind by removing the chaos of irrational thoughts. As the mind calms, so does the body, from a state of alarm to a state of neutrality.

Fortune is apt to favor the man who keeps his nerve. That is the formula for survival. That is what my Anglo-Saxon will tells me to do. But how do I maintain my nerve over months and years of continuous battles, when fatigue and world-weariness wears me down? What is the mechanism to keep the will strong and prevent it from faltering?

Breathing, again, breathing. When the will falters, when we’ve reached the breaking point, let go. Don’t quit, that’s different. Let go. Breathe. Allow things to happen, don’t try to make things happen.

Breathe. Breathe. I’ve seized the monkey. Bring on the next monster.