February 1, 2023, three years ago today as I publish this, was the day they went in surgically to get the tissue sample that led to the diagnosis. It was the unofficial start of what has been three years living a life that had been unthinkable to that point.

Year one was all about scratching and clawing and going toe to toe with this thing. The results were nothing short of miraculous. We beat it back enough for me to undergo surgery that was needed to keep us moving forward.

Year two was a different kind of challenge. We saw the first signs of recurrence via blood tumor markers. I started feeling physical pain from a location where a tumor had been identified. We watched as the tests continued to increase right up until we got back on chemotherapy and saw the pain go away and the numbers go down.

If year two was a different kind of challenge, year three was a series of tests. Mostly the kind that puts pressure on my mindset and perseverance. Just before the anniversary last year, I wrote about attitude and mindset. I admitted to having momentary lapses and discussed dealing with them. I also remember this time last year wanting to write something powerful and timeless for the second anniversary. Turns out there was no idea solid enough to pursue.

Shortly after the February 10^th diagnosis day marker came and went, I got sick. Not directly because of the cancer, but as a biproduct of the bladder removal surgery from October 2023. Invasive abdominal surgeries leave scar tissue. I had some in my intestine cause a small bowel obstruction. A week of intense pain followed by a week in the hospital that involved another abdominal surgery led to six weeks of recovery.

Coming out of that ordeal, we were still on the chemo treatment that had been going on since December. At some point in the spring, tumor marker numbers started rising. The numbers we saw were nearly as high as they had ever been. One day while we were out and about, I saw some recent test results. It was only 11am on a Tuesday, but I told my wife we needed to find a place to get a bottle of wine and drink it.

Then, you can add in what happened over the summer. We switched treatments and the new one didn’t work at all. By August we hit new all-time high numbers. In September and October, those shot up exponentially. By November, we wished we could get those numbers back from June.

I believe I am tough. I believe my attitude and mindset are as strong as they come. I believe in my care team. But if I were to tell you that I had no doubts during this time, I would be lying.

What I want to do is explain how, for me, having these thoughts does not equal decisions. They are inevitable. To not experience them is essentially having your head in the sand to the degree that you might as well just ignore the situation you’re in at all. But having a thought is not choosing a direction. It is confronting the brutal fact that you have something very heavy to carry and choosing how you carry it.

For the first time I truly started asking how much time is left and what will it be like? How much should I be preparing for not being here? What do I need to do so my wife can go on without me? If I spend all my time thinking like this, am I going to manifest an ending that comes quicker than I want?

Those were (and are) the questions that penetrated my mind. How could they not? I find myself being involuntarily thrust between two different paths. On one, I look to the future and plan for life in a normal sense. Long term business offerings and decisions to keep life as we know it moving forward. The other is full of turns where I can’t see that far forward. It is very uncertain, and there is the belief that any one of those turns could lead to the end of the path. On that one it’s a rush for how to utilize the time to make sure I’m not only living every moment to the fullest but trying to come up with concepts and messages that can carry on with or without me.

I feel like I possess the power to choose which path, but there are times when my subconscious grabs the wheel and takes control. Hence the being thrust back and forth. I want to choose the future. I want to have a five-year plan. But I struggle with that little voice reminding me that I am not guaranteed any of that. That it is more important to make each day count for more. That the “virtuous” patience I’ve had my whole life now does me a disservice. Patience now equals a lack of achievement due to “waiting for conditions to be right.”

So, where does that leave me? Honestly, it feels like I’m fighting a multi-front war. On one front there is the actual cancer. It’s real, it’s pushing and I must push back or none of the other fronts matter. Then there are the battles of how to spend my time and energy. There is no money tree in the back yard, so I must work. That comes with its own challenges. I must perform, but it must be around treatments and all that comes with them which means limited energy and resources. With work comes work-life balance – my third front. Some time and energy must be allocated to living. Otherwise, there is no point to any of this.

And there is a fourth area that I call “everything else.”  The world is still happening, and areas of concern will enter the field. Even if there is nothing I can do to affect them, they will still account for some percentage of my time and energy. This is where the distractions of life live: scrolling on social media and all the small emergencies that don’t fit into the other boxes.

So, what is my answer to “How do I deal with the unthinkable?”  I’m not sure I can give a clean one that is satisfactory. I’d like to think that I am in the command center of this war I’ve described, calling the shots on how much resource allocation goes to each front. It changes constantly depending on what is happening in each area. So, my awareness needs to be balanced. Too much attention here means a breach somewhere else. Am I able to put up a barrier for the “everything else” section and hold that back without using valuable assets? It’s almost a decision that needs to be made daily. The bottom line and the answer to the big question for me is this: Choosing to stay engaged on each front and refusing to quit. Digging for more resources when it seems there are none left. Deciding to Keep Fucking Going no matter what.

I’m lucky enough that we changed treatments in October and halted the upward curve and directed it back down. On top of that, I became eligible for a Phase 1 clinical trial a month later. We, along with our doctor, chose to pursue that and put the other treatment in our war chest. As I write this in late January, the markers have come down some and are not going up. The jury is still out on how effective the trial treatment is working, but true to form, we’re still going. I’m still writing, still pushing forward, and there are no plans to stop.

Back to my point: Inevitably, we are all likely to experience thoughts that don’t serve us and our desires. That is natural. The difference will come when you recognize that you have the power of choice. You get to choose how you react to those thoughts. Do you let them take over and consume you? Or do you see them for what they are – just thoughts – and make the decision to push on anyway? I choose to show up and push back. My intention is to do so until I have left it all out there. I choose to keep getting up. Even if I can’t.