Durability

In July I received the spectacular news that I have had a "nearly complete response" to lorlatinib, a new cancer medication (so new it's still in clinical trials) that I began taking in late May. Not only was the response nearly complete; it was fast!  All tumors in my lungs and lymph nodes are gone, and all fuckles but one tiny speck in my brain have disappeared as well. So, everyone, family, friends, medical team, especially me, was/is happy and grateful. Because I have stage iv disease, which means the cancer is still hanging out in my body and can become resistant to lorlatinib at any time, we can't call me "cured," and we will have to continue "surveillance" (MRI and CT scans every three months) so that if cancer shows up again (which it likely will, stage iv disease and all), we can pounce on it with another treatment. This is what we mean by stage iv cancer becoming a "managed" disease rather than a fatal one.

Another word we get to use a lot now is "durable," as in "We hope this will be a 'durable' response to treatment." Until I got sick with cancer, I never used the word "durable" in relation to health. Certain kinds of upholstery fabric maybe, or Amish barns are durable, but a response to medical treatment...well, either you are cured or you aren't, right?  Definitely not in Cancerland (and other lands too)  – welcome to another one of cancer's vocabulary lessons. A "durable" response to treatment in Cancerland is one year or more of DFS or PFS (disease-free or progression-free survival). Oh, and a side note here. Isn't it weird that cancer "progresses", that we have "disease progression"? I'd hardly call the spread of cancer progress.

Opus 40 Environmental Sculpture, Saugerties NY

Anyway, in mulling over this idea of "durable" response to treatment, I consider what is designed to endure, what we want to last. 1) Big things we build – monuments, roads, houses, barns, libraries. 2) Things we buy – cars, shoes, backpacks, refrigerators. 3) Things we make – sculptures, gardens, poems, promises. All designed to last.

They don't, of course. Well, some things last more than others. Art. Art lasts. For awhile. (As an artist, I'm required to say that.) But libraries are sacked and burned at the fall of empire; roads and buildings crumble; cars go to the junk heap, gardens get gated, and so on. And then there's climate change, nuclear proliferation, superviruses, and the demise of the Oxford comma to worry about. It would seem, then, as a race, our prospects need improving.

Old Pick-up Truck Used for Target Practice

And yet. Mountains. Wide rivers. 

Catskill Mountains, Delaware County NY

Hudson River from The Walkway Over the Hudson

Dingle Hill Daisies

The great and certain circle of seasons.

And, perpetually, hope – that little boat we keep rowing.

We can't not. It's how we're made.

And that's what I call a durable response.

Saugerties Lighthouse