My year (plus) of walking into walls

My year (plus) of walking into walls

 Peter A. Hempel

[begun] July 13, 2026

“Believe me, when it gets medical, it gets real.”

[from The Contract – A Novel, by P.A. Hempel]

In the spring of 2025, I had my routine annual “wellness” appointment with my doctor. I was 81, with my share of the slings and arrows of age, and was hoping my decline would continue at its semi-moderate, if sometimes bumpy, pace.

At the end of the appointment, I managed to remember to mention that I had a swelling of my lymph gland on the right side of my neck.

The doctor didn’t seem to be alarmed, it could be any kind of a minor infection, but, like most of my doctors, he was good on follow-up (having good insurance helps) and sent me for an X-ray.

The X-ray didn’t reveal much of anything, so he sent me for an MRI (Magnetic resonance imaging) scan. The results of the MRI were obviously disturbing (to me as well, even with my more limited expertise in reading medical results), and he sent me to an ENT (Ear, Nose, Throat) doctor, who ran a small camera down my nostril to my throat.

I got to watch all this on a video screen in full color. Sure enough, there at the back of my tongue, well out of range of the “stick out your tongue and say ‘Ahhh’ ” test we’re all familiar with, was a spherical growth, perhaps the size of a frozen pea – whether a petite pea or regular pea, I don’t know, but I didn’t need to be Radar O’Reilly to know immediately it was cancer.

Tongue and throat cancer are surprisingly common these days. The introduction of the relatively new HPV vaccines is a major step forward for those young enough to benefit (initially young teens, but up to the early 40s at this point). I don’t need to go into the potential avenues for transmission, except to note that even French kissing will do. (Many parents worry that getting the vaccine will give their children a free pass to be sexually active.) Be sure the young people in your life get the HPV vaccine!

The doctor immediately set me up with an appointment with a specialist in Philadelphia, named Dr Raj (his name is actually longer, but like a number of Indian doctors I have encountered, he has adopted a shortened version of his name for the American workplace). Dr Raj explained to me that they could either do radiation and chemotherapy, or surgery. I asked him which he would do if it were him. He said that since he was in his 40s, he would definitely have the surgery, since otherwise it could come back later. At my age, it was more of an open question.

Even though I was relatively close to my personal sell-by date, I decided on the surgery. It turns out that this kind of surgery requires robotic-assisted surgery, since obviously you can’t fit a pair of hands into that space. (Later on, another surgeon explained helpfully that before robotic surgery, the “cure” was cutting out the tongue. Think about that for a while. My body, my choice?)

We only discover the questions we should’ve asked afterwards. One big question I didn’t ask was how much of my tongue he was going to remove. I had thought it was just that damn little pea. But apparently, it was much more extensive than that, and I am now left with a feeling of having a floppy tongue and mouth, both for eating and speaking. (It has made me wonder if radiation and chemo might have been a better plan, although surgery does seem more decisive.)

Obviously, the first few days after surgery, I couldn’t really eat. I found a feeding tube a real convenience (why doesn’t everyone have one?), keeping me from having to do all that painful swallowing, but the doctor was eager to get me off it.

I have also always had a problem with blood draws; one morning it took a total of four tries by three nurses to get my blood sample, a new record for me, and news that had obviously made its way around the hospital floor judging by the looks of nurses and staff as I made my way around the floor.

After that, I had to go through radiation treatment, but I was very lucky that there was an experimental program that let people get it done in two weeks rather than the usual five or so (apparently with comparable results). Not sure how the dosage compared.

Radiation is both lovely and deceptive. It’s lovely in that you don’t feel a damn thing while you’re bolted down to the table wearing a mask to make sure they hit the right place.

Radiation mask

But damn, that radiation does a job. It absolutely hammers your body. I got to where I couldn’t eat or swallow. (Radiation doesn’t just “treat” the target area, it blasts all the tissue – muscle and otherwise – in its path, potentially leaving permanent scarring and other after-effects. (There is another treatment, proton therapy, where instead of blasting through you, the particles hit their target and stay there. Much less damaging. Also, much more expensive. Nobody mentioned it to me while discussing my treatment.)

Even with the shortened radiation schedule, it was a lot of commuting. Fortunately, my older daughter had come into town and was able to help with some of the driving into Philly. After she left, my younger daughter took over the job of driving me to Philly. Actually, I had never spent much time in Philly before, but I rather like it. It’s the only major Quaker city I’m aware of and that whole thing of Brotherly Love does seem to make a difference. (At least in the less crime-ridden parts of the city.)

Not being able to swallow or eat was a major problem, and I found myself missing the option of the feeding tube. It took a long time to finally get back to where I could eat again and swallow without pain. Eventually, I started getting back to semi-normal, able to eat pretty much normally, although I had to work hard at speaking because my tongue felt floppy and unbalanced. Enunciation, which I have always taken for granted, felt more like a workout at the gym. (Still does.)

This would be a drag for anyone, but for me, it was a bigger problem because I have Dupetryn’s contracture of the tendons – more glamorously known as the “Viking disease” because of its prevalence among the formerly bloodthirsty Scandinavians – in both hands (my 5% Scandinavian ancestry – according to ancestry.com – punched way beyond its weight on this one) so I am no longer a remotely nimble typist and had long since switched to dictation software. And dictation software wasn’t entirely up to my new condition.

It all feels like a conspiracy to silence me. Or at least to generally fuck me up.

Anyway, I was going along OK, getting better, able to eat more kinds of foods, ready to leave the whole cancer business more or less behind. Then, after several months, I went in for a couple of follow-up scans, including a PET (positron emission tomography) scan, which measures cell activity in the body, looking for areas where the cells are too active. (Cancer cells are very busy little buggers, and as far as scans are concerned, they might as well be standing there, waving their arms and yelling “Here I am! Look at me!”)

Well, as far as my neck and throat and that whole area, everything was fine. Hooray!

However... the doctor suggested that I needed to get checked out because my colon was lit up like a Christmas tree.

* * *

Cancer is the original sin of diseases. Like the Terminator, it does not rest. It will not ever be killed. Getting cancer means falling into a state of eternal sin. If we slice out tumor, or radiate it or chemo it into submission or send it into hiding, we remain under watch. Has it found a new home elsewhere in the body? The medical team, the medical community, becomes a dystopian Santa Claus, watching us and testing us day and night to see if we’re good or bad. The problem is, there is no “Ho, Ho, Ho!”, and there are never any presents under the tree.

* * *

Here I was, thinking I was on the easy glide path to recovery.

Nope. I got in touch with the office of my gastroenterologist. The first appointment they could give me for a colonoscopy was a couple of months away. So I got in touch with the doctor himself, who was a friend of mine from my (former) swim group. He got me an appointment for the next day. Sure enough, I had colon cancer. (Given the odd circumstances by which it was discovered, I’m assuming they caught it fairly early.)

Time to start all over again.

This time I began with an extended regimen of 35 radiation sessions or so, followed by four months of chemo (one session every two weeks). For some reason, some part of this got me to where I couldn’t eat or swallow again, and I spent a fair amount of time with swallowing specialists (yes, there is such a thing). There is even a tongueometer to let the doctor measure the strength in your tongue.

The trusty Tongueometer – don’t leave home without it

I was very fortunate – no nausea or vomiting (which is apparently very common). (But don’t even ask about the constipation.)

Chemo sucks. I had gotten way too heavy (fat) before any of this started, but right now I am 80 pounds short of my heaviest weight. In fact, I’m down to a weight I haven’t seen since my early days of grad school. Chemo leaves you with a rancid taste in your mouth like somebody had just dumped a barrel of toxic waste into you. Hard to enjoy any kind of food with that taste of rotting garbage as your default setting. I’m gradually getting past that now. And the fatigue is brutal. Nap? I would have been happy to sleep the entire day.

Problems with eating and swallowing returned. Two different swallowing and eating specialists, along with a test where I ate and drank while my mouth and throat were recorded by an X-ray camera. It would be so nice to be transported back to a time when I could eat without thinking at all, but I’m not sure that will ever happen again. I kept (and keep) looking for things I could eat.

I discovered I could eat Asian dumplings with soy sauce or sweet-and-sour sauce. So that became dinner for months. When I couldn’t look at another dumpling, I found I could eat Chipotle’s Mexican food. So tacos and burritos for way too long. Having burned out on Chipotle’s, I am on yet another quest. I can eat sushi rolls, but tuna is too loaded with heavy metals to be an everyday choice. And on and on it goes. But the most routine things, like eating rice, or even pasta, are far from guaranteed to go well.

This whole thing has been going on for somewhere over a year and a half now. At first, I had to stop drinking because of the surgery and radiation and all. After all this time of being sliced and irradiated and loaded with toxic waste, I am now free to drink again. Only I can’t. Alcohol now burns my throat. I haven’t had a drink in all this time. (I’m not a big drinker anyway, but I wax nostalgic about a nice, cold Margarita.)

At this point, I finished chemo about a month ago and I’m gradually detoxing and finding it easier to eat and swallow. I even went to a restaurant and ate in public last night for the first time in a long time.

* * *

In a couple of weeks, I go in for a CAT (CT) scan and MRI to see what the colon tumor is looking like, to see whether I need surgery. In any case, I know it shrank from the radiation, but I’m not terribly optimistic about avoiding surgery. (Apparently about 40% of patients can skip surgery, but with my luck so far, I’m definitely not counting on it.)

Lessons

He tried to hold on to the idea – the hope – that age was something we could negotiate with. We could offer to do this, or eat that, or meditate, and that age would agree to wait, to hold off, to stop with the surprises. He would read articles about a constant flow of scientific discoveries – hairless voles that did not age, single-cell organisms that were as old as life itself. There were tech bros and scientists who proclaimed that age, and even death, were aberrations, and that a few more discoveries and refinements and breakthroughs in research would catapult us into immortality on earth – but, as was obvious, only for those whose decay had not yet become – as his surely had – irreversible.

* * *

This is where you’re looking for me to sum up all of this into some kind of neat package. Something positive must come out of all this. Right?

Well, to borrow from Larry David when he was setting up the rules for “Seinfeld”: “No hugs, no learning – nobody learns anything.”

In the traditional sitcom, from “The Honeymooners” to “Family Guy,” we often see the clueless buffoon hugging his wife or family, reciting the lesson he’s learned from that episode, and proclaiming, “I love you” or “I love you guys.” Only to return to being a complete idiot in the next episode.

So, occasional hugs, but not much learning. We live, we die, and that’s pretty much it. And, unless you die in a car crash or something, or maybe an unexpected heart attack, the back part is less and less fun.

You might think that cancer would put thoughts of mortality front and center. When I was in college (and grad school), I was an English major, and death was a constant subject – “Because I could not stop for Death, Death kindly stopped for me” (Emily Dickinson). It was serious, but also abstract and distant. Perfect for the faux sophistication of grad students, as in this quote from my dissertation:

“In this vale of tears, it is temptingly easy to conclude that our too-brief life is but a cruel irony, a lingering death sentence with no hope and little consolation.”

And even now, in my case, cancer was more an oddity than a threat. With my tongue cancer, I was told the survival rate was 90-95%; hardly worth thinking about, though it would definitely suck to be part of the 5%. With the colon cancer, they have been more circumspect, but no one seems terribly alarmed. (I have seen the claim that when it is discovered early, the survival rate for colon cancer is 90%.)

So not much of a reality check there.

On the other hand, there is another level of on-the-ground learning that was impossible to escape.

Some time ago, I wrote a piece, “My car, my body” (https://peterhempel.wixsite.com/peterhempel/post/my-car-my-body ) about the learning curve associated with car repairs and body maintenance.

“My medical education has followed almost exactly the same path. I keep learning about what can go wrong when it does go wrong, one damn thing after another. I keep earning credits towards a wholly unasked-for medical degree. I have learned about so many things that can screw up, so many procedures and treatments, so many pills and injections. I accept my destiny as a human pincushion for shots, blood draws, and anything else they come up with. I am not an eager student, and the homework sucks.”

Sadly, my “Dr.” credentials (Ph.D.) don’t get much respect in the hospital. I know what I need: steroids and speed – steroids to rebuild my muscles and speed to restore the energy of my youth. Obvious. But somehow, when I mention this, no one ever takes me seriously. I get the impression they don’t think I’m a “real” doctor.

Still, at a time when my schedule is driven primarily by doctors’ appointments, I am vastly broadening my base of medical expertise, one new specialty after another. I marvel at the array of insanely complicated and wildly expensive machinery I encounter. “Someone thought of this? And they actually made it? And this machine that’s treating me cost millions of dollars?”

But even beyond that is a whole world of people bound together in the common cause of health care – taking care of people.

Normally, we don’t think much about it. We go to the doctor’s office when something comes up, but it’s a minor pit stop in the rhythm of our lives. Now, for me, not so much. I have entered “medical world,” where everything and everyone connects to medicine and procedures and you face lots of conversations you never wanted to have and options that no longer seem like a good thing.

Still, the medical world unto itself is different. There are lots of kinds of jobs out there. Some of the people are drawn to them because of security and benefits, beyond the private sector norm. In part, the security and benefits seem to resemble those of government jobs. But when I go to the DMV or the Social Security office or the Post Office or whatever, the people are there, and they’re working, but basically, it’s just a job, with retirement as the goal. (An entry-level position to middle-class stability.)

In the medical world, it seems different. Even people in the lowest of support jobs seem to feel some sense of participating in something bigger. Unlike people in most jobs, they’re there to help people. As my older daughter used to put it when she was working in market research, “It’s not like we’re curing cancer or anything.”

Here, even if the individuals themselves are not doing the operating or conducting the research, they (even orderlies or security guards) are part of something bigger. They know that they are helping people. That makes them feel better about what they do – it gives them a purpose and sense of teamwork that is missing in so many other kinds of jobs. (It doesn’t hurt that in most cases the jobs pay reasonably well and have a fair amount of security, but this goes beyond that.)

When I first met the doctor in Philadelphia about surgery on my tongue, it was a fairly normal office building, and the hospital building where the surgery was performed and where I stayed for recovery was a block away. It all seemed fairly standard. But then, for a later follow-up visit, I had to go to a different building in what I can only describe as an almost Kafka-esque medical city, what is known as Penn’s medical campus, a complex that seemed to go on for blocks, with different buildings for different specialties and thousands of people working there. For the first time, I had a sense of just how huge the medical care industry really was. I have the feeling it is comparable to the military in size and personnel. (And, of course, the pharmaceutical industry has vast campuses of its own.)

But that’s the real size of healthcare, with all its specialties and advanced facilities and esoteric machines. It’s our cathedral to the job of keeping people running and doing our best to slow the process of dying.

This is also a mark of our culture, writ large. If we look back through our history, one of the fundamental dynamics is a clash not only of civilizations, but of cultures. We have seen warrior cultures (e.g. the Mongols) conquer huge swaths of territory, but they in turn got swallowed up by the cultures they conquered. The greatest strength of Western civilization has – for all its wars and atrocities and greed – been cooperation. And medicine in all its forms has become one of the most massive cooperative ventures in human history.

Modern medicine is an astonishingly recent phenomenon. Handwashing before surgery became the norm only in the late 19^th century. During the Civil War, there was no such thing as modern medicine. The primary medical procedure of the day was amputation using a handsaw and often with no anesthesia. (Although morphine was available, many doctors felt that feeling pain helped the patient heal better. [Mother Theresa would have agreed wholeheartedly that suffering is great – for other people.])

Some of you may remember Doc Festus from “Gunsmoke” days. I have no idea what kind of good he could have done for anyone, beyond perhaps trying to put broken bones back into place. And dentistry was simply a matter of pulling teeth, perhaps with a shot or two of whiskey to ease the pain. I have nothing but good things to say about where we are now.

With AI, the pace of medical innovation will accelerate massively, both in terms of finding and developing new drugs, but also in terms of customizing drugs and treatments for individuals. Ten or 20 years from now, I anticipate the landscape looking vastly different. Just not for me.

* * *

Update of sorts

When I got the results from my CAT scan and my MRI, the result was the best possible outcome. The tumor had not just shrunk, it was gone. Disappeared. (At least for now.)

Wonderful news, right? I had been making plans in my mind to throw a dinner with my friends to celebrate if things were good.

Never happened.

What should have been great news actually left me depressed.

I should have been delighted at the reprieve from surgery and another round of recovery from that. But I was hit by this feeling, “So, that’s it? Is that all there is?”

I had been in the middle of so much action, the focus of so many teams, my life had had a busy schedule organized around doctor’s visits, tests and treatments, the arrivals of home health staff to check in on me and provide physical therapy and coach me on how to eat and swallow, and now…

* * *

You know that saying about the cure being worse than the disease? For most treatments and procedures, even major surgery, when it’s over, it’s over. A friend of mine who went through heart bypass surgery is now back to playing tennis (at 80). He told me his doctor described the operation basically as “plumbing.”

Cancer isn’t like that. For one thing, beyond surgery, the two major forms of treatment, radiation and chemo, both beat the shit out of your body, and what it does to you doesn’t just go away. Second, even if you are lucky and the tumor is gone, it’s never really gone, the cancer has just gone into an underground bunker somewhere, waiting to pop out and settle in somewhere else, in some new and more virulent form. For me, I now face screenings every three months (sigmoidoscopies – same prep [the worst part] as a full colonoscopy) for two or three years, then every six months, and so on. You get a reprieve, not a cure.

I know friends who have gone through cancer treatment. It is uniformly an awful process. One horror story after another. And yet 40-45% of Americans are likely to end up facing it at some point, and the longer you live, the higher your odds.

It has been a journey (even if it’s not over). Aside from the cancer itself, I definitely can’t say I’m better off now than I was before (though I hardly had a choice). With the weight loss (some of which was much needed) and the accompanying muscle loss and the floppy tongue and a pattern of taste and eating changes I have not yet come to grips with (I have made my way back to medium-hot salsa, but not alcohol – haven’t had a drink in over a year and a half), I feel I have aged 10 years almost overnight. My weight loss has left me looking more like an Auschwitz survivor than a successful and delighted dieter.

Getting old sucks. When we are young, we rejoice in growing up. Now, it seems, we are left with growing down. We shrink – the days of growing are long past.

“As you grow older, you trade all that you might have been for what you are. All the things you might have done for what you did. Your potential hollows out, year by year, until whatever it is that you are, is left.”

Not exactly my choice. But this is my circus, and this is my monkey.

So many things have fallen away over the years – dancing (I used to teach two-step at a honky-tonk in Austin), swimming (lap swimming for almost 50 years), even the joy of long walks. My attention span has diminished, making it hard to read whole books or even take on full-length movies. My list of past and present ailments in the medical portal has grown discouragingly. (A medical history tour of my body would include lengthy stops almost everywhere.)

At least for now, I can still write. (It’s easier for me to write a novel these days than to read one.) There was a period during chemo and the killer fatigue that went with it when I had no energy to write, and I worried that that too might be lost. Fortunately, I have recovered from that and am fully returned to writing on all fronts.

And I can still think (though some people might dispute that).

What’s next? We’re all a bad fall or a clutched hand to the heart away from oblivion.

I think Woody Allen may have said it best: “I’m not afraid of dying, I just don’t want to be there when it happens.”

* * *

I did my undergraduate work at Princeton, which is famous for its colorful annual alumni reunions over Memorial Day weekend. During the weekend, each class holds a meeting of class officers, which all members of the class are welcome to attend. At the end of one such officers’ meeting, they opened the floor to questions from the assembled classmates. Someone asked, “How many people are we losing each year these days?” There was an awkward pause, and then one officer said, “We’re losing about one classmate a month on average.” There was a rather somber silence. Then, from the back of the room, a voice called out, “We can do better!”

© Peter A. Hempel - 2026

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