Posted on 29 August 2017 by Andy Skuce

This is a re-post from Critical Angle

Participating in social media creates a wide and diverse network of acquaintances. Often, these people become “friends”, even though direct personal contact may never made with them. It can be hard to establish traditional friendships without face-to-face encounters. Before the Internet, reading body language, voice inflections and facial expressions was as big a part of communication as speech itself. For many of us who spend a disproportionate amount of time in front of screens, much of our communication has become disembodied. But we still have bodies and, unfortunately, bodies break down.

I never wanted to write this post, but I feel that I owe it to the people I have come to know as online friends. They deserve to know that I’m suffering from a fatal illness. However, I hate the idea of now being treated differently because of this disclosure. I am not fishing for compliments or looking for moral support.

In 2002, at age 48, I was diagnosed with aggressive prostate cancer. I had a prostatectomy, but, despite the entire removal of the gland, there were small amounts of metastatic disease detected in nearby lymph nodes. The cancer had not been cured. Progression of the disease was slowed for many years by intermittent hormone treatment. I experienced no physical symptoms of the disease for twelve years, although the consequences of surgery and hormone treatment were no fun. But life continued and it was good.

As Hemingway remarked about going bankrupt, my cancer progressed gradually at first and then suddenly. About two years ago, my body’s plumbing and scaffolding started to show signs of trouble. More aggressive hormonal drugs were prescribed, which brought me back to good health for a year. Then, as the effectiveness of those drugs failed, chemotherapy beat back the worst symptoms for most of another year. Chemotherapy side-effects can often be managed quite well these days and it is not the horror that many imagine.

You become aware that the treatment options are running out when the oncologists start talking about maximizing quality, rather than quantity, of life. That’s where I am now. My life expectancy has been reduced from years to months. There still may be a few tricks left in my doctors’ books that may help extend my life beyond current expectations, but they are long shots and may not be available.

Reasons to be thankful

I was originally given a median life expectancy of six years. I have lasted fifteen and I’m not done quite yet. The palaeontologist and science writer Stephen Jay Gould wrote an excellent essay on statistics and cancer: The Median Isn’t the Message.  He had an eight-month median life expectation after his diagnosis of mesothelioma, but Gould lasted twenty years and was eventually killed by a different kind of cancer.

Being born as a white, male baby-boomer into a good family in a prosperous country (Britain) and having made some lucky life choices means I’ve been a big winner in the human lottery. I’ve never had to live through a war, never gone hungry, never been abused. My career as an industrial scientist was challenging and rewarding. I even managed to sneak in a little publishable research along the way.

For most of my teenage and adult life I’ve been a keen—if average ability—rock-climber, back-county skier and alpinist. I’ve had several near-misses and the occasional epic outing, but never suffered any serious injury. A careless slip or an avalanche could easily have ended my life early. Only once did a climbing companion of mine need rescuing and hospitalization. He was hit by a falling rock in Bristol’s Avon Gorge. His helmet saved him from lasting injury, we lowered him to the roadside below and he was in an ambulance in minutes. I’ve indulged in many dangerous activities and never paid the price.

Living in Canada means that I have received first-class medical treatment, without once having had to worry about paying for it. I held a high-stress oil-company executive job for a few years before and after my diagnosis. I had an inkling that the long hours would have killed me if I had kept it up. My employer was understanding and eventually laid me off with a generous redundancy package. There wasn’t room in that corporate culture for employees who were not able to give their all.

I quit full-time work in 2005 and moved from Alberta to the beautiful coast of British Columbia. I became a geoscience consultant, setting my own hours and my own pace. Working mostly from home removes the stress of the daily commute, although I did have to make occasional trips to Calgary as well as to the UK, Peru, Argentina, Romania and Russia. Consultants get paid for travel time, employees often have to give up their weekends unpaid. The relationship between client and consultant is usually easier than between boss and employee.

There were no worries about losing health insurance. Had I been an American, I would likely have faced a terrible decision about whether to hang on to my stressful job, or impoverish my dependents by quitting and giving up health coverage.

Canada now permits physician-assisted suicide, so I’m reassured that I won’t have to needlessly endure a protracted death. I’m told that relatively few people follow through with it in practice, but it’s comforting to know that there is an option.

Most importantly, I have had indispensable support from loved ones. Family members can suffer as much or more than the patients. They feel obliged to stay strong and supportive whereas I’m allowed—even expected—to let go emotionally. Perhaps I’m revealing too much detail about myself in this blogpost, but I’m going to respect the privacy of my carers by saying nothing more about them.

There are plenty of younger, better people who have suffered worse diseases. The British physicist Sir David MacKay springs to mind. He died of cancer at age 48—the age at which I was diagnosed fifteen years ago—leaving behind a young family and the potential to add to his already brilliant contributions to the debate on climate solutions. MacKay wrote a detailed and fascinating account of his treatment on his blog, I’m not going to attempt to do that.

Seeing young children in cancer centres and the horror in the faces of their parents, provides a sense of perspective for those of us who face a perhaps untimely death after decades of happy lives.

Nothing more terrible, nothing more true

Philip Larkin, in his masterpiece poem Aubade, expresses the deep fear of death that most of us have felt. An extract:

The mind blanks at the glare. Not in remorse
—The good not done, the love not given, time
Torn off unused—nor wretchedly because
An only life can take so long to climb
Clear of its wrong beginnings, and may never;
But at the total emptiness for ever,
The sure extinction that we travel to
And shall be lost in always. Not to be here,
Not to be anywhere,
And soon; nothing more terrible, nothing more true.

This is a special way of being afraid
No trick dispels. Religion used to try,
That vast moth-eaten musical brocade
Created to pretend we never die,
And specious stuff that says No rational being
Can fear a thing it will not feel, not seeing
That this is what we fear—no sight, no sound,
No touch or taste or smell, nothing to think with,
Nothing to love or link with,
The anaesthetic from which none come round.

He writes later:

…Courage is no good:
It means not scaring others. Being brave
Lets no one off the grave.
Death is no different whined at than withstood.

Perhaps it’s understandable that a young man like Dylan Thomas (who died at 39) should urge his elders to “Rage, rage against the dying of the light”, but older folk might be better advised instead try to find the wisdom to be grateful for a long life, well-lived, and accept the inevitable with as much grace as they can muster.

A recent, brilliantly written piece in the New Yorker by Cory Taylor expresses my current attitude about dying almost exactly.

Lessons learned

Initial reactions to a dire diagnosis vary, but most of us initially suffer denial. People like me who are used to having technical control instinctively try to find out everything we can about the disease. Almost everyone I know who has been given a cancer diagnosis has looked for an unconventional cure at first. They try a drastic change of diet or concoctions of herbal infusions. I did too. But I’ve given up trying to pretend that I can find out anything that the specialists don’t already know. I’ve learned to try to focus on living well and leave the treatment choices to the consensus of the experts.

Many people become uncomfortable around cancer sufferers. There’s a natural tendency to look for reasons for the disease—why them, why not me?—and to resist the notion that in most cases getting cancer is just lousy luck. Humans instinctively  try to find underlying reasons for outcomes. Good health can sometimes be attributed to having lived a virtuous life, with illness blamed on bad lifestyle choices. This can be partly true, of course, but more often than not, shit just happens.

With good intentions, friends will sometimes urge sufferers to adopt a more positive attitude. Certainly, if cancer patients are unduly stressed it may not be helpful for the progression of their disease—perhaps misery depresses immune systems and it certainly makes lives less bearable. But there’s scant evidence that urging sufferers to buck-up and look on the bright side helps outcomes at all. On the contrary, this can place an extra burden on the victims by making them feel they are not doing enough to help themselves. If you know someone with cancer, please put aside any advice and judgment. Just be nice.

Importantly, the family members on the front line of providing care can suffer even greater mental anguish than the patients. Their pain and grief will endure long after the patient has died. Help them, sympathize with them, never tell them they are not doing enough.

The certainty of a premature death focuses the mind. Strangely, at moments of acute stress, one sometimes feels the exhilarating sensation of living in the present moment—experiencing a beautiful, perfect, harmonic world—instant Zen mastery. But it is fleeting. Familiar mental attitudes reassert themselves. At least that’s what happens to me.

But one unexpected change is acquiring a lasting and enhanced appreciation for the humdrum, the everyday stuff of living, rather than the extraordinary experiences that we sometimes think ought to define our lives. As he died of cancer, the singer Warren Zevon advised: “Enjoy every sandwich.” It sounds trite, but it’s true.

Forget about bucket lists. Get used to replacing the thrill of new experiences with the intensity of doing ordinary things for perhaps the last time.

Climate change and me

It may seem a little odd to end this disclosure about my looming demise with a technical commentary on climate change. However, concern about what happens to the planet after my death—whenever that date might be—has been important to me over the past few years. Having the fatal moment moved forward doesn’t change anything.

For the past ten years, I’ve become obsessive about learning and writing about climate change. I’ve done my best to provide my own perspective as an ex-oilman and geoscientist. Most of my contributions are recorded on this blog. I’ve lately found it hard to apply the sustained effort to research and write in-depth pieces that add anything coherent and novel enough to be worth publishing. I would love, for example, to dig deeper into the means and benefits of mitigation technologies and the costs of inaction.

I have become reluctantly pessimistic about our ability to avoid dangerous global change. If the best mitigation efforts are made and we get lucky with climate sensitivity and carbon-cycle feedbacks, we might succeed in limiting surface warming to 2-3°C. If we are mitigation laggards and the response of the Earth System to the abrupt chemical changes we are delivering to the atmosphere turns out to be severe, the consequences could be dire. Even in the best imaginable case, we are in for some nasty, disruptive shocks, unfairly focussed on the poorest people: those who have done the least to cause the problem.

A recent paper by Mora et al. predicts that parts of Brazil, W Africa and SE Asia will experience, by 2100, “deadly” outdoor conditions of heat and humidity for humans for most of the year, even under a middling emissions  scenario like RCP4.5.

The very worst cases—much more than 4° C of average surface warming—may have only low chances of happening. Nevertheless, such outcomes would force such drastic transformations in the world order that conventional economic cost-benefit analysis and discount-rate considerations would no longer apply. When it becomes a matter of survival—war, disease, disaster—money becomes no object. Rates of return on investment and enhancing economic growth take a back seat when the future of civilization itself is threatened. Admittedly, finite resources would still need to be optimally allocated: I wouldn’t argue for throwing the entire discipline of economics out of the window.

Geoengineering as a remedy

I fear that the defining issue of the latter part of the twenty-first century will be the application of geoengineering, particularly albedo modification. The technical uncertainties and political implications are staggering. But it’s likely coming, whether we are ready or not. It’s crazy that policy makers and researchers are giving it so little attention.

We can speculate, of course, that there might be other perils—a horrible pandemic; out-of-control artificial intelligence; an all-out nuclear war; an asteroid; unforeseen consequences of genetic modification—that could prove even more destructive. But anthropogenic climate change is a certainty rather than some remote risk. The temptation to apply a quick fix will one day prove irresistible for those countries that find themselves under acute climatic stress.

I dislike applying both military and disease metaphors to the climate crisis. More often than not, they distort rather than illuminate the true nature of the problem.

Nevertheless, proposed geoengineering remedies for global warming have some parallels with cancer treatments. There’s little doubt that they will reduce the impact of some of the worst symptoms and prolong survival. But some problems, most notably ocean acidification, will remain unaddressed by solar radiation management. Even though average global temperatures can certainly be lowered by feeding reflective particles into the stratosphere—we know this from observations of big volcanic eruptions—regional consequences can’t yet be adequately predicted by climate models.

Cancer treatments affect only the patients. Medical ethics protects them by insisting on first obtaining their informed consent. Albedo geoengineering, in contrast, can be applied unilaterally and inexpensively by any middle-power country, which could well be oblivious to any negative consequences inflicted on its neighbours.

The dosage of the stratospheric sulphate medication will forever have to be maintained. It will have to be increased if we continue to burn fossil fuels. If, for any reason, the albedo meds were suddenly interrupted, the shock to the global climate system would be sudden and truly catastrophic. Global temperatures could shoot up several degrees in a few years: it would be like taking a wrecking ball to our planetary home.

The only “cure” for climate change will be in attempting to restore the stable climate in which human civilization developed. We will have to find a way to reduce atmospheric CO2 concentrations back to below 400ppm, perhaps even to 350ppm, as James Hansen and other scientists have recommended. That will be extraordinarily expensive and perhaps not even physically possible.

It will demand sacrifice, investment and restraint from the majority of the world to achieve a positive result that will take decades to manifest itself. It will require not only sucking CO2 out of the air, but a nearly equal and additional amount out of the oceans. Basically, we would have to put back in to the Earth most of the carbon we have taken out of it since the Industrial Revolution. The challenge is made harder because the physical mass of the required carbon disposal is amplified by a factor of more than three: those carbon atoms we dug up and burned are now wedded to two heavier oxygen atoms.

A long-term program of planetary CO2 liposuction, combined with a strict carbon diet, could eventually turn things around. But even with such an attempted cure, there will still be the earthly equivalents of scar tissue, damaged vital organs and lost limbs—coral reefs, ice sheets, precious ecosystems—that may never restore themselves within human timelines. 

Coda

One of the great benefits of my engaging in research and activism on climate change has been making friends with some determined and talented people. They have taught me so much. They will continue the struggle to communicate the nature of the crisis and advocate for solutions. In particular, the volunteers in the Skeptical Science team have been an inspiration. Long may they run.

I’m still keen to continue conversations, especially with people I don’t agree with. There’s so much more to learn. A politically conservative perspective on climate solutions is essential. It’s a tragedy that many right-wingers have ruled themselves out of serious debate, with their idiotic, tribally motivated denial of basic science. To solve this problem we will have to change everything. That will require willing contributions from all of us.

Participating in the struggle against denial of the scientific consensus on climate is something I would dearly like to continue doing, but force majeure dictates some triage of my efforts. I’m no longer going to bicker with those who don’t engage in good faith. Life really is too short.

I’m not gone quite yet and I’ll try to keep doing what I can.