I'm trying to merge my two blogs, so I'm going to try posting personal entries on the art blog from now on. You can find them in the "Personal" category there. Let me know what you think!

I was all set to make a drawing for my first Monday Art Day on my revamped art blog, but we just spent four hours going to and from the vet hospital and waiting for Tisha's bandages to be changed, and now I'm can't concentrate. While we were in Concord the oncologist caught us and told us the biopsy results came back, and Tisha has squamous cell carcinoma. (It just sounds evil, doesn't it? And FYI, the photos on the link are not pretty.) So it is cancer after all. I can't say I am surprised. There are some treatment options, but it seems like the best possible prognosis is about 8-9 months, and the doctor told us Tisha has already outlived his usual sans-treatment prognosis of 3-4 months. At any rate it's best not to start treatment until after the current surgery wound heals, which may take 2-3 more weeks. So there's nothing to do for now.

It's a grim outlook, but aside from distracting me from my art-making, it has strangely little effect on my mood. I still feel so grateful Tisha was spared to us last week... we were prepared for him to die then, so the fact that he still lives is everything I could want. He's with us now and he's as happy as anyone with a giant healing wound in his neck can possibly be. We spend as much time with him as possible, and he purrs to show us he likes it, and that's that. Our goal for the remainder of his life will be to give him as many and as comfortable days as possible. If that means radiation, we'll try that; if that means foregoing treatment so he can avoid any more car trips and meds, then an option too. It's all about Tisha at this point. And we're not going to worry about it until after he's recovered from the surgery.

But you probably know, even when you declare fervently that you're not going to think about something, you still do; even when you make a decision, it's still not over. Your brain still mulls over things underneath your conscious thoughts, and that affects you. That's why I'm writing here right now instead of drawing.

Tisha made it through surgery!!! (If you haven't visited this blog in a while, read this post for background.) I really couldn't allow myself to hope that he would, because I was concentrating all my energies on preparing myself in case he didn't. I have long grappled with the understanding of our mortality... I think all of us who share our lives with pets know that we're likely to confront death sooner through them than through our human loved ones. In the week leading up to the surgery I found myself at a loss to describe my feelings. I wasn't wholly sad, because Tisha was suffering and I wanted to see that pain ended. I wasn't really angry because death comes for us all, and I had no regrets. And I couldn't be completely anxious, because we knew things were out of our hands. But there was definitely something, a tightness and a weight I wasn't fully aware of until afterward, when we got the good news and I wept in relief and gratitude. Whatever that emotion was, it made its way through all of me, affecting my thoughts and my reactions as well as my body. Today I feel a little empty without it, just calm and even. And I thank god for it. I can breathe easy and rest well for the first time in weeks.

The danger is not over yet. They couldn't entirely close the wound after the operation, so that will take almost a month to heal, and in the meantime we must be very careful. When the get the biopsy result back we'll know whether this is an end or only a beginning. But it's all right. We've got our tiger for now, and we know how lucky we are.

Thank you all for your wonderful well wishes and your loving thoughts and prayers. I'm convinced you helped carry Tisha through all the risks of this massive surgery. Love.

I suggest you read this previous entry before proceeding.

On Saturday Tisha's wound reopened. This has happened with regularity every month or so. A hole appears, fluid drips out, it's messy for a day or two. Then, the pressure relieved, the flow of fluid lessens, and the wound scabs back over temporarily. The first time this occurred back in February or March, the hole was very small, and the fluid looked more beige than anything. This weekend the hole was about the size of my pinky fingernail and wherever Tisha moved, he left gleaming drops of bright red blood swirled with whatever that beige fluid is. When I saw the first one on the carpet near our bed, I actually thought it was a button or a bead, it was so bright and round and crimson.

For the past few weeks Tisha has not eaten much. He's taken only a few bites at a time of dry food, barely touched his wet food, and eaten only half egg yolks and dribbles of broth. In the past few days he has hardly eaten at all; in fact, I'm not sure he has. When I enter the living room first thing in the morning, he's curled tightly in his bed by the window, and unless I stand directly above him, he doesn't even look up when I come in. When I feed Lyapa he doesn't stir. In the late afternoon if I reenter the room to do some exercises, he might stand, stretch, and come over to see me, but usually Lyapa butts in and he removes himself back to the bed to curl up once more. For the past few days the most activity we've seen from him all day is when I sit down after dinner in my new reading chair. Then he knows it's cuddle time, and he'll come purr on my lap for an hour or two until I get up from my seat to go to bed.

This morning we had an appointment with the surgeon, to have a look at the reopened wound (now mostly scabbed over), and when we put Tisha in his carrier he began immediately to protest, as he always does -- but his voice was raspy, his meow hoarse, even though he complained for the entire forty-minute ride. They had told us this might happen. The growth on his neck is now interfering with every possible function in that region, save respiration, and it seems obvious that that is only a matter of time.

It is basically surgery or death, the doctor told us, and it may even be surgery and death. They might be able to remove all the growth, but it's more likely that it will elude them yet again. There may be permanent damage to the nerves in the region, and they may even have to remove his jugular vein or carotid artery. And of course, he may die on the operating table; the surgeon was very clear about that. It will be up to us, he said. If it looks like further action will be impossible without the most significant risk, the decision will be ours, and they will accede to whatever we wish. If Tisha comes out of surgery alive, there will still be after-care: bandages, possibly the Cone of Shame, and two or three weeks of the medications he hates so much.

If we don't do surgery, the outlook is not much better. We have seen how quickly his health has deteriorated in the last couple of weeks. I hate to think of our tiger dying on the operating table, but equally repugnant is the thought of him emaciated, lethargic, dehydrated, and finally gasping for air once the mass begins to obstruct his airway. If you'd asked me a month ago I would have said I'm sure he can hang on a few more months, but now I have no confidence at all. It is purely a physical problem: the mass is too big, and when it gets big enough, it will kill him, one way or another.

I think we have decided on surgery, because it seems that if there's any chance at all to get the thing out, we ought to take it. He's not such an aged cat, and he's still as sweet as ever. When he curls up purring on my lap in the evenings I think, "He should get to keep doing this." But I don't know for sure. If surgery accomplishes nothing but he still lives to endure the Cone of Shame and weeks of pills, isn't living out the rest of his days in peace (be they only a week), and then euthanasia, the kinder thing for him? We have until Tuesday to think it over.

I cried in the car on the way back from the visit today, my first real tears since this whole thing began. I cried because I thought the decision would be a little more clear-cut than this, and because I didn't expect it quite so soon. Every time we've done a surgery there has been the chance of death, but that's quite a different thing than sending him into the surgery with the instructions: "Yes, do it, even if it kills him." I guess I had been thinking of this surgery as yet another step, rather than as the step, as it may well be.

The only consolation in all this is that whatever we decide, we can have no regrets. The options are all terrible, including the option of doing nothing. The surgery may be successful; that will be good. If he dies on the operating table, it will be painless (for him). If he survives unsuccessful surgery, we won't try it again, and it will only delay the do-nothing option of letting him waste away more gradually -- which will let him live out his days in the way he knows.

In the car we seemed to be on a threshold; now that we're home, everything seems just the same. Until Tuesday we will think, then, and be with Tisha, and let everything else proceed as it will.

Yesterday I had lunch with my friend Patrick, in Berkeley, where we got our undergrad degrees at the same time (in the same department) without knowing each other. I hadn't seen him for probably a year. He gets more handsome every time we meet! We had an enjoyable Japanese bento lunch and walked back up to campus together. I got to see his cubicle in the Regional Oral History Office, and he showed me the gorgeous new rotunda of the Bancroft Library. I have so many fond memories of that place before the retrofit, and it looks even more imposing now, though I miss the dusty old-school look just a little.

Patrick and I spent about an hour and a half together, catching up on our recent activities and looking forward to his September wedding. After we parted I thought how curious it always is to see old friends. I find that no matter how much time one spends with the other person, it still feels so impossible to really understand his life, the way one knows the day-to-day activities of the people one sees more regularly. Whenever I'm playing catch-up with old friends we talk ostensibly about our lives, but I never really feel I get it until I have a moment to digest what I've heard -- usually while I'm in the restroom, away from anyone else -- and think of questions to ask, to fill in the spaces of things unsaid. I didn't just notice this with Patrick yesterday, but with old high school friends at Jennifer's wedding a few weeks ago, and at other such events. People tell me "I've started working at a startup" or "we live in New York now" or "last month we took the baby to see my parents," but somehow that's not enough. I don't know whether anyone else feels this too. I always want to know more deeply. I want to know, "what motivates you these days?" or "what exhilarates you?" or "what do you worry about when you lie awake at 3 am -- or do you?" But these aren't questions one can find out by asking directly. These are the things one only knows after spending time with someone day in and day out, during late nights and early mornings, lazy afternoons and splendid all-day outings.

And yet... badly as I want to know these things about my old friends, somehow it's all right not to know, to just see them and hug them and chat a little while in a booth at a restaurant. To see with my own eyes how beautiful and accomplished and grown-up they are, and to see the person I knew before, still there within them.

I went to a dear friend's wedding this weekend, spending three days in the company of all our mutual friends: Jennifer's family, our high school group and their partners I've come to know, the lovely women I met at her bachelorette getaway and bridal shower. It was a sweet and beautiful wedding.

Concentrated friend time always makes me think deeply about my life -- as do weddings, by virtue of their very momentousness (and the rituals and traditions that emphasize their significance). I'm trying to think how to lead gradually into what I want to say here, but I don't seem to be able to do it, so let's just get to the point. I'm not the friend as I used to be. This might not be apparent even to my good friends, but I can feel the difference in my heart. I used to spend hours making cards for everyone's birthdays, and now I mostly don't. I used to pour out all my affection in these same cards, and I even made them for people who didn't know me, like professors in large lectures. My attitude was, life is short; everyone who's ever touched me deserves to know it. My mom used to warn me against taking so much time for people who wouldn't "appreciate it." She'd see me drawing away at someone's thank-you note and say, "You should just buy a card for so-and-so. This person can't tell the difference between a Hallmark card and something you spent three hours on." Even knowing this was often true, I rejected this philosophy, telling her, "That's not why I do it." Love is not an investment to be made only when returns are guaranteed. Friendship is not a balance sheet. Over the years my friends have proven this in ways I could never have foreseen. I get emails from people I've fallen out of touch with, telling me how much they've treasured my cards. I maintain contact with people who should have left my life long ago, just because I took the time to tell them what they meant to me. Even if love were an investment, my returns have been more than generous.

But at some point... I stopped doing the cards, and I stopped reaching out to everyone I wanted to acknowledge. On some level it was an inevitable logistical decision: as one grows older, it's simply no longer possible to write lengthy, heartfelt notes of appreciation to every single person who's made an impact on one's life. And relationships grow more complicated with time and age; by the time one graduates from college it's already obvious that the pure simplicity of "love always" isn't accurate in every friendship. But deep down, I know my mom's return-for-investment perspective did play a role, even though I fought against it. As I say, the love I've sent out into the world has more than made its way back to me, but there have been plenty of times when it seemed it wouldn't. Too many affectionate gestures unacknowledged, too few of my own received, too many beloved friends who seemed to love me less than I loved them (as if the same yardstick could be used to measure each person's heart). At some point, my heart just didn't want to be so open anymore. My regular outpourings of loving cards dwindled to a trickle, and even those weren't as elaborate as they used to be, nor their messages as earnest. What I didn't realize until I started writing this was that my love had become conditional... and that before the change, it had been so close to unconditional, and I never knew it. I went from loving without expectation of return, to holding back when return wasn't guaranteed. And since it's never guaranteed, that means holding back always, with everyone.

As I think about this, I'm certain this closing down of my heart has everything to do with how easily I cry these days -- and also what doesn't make me cry, like VONA and weddings. At VONA it hit me that protecting my heart is damaging my writing too. Really being an artist means keeping one's heart open as much as possible, in spite of not getting that love back, or in spite of being hurt. When I hold my heart back, I can't give it fully to what I'm doing, and that's as much true in art as it is in friendship. There was a time when I kissed all my friends when I hugged them; these days, if someone I'm not used to touching puts an arm around me, my shoulders stiffen. In spite of my own objections, I do keep that balance sheet: this person I can trust with my hugs, this person probably doesn't really like me as much as she likes her other friends. I think my best friends still know how much I love them, but I don't take the time to articulate it anymore, to demonstrate it in every way I can imagine. I think if I did, they'd be surprised at the difference in intensity. I think it would surprise me too.

I'm not sure exactly when I started holding back in my love, chronologically speaking, but emotionally I can make a guess. It's when I started wondering whether all my cards were appreciated, proportional to the amount of time I'd spent on them. It's when I started questioning others' declarations of friendship, when I started wondering "then why don't we hang out more often?" or "then why didn't I hear from you on my birthday?" whenever I heard or read an "I love you." I think back on people I've wondered this about, and I realize that it's not so much about closing the heart down as it is about denying its full capacity. Protecting myself means I don't lay my love out on the line, but it also means I pretend it doesn't hurt when someone responds less enthusiastically than I expected them to. Our hearts were made to love, and love means pain as well as joy. When we deny the pain, we deny a vital part of what our hearts were meant to do. I think now that this is what happened to me. At VONA Evelina taught us to be brave in our writing; I resolve here to be braver in my love and to open my heart up as full as it can go. I don't know if this means the birthday cards will begin again, but I'm going to try not to hold back anymore.

Let me love.

Let me hurt.

Let me love.

Tisha is crouched on my computer desk, purring with that gulping little hitch his purr now has because of the growth on his neck. He's so normal except for this... but this is no small thing. He doesn't eat as much (the mass probably makes it less comfortable to chew or swallow), his left eye is a little skewed (the mass presses on a nerve there), his neck looks skinny from being shaved before his last surgery. He's got scabs all over the area. It's hard to tell with cats how much discomfort they feel, so I'm glad at least to have him following me around and asking for pettings the way he always has. He still looks into my eyes, head-butts my hand. But he's not well.

This photo is from a year ago:

Here's one from this morning. It's not the greatest quality but check out the difference between his eyes. And see how he looks a little more unkempt, a little more tense?

These are the first photos I've taken of Tisha since this all started back in January. At that time we thought it was a one-off issue so I didn't mind documenting his recovery, but as the situation continued, I couldn't bring myself to take the camera to him again. It's not an experience I particularly want to capture.

As it stands, Tisha has had four surgeries and numerous medications. He has seen several vets, including an oncologist and a board-certified surgeon. They've done biopsies and cultures. First they thought he had an abscess, then a blocked salivary gland, then an infection, and the surmise now is that it's a benign tumor that's excreting some kind of irritant. They want to go in one more time to try to get the thing out -- a tricky proposition because of its location on his neck, a sensitive highway of nerves and arteries -- but we're waiting for the results of the fungal culture before we agree. The surgeons say their next steps will be the same whether there's an infection or not, but after all this, we want to collect as much information as possible before we subject him to anything more.

But on some level, the medical situation is just talk. It's just words. The reality is this beautiful, sweet, trusting cat, who wants nothing but to be loved and fed and comfortable. Who remains so on edge after his long series of vet visits and forced medications that he still cringes away from us when Erik and I approach him together. Who now sleeps away most of the day, eats only in little nibbles, and leaves disgusting fur-coated scabs all over our carpet. Does he know what's happening in his body? Even if he understood what our choices were, is there space in a cat's thoughts to weigh the pros and cons of a few weeks' acute fear and misery versus years of health? To weigh those years of health versus those same years marred by surgical complications? To weigh those few weeks of terror against... whatever will happen if we do nothing?

The other reality, for us, is that we've spent more than $8000 on Tisha so far, and every surgery adds another thousand or two. The vast majority of people in this world don't have $8000 to spend on their children all in six months, let alone animals. It's not that Tisha's life is worth less or his suffering less acute than a human's. But it makes me deeply uncomfortable to think we might be dropping this amount of money on treatment he might not want; that we might be doing it for us, not for him. How do we know? Or have we already crossed that line?

The simple reality is that I want our boy to be well. But I don't know how to do it.