on the quality of life

🍂

Given the ease with which health infuses life with meaning and purpose, it is shocking how swiftly illness steals away those certainties. It was all I could do to get through each moment, and each moment felt like an endless hour, yet days slipped silently past. Time unused and only endured still vanishes, as if time itself is starving, and each day is swallowed whole, leaving no crumbs, no memory, no trace at all.
~ Elisabeth Tova Bailey
(The Sound of a Wild Snail Eating)

It’s hard to believe it’s been five years since I received my radiation proctitis diagnosis on January 3, 2020. It’s been a difficult journey, learning how to live with a chronic illness. I feel like Sisyphus, continually pushing a boulder up a hill, with no reasonable hope for relief.

I’ve learned that radiation proctitis is called pelvic radiation disease by the medical system in the United Kingdom, a much more comprehensive description than we have here in the United States.

In the last few decades radiotherapy was established as one of the best and most widely used treatment modalities for certain tumours. Unfortunately that came with a price. As more people with cancer survive longer an ever increasing number of patients are living with the complications of radiotherapy and have become, in certain cases, difficult to manage. Pelvic radiation disease (PRD) can result from ionising radiation-induced damage to surrounding non-cancerous tissues resulting in disruption of normal physiological functions and symptoms such as diarrhoea, tenesmus, incontinence and rectal bleeding. The burden of PRD-related symptoms, which impact on a patient’s quality of life, has been under appreciated and sub-optimally managed.
~ Kirsten AL Morris & Najib Y Haboubi
(World Journal of Gastrointestinal Surgery, November 27, 2015, “Pelvic radiation therapy: Between delight and disaster”)

Quality of life — how on earth can it be measured?

The necessary low fiber, low fodmap diet is terribly restrictive and makes eating with others and/or eating out in restaurants very awkward. I need to bring my own food.

The unpredictable and painful flare-ups of symptoms keeps me from making too many plans and the plans I do make need to be tentative. It’s frustrating, but the alternative is to never go out and do anything.

In my darkest moments I feel like this steep price paid for cheating death is not worth it.


The Heart asks Pleasure — first —
And then — excuse from Pain —
And then — those little Anodynes
That deaden suffering —

And then — to go to sleep —
And then — if it should be
The will of it’s Inquisitor
The privilege to die —

~ Emily Dickinson
(The Poems of Emily Dickinson, #588)


Coping mechanisms — there are quite a few…

Gathering information and helpful tips from my sympathetic gastroenterologists (both in Connecticut and North Carolina) — I’ve been lucky with that. (On the other hand, the radiologist and oncologist who dished out the radiotherapy were shockingly unsympathetic about the iatrogenic disease this cancer treatment caused.)

Finding the Pelvic Radiation Disease & Radiation Colitis support group on Facebook. It’s validating to know others who understand what it feels like to be living with this.

Working on my original 2020 goal “to take a walk in the woods.” Spending time with nature and capturing its wonders with my camera is very healing.

Reducing stress by practicing yoga, reading poetry and books, and listening to music. (I’m so grateful for the beautiful Chapel Hill Public Library and for my playlists on Spotify!)

Distraction = long hours of family history research.

Learning to say “no” (and trying not to feel guilty about it) when I need to rest and recuperate.

What a long strange trip it’s been these last five years, running concurrently with the pandemic in the beginning, and complicating our move to North Carolina. Most of all, I’m grateful for my husband. Tim lends a patient and supportive listening ear, bearing witness to my pain and struggle. I honestly don’t know how I would have gotten this far without him!

🍂

as autumn becomes a memory

11.27.24 ~ North Carolina Botanical Garden
northern mockingbird

November ends. I come across a poem by my favorite poet — she describes the sense of loss and disconnect I had been feeling all month.

She could not live upon the Past
The Present did not know her
And so she sought this sweet at last
And nature gently owned her
The mother that has not a Knell
For either Duke or Robin

~ Emily Dickinson
(The Poems of Emily Dickinson, #1535)

I’m grateful for and encouraged by nature, poetry and my books, and family and friends, as I imagine most of us are. This squirrel came up to me on our last visit to the botanical garden, as if to say, “I’m here, too.”

The poorest experience is rich enough for all the purposes of expressing thought. Why covet a knowledge of new facts? Day and night, house and garden, a few books, a few actions, serve us as well as would all trades and all spectacles. We are far from having exhausted the significance of the symbols we use. We can come to use them yet with a terrible simplicity. It does not need that a poem should be long. Every word was once a poem.
~ Ralph Waldo Emerson
(The Poet)

hemlock cones
looking up
mountain witch-alder
spotted cucumber beetle on a New England aster
sweet-gum

simple healing in
watching a mourning dove feed
on the forest floor

~ Barbara Rodgers
(In the Woods)

facing the growing darkness

“Autumn Leaves” by John Everett Millais

The inspiration of nature can help us deal with death and endings, gifting us with the courage to let go and the strength to carry on. The pain and uncertainty may be no easier to bear but the release of autumn asks that we trust in the process, bravely facing the growing darkness without ever knowing if the light will reappear.
~ Maria Ede-Weaving
(The Essential Book of Druidry: Connect with the Spirit of Nature)

in the slanting light

10.18.24 ~ Pritchard Park
Chapel Hill, North Carolina

There’s hardly a spot of color on the hardwood trees in our yard, but the light is glorious, as it always is in October, and the signs of fall are unmistakable. ….. Always, when nature works as nature must, there are joys for every grief, a recompense for every sorrow. ….. Night falls earlier with each passing day now, but the recompense of shorter days is the glorious light of October. I wish you could see what happens to the magnificent colors of berry and bird and flower in the slanting light of October.
~ Margaret Renkl
(The New York Times, October 14, 2024, “Growing Darkness, October Light: A Backyard Census”)

These pictures were taken on Friday morning, the day we stood in line at the Chapel Hill Public Library to vote. Afterwards we took a walk on the trails in the woods surrounding the library. North Carolina has early voting, something new to us. Before we left Connecticut we had voted in favor of bringing early voting to our old state. I wonder if it passed. Our habit was to get up early on election day and get to the polling place before it opened. We were always near first in line.

Something new for the citizens of NC is having to show a photo ID when they check in to vote. We always had to do that back in CT. It’s so interesting getting to know the different ways the governments of different states run things, something I never thought about before, having lived in only one state my whole life.

As I stood in line I reflected on how encouraging it was to learn that our 39th President, Jimmy Carter, made the effort to vote while in hospice care at the age of 100. He was the first president I ever voted for. My thoughts also returned to the sacrifice so many of our ancestors made for us in the Revolutionary War, so that we could have the right to vote today. As the granddaughter of Ukrainian immigrants on one side and the descendant of several Mayflower passengers on the other, my complex place in American history has always fascinated me. While appreciating the myriads of reasons Europeans have crossed the Atlantic over the centuries to make better lives for themselves here, I also feel deep regret for the harm they have caused to the original people who lived, and still live here.

When we moved down here I started looking for southern nature writers who might help me get acquainted with my new environment. I’ve become a big fan of Margaret Renkl, who lives in Tennessee at the same southern latitude as we do. Her lyrical writings resonate with the seasonal observations I’m experiencing here. I’ve read three of her books, checked out from the same beautiful library where we voted, and enjoy her occasional editorials in the New York Times.

I tried to capture some of the slanting light of October to match Renkl’s words. This is our second autumn down south and the way it is unfolding feels much more familiar now, it’s starting to feel more like home.

sculpure at Chapel Hill Public Library parking lot

in the middle of things

9.11.24 ~ Cedar Falls Park

It has been a difficult couple of weeks dealing with the side effects of vaccinations and an unwelcome osteoporosis diagnosis but we finally got out to enjoy some pleasant weather and a walk in the woods. We returned to Cedar Falls park to take a different trail and see if we could find a waterfall mentioned on a website. I think we heard the waterfall but could not see it from the path. The foliage was pretty dense and the terrain very steep so we didn’t dare go off-trail.

To pay close attention to the natural world is to exist in medias res. Life is an unfolding that responds to the cues of seasonal change, but for our purposes it is also suspended in an everlasting present. We can see some of the creatures we share our world with, or at least some evidence of their nearness, but we cannot know the full arc of their story. Every encounter in the outdoors is an episode with a cliffhanger ending.
~ Margaret Renkl
(The Comfort of Crows: A Backyard Year)

We definitely share our world with the squirrels and crows we saw and heard, and there was plenty of evidence of other creatures nearby, including deer scat deposited on the trail and countless cobwebs clinging to twigs and branches. I had to smile when I noticed once again, it’s that time of year when Tim is still in shorts and I needed my sweatshirt. Not quite time to pull out my gloves, though.

some of that uneven terrain that works so well for Tim

It felt so good getting out into the woods again!

under the trees

8.21.24 ~ eastern tiger swallowtail
Cedar Falls Park, Chapel Hill, North Carolina

We are all woodland people. Like trees, we hold a genetic memory of the past because trees are parents to the child deep within us. We feel that shared history come alive every time we step into the forest, where the majesty of nature calls to us in a voice beyond our imaginations. But even in those of us who haven’t encountered trees in months or even years, the connection to the natural world is there, waiting to be remembered.
~ Diana Beresford-Kroeger
(To Speak for the Trees: My Life’s Journey from Ancient Celtic Wisdom to a Healing Vision of the Forest)

At last! A day arrived with low humidity and a chance for a walk in the woods. Though I was tempted to visit the botanical garden I was drawn here to visit a new-to-us park we had discovered some time ago while out running errands in the heat. We found lots of interesting things growing under the trees in this lovely park.

Asiatic dayflower (beautiful but invasive)

The trees at Cedar Falls Park are typical of an upland forest in the Piedmont, with oak and hickory predominating and here and there a pine tree. Second growth trees with a brushy understory line both sides of the trails near the northern part of the park.
~ This Way to Nature website

red chanterelles
sweet-gum seedling
(thanks to Debbie for the identification)
a tiny blue feather
upside down indigo milk cap with a tiny snail
leaf just landed in a cobweb
fall preview

They would worry about wearing me out, but I could also see that I was a reminder of all they feared: chance, uncertainty, loss, and the sharp edge of mortality. Those of us with illnesses are the holders of the silent fears of those with good health.
~ Elisabeth Tova Bailey
(The Sound of a Wild Snail Eating)

the biggest of the many cobwebs we saw

The march of human progress seemed mainly a matter of getting over that initial shock of being here.
~ Barbara Kingsolver
(Animal Dreams)

partridge berry and moss
a puddle of water left in Cedar Fork Creek
dry bed of Cedar Fork Creek

Finding the snail moving across the blue mushroom and then the patch of partridge berries simply filled me with delight!

the purposeless life misses nothing

4.24.24 ~ North Carolina Botanical Garden

On this visit to the botanical garden there wasn’t much change in the American columbo’s flowering stalk, but we’ll keep checking back. In the meantime there were more new blooms to appreciate as spring continues along its way.

common sage
onion

Paradoxical as it may seem, the purposeful life has no content, no point. It hurries on and on, and misses everything. Not hurrying, the purposeless life misses nothing, for it is only when there is no goal and no rush that the human senses are fully open to receive the world.
~ Alan Watts
(The Way of Zen)

Stokes’ aster starting to bloom
narrowleaf blue-eyed grass

Back in Connecticut we had eastern blue-eyed grass.

I heard a towhee singing “drink your tea” and was determined to locate him somewhere in a nearby tree. At last I spotted him and did my best to get a picture of the elusive bird. My last attempt was in 2020, when we heard one rummaging around in the brush on the ground. If you’re interested see this post, eastern towhee. What a treat to get a picture of him singing!

It is only when singing that the Towhee is fully at rest. Then a change comes over him; he is in love, and mounting a low branch, he repeatedly utters his sweet bird s-i-n-n-g with convincing earnestness.
~ Frank Michler Chapman
(Life Histories of Familiar North American Birds)

eastern towhee
wildflowers in a sassafras sapling grove
marshallia
2009 NC Wildflower of the Year
(these reminded me of the Sno-Caps candy I used to love)
Georgia false indigo aka Georgia indigo bush (rare)

As for the wild spontaneous Flowers of this Country, Nature has been so liberal, that I cannot name one tenth part of the valuable ones.
~ John Lawson
(A New Voyage to Carolina, 1709)

downy woodpecker
female house finch
male house finch

The finches seemed to be a pair. He kept coming down from the tree to the feeder but she wouldn’t follow him. Wish I could have gotten a picture of them together. And so ended another lovely morning in the garden.

of leafing and blossoming

“Chestnut Tree in Blossom” by Vincent van Gogh

Beltane is the joyous time of leafing and blossoming. This festival celebrates sex and the transformation that comes when we open ourselves to another at the deepest level. This alchemy can also happen when we allow ourselves to be profoundly touched by nature. When we open to and merge with our environment, we can discover sacred union with the world itself.
~ Maria Ede-Weaving
(The Essential Book of Druidry: Connect with the Spirit of Nature)

green woods laughing with joy

4.22.24 ~ Johnston Mill Nature Preserve

Six months ago, in the autumn, we visited this gorgeous nature preserve for the first time. It turned out to be equally enchanting in the springtime. It was so green! We started at the other end of Robin’s Trail. It was cold out, however. After days in the 80s on this morning I was back in my winter coat and wore my gloves the whole time.

When the green woods laugh with the voice of joy,
And the dimpling stream runs laughing by

~ William Blake
(Laughing Song)

lots and lots of beech leaves
wild sage
New Hope Creek

Nature is ever at work building and pulling down, creating and destroying, keeping everything whirling and flowing, allowing no rest but in rhythmical motion, chasing everything in endless song out of one beautiful form into another.
~ John Muir
(The Wilderness Essays)

sunlit ripples in the creek
wildflowers and orbs at the forest’s edge
zephyr lily

As it was last time we visited, a very pleasant spring morning ramble along the creek and in the woods. 🍃