Decisions. Decisions.

Approaching Two Years Post Stem Cell Transplant

Decisions. They’ve always fascinated me. Even the most mundane daily decisions may feel like they have no bearing on our future, but the accumulation of these decisions do. When I was young I was a big science fiction fan (confession: still am), and Isaac Aasimov’s Foundation trilogy fascinated me. It was in many ways, an exploration of the butterfly effect — that a butterfly flapping its wings on one side of the world can change the weather clear across the globe.

In the science fiction world of Foundation, those decisions are studied, analyzed, modeled and molded to redirect the course of the future .

In reality, it’s all but impossible to tell in the moment whether the decision on the table is an inflection point, and whether choice A will careen you down a different path than choice B. If I wake up at 7:15 or 7:30, will that change the course of my life? Maybe. Maybe not. But looking back, it’s a bit clearer when certain paths presented themselves to you.

I can trace the life I have today to decisions I made in 1989. I wasn’t consciously mapping out my future, but simply by deciding to go out with some friends one evening, I am where I am today. That simple decision led to a chance conversation in the back parking lot of some comedy club that led to a part time job, that led to my first writing job, that led me to interview someone that led me to a second publishing job, that led me to Newport, RI, that led me to meet my future wife.

And if you break it down, what were the decisions I made over the course of the night - the drinks I ordered, when I decided to leave, who I spoke with - that led me to that conversation with those people that led to my job?

When I was first diagnosed, I wondered, as many cancer patients do, what led me to this diagnosis. If my lymphoma wasn’t hereditary (it’s not), what factors led my genes to mutate to allow the cancer cells to multiply and grow? What decisions did I make in the 70s, 80s, 90s or beyond that led me to my 2011 diagnosis? And inevitably, was there something I could have done differently to change the course of my health future? In short, what did I do to cause this?

It’s futile introspection. Even if I could do the impossible and chart out that labyrinthine flowchart, I couldn’t do the doubly impossible feat of changing the decisions that propelled me down this particular fork in the road.

It’s been years since I’ve entertained these thoughts but they popped into my head the other day. I was driving over to meet my boys to hit some golf balls, and my thoughts drifted. They started with gratitude (more on that in a bit) and floated over to speculation. I started wondering what would have happened if I didn’t end up in this career, in this life, working in Boston for the last 30 years. Would I still have ended up at a patient at Dana-Farber or someone else. And would another cancer center have done what Dana-Farber has done for me - and not to overstate it, but would I still be here.

The natural tendency, it seems to me, would be that the further I am away from my stem cell transplant, the more I’d take it for granted. The opposite is true. Today, I’m even more grateful for all the things I can do. The gratitude doesn’t fade, it builds. And, now, as I approach the two-year anniversary of my stem cell transplant, I have a decision to make.

Do I contact my anonymous donor or not? For the first two years after transplant, any contact with your stem cell donor is anonymized. You can reach out but anything that would identify you has to be left out. But at two years, that restriction is lifted. I can identify myself and the donor herself (all I know is that it was a 20-year old woman) has the same choice. We both would have to agree to identification for any direct contact to occur.

If you had asked me a year and a half ago, I would have quickly said that I would want to meet the donor whose stem cells saved my life. But as the two-year mark is upon me, I’m not so sure.

Either way, it’s just one more decision to make.