Hello friends. Below, an essay from Garrett Kamps, editor of Healings. Garrett last wrote for TSB about cancer remission and the poet and activist Andrea Gibson. Today, he wonders how close to death he came while undergoing chemotherapy — and if that kind of quantification matters.
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A Game of Inches
by Garrett Kamps
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Lately I’ve been thinking back on the time we called 911. I’ve been thinking about it because a friend of mine was recently diagnosed with throat cancer. His dentist was the one who caught it — the growth — corroborating his worst fears about a tickle he felt when he swallowed. And so: CT scans, biopsies, diagnosis, treatment plan. We’ve been checking in throughout the process. I’ve tried my best to be supportive without sounding too much like the annoying guy who’s been through the cancer wringer twice now, which for me is admittedly hard, a character defect, in the parlance of recovery: Instead of just listening and showing support, I’m always so fucking eager to show off my hard won knowledge, thinking it’ll win me someone’s approval (I’m about to do it again, right now).
So here’s what I’ve been thinking about: How close did I actually come to actually dying? There’s that expression: He came within an inch of his life. Was my 911 episode an inch? A millimeter? Half a mile?
Here are (some of) the facts: I had my first chemo treatment on a Tuesday. Just less than two weeks later, on a Sunday — which I remember because it was the penultimate episode of Succession — I felt what can only be described as my life force draining from me. Over the course of the previous 12 days, the side effects from chemo had taken a particularly harsh and statistically aberrational toll, snowballing into total bodily collapse. Chemical balances we all take for granted went out of whack (low potassium can kill you!). I couldn’t sleep, couldn’t eat, couldn’t even walk to the bathroom, which I needed to use constantly, for all the worst reasons.
Finally on that Sunday evening, I was sitting on the couch trying to concentrate on this or that Roy sibling monologue, and I realized it was as if I was looking out the wrong end of a telescope. The world was literally receding. That’s when I told my wife to call an ambulance. Firetrucks materialized; large boots appeared on our rug. I was the guy getting wheeled out on a gurney, lit up by sirens, my neighbors looking concerned out their window.
I spent most of the next 24 hours in the ER; there was debate as to whether I should be transferred to the ICU, but they got me stabilized and I ended up on the floor just below it, IVs in both arms, closely monitored and coaxed back to life over the next three days.
So then: How close did I get to dying? Certainly closer than your average Sunday prestige cable viewing session, but how about compared to, say, a gunshot victim? Or like, there was that guy Damar Hamlin on the Buffalo Bills, who went into cardiac arrest mid-play, right there on the field. I’m not even a football fan but I happened to be watching that game live, as it unfolded — there was a sense that millions of us had just watched someone die on live TV, and then thankfully it turned out he was OK. How close did he get?
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As far as I can tell, there’s no single “proximity to death” measurement that exists to answer this question. There are various trauma scoring systems that hospitals use for triage and assessment purposes. There are different systems for determining whether someone should be admitted to the ICU, and then for measuring how likely they are to die once they’re there (as in: APACHE). There are, in other words, a fairly robust set of diagnostic criteria health workers use to figure out how fucked up someone is.
And so presumably there are some records or notes somewhere in my file at Huntington Hospital that correspond to one or a combination of these criteria. I remember there was this ER doctor who examined me when I first arrived, real nice guy, good at small talk, put us more at ease, at least relatively speaking. Presumably this guy made a determination and wrote it down.
So let’s just say, for argument’s sake, that we have a scale from one to ten, where ten is You Died and one is you watched the entire episode of Succession blissfully unaware of your own mortality. And let’s say that based on both an extensively peer-reviewed clinical scoring system and this nice doctor’s seasoned judgement, I was given some kind of score — not high enough for the ICU, but sufficient to nevertheless be hospitalized and administered to by a team of specialists big enough to field an intramural basketball squad. How close is all that to dying?
And then what about having cancer generally? This is much trickier. I had testicular cancer back in 2012, and while the experience was harrowing and body parts were removed, the cancer never spread, and the whole thing was over relatively quickly, like about two months maybe—so what’s that, like a 6.5? Non-Hodgkins lymphoma, the cancer I had in 2023, is among the more treatable cancers, as compared to varieties like pancreatic and brain cancer, versions of which are basically death sentences. It was the side effects of the chemo that nearly killed me, in a very acute and specific way, but that 911 experience, which happened right at the outset, cast a deathly shadow over the entire treatment process, which lasted six months but got easier over time.
Even after my doctor told me I was in remission, and I started putting on weight again and growing my hair back, I carried with me this faint but unmistakable sense that death was now proximate in a way it hadn’t been previously. We actually just passed the two-year anniversary of that declaration of remission. The feeling’s never gone away. I don’t expect it ever will.
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When it comes to proximity to death, some of it can be measured objectively, scientifically, and some of it — actually a lot of it, I’d argue — is just how you feel about it, and in turn what you do about it.
Because keep in mind: I’ve been discussing cancer and hospitalization this whole time, but the statistical reality is that we come within a certain proximity to dying every day, and mostly never think about it. I don’t say this to make you fearful or paranoid. All I’m saying is: If such a proximity scale existed like the one I describe above, with nine being you’re in the ICU, or your heart stops on a football field, then there are different examples and use cases all on down the scale. The other day, a truck ran through a yellow light as I was trying to turn left, and I slammed the brakes at the last minute — was that a five? A three?
You hear it all the time: A brush with death often causes people to change something about their lives. They become open in a way they weren’t previously. Nearly dying from alcohol withdrawals (or, crucially: believing I was nearly dying) was what finally led to me getting sober. Nearly dying from cancer led to a spiritual awakening I’m still processing, and to making a big life change as a result. If I had to guess, I’d say something like a seven, on our hypothetical scale, is what it would take for me to contemplate and maybe make a big change.
Maybe think about it, maybe ask yourself: What’s your number? How close do you have to get to dying for it to change your life?
And think about this, too: What exactly is the difference between a seven or a five or a three? What’s the difference between nearly dying and simply believing that you nearly died, when maybe you didn’t even come that close? What are the implications of all the times you might have nearly died but never even realized it. What’s the difference between all of these? I’m honestly curious, and a bit vexed. Because consider that in each case, the outcome is the same: You didn’t die. You’re still here. For now.
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Selfishly, I wish Garrett wrote more these days.