Update GARTH CALLAGHAN I have something to share. I'm not even sure how to say it. I don't feel like I can say again. I have new cancer. We've been tracking a growth that I've had in my lungs for a number of years that has never changed. We thought it could be a small amount of scar tissue from an illness as a child. A couple of weeks ago I had a routine scan and that growth has doubled in size. I've spent the last couple of weeks with surgeons and specialists and my medical team trying to figure out what this is and what it means. I think we've decided that we're not going to do anything. Statistically speaking, my survivability does not go up by cutting this out. Four years ago I was told people with metastatic kidney cancer have a median life span of 12 months. Based on the growth rate that we were seeing, we knew that there would be a problem managing it. Fortunately, I'm one of the lucky few in that my body responded really well to the treatment program. My daughter Emma is graduating from high school in a couple of weeks and I didn't expect to be here. When initially diagnosed with a serious chronic illness like cancer, people take a while to process all of the emotions. I've already had to do that three or four JOHN WADSWORTH Garth Callaghan was featured in Volume II of Art of Dying. You can read his Observations at www.artofdyingmagazine.com times. This time, it was like, okay, let me get really angry for a couple of minutes and then I'm going to get really sad for a couple of minutes and then I'm going to be ambivalent for a couple of minutes and then I'm going to be curious for a couple of minutes. It was just churning and churning and churning. It's weird because I haven't thought about this in a while, but I remember when I was first diagnosed with prostate cancer and it took us six or eight months to get to the point where we decided we weren't going to treat it, that we were just going to watch it. Even with my next occurrence of kidney cancer, when it spread to my liver, although we were treating it with an oral chemo, we weren't cutting it out. I had to get used to that feeling of waking up and knowing that there's cancer in my body. To be honest, I haven't thought about it for a while, and now I have to start thinking about it again. Because of cancer, I have a current role. Because of cancer, I have an advanced medical directive. Because of cancer, I have a trust. Because of cancer my wife carries the power of attorney and my advanced medical directive in her car’s glove box. If at this moment I had to be rushed to the hospital she would meet me there with my paperwork. We also carry her advanced medical directive in our glove boxes. We know that life is fragile. Do I see the specter of death waiting for me? That answer is no. But I think about death, sure. I don't think it's happening today, but I see it on my timeline. I have a difficult time picturing my life three years in the future. I can see the next year, even two years, but after that my future is really cloudy. I can't see that far out anymore. Over the first few years of being diagnosed with cancer over and over again, I didn't see far out at all. That's why I wrote that big box of 42 | ART OF DYING Napkin Notes. I didn't think I was going to make it.