Florence is one of my favorite places on Earth. No doubt, this is because when I studied abroad there (4th year at JMU), I happened to have several lifelong friends along for the ride (that’s you Z, Mase, and Nels) and met another while there (that’s you Ray). I’d only been out of the country twice in my life up to that point: the first, when our entire family moved to Guatemala City in 1974 (not a great experience); the second, a short trip to Bermuda, of all places, in the 3rd grade—if I recall correctly, my dad had won some award from the company he worked for. Florence at age 21 was nothing short of magical … I was old enough to appreciate where I was, but young enough to have the curiosity throttle wide open. What better place to unleash a full tank of wanderlust than the home of the Renaissance and the old stomping grounds of Leonardo Da Vinci, Michelangelo, Dante, Galileo, and the Medici fam? It was the kind of experience that infiltrates your dreams for the rest of your life—it’s no coincidence that Florence has found its way into every piece of fiction I’ve ever written.
Favorite memories of Florence? Too many to count. But one image that’s stuck in my brain over the years is that of Giotto’s Campanile, the bell tower that’s a part of the Duomo, the iconic cathedral complex that dominates the Florence skyline. We used to walk by the Duomo daily, on our way to classes at the British Institute of Studies. We’d often take a different path returning to our apartment building after class, so we could hang out at the Boboli Gardens or swing by a random (and rare) outdoor basketball court we’d stumbled onto. Hooping it up with the locals … good times.
Of course, there are bell towers all over Italy. Another one of my favorites is in Fiesole, the tiny, ancient, hilltop town that overlooks Florence—love that place. The weird thing is, I don’t actually remember ever hearing the bells of the Campanile, those in Fiesole, or any other bell towers in Italy, either in the spring of 1991, or during any of my return visits since. I know the Campanile bells ring a few times a day, and I’m quite sure I’ve heard them at some point, but I have no memories of the sound.
Sticking with the bells theme … a few of my favorite quotes have bells at their center … there’s John Donne’s Meditation 17, of course, where the 16th/17th century poet contemplates the fact that no man is an island, and what happens to one of us happens, in some small way, to all of us:
… I am involved in mankind, and therefore never send to know for whom the bell tolls; it tolls for thee
And of course, there’s the classic from our favorite philosopher/boxer, Rocky Balboa:
… if I can go that distance, see, if that bell rings and I’m still standin’, I’m gonna know for the first time in my life, you see, that I weren’t just another bum from the neighborhood.
Why in the hell am I writing about bells, you ask? Well, there’s one type in particular that has, off-and-on, loomed large for me over the past few years. The cancer bell. I wonder how many people know what this is … is this something everyone’s familiar with, or no one outside of cancer patients and their loved ones? For the record, a cancer bell is a ceremonious bell you’ll find in just about every cancer chemo infusion center, radiation center, etc. The idea is, when you finish treatment, you ring the bell, often with loved ones and a gaggle of nurses or doctors standing around cheering you on. It’s pretty cool. I’ve seen a lot of people ring the bell over the years. Just a week or two ago, an older fella came out of radiation while I was waiting on-deck, and I grabbed his phone and took pictures of him ringing the hell out of the bell (but not before he mansplained to a bunch of nurses the history of ship bell protocol—I think he’d been in the Navy years ago). Anyway, he told me they’d caught his prostate cancer in time, he was in the clear, and that he still had a lot of fishing and shooting guns to do. Brutal honesty: I used to get a little pissed when I’d watch someone ring the bell, because I feared I’d never be “in the clear,” myself, but it didn’t take long to get over that. Now, I’m happy for my brothers and sisters in arms who make it out—whose tour of duty ends—and I was happy for this guy and hopeful he’d get a line in the water soon enough.
As you can probably guess by now, I’ve never rang a cancer bell. I’ve been encouraged to, whenever I’ve finished a defined period of treatment, but I can never bring myself to touch them. I don’t want to ring a bell after 10 straight days of radiation to my shoulder, when I know I’m just gonna be back in there starting radiation on my other shoulder the following week. I have it in my head that I won’t grab that rope until I’m somehow cured or in a true remission (meaning the cancer is eradicated for the time being or at least completely stable without any further treatment). This is possible, but maybe not likely. Understand I’m one of those hopelessly optimistic, yet undeniably pragmatic types. It is, as they say, what it is. That’s okay. I don’t ever have to ring the bell, as long as I can get many more years of just looking at it and taking pictures for others as they celebrate.
Speaking of tours of duty, I guess you’d say I’ve been on a short leave recently … two weeks off without any treatment. I’ve been in some form of treatment, chemo or radiation, just about every weekday for the past 5 ½ months straight—actually, looking at my schedule, I don’t think I’ve had more than a week off going all the way back to February of 2024 … so about fourteen months. Since my last post, we’ve radiated my liver, a few more ribs, a lung lining tumor, both shoulders, both arms down to the elbows, and a shoulder blade, squeezing in chemo whenever we could.
In the meantime, we’ve had a twist in our story … when they biopsied my liver up in NYC recently, the pathology report came back with markers for thymic carcinoma. Now, I know this stuff is hard to keep track of, but you may recall I’ve always been diagnosed with thymoma type-A. On the spectrum of thymic cancers, thymoma type-A is the best to have, thymic carcinoma is the worst. With that being said, that path report was a bit of a punch in the gut. But here’s the thing: we’ve been taking consolation in having type-A for 4 ½ years, but my cancer’s never exactly behaved like type-A, which is supposed to be very, very slow-growing and not supposed to spread anywhere. By the time I was diagnosed back in 2020, my cancer had already spread all through my chest wall, lungs, and into my bones. So, although it’s been nice to say I have type-A, and some of my cancer has indeed progressed very slowly, the reality is that other tumors have behaved a lot more like thymic carcinoma, all along. We’re currently having a bunch more tests done to the biopsy sample to see if we can get a more accurate diagnosis and to see if there are any biological “targets” we can go after with treatment. Do I have a mix of different types of thymic cancer? Has my cancer evolved from one thing to another? Was I misdiagnosed to begin with? Who the hell knows, but we’re trying to get to the bottom of it. Punch gut aside, drilling down on my diagnosis may lead to us stumbling onto more effective treatment, and one advantage of having thymic carcinoma versus thymoma, is immunotherapy may be back on the table (thymoma and immunotherapy are a toxic mix, but immunotherapy isn’t as dangerous when treating thymic carcinoma).
In the end, whatever you want to call my cancer, it really all comes down to two things: what the scans show, and how I feel. How do I feel? Admittedly, not great all the time. I think this is less because of the cancer itself (besides a few bone issues) and more because of the side effects of treatment. Chemo is comically toxic, of course, and radiation destroys muscle, soft tissue, etc. etc. etc., along with tumors. If I could just get a decent break from treatment—like a few months—I think I’d be able to reasonably recover. As for the scans? Well, I just had a head-to-toe PET-CT two weeks ago, and honestly, it was one of the best scans I’ve had. All the tumors in my lungs have remained pretty stable, and the tumors in my liver, lungs, and most of all, bones, that we’ve radiated, have responded very well (as in they’re dead, shrinking, or neutralized). Hence the short leave I’ve been granted. I re-start chemo today, but I’ve had the past couple weeks off.
There’s a sequence of scenes in what might be the best episode (“Crossroads”) of the phenomenal series Band of Brothers, where our hero, Easy Company’s Major Dick Winters, is forced by a superior to take a 48-hour leave and go to Paris. When he gets there, we see Winters eating alone at a café, riding a train, walking the dark streets. All the while, he’s flashbacking to a particularly tough experience he recently had in combat. You get the picture: he’s finding it hard to process going from combat to “normal” life, especially knowing he’s going right back into combat in just a few short days. I’ve had a sense of that, myself. My scan was good. I’m thrilled, in fact. And, after even just two weeks or so out of treatment, I’m already feeling a bit better. One of my doctors told me not to fall down or get in an accident (solid advice for all humans, in my opinion) until my arms and shoulders recover some from the radiation, but a few days ago I broke out the chainsaw and started cutting tree limbs … probably one of the best times I’ve had in months! But this little break I’ve been on has been weird … and confusing. Mentally, I haven’t wanted to let my guard down—it’s been hard to disengage from what’s been my primary job for months, just enduring treatment. As much as I’ve enjoyed this time (a shout out to God for blessing me with it!), I know there’s more work to do if I’m ever gonna have a shot at ringing that bell and not being just “another bum from the neighborhood.”
With any luck, over the next few months, we’ll dial in on a more effective systemic treatment, whether it’s another form of chemo or immunotherapy, and, now that we’ve “caught up” on all the places that needed radiation, we’ll stay on top of things and just pick things off as they come up. In the meantime, I’m still eyeing that comeback (I don’t want to say what it is, less I sound hopelessly unrealistic), making some travel plans, and writing. I’m having a great time on that last front. All Good Quests was awarded the “Guaranteed Development Prize” by a Hollywood producer in some random prose contest I stuck it in last year. The odds of the novel ever being turned into a movie or Netflix series? I’d honestly say about 1 in 5,000. In fact, not much has happened since the award except the trading of a few emails and the production company sending me coverage notes, but it’s fun to think about, anyway. And, three years after publishing, we finally put a little marketing behind the book, and sales have actually been pretty decent—I’m quite a ways off, but I think getting to my “mid-list” goal of 5,000 copies sold somewhere down the road is reasonable. I have a second novel coming out later this year … The Short, Happy Life of Cob Logan. I finished the first draft of that one way back in 2002! I’m working on final structural edits now, then it’ll go off to the copy editor, proofreader, and cover designer—hopefully it’ll be in print by late summer or early fall. I’m also about half-way through a screenplay trilogy that I then plan on converting into three novels, and I have four other books currently in the “thinking through” stage. Basically, after a lifetime of talking about writing, I’m having a blast actually getting after it.
Until next time, God bless all of you, and thank you for the continued support and prayers. If/when I ever get to pull that bell rope, you can be sure every last one of you will be invited …
Peace out!
Joe