Almost three months in, 2015 is at last starting to feel like a new year. I think that’s because 2014, for me, still feels as though it begin last April, a month that was the culmination of a journey that I began in 2013.
2013 was an intense period of transition, new projects and new graphics research. By the time summer arrived, I was working extra long days, obsessed with new ideas for games, procedural worlds and some deliciously math-heavy work for a client. Summer brought along some punishing trail runs, too — extra hot, very dry, and I was loving every minute of it.
Near the end of that summer, I developed a prostate infection — my first and only case of prostatitis. I learned that it was not uncommon, and after a visit to the Urologist and a couple of rounds of antibiotics, it was gone. However, my PSA, which was a bit high during the infection (not uncommon either), did not return to normal. This led to a Digital Rectal Exam, which was normal, a cystoscopy (normal) and a prostate biopsy in January. The biopsy, to my utter surprise, was not normal, revealing prostate cancer.
You never really think you’ll hear the words you have cancer and, predictably, the moments that follow are impossibly immobile. Sitting in the doctor’s office, holding my wife Kahty’s [sic] hand, I was in a singular state of frozen shock (my Urologist at one point actually said, “you’re obviously in shock right now”). But there was good with the bad: it was early stage (though not early enough for active surveillance), no palpable tumor, not terribly aggressive morphology and an optimistic prognosis due to my age and health.
I wasn’t unfamiliar with prostate cancer. My dad had been treated successfully for it just a few years ago, opting for radiation, while a few years earlier my father-in-law, with a family history of long-life, exceptional health for his age, and as a retired surgeon who was very comfortable with surgery, had a successful prostatectomy. Both of them are much older than me — it was awful, but not a complete shock, when they were diagnosed. Prostate cancer is not unusual in older men, and many men will eventually die with it but not from it.
It’s more unusual for a man in his 40’s — in this case, me — but certainly not unheard of. There is no definitive research on the cause. As a life-long runner I was in good shape and had never had a problem “down there” (other than the prostatitis, which was more annoying than alarming). I knew that I’d need to add a PSA test to my regular checkups soon, and that I was in a higher risk category because of my father’s diagnosis (though interestingly, according to my 23andme workup, genetically I was lower-risk), but I hadn’t thought too much about it. (Looking back on it now, I may have benefited from having my PSA checked earlier, since it might have led to even earlier detection).
Three months later, after interviews with surgeons and tons of research (this book is required, as is this forum, and this, and this), Kahty and I found ourselves on a two-week “holiday” in Duarte, California at City of Hope. After checking into the hotel where I would subsequently recover for ten days after surgery, two days later we arrived at my real destination: three hours of anesthetic oblivion, my body stretched out and rotated, feet-up, on an eight-foot table, six robotic arms inside my abdomen.
My doctor, Dr. Timothy Wilson — one of the top RALP surgeons on the west coast — did an incredible job removing my prostate. My physical recovery has been better than textbook. Common side effects (decreased bladder control and ED) have essentially been non-issues. Nearby lymph nodes removed during the procedure showed no signs of metastasis, nor did the surrounding tissues; the cancer was confined to the prostate. Since the surgery, I have seen my PSA rise slightly and I will receive adjuvant radiation to cement the cure, in fact I’ll be participating in a treatment study at City of Hope, led by Dr. Sagus Sampath, a passionate Radiation Oncologist who is devising better and faster ways to treat prostate cancer with radiation. My statistical probability of a cancer-free future is good, and I remain in good health.
Emotionally the story is not quite textbook — or maybe it is — to say it’s been a roller coaster doesn’t really capture it. On the heels of the Kineplay service dying a quick death in 2013 and a short bout of depression unlike anything I’d ever experienced, my cancer diagnosis was an insult-to-injury, kick-me-while-I’m-down sort of affair. These things never have good timing.
When we started Kineplay I thought that the path before us was solid. I’d spent a lot of time in startups and intimately understood the milieu. I knew we were in for a ride but I was confident it was balanced and well-designed: Every low would have a high and the highs would be thrilling. But the plain and simple truth is that, like so many others before me, I failed to make it happen. I have plenty of buts:
But we were remarkable. We had the experience, drive, passion and technical chops. We had a solid network with great connections. We received nice early press and credible encouragement from colleagues and friends. We launched our first product in six months when it would have taken just about any other team I know twice as long with double the team. Our demos were killer.
But we were motivated. Our core relied on content in addition to service and we moved into content too quickly. We trusted potential partners too easily — the industry is seriously cutthroat and we knew that all too well, but we couldn’t get the wishful out of our thinking. We were mesmerized by our own bullshit.
But the industry changed. We had a front-row seat to the changes that the video game industry was going through, but clung to our comfort zone (traditional game design) as a core piece of a non-traditional product (mobile game discovery) in an overwhelmingly non-traditional, short-dev-cycle, massively hit-driven market.
But we were early. It’s a line I’ve heard frequently from other failed startups. In our case it really was true: We had a product and service that nobody knew they wanted. They still don’t.
But we were under-capitalized. The product was too big for us to bootstrap on our own but we thought we would get lucky. We became classic victims of our own over-optimism and by the time we understood that, the industry had pivoted and we were out of funding.
When we knew that Kineplay wasn’t going to live up to the dream, I had a moment not unlike that dreaded day in the Urologist’s office — time stands still when you’re deep into the realization that you have failed spectacularly.
So much has been written about failure, especially with startups and often by others who have failed big but have had subsequent successes. Everybody loves a happy ending, especially when it happens to them. And it’s all too human to be drawn to the drama of failure — as long as it doesn’t happen to us.
Nothing can prepare you for failing to make a powerful dream come true. Such a failure is something you don’t ever forget, not really — there is always a sense of your own lost potential, real or imagined. And cancer, or any condition that has the potential to extinguish your own natural expectation of health and strength, is much more frightening because it waves the biggest failure of all — mortality — in front of you with abandon.
2014 might have found me somewhere near the summit of three of the most intense and happy years of my life — instead it was more like a horrifyingly real MacGuffin, an anti-climatic last scene where the main character’s fate takes a nose-dive instead of arcing toward resolution. It was a year of long, dark tea-times replete with sleepless, soul-crushing nights punctuated by solitary days that swung from meditative to manic on a whim. It was a year of coping with mortality in the most non-academic of ways.
But like Dirk Gently, I may not have gone where I intended to go, but I think I have ended up where I needed to be. Kahty was there for me every step of the way — I don’t know where I’d be today without her — as were our families and friends. And for the first time in my life, I grokked what it must be like for others who have real depression as I experienced, at times, little control over my own thoughts and feelings.
Even more, I possess an empathy now that is difficult to articulate. It’s made profound when I see others suffering, from the all-too-frequent images these days of economically-deprived and oppressed cultures, to the homeless fellow on the street, to the elderly woman using a cart to get around the store, to the countless other patients at City of Hope who have been through debilitating physical trauma in their very personal battles with cancer. But it’s just as perceptible when I listen — really listen — to my friends and family. Life is hard on some level for everyone — no one is exempt from suffering.
The road leading up to today has been a gradual transformation into a new narrative where I’m reconnecting with myself and those I love, re-evaluating the importance of good work and purposeful and mindful living. I’m looking in directions I had not previously noticed. I’m still a self-absorbed person — sometimes to the point of arrogance — and my obsession with computer graphics and games has not changed. I still have a fire in my gut to make things that are beautiful, functional and valuable to others. I’m still focused on achieving something meaningful. I still believe deeply in the importance of play and fun.
But I’m seeing more and more clearly the inestimable value of how suffering threads itself into the fabric of being human, and I have a strong sense that I’ve been taught something big, that I’ve leveled up. I’m humbly starting to take stock of what I’ve learned.
A few final words: if you’re over 40, or if you’re in a high risk category, insist on a PSA test with your annual checkup. If caught early, prostate cancer is very, very treatable. If you’ve been diagnosed with prostate cancer, listen up:
Be the CEO of your condition. It’s up to you to lead the charge and assemble the best team you can find to treat you. Don’t stop educating yourself — read everything you can and connect with others, online and especially in-person, who are going through the same thing.
Realize the value of trusting your team — there is not enough time for you to know what they know. This is especially hard to do if you’re an engineer or someone who is a deep problem-solver by nature, but it’s critical that you trust and accept your team that you assembled.
No matter how bad you think things are, it can be worse, and it is worse, right now, for far more people than you will ever know. Try not to obsess over what you may lose; consider the possibility that you will gain something valuable.
Contemplate the idea that you will end up where you need to be. Don’t think of this as woo-woo, think of it as accepting the outcome of the moment you set your team in motion.
Try to have a sense of humor. I’ll never forget the laughter when, just before surgery, I asked for a different IV — something in a “gluten-free organic”. We’re all human, and the work that your team does is serious, complex stuff. Your attitude makes all the difference and gives them the confidence they need to do their best.