It is February 3, 2018, and tomorrow is my birthday. It is also now a national holiday. It didn’t used to be, but over the years, the Super Bowl has crept ever closer, and now it has finally arrived, stealing the spotlight and making my birthday somewhat of an inconvenience. I’m kind of bummed about it, but I also feel like there’s a lot to celebrate, because I am a big football fan. But I am an even bigger fan of my birthday, for obvious reasons. I mean, here I am, alive and kicking. But there was a time, quite recently, when that wasn’t such a foregone conclusion.

You see, I almost died last year.

It wasn’t pretty. It wasn’t fun. It wasn’t mystical. It wasn’t even inspiring. What it was, was a shock. It was a fight. It was terrifying. And it was the hardest thing I’ve ever done, and I thought I had done a lot of hard things.

Like wiping my father’s ass when he was dying of cancer. Like moving my mother back to Los Angeles when she was dying of cancer. Like sitting with my older sister during her treatment for two different kinds of cancer. Like beating ovarian cancer myself seven years ago.

Detecting a theme? But none of those experiences came close to what I did last year.

I had beaten cancer rather handily back in 2010. There were side effects from the chemo that took forever to overcome—chemo brain, neuropathy, fatigue—the usual suspects. But I was lucky; the cancer had been caught by surprise—by accident, really—very early, and unexpectedly, making treatment pretty straightforward. The cancer was removed, and chemotherapy was more precautionary, you might say.

People like to talk about cancer survivors having a new lease on life, a new or renewed sense of purpose, a desire to drink up the world as they relish every moment of time.

That didn’t happen to me. All I felt was guilt and grief and loss.

I pushed myself to get better, to “get back to it,” to return to my life. Instead, I ended up wanting to kill myself. I had just survived cancer, but felt I had nothing to live for. Not my wife, my siblings, my friends, my work—nothing.

I knew I had to change my thinking or I wasn’t going to make it, so I started practicing mindfulness meditation. I learned to look at things differently, to be kind to myself, and by extension, kinder to others, to appreciate being alive, even if just for a few brief moments at a time. Eventually, those few moments grew into hours, and then days, and then months, and finally, years. I found a rhythm and returned to the world, going blithely about the business of living.

When you’ve had cancer, five is the magic number. Supposedly. They say if you go five years without a recurrence, you’re good, you’re golden. At least, that’s what I had thought the five-year mark meant. Turns out I misunderstood. It just means that if you go five years without a recurrence, the doctors are “encouraged.” Not sure how encouraged anyone was by this recurrence. At six years, I suddenly had cancer again. Still ovarian cancer, only this time it was impressive; there were three inoperable tumors, growing very rapidly, where there had been none just a few months before.

I think the shock of it disconnected me from the gravity of the situation. I was in survival mode, and paradoxically, survival mode prevents you from fully grasping just how much danger you are in.

My instinct was so strong that I didn’t reconnect when a routine procedure turned into a hospitalization.

Or when the preferred course of chemo sent me into anaphylactic shock, twice. Or when my doctor said we had to try different chemo. Or when the new chemo caused immediate, permanent hearing damage. Or when I could no longer eat anything because everything I put in my mouth tasted like garbage. Or when they put a port in my arm to feed me the chemicals because my veins were too burned from the treatment. Or when I ended up in the hospital a second time because my immune system had disappeared.

This time they put me on a cancer ward in a quarantine room with an alarm on the bed that went off when I tried to get up. Wait, what?! What am I doing on the cancer ward? That’s for… people who are really sick… with cancer. I often hear people say that they won’t let their cancer define them. But how can it not? I would wake up every morning, and for just a brief moment, I’d forget.

But there was something bothering me, something hovering out here, and I’d think, “Wait a minute, there’s something wrong, something different. What is it?” And then I’d remember, and I’d have to say it out loud so it would stick, “Oh, yeah, I have cancer. I have fucking cancer. Again!”

My condition deteriorated with every round of chemo, while every rare side effect I experienced forced my oncologist to proceed with caution against a cancer that had thrown caution to the wind. My life had shrunk so much, even as the tumors had not shrunk enough.

Then came last year’s birthday.

By the time it rolled around, I’d been in treatment for six months, and was frightened of everything. The day before, I had had a crucial test to see how those pesky tumors were doing. I wasn’t going to get the results for several days, but I knew. I knew the tumors weren’t gone, and I was terrified. On the morning of my birthday, I curled up on the floor, paralyzed with fear. I still had cancer, and I realized there was a distinct possibility that it was going to kill me. I had finally, fully connected; I was in the fight of my life, the fight for my life, and I didn’t know if I was going to win it.

Do you read obituaries? I do. At least, I used to. They often state that the person died “after a courageous battle with cancer.” I never understood that. I never understood what there was to be courageous about. Going through treatment? Fighting for your life? Doesn’t everyone? Wouldn’t everyone? People would tell me how strong and brave I was, but I just couldn’t connect to that description; I was weak as a kitten and frightened as hell. Then one day my therapist told me the origin of the word courage. It comes from the Old French word for “heart.” And then I got it; courage means “strength of heart.” And I realized that I needed to find it in my heart to go on. Though my body might win or lose, my heart could not give up. That’s the courageous battle with cancer. Once I understood that, I set out to be fierce in this fight for my life. In the end, as you can see, I made it.

I survived the relieved smiles of those who needed to hear me say I was okay, the silence of friends who vanished when they heard the news, and the panic of others who could only see their own mortality.

And I survived with the help of countless compassionate professionals who wanted nothing more than for me to succeed, while suffering only what was necessary to do so, with the kindness of those who listened without comparing, with the generosity of those who gave despite the distance of time or place, and with the love and comfort of those who put their fear aside to hold mine at bay: my friends, my family, and my wife, for whom this was as terrifying a journey as it was for me.

So here I am, about to encounter another birthday. This time I don’t have to learn to appreciate the beauty inherent in being alive. I still have stress, and money problems, and aggravations, and frustrations, but I can tell you without hesitation, that these are beautiful problems to have because I am alive to have them. And I face every day now with a strength of heart I never knew I had.

It is now August 2018, and I am about to start round five of a six-round course of chemotherapy. I have had another recurrence. Not long after I wrote the story above, my tumor markers started to misbehave. In May 2018, we found out that the cancer was back. Not as bad this time. Luckily it was caught early, but still, it is back. I had been in remission only a year.

I will admit to being devasted. I will admit to losing that sense of strength and courage I described above. I will admit to feeling like I was a “dead woman walking,” especially when my doctor told me I could expect this pattern to repeat itself going forward. Recurrence, treatment, remission. Wash, rinse, repeat.

Through all of this, I’ve never been a “why me?” kind of person. I’ve never understood why people ask that question. But this time, I will admit to feeling like this wasn’t fair. I went through so much, and worked so hard to beat it last time. It had never occurred to me that I wasn’t done, that it might not have been the last time, that there might not ever be a last time, until there is.

I spent about a week feeling demoralized, depressed, angry and defeated. I felt pretty sorry for myself. Then something happened. A switch flipped, and I don’t know why or how. Maybe it was the newfound resilience of my courageous heart. Maybe it was the mindfulness practice that taught me to appreciate what is, rather than ache for what isn’t. Maybe it was just my desire to live. Either way, I just thought “Okay, here we go. Let’s get on with it.” So here I am, once again, fighting for my life. This time it’s easier, physically. The cancer is smaller, the chemo less harsh, but it is no less daunting a task to keep myself going, to remain present, and to plan for the future when the future likely involves more go-arounds with the beast. It’s getting tougher keeping this body alive, and at some point, I won’t want to do it anymore. I know those words will put my wife over the edge and I don’t want to scare her. I am not alone on this ride. We are in this together and I am grateful for that, even though it is so hard for her to watch.

I don’t know how to conclude this. Probably because there is no conclusion, until there is. I do know that I am still adjusting to this new normal, and that I will find a way to keep going, until I can’t. That I will find meaning in what there is to buoy me along—the love of my family and friends, the charge of creative self-expression, the contentment of a good book, the purring of my cats. Not to be trite, but I have come to understand that life is what one makes of it. Learning that has been the best present I ever gave myself.

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