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“What does it mean?” he asked when I saw him in my office the following day. “The cancer hasn’t come back, has it?”

“I hope not, but it’s possible,” I answered evasively. “I’m going to send you back to the cancer clinic. They’ll run some more tests and then do a biopsy.”

The scans confirmed our worst fear – the spot on his lung looked cancerous. No other traces of malignancy were found, though. The chest surgeon was hopeful the lesion was a new primary rather than a metastasis. If it had arisen de novo, removing it could be curative. If it turned out to be a metastatic subsidiary of the original cancer, his long-term prognosis would be abysmal.

Max’s lung surgery was uneventful. A month later he was back in my office to review his pathology results.

“Did they get it all?”

“It looks that way, judging by the reports.”

“Was it related to the first cancer, or was this one brand new?” His voice quavered slightly.

“They’re not sure – the pathology findings were inconclusive.”

“How could I have gotten lung cancer, doc? I never smoked a day in my life!”

“Well, every once in a while a non-smoker gets lung cancer. Just bad luck, I guess.”

“What happens next?”

“Chemotherapy.”

The chemo left Max weak and hairless, but he didn’t care. Anything to reduce the chances of a recurrence.

Six months later an abdominal ultrasound picked up a new lesion on his liver. Max nearly cried when I told him.

“What do we do now?” he asked. I sent him back to the cancer treatment centre. The chemo regimen he was given failed. So did the next one. After the third failure I tried to gently broach the topic of terminal cancer and palliative care, but he recoiled. “I don’t want to know how long I’ve got. I’m not ready to die yet.”

Max has undergone many more chemo and radiation treatments. Each successive scan shows more lesions than the one before.

My patient now weighs about 90 pounds. We’ve run out of treatments to offer. Although his emaciated body is riddled with cancer and his candle is slowly guttering, he’s still not yet ready to talk about dying.

I don’t think he ever will be.

Shotgun Bubba

“My husband and I are worried about Bubba. He’s been acting really weird lately and we think his schizophrenia might be getting out of control. He’s got this idea there are people hiding in the attic and they’re plotting to kill him.”

“Gee, that’s too bad. We may have to increase his antipsychotic medication.”

“Thanks, doc. Things have gotten so out of hand Bubba’s even refusing to go outside because he’s worried he’ll get kidnapped.”

“That sounds pretty paranoid. Is he saying or doing anything that makes you feel nervous or unsafe in any way?”

“No, nothing like that.”

“Are you sure?”

“Well, come to think of it, a couple of nights ago I was sitting on the toilet in the middle of the night when all of a sudden the bathroom door banged open and there he was with a shotgun in his hands!”

“A shotgun?

“Yeah.”

“Was it loaded?

“Oh yes, we always keep our guns loaded. Sometimes we get bears on our property.”

“Good grief!”

“Since then he’s taken to walking around the house with the shotgun all the time. He says he’s seeing spooky faces in the windows and holding a gun makes him feel safer.”

“Your paranoid, psychotic and hallucinating brother is patrolling your house night and day with a loaded shotgun and that doesn’t worry you?”

“Why should we worry? He never points it at us.”

Disneyfied

Little Tiffany’s dad has brought her in for her four-month well-baby check. She’s been healthy and so far everything looks normal. While I’m examining her eyes I ask her father: “Do you have any concerns about her vision?”

“No doc, as far as we know, her eyes are fine.”

“That’s good,” I reply.

“And she sure loves her Disney!”

“What?”

“Disney movies, doc. The cartoon ones! She just loves them!”

“She watches Disney movies?”

“Yeah, she can’t get enough of them!”

“But she’s only four months old! How long has she been watching television?”

“Oh, since she was about a month and a half. We put the TV right up beside her crib and prop her up on a pillow. Sometimes she’ll watch an entire movie! You should see her smile!”

“Um, several studies have suggested it’s better for kids to not watch television until they’re at least a year old.”

“Those guys don’t know what they’re talking about.”

Slippage

Things are slipping. It’s a steady, relentless process. Every day another inappropriate behaviour crawls out from under a rock and suns itself in plain view. What’s going on? And where will it end?

Not that long ago even the snarkiest adolescent would at least have made a token effort to not swear within earshot of an adult. My, how times have changed. Some of the language you hear from kids nowadays is harsh enough to make your ears bleed. More than once I’ve had to hastily round up my children and flee a playground in order to escape the profane chatter exploding all around us. I’m not just talking about the odd expletive being lobbed around. That doesn’t even make me blink anymore. No, I’m talking about the air being saturated with verbal shrapnel from continuous f-bombing. It’s like a sonic blitzkrieg. I’m no choirboy, but I’ve got my limits.

Where are kids learning such extreme language? Everywhere. Reality television, ultraviolent video games, laxly-censored movies, gangsta rap, shock radio… . The vulgarity envelope gets pushed a little further every day. You don’t have to be a nuclear physicist to recognize the linear relationship between unsupervised access to certain media and Potty Mouth Syndrome.

To make matters worse, there doesn’t appear to be a lower age limit to this worrisome phenomenon. Last fall Ellen started grade four. One day she was helping out in a kindergarten classroom at lunchtime. One of the littluns she was in charge of made a mess and casually strolled away from it. When Ellen reminded him to clean up, he glared at her and told her to f**k off. What’s next, fetuses cursing in utero?

Generation Z also seems to have no qualms about littering. It’s hard to believe the amount of garbage strewn around some playgrounds and schoolyards. The same can be said about the routes along which kids walk to get to school. The elderly widow across the street from us allows neighbourhood kids to cut through her yard on their way to and from school. How is her kindness repaid? Every day her property gets littered with empty pop cans and junk food debris. I’m surprised she doesn’t complain. Maybe she’s afraid to.

Our daughters get frustrated whenever they see people litter. Once Alanna asked a classmate why he dumps his trash on the playground every recess. His reply? “Someone else will pick it up.” I shouldn’t demonize kids who litter, though. Children learn through instruction and observation. A few months ago I went to the washroom at a movie theatre. A little boy and his father were standing in front of the urinals. The boy was holding a Kleenex. Try as he might, he just couldn’t manage to unzip his pants while maintaining his grip on the tissue paper. Eventually he asked his dad for help. “Just drop it on the floor,” his father advised. The boy complied. It was still on the floor when they left.

Recently I was waiting for a bus in Toronto when a pack of pre-teen girls carrying bags of McFood emerged from the subway. They leaned against a nearby retaining wall and proceeded to wolf down their pink-slime burgers. Despite the presence of a large garbage can a few feet away they all threw their leftover food, condiments and cups on the sidewalk. Partway through their feast the city worker responsible for keeping the area clean came by and swept up the mess. As soon as he was out of sight they tossed the rest of their garbage on the sidewalk and howled with laughter.