CHAPTER ONE: “WE GOTTA TAKE YOUR LUNG”

Fat raindrops slid down my window, beyond my computer’s glowing screen. I’d been paying only half attention to the talking head on Zoom, a thoracic surgeon I’d never met before this call. I struggled to maintain eye contact during the first few minutes of casual chitchat and the usual pleasantries. The storm kept distracting me, and my mind wandered to how this unfortunate weather would derail my plans for the day. Then my entire world irrevocably changed with a single statement:

“We gotta take your lung,” he said casually.

His dire words snapped me into the moment. My vision blurred as the surgeon politely tried to assure me I could live a normal life with a single lung. I froze, speechless. Finally, fury took over, and I responded in a raised voice, cracking with emotion.

 “What does that even mean? Regular life? That I can walk? That I can talk? I don’t want a regular life! I want the life I have! I want to ride my bike and surf! And I want to do those things every day!”

Could anything be more immediate and essential to life than breathing? Struck by this reality, I noticed my elevated heart rate and rapid, shallow breaths. Sheer panic replaced self-control. How could I possibly remain active and healthy with a single lung?

It felt especially cruel that this misfortune should happen to me, a 41-year-old who, until very recently, had been the picture of health. I took great pride in my focus on fitness; I was a vegetarian, never smoked, and rarely drank. I had done everything right and enjoyed an active life as a dedicated husband, a caring father to a young child, and a bike-industry executive who competed with pro riders on weekends. I lived in the coastal paradise of Santa Cruz, California, where I could prioritize year-round exercise. Even in my health-conscious hometown, most of my friends said I was the “healthiest guy they knew.” Like many others in our culture, I believed my responsible choices would protect me from unforeseen illness.

I’d spent the previous spring and summer on “funemployment” after a sweeping round of corporate layoffs from my longtime employer. I quickly filled that downtime with surfing, hiking, and long bike rides. Sometimes I’d pack all three into the same day. Looking back, six months of intermittent chest pain warned of something deeply wrong. But I attributed the pain to crashing and injuring my ribs multiple times over the years and did what we all do: I ignored it. I took Advil and moved on. At the end of summer, I’d started an exciting new job with a heavy workload. Colleagues may have noticed my persistent cough, but I ignored that, and my chest pain, even as it kept me up at night.

On the day of a friend’s funeral, I finally confronted my illness, but not for the reasons you might expect; my own mortality still felt as distant as the moon. That afternoon, I joined my friends Jason and Wendy for a casual mountain bike ride. They expected me to be unstoppably fit after months of nonstop exercise, yet I struggled behind them, coughing, wheezing, and gasping. Perhaps cancer was on Wendy’s mind—she’d been at the same memorial, and our friend had died of the disease—she found my avoidance unacceptable.

“What the fuck are you doing?” Wendy asked. “Promise me you’ll see a doctor and get a chest X-ray immediately.” 

Two days later, my primary care doctor reviewed my chest X-ray and called me with the news as I rushed out the door to photograph a Halloween parade at my daughter’s elementary school. My wife was already on her bike, pedaling away, when I answered. First, Dr. Smith asked if I was home, then if anyone else was around. My response was impatient: “Yes. No. I’m rushing to my daughter’s school.” 

“Okay,” Dr. Smith said calmly. “Well, I’ll make this quick: we found a large mass in your chest. I’m going to refer you to an oncologist for a biopsy as soon as possible. I wanted to call you to deliver this news personally. The next few months won’t be easy. Please feel free to call me. We also offer services to support your family.” 

Although I knew this news could be life-changing, I pedaled over to the local elementary school without dwelling on the brief phone call. I smiled, laughed, congratulated first-graders on their unique costumes, and filled my camera card. At some point—amid the chaos of kids’ screams—my wife, Katie, asked why it had taken me so long to get out the door. “Dr. Smith called,” I said. “Let’s talk about it later.” 

That evening, before the house guests arrived, Katie and I chatted briefly about my X-ray results, and then we all went trick-or-treating. Our homemade costumes followed a theme: a block of Swiss cheese (Katie), being chased by a mouse (me), who was chased by a Siamese cat (my daughter, Junie). I struggled to greet Katie’s aunts, Dot and Barb, between coughing fits. They both said I looked and sounded awful and that I should see a doctor ASAP. I told them I would, thank you. I didn't want to ruin Halloween with my news.

I knew that “oncology” meant “cancer,” but the magnitude still felt inconsequential. Slowly, over the next three weeks, the news grew progressively worse. My journey began with my primary care doctor, then moved to a local oncologist across town, who assured me I had a common lymphoma that was easy to treat. I underwent a bronchoscopy, in which they accessed my airway to take tissue from inside my lung for a tumor biopsy. After waiting an agonizing two weeks for the results, our local healthcare providers admitted that this cancer was beyond their experience and sent me to Stanford Health Care.

My new oncologist at Stanford diagnosed the tumor as synovial sarcoma, a rare cancer usually found in large joints like knees. A one-in-a-million case. Not hereditary, not environmental—just something that happens to some people sometimes. I began aggressive chemotherapy at Stanford the day after Thanksgiving, with a PICC line inserted in my arm (a Peripherally Inserted Central Catheter—basically a plastic tube running from my bicep to my heart). The PICC line allowed different bags of chemo and other medicines to flow into my bloodstream without burning my skin. I’d have to live with this foreign tube, jutting from my arm, for the next four months. The PICC line couldn’t get wet, which meant using creative plastic wrap to shower, and I had to use extra caution not to snag the exposed plastic tube in my daily life. The first round of chemo knocked me down and caused side effects in my mind and body. But I embraced the process, trusting my care team to bring me back to full health quickly.

These first weeks disrupted my routines with myriad discomforts, but until this Zoom call, no one had warned me that cancer could take away a vital organ, along with the things I loved most: riding my bike and surfing. It would still be months before I realized my life was truly at risk.

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Before the surgeon’s words snapped me back into focus, the rain outside seemed like my biggest problem. Although a chemical hangover clouded my thoughts and cancer treatment’s blunt force made my body ache, my second round of chemo was still two weeks away, and I was eager to get outside. Mountain biking was central to my identity and career. It was also the backbone of my social life and a cherished outlet for relieving stress. I’d met my wife through mountain biking, and we now spent our weekends with our six-year-old daughter on the trail. 

Katie and I both worked in the bike industry. I was the VP of Sales and Marketing at Leatt, which specializes in cycling and motorsport helmets and equipment, and Katie worked in marketing at Santa Cruz Bicycles. We had easy access to the latest and best mountain bike gear, so I borrowed a Santa Cruz Heckler SL to help me through chemotherapy. It was an electric-assist mountain bike—a high-end full-suspension model with a stealthy motor built into the lower frame. There was no throttle; I still had to pedal, but the electric motor gently helped me climb the steepest hills as chemo weakened my body.

Of course, mountain biking was inherently dangerous, and my doctors kept reminding me of my body’s fragility. Chemo attacked my white blood cells, compromising my immune system; contact with dirt could lead to infection. So I never asked my oncologist for permission. I trusted my own judgment; I’d been riding long enough to know how to stay safe. I’d avoid technical trails, stay out of the rain, and steer clear of unnecessary risks. The last thing I needed was a deep cut or a broken bone on top of chemo. 

By the end of the Zoom call, that spirit of self-preservation had dissolved. I slammed my laptop shut, seething, and rushed out with my bike and riding gear. The surgeon’s words echoed in my mind: We gotta take your lung… We gotta take your lung.  I drove up a serpentine mountain road in silence, muttering to myself. Return to normal life? With one lung? I grew more irritated and irrational with each passing minute. The roadway and surroundings blurred in the rain, and I reflexively parked in a muddy clearing at the top of an old favorite descent. I knew this parking lot, this forest, and this trail intimately. It was exactly the kind of steep terrain I had promised to avoid during chemo. The trail—mostly rocks, roots, and rich redwood duff—drained water in fast-flowing rivulets. It would be slippery, and rain and mud kicked up by my tires would reduce visibility. 

As I rolled away from the muddy lot, the surgeon’s words vanished under gravity’s pull. With no time to think about cancer, lungs, or infections, I focused only on my tires slipping, gripping, and struggling to find traction. As my speed increased, I concentrated entirely on pulling up on my handlebars, trying to keep my wheels from smashing into sharp rocks, slick roots, and deep holes. My wet brake rotors squealed with every squeeze of the brake levers. I followed a deep rut flowing with water and dislodged tumbling stones.

By the time I reached the bottom, muddy rainwater had saturated my shoes, socks, undershorts, pants, and jacket. Pine needles and dirt speckled my face, and grit scraped my eyeballs with every blink. I crossed a rushing creek to venture deeper into the dark woods and finally stopped an hour later to calm my ragged breathing beneath the twisted limbs of an ancient oak. I felt the tightness in my chest where the fist-sized growth had colonized, and the surgeon’s mantra once again echoed in my mind. Yet I felt healthier than I had in months. 

The forest had transformed in the rain. The familiar sights, smells, and sounds now felt exotic and otherworldly. Layers of fog filtered through the tall redwood canopy, and heavy raindrops dripped from the broad oak leaves, clattering onto my helmet. Everything around me sparkled; the moss and leaves glowed iridescent green.

It could have been the rush of endorphins through my veins, but the day’s calamity had lost its crippling force. My anger softened, and I barely remembered why I’d reacted so strongly in the first place. I was alive, outside, and immersed in this beautiful world. Sure, the treacherous conditions had put my physical well-being at risk, but as it often did, the gamble had paid off. The short ride had completely shifted my perspective. Yet in the back of my mind, the question persisted: How much longer would I be able to rely on this outlet as cancer gnawed away at my vital organs and life spirit?