Advice to New Readers

Welcome to The Last Train!  If you’re a new reader, my advice would be to begin by reading the “Introduction” and then work your way up the topics from oldest to newest (see the recent posts on the right).  That way you will start from the beginning of this journey rather than joining on a later stop.  Welcome aboard…and I hope you become a regular “rider” on The Last Train!

Jeff Schmahl


A week ago at the end of a 30-minute phone conversation, a good friend of mine said, “you should start writing, it would be good for you, and you’re a good writer.”  Terry Pettit has written several books and has a mind that looks at life from just a slightly different perspective.  But in turning that crystal ever so slightly like Terry does, an array of light exposes an entirely different vantage point and I have always loved to discuss, argue, laugh, and be enriched in my time with him. Continue reading

More good news…and Jerks

Medical/Personal Update

I’m switching things up by starting off with a health update…besides, the jerks don’t deserve to go first!

I recently had my “six-month scan” and received more great news that my tumors are continuing to shrink.

Back in April, when I was first diagnosed with the big c in my pancreas and liver, things did not look good.  The tumor in my pancreas was the size of a golf ball.  I had four dominant tumors in my liver, three the size of golf balls and the largest the size of a racquetball.  Worse yet, they were growing rapidly.

But chemotherapy and prayers are working a miracle in my body.  With my tumor marker numbers indicating little to no cancer in my body, I was hoping to hear the word “remission” after my latest scan.  Defeating the big c, however, is never easy and this evil disease is always looking for ways to mutate, spread, and destroy.

But the big c is quickly becoming the little c in my case.  The largest tumor in my liver is now down to the size of a walnut and the three others have shrunk to marble and even pea size.  The tumor in my pancreas is also now pea size…everything is getting much smaller.

Here’s how Dr. Ocean described my scan:  “This is great news, everything keeps going down which hardly ever happens.  This much progress in six months is wonderful!  Remission is when we see no active cancer in the scan and you’re not there yet, but I’ll take this for sure.  The drugs are working!”

We then talked about treatment options.  I told Dr. Ocean that my attitude from a life in the world of athletics has been to never let up on an opponent when you have them down.  She agreed…so we’ll continue with chemotherapy…even though my body is struggling more and more with the “cumulative effects” of six months on chemo.

I’ll also be visiting with doctors from the Sloan Kettering research hospital in New York City to see if I am a candidate for some of the new drugs being used on patients with a genetic family history of the big c.  More on that in future blogs.

I recently had a sad reminder of just how deadly the big c is in the pancreas.  A friend from my college days, Leo Casiano, surprised all of us on September 7th that he had pancreatic cancer with only six more months to live.  I communicated with Leo via Facebook and learned that he was also first diagnosed in April but had chosen to keep things private.  I planned to see Leo on my recent trip back to Nebraska, but on September 17th, he passed away.  His six months became only ten days.

This is what pancreatic patients are up against…I’m one of the few lucky ones.


My all-time favorite cartoonist is Gary Larson creator of the “Far Side.”  I often laugh out loud at his off the wall humor…which many times contains nuggets of wisdom.  Below is my favorite Far Side cartoon entitled “Jerks.”


I kept a copy of this cartoon on my desk at work for over 10 years.  Why?  Because it was a good reminder to me of how I wanted to deal with jerks.  Rather than get upset, I view jerks as an inevitable fact of life…and my goal is to not let the jerks upset me or worse yet, cause me to act like a jerk in return.

In Luke 6:32 Jesus said, “If you love those who love you, what credit is that to you?  For even sinners love those who love them.”

The same holds true for jerks…just because someone acts like a jerk doesn’t mean you should act like a jerk in return.

In my opinion, jerks are people who don’t treat others with kindness.  They actually take pleasure in treating people badly.  Some jerks are power hungry authoritarians.  Some are insecure egotists who take pleasure in cutting down others.  Some are just miserable people who want to make other people’s lives miserable.  But the common thread is they are just not nice people.

I have many, many friends in my life from a variety of backgrounds and philosophies…but none of them are jerks.  Oh…we all act like jerks now and then…but my friends care about others and by-and-large treat friends and strangers with kindness.

Unfortunately, sometimes there are jerks in our lives that we can’t ignore or get way from.  Bosses especially come to mind…and I’ve had a few jerk bosses.  Co-workers and neighbors can be annoying jerks…and then there’s the inevitable jerk relative.

I don’t claim to be Dr. Phil or anything…but here’s my advice for dealing with jerks:

  1. As my friend, Charley North likes to say, “kill ‘em with kindness.” It doesn’t always work, but it’s usually my first option.
  2. Don’t be afraid to confront a jerk. Let them know what you think of their behavior or actions.  Early in my career, I worked with an older jerk who was in a position of authority.  For seven years, I tried killing him with kindness but when I finally stood up to him and called him out, he backed down and started treating me better.
  3. Ignore them. Not always easy, but simply choose to not make them an important part of your life.
  4. Laugh them off…they’re here to “make life interesting” so don’t let them get you down (and realize that as life goes on, the jerks will become more and more miserable and have very few friends).

Bottom line, I think many people waste a lot of time, energy, emotion, and worry about things that they really don’t have any control over.  It’s why the Alcoholics Anonymous “Serenity Prayer” has long been one of my favorite philosophies :

“God grant me the serenity to accept the things I cannot change; courage to change the things I can; and wisdom to know the difference.”

Next stop: When life gives you a 2nd chance

Chemotherapy Treatments

One topic that people ask me about quite a bit is “what is a chemotherapy treatment like?”  Television shows and movies make it look like a cold, impersonal experience with brutal side effects.  But that hasn’t been my experience at all.

I get chemo every two weeks at the Weill Cornell Medical Center in NYC and it starts with a 15 to 30 minute meeting with my oncologist, Dr. Allyson Ocean.  Dr. Ocean discusses with me how well the chemo is working and what side effects I am experiencing.  She then makes minor adjustments, if needed, to the chemo drugs and more so the other drugs they give to limit the side effects of the therapy.

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Left: Dr. Allyson Ocean, compassion, hands-on care, and expertise make her a great doctor
Close-up of my “port”

Prior to treatment, they take three small vials of blood which they use to test all kinds of things like sodium, potassium, chloride, calcium, red and white blood cell counts and most importantly my tumor marker number.

The treatment center itself is very nice.  They have more than a dozen private rooms, all of which have TV’s, reclining chairs, and extra room and chairs for guests.

The drugs and saline solution are given intravenously, but instead of putting the IV in your arm, they access a vein through a “port” in your chest.  The port is sewn in to a major vein that leads to your heart during an outpatient procedure and it makes the chemo treatments safer, more efficient, and less painful.

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Left: Getting ready for my chemo treatment
Right: A comfortable, private room for treatment

The treatment itself begins with a series of IV drugs to offset the negative effects of chemo along with saline solution to prevent dehydration.  I get Benadryl to limit swelling in my mouth, anti-nausea and anti-diarrhea medicines, as well as drugs to ward off numbness in my extremities.

The chemo drugs come last but I don’t experience any negative side effects, at least while the treatment is taking place.  In fact, the worst part of a chemo treatment is how long it takes.  In my first round of six treatments, I was receiving three types of chemo and my treatments would take four to five hours.  In my last six treatments, I was only given two types of chemo so the treatments took about three hours.

For all but one of my treatments, I have had a visitor with me to help pass the time.  My brother-in-laws sister, Dr. Debra Klein, is my most loyal chemo partner and it really helps having someone so knowledgeable in the field of medicine with me.  Debra is one of the top infectious disease doctors in the New York City area and I consider it an honor that she is willing to spend so much of her valuable time with me.

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Left: My chemo cocktail on wheels (for bathroom breaks)
Right: Nurse Practitioner Erika Florendo and Dr. Debra Klein, my chemo partner

If there’s any advice I would give you, it would be to offer your services to be a chemo partner (and driver) for a friend or family member who is on chemotherapy.  To do so, is one of those “blessing” things that will benefit both you and the patient.

The nasty part of chemotherapy comes after the treatment itself.  Again, I’ve been very lucky and haven’t experienced the really bad side effects.  I do get nausea in the form of an upset stomach and loss of appetite for a couple of days.  I also sleep quite a bit more for a couple of days and my energy level goes way down.  There are several other “minor” things…that can sometimes become major (like diarrhea) if you aren’t quick on your feet and quick to the seat.

On the third day after chemo, I start bouncing back to “normal” and during those 10 good days I try to stay as active as possible.

Some patients get so sick from chemotherapy that their quality of life becomes a living hell.  But chemotherapy is a wonder drug that has saved millions of lives.  In my opinion, it is always worth it to take chemo…don’t give up, don’t ever give up!

I hope to have some good news to share next week.  I just had a CAT scan and am cautiously optimistic that I’ll get a good report.  My latest tumor marker number was 24 to which my sister Judi said “that’s even lower than mine” and she has been in remission for several months.

Bathroom humor

Disclaimer: If you don’t like bathroom humor stop reading right now!  I’m going to get pretty descriptive in the next few paragraphs…some will be offended and think what I have to say is really gross.  Sorry that you might feel that way, but if you haven’t realized by now, there’s no holding back when it comes to The Last Train.  I’m always going to try and be brutally honest when writing to my riders.

Here’s what I think is a funny story of what happened following my second chemo treatment.

On the afternoon of May 1st, I drove our red Mini Cooper (our little NYC car) to the doctor’s office, valet parked the car, and road the elevator to the 12th floor.  Maria didn’t want me driving home but I said “don’t worry dear, I’ll be fine, and if I don’t feel good you can come get me.”

I had the last appointment of the day, so my chemo didn’t get over until 6 pm.  After the treatment, I felt fine, went downstairs and gave the parking attendant my ticket, I knew it wouldn’t be a problem driving home.

I got in the car and was just about to engage the gear shift when I thought “you know, I might have to poop (that’s the word I use for it) and I’ll probably run into some rush hour traffic, so I’d better try to go.”  So I got out, went to the bathroom and let loose with a pretty good one.  I thought “man, lucky I didn’t drive off” and then I did the right thing and sat down in the lobby…knowing that diarrhea is a common side effect of chemo.  Sure enough, 10 minutes later another trip to the  bathroom…so I went back upstairs to the chemo treatment center area knowing they would have some medicine to help.  To my surprise, the doors were open but no one was there.  I stayed in the treatment center to relax and wait this out…and 10 minutes later I had a full-blown case of diarrhea.

I called Maria to tell her what was going on and that I’d be late.  She wanted to come over and get me but I said “no” knowing it would take her at least an hour to travel  by bus and then taxi in rush hour traffic to get from our New Jersey apartment to the doctors office on Manhattan’s east side of Midtown.  Besides, I knew Zach could come get me and drive me home if I needed the help.

A little after 7 pm, I wasn’t feeling good at all so I called Zach and said “Bud, I’m not feeling very good and I need you to come over and drive me home.”  Zach said, “dad I’ve got an 8:30 date tonight, can’t mom do it?”  I said “this takes priority, pick up a big bottle of Kaopectate on your way and you should still be able to make your date.”

Zach was there by 7:30 pm, and I took a couple of healthy doses of the Kaopectate (I’m sure much more than the directions called for).  We formulated a plan that Zach would drive me crosstown in midtown Manhattan.  We’d meet mom at the ferry and then she could drive me the rest of the way and Zach could still make his date.

At 8 pm I told Zach “let’s go, but just in case you grab some trash bags and I’ll get the toilet paper.”  He replied “Seriously?!”  And I said that I didn’t want to take any chances.

We got in the car and I said somewhat humorously, “We gotta say a little prayer first…God help us out here.  We don’t want this to get ugly so please let us get home without making a big mess in the car.”  We both laughed and off we went, but I warned him “take it slow and avoid any big bumps.” He knew I was serious.

I was talking non-stop telling Zach about the day’s chemo treatment.  But a couple minutes later, I stopped abruptly, I was having an “Uh oh” moment.  Zach turned to me and said sternly, “squeeze dad…just squeeze hard!”  I did and there were no jokes now, we knew things could get really bad any second.

The drive went quickly.  And at 8:15 pm we made the exchange with Maria and Zach was able to keep his date.  Once Maria started driving, I relaxed a bit feeling that I was going to be able to make it…but I did keep squeezing just in case.

We arrived home at 8:30 with no problems…but two minutes after getting inside…my bowels cut loose once again!

Upon finishing, I texted Zach these exact words “I thought you’d like to know, about 2 minutes after getting home I let loose with a HUGE poop.  Your squeeze technique  did the trick!  Praise the Lord. J”.  He quickly responded back, “LOL. Just died laughing. Bahahaha.”

The three of us have retold that story several times over the last couple months both from my point of view and Zach’s point of view.  And each time, we shared a good laugh and know that we’ve added yet another to our long list of family stories we’ll never forget.

Both times Maria has ended the conversation sternly saying, “you’d better not write about this!  And no more trying to play tough guy.  I’m your wife and I’ll be driving you home from chemo treatments from now on!”

Sorry, dear.  I couldn’t resist. I am an open book when it comes to The Last Train.  But I promise, from now on you’ll be my designated driver.

Next stop: Jerks