So You’re Not Dead Yet: Lessons From Chemotherapy | Tara Howley with Guest Michael Nagle

I've been really, really interested in— I call it the psychedelic of mortality— what it does to people to be near me, like the contact high, what it does to me, what it does to my relationships. Both people around me are hornier, but also with me. It's almost this image of like the "why not now" just kind of infects people. Something about hanging out in the space of like, what if there's not a later cascades to a, you know, oh my goodness, there's a thing I need or my partner needs.

That's amazing. I mean, that's a, that's a gift.

And the like thread of love in it is like very clear to me.

Hi everybody. I'm Tara Howley. I'm here today with Michael Nagel.

Hi.

And this is The Art of Accomplishment, where we explore living the life we want with enjoyment and ease. Michael is an incredible member of the AOA community, and he's currently undergoing treatment for metastatic colon cancer. And before that, he worked in alternative education, designing an elementary school aged learning environment in Boston. Hi, Michael.

Hi.

Thanks so much for being here today with us.

Yeah, very happy.

I'm so excited to see you.

Yeah, that's very nice.

So I'm going to start with the question. So you're not dead yet. You're not dead yet, though you might be soon.

Yes. Yep.

Like, what's it like to want to live? Because you really want to live.

I do. I've, I've had a cancer diagnosis now 14 months. So since October 2023, total shock, total blindside. Just, I've never been sick in my life, so it's a totally strange experience. I've always been healthy and able to do things and, you know, minor musculoskeletal issues and things like that, but nothing serious. I've been doing we could call it 3/4 conventional treatment, 1/4 alternative treatment. You know, so I've done chemotherapy and radiation and surgery, and it has helped a lot with my quality of life. And currently we're just maintaining the cancer state in my body. So currently I do chemotherapy. It's every 2 weeks. It takes about 50 hours or so. It's long. There's a part in the hospital and then a part comes home with me. So if we start Wednesday morning, it goes till about Friday afternoon. It's about 2.5 days. Takes me a day or two to recover from that. And then I kind of have 9, 10 solid days with some luck. And each 2 weeks has that of going from chemo and symptom management So, okay, I'm getting back to steady ground. And lately it almost feels like a race, like, okay, I've got 8, 9 good days. What are we doing with them?

Yeah.

Yeah. As long as I keep doing conventional treatment, which is a huge question for me, if I stay with it or not. It's kind of like, you know, I'm told that my cancer is stable and for modern oncology, that's a good result for my cancer. And for me, it's incredibly unsatisfying. You know, it's, it's not what I want. I want— I feel up for the challenge. If I knew, you know, we're going to have a cancer-free body in a couple of months or a year. Okay. A really challenging experience to hold things stable. What I realized was like, wow, I have to pay 3 days of pretty intense illness to get 11.

It's a steep price.

It's steep.

Can I ask a question? What, what makes it worth it?

Yeah, the truly honest answer is I'm not sure if the exchange is worth it. It's such an intense exchange rate.

Very expensive.

But I've seen it in this process of Oh, I don't like what's happening to me. This feels like such a waste of a human life. And that feeling, it's tied into the— well, I'm not dead yet. Okay. What would I like to do with this time? Yeah, there's a couple of feelings. I mean, one is, for better and for worse, it heightens almost all of my interactions. I've been really, really interested in, um, I call it the psychedelic of mortality, like what it does to people to be near me, like the contact high, what it does to me, what it does to my relationships.

And what, what is it like? What does it do?

Most of my interactions feel heightened, you know, Oh, maybe all. It gets harder to leave things unsaid when there's this like, hmm, is there a later?

Hmm.

I feel much, much messier as a person interpersonally than I ever have. Yeah, there's a way that I constructed my life to be, you know, I'm an energetically sensitive person, so I need a lot of alone time and There's truth to that. I still have that preference. And there is a messiness to like, I am an interdependent human right now. 100%. My survival depends on my community and people showing up. And there's a messiness to it. With some people, I've hit triggers that I never would have expected, you know, never had any idea was in me or in someone else. I feel like both people around me are hornier, but also with me. It's almost this image of like the why not now just kind of infects people. You know, I've seen people's relationships change in substantial ways after spending time with me. I've just— something about hanging out in the space of like, what if there's not a later? Cascades to, you know, oh my goodness, there's something I need, or my partner needs, or it's taken me 15 years to ask for this. And finally, I can say, hey, wait a minute, you know, something about this.

That's amazing. I mean, that's a, that's a gift.

Yeah. And the like thread of love in it is like, very clear to me, very, very clear to me that I'm cherished, that I'm valued, that I'm cared for. Things that I think I would have pushed away. I would have pushed, you know, in some— I can take care of this, I'm my own self-sufficient human, you know. There's so much evidence to like, oh my goodness, a community just spontaneously formed to try to protect me through an impossible experience. It's not possible to protect me from this, and yet people come here every week and they, you know, they do the absolute best they can. You know, they cook and they drive me around and they try to come up with fun things to do. You know, this is somehow— it's not the forcefulness of saying yes to it, but it is that like, okay, you're here, I want to spend time with you. We're going to celebrate basically just this long celebration.

Celebrating love and messiness.

Yeah.

You don't get one without the other. Our humanity. It's like, really. Celebrating humanity. My assessment, or my knowing of you, is you offered that level of support to your community always. You were the rock. You were the support system. And so what's it like to be on the other side receiving?

Yeah, the first thing out of my mouth is I hate it.

What makes you hate it? Because you can give it. I've seen you give it time and time again.

Yeah, it's funny. I, I could see myself about to hold that sentence in. I was like, let's just say it and see what happens. It's vulnerable as shit. God, to not believe that I'm self-sufficient.

Mm-hmm.

Up until this point, I've really constructed my adult life to to have a lot of autonomy and a lot of, here's my sanctuary, this is my space. I really care about that. If I'm inviting you in, it's very conscious on my part. And there's kind of some switch for me of like, oh, if I'm inviting you into my world, I'm trying to do it, the aspirations with total acceptance. But the flip side to that is like very, very selective.

I totally, fully, 100% get—

I hate it.

I get it. I can imagine many of us would feel the same way in your shoes. But if you couldn't feel that, if you couldn't have that reaction, what would you feel or notice?

I've never done a trust fall per se, but that's the image that's coming to mind. Like, it just feels like this infinite trusting that I'm gonna be caught or I'm gonna be cared for. I sometimes talk about this experience as both deeply unlucky and deeply lucky. Yeah, you know, Cancer like flash freezes your life. Like, whatever setup you have, that's what you're gonna work with. I don't think this is like 100% true, but the people you're close to are the people you've got. Yeah. So I don't have a partner, but I've had someone with me basically the whole 14 months. People have made a calendar and rotated in and rotated out and come up with systems. And so I had an infusion just this past Wednesday to Friday Friend Will scheduled to come. He got sick. My friend Will kind of manages my care, put out a call, and I mean, I don't know how long it took, 48 hours, someone had bought a plane ticket and they're like, oh, I can come for the week. And that feeling like of being caught or held, it's powerful. It's unfamiliar. It feels a bit like strange. I do feel a bit young in it. Like, I do feel a bit like I'm the toddler in the playpen and I'm just kind of like, what's going on? What? Who's here? Someone else is here. You know, just kind of having my big experience. And then something's happening around me to protect me. I feel very protected right now.

It's really an amazing dichotomy to be on an edge, right, where you don't know what life's going to be like in 6 months or 1 month or a year, and to feel protected and perpetually held in that trust fall.

It's a mindfuck.

It's a mindfuck.

Weird. It's weird. It's— yeah, it's this like strange staring into the unknown, feeling well protected, knowing, you know, of course I know a lot of people now who have cancer. It's new to me, that community. And the support systems tend to be partners. Yeah, hence the support system. And so I know folks who are single going through this and they don't have this rotating cast of loving characters who will, you know, come and, you know, I'm trying this alternative thing, so you have to cook this really specific way. They're just like, sure, I don't even cook meat at home. You want to eat? Oh, sure. Okay, we'll figure it out. Sure, whatever.

The mind is like, okay, this is a mindfuck. And the heart How does the heart hold those two, if at all?

Mm. Grief and gratitude. Those are the two big ones. Yeah, the grief is an interesting one, because it comes up in all these different nuances. Grief for my own life. There can be a heart pull when someone leaves of like, am I gonna see them again? And there's also something like, I feel very protected by my community.

Mm-hmm.

Somehow a community has appeared and just sort of decided, you know, to the extent that another human can help me with this experience, that will happen. Mm-hmm. And, you know, this is one of the places I think about the work of that weird It feels like a paradox to me of no one can do the work for you. But having support makes it a lot less harsh. There is a commitment in this community to make sure I never go to chemo alone. We were talking a little bit about the denial. Like, I still, I still hope I'm going to wake up and realize that, like, I don't have cancer, or that this was all just some confusion, or maybe the doctors are making too big a deal out of this, and, you know, it's not really lethal.

It's amazing, the power of the mind, right?

It's amazing.

14 months chemo every 2 weeks.

Wait, oh, it's amazing how much the mind bucks against this, and almost the shock of like It feels like that should be a birthright. It feels like that should just be— you're human, of course you never go through an experience like this by yourself.

Mind denial, heart grief and gratitude. And because you're dealing with colon cancer, how's your gut feel about holding this dichotomy?

I don't know if it's heart or gut, but let's go with gut. It's like under the denial and under the the kind of slamming back and forth from grief, gratitude. I would say the gut is probably where the curiosity about this is living. The like, this is what's happening to me. And it's like, yeah, like actually being able to turn into it, being like, this is my reality. As much as I want to not believe it, like, under all of the turmoil, there is a like, so this is what's happening. Okay. Does that mean that I don't get to live a meaningful or joyful life? I don't know, actually.

What does it mean? From the gut, right? Asking the gut, like, what does it mean?

I've gone back and forth, but I tend to lean towards there's some kind of animating force, spirit, divine force. And from the gut point of view, it's like, so what if this isn't just a mistake? What if this isn't just tragic? I've had to learn If I skip the denial and the heartbreak, that feels terrible to me.

Yeah, of course.

You know, it's the most obvious thing, and yet I've really had to come into— I can't go to the spiritual without watching my mind just be like, I hate this situation, and watching my heart being like, I don't want to say goodbye to people. This is terrible. What?

Yeah.

And then under that, there can be a bit of a like, so this is what's happening. And the aspiration to still have a rich, beautiful life is still there. Huh. This is never the script I would have written for myself. Here we are. What do we do with that?

What do you— what do you do with that? And I don't want to bypass the denial. I'm also in denial, like, no, fuck this. Terrible idea. And grieving, like, oh my God, heartbreaking. And so not bypassing those. So what, what is there?

Yeah, there's a couple things that are alive there. And like, what if this isn't a mistake? You know, what if this isn't wrong? What if this isn't just tragic?

Yeah, if it isn't a mistake, what is it?

Oh, I love being able to write. I love being able to speak into this experience. That feels really, like, that feels worth it. That feels worth it. I get curious about just how far does mind-body energy healing go? And there is a movement in me that's like, why not push it? Can it interact with my cellular dysfunction? I have no clue. But I believe in that. I believe that there's some way that the body holds emotion as energy. And there is something where, you know, when we release and we move, it feels like health. It's an undeniable feeling. I think of, you know, so many kinds of work of just, we move something and we feel healthier, we feel more resilient, we feel more present. And call it emotion, call it energy, call it trauma healing, you know, there's some signature that just I can't deny that feels like health to me. And so there's something in me of like, okay, I want to spend time with the people I love. I want to write and I want to go as far as I can in the mind-body healing path and just see what happens. And there's some just like, if not now, I don't have a later anymore. It's really intense to not have a later. But it also, it's, it's confronting in a helpful way. Now's the moment. Now's the moment, right?

There's no tomorrow, like, okay, I'll do it next year.

I don't know how long my body can hold out, and I don't know how long I'm gonna be up for this 3 days for 11 days trade. Yeah, for now I keep doing it. That trade isn't even a long-term promise. The expectation is at some point that will no longer be available to me. And so for now, you know, in this minute, I think, well, I'll keep taking the trade, not knowing if it's a couple months, 6 months, a year. I leave myself the door every chemo to be like, if you want to be done with this, you're welcome to be done. There's a heuristic that I learned from AOA. Like, the way I remember it is like, if you're worried that you might have conflict where it could rupture the relationship, like a breakup, you know, it can be really helpful to grieve that breakup first, and then you can actually be yourself and be like, hey, here's my limit, here's my boundary, and I'm no longer contorting from that possibility. And I found an analogy of that for me in mortality. Of like, oh, if I'm not open to the fact that this is the end of my life, I can't choose chemo. I'm just like, don't want to die. Don't want to die. They say they're going to keep me alive. Blinders are on versus the like, I'm actually at choice. That choice might be the end of my life, but there is a choice. It's not actually being forced into it. It's so easy to project captor onto my oncologist. It's so easy to make that projection. Mm-hmm. But he's not actually my captor or anything like that. This is him basically saying, I wish I had better for you. This is what I have. Do you want to take the 3 days for 11 days trade?

Mm-hmm.

That I can help you with. Mm-hmm. It's gonna be— we can do that together. And yeah, there's this like, oh, if I'm not open to this being the end of my life, I can't choose, right? You know, I'm so scared that I'm just like, have to, have to do chemo.

What I'm hearing is that accepting the end of your life is actually empowering you to know you can say yes or no. So you really know where your no is and what your yes is.

You know, it just, it feels like the will to live is, at least in me, It's strong. I've wondered a lot about what's the functional side of the denial.

Uh-huh.

You know, writing's an easy example. Art making. Yeah, it takes time, it takes effort. You want to revise things, you want to work on it. And if I'm really in the short, short, short term, I don't know how that would go. And I have to believe, okay, I've got some time. I don't have to drop everything and write everything out that's inside of me right this minute. We can work day by day. And I sort of see denial as like, oh, right, you know, if one wants to build a creative life, an intimate life, a professional life, it's really useful to not be in life with death every minute. It's a function.

It's protective. You talked about the community being protective, but it sounds like denial has a protective quality too.

I think so. I've been really interested in like What's the positive of denying death? And what's the dysfunction in denying death? It's hard to be at choice with chemo. It's very hard. But if I don't buy the story that cancer means joy and meaning are impossible, it's a really easy story to buy. Really, really easy. But if I don't buy that story, I am choosing to poison myself. I'm choosing to do it.

So it's very different. But do you know what it reminds me of? I did a natural childbirth with our first daughter. So different. Death birth. But she was turned the wrong way, so we were spine on spine. So I had back labor for like 42 hours and we were doing a home birth and I was just like, fuck this, this sucks, this is awful. Which I can imagine is what happens to you every 8 days when you go into the cycle. And my midwife was like, uh-uh, Tara. She was from the Bronx. She was like, uh-uh, none of that. She's like, yes, you say yes, I want this, I choose this, I pick this. You say yes, baby, we got this. I was like, fuck that. I was like crawling up the walls. I was like resisting the pain, running away from it. And I had 42 hours to adjust. And you have birth hormones and things like that, so you have a little help, thank golly. But, and I had her like a drill sergeant over my head, and she kept making me say, I want this, I choose this. My mind was like, I don't want this. I'm going to just say it because she's going to hit me if I don't. But by the end, it was like I was turning right to it, and it was like, yes, I want this. I choose this. Come on, baby. We got this. Thank you, body. And I was so grateful for the pain. And the more I said yes to it, actually, Saying yes really changes the experience.

Yeah, I think what one of the things I've learned is like at the beginning of diagnosis, if someone had tried to say, you know, I don't know, spirit has a way of working, I would have been like, oh, fuck off.

Oh no, people said it to you and you said fuck off? Like, don't give me that bullshit.

And I, I think now what I believe is if I can make room for brain is in complete denial, heart is breaking in all kinds of ways, then there might actually be a genuine yes available. Maybe. Yeah.

Can I actually ask something? Because you said brain is like, uh, denial and heart grieving. Can you hang out with those two? Because you said then there might be a yes. And can you just hang out with the denial and the grieving, right? That freaking heartbreak. Uh-huh. And when you're with both, what, if at all, is the yes?

It's, um, I just love being alive. It's that fundamental. It's so interesting. It's so fun. You know, at some point I even realized, I was like, Oh, struggle is fun. Oh, what joy to resist.

What is chemo from there? What does it look like? I get to struggle, I get to do this weird thing, poison my body.

It's two things. It's one, is it is this pass of, yeah, I hate the 3 days for 11 days deal.

Can I ask you a totally leading question? And I'm coming from my experience with childbirth, which is, I want to acknowledge, totally different than chemo. And I had hormones helping me. But if I were to play my midwife with you, uh-uh. No nos, no I hates. You say, fucking, I love this fucking chemo. Give it to me hard. Yeah.

You know, one of the images that comes up is like, chemo is such an insane thing to say yes to. Why wouldn't I say yes to anything else in my life? Like, nothing is as extreme that I have found. And so there's a like, oh, if I'm going to say yes to chemo, What would I be a no to? Yeah, ever, ever. Because, and I mean that both from the health point of view, but also not, you know, like, I use that argument a lot where medical oncologists, they're very conservative, they have their reasons, you know, and if I bring up like, hey, I want to fast for 5 days, they'll be like, oh, I'm not sure about that. I want to be like, you, you prescribed me poison. I can sit in a room quietly and not eat. That's really not a big deal to me. Actively poisoned for 3 days, really not a big deal. There is a spark of life in there. There is a like, yeah, I want to, I want to see this out. It's, it's so fun. Even the parts that I hate about living, actually, it's been a pleasure to get to struggle and get to resist and get to be confused. It's fantastic. It's not actually a problem.

Oh, wild. So beautiful, Michael.

Mm. It's nice to zoom out with you and, you know, just sort of look at the landscape together for a minute.

Let's do it again.

I love that. I love that.

Thank you for listening to The Art of Accomplishment, our shared humanity and all its messiness. You can join our newsletter or check out our courses at artofaccomplishment.com. And if you enjoyed what you heard today, share it with a friend. And of course, follow us and rate us in your podcast app. And I wanna give a huge, huge, huge send-off thank you to Michael Nagel for being with us here today and taking time to come and see us. Michael, it's so grateful, such a joy to get to spend time with you.

Yeah, yeah, likewise.

Big, big love.