Today the clock started.

At noon, my clinical trial officially began.

I meant to let everyone know sooner that I had finally gotten the insurance mess sorted out and completed the last test I needed last week, but I just ran out of time. That may end up being a theme for me over the next six months.

The clock is running now.

I have 180 days in this trial. Which means, at the very least, I have 180 days to be overly confident that I’m going to be cancer-free when they’re over. If not, it’ll probably be time to start facing a different set of realities. The kind that involve conversations about quality of life versus quantity.

I know nobody really enjoys reading that. Trust me, I don’t exactly enjoy writing it.

But I’ve become a pretty practical person over the last couple of years. I’d love to tell you it’s because I’ve matured, but that would be a lie. I probably never will, no matter how long I live.

I think it’s just because I’ve always worried more about other people than I do about myself.

Before I go any further, though, I want to make something very clear. I believe this trial is going to work.

Nothing about today changed that. I’m not writing this because I’ve suddenly lost hope. I’m writing it because starting the trial doesn’t make death any less possible. It just gives me a timeline that makes pretending it’s impossible feel a little dishonest.

So I think about it. Probably a healthy amount.

Not because I’m expecting it, but because if things ever do go the wrong way, I want to leave as little for the people I love to carry as possible.

After my dad died, for years I assumed he was the one who suffered the most. Cancer absolutely ravaged him. Thankfully, I was too young to really understand most of what was happening or remember much of the worst of it.

What I do remember is everyone else.

I don’t think that anymore.

That’s the cruel thing about death. The person who dies isn’t really the one who suffers. It’s the people left behind who have to carry everything that comes after.

So lately I’ve found myself doing things I never imagined I’d be doing in my forties. Getting a will together. Making a list of all the important stuff. Making sure people know where everything is.

Trying to figure out how to get away with tax fraud so that if things do go south, whatever is left ends up with my family instead of Uncle Sam.

Plus, I kind of like the idea of committing tax fraud as I’m walking out the door that is life.

I’m probably romanticizing fraud a little too much there, but whatever.

With those things finally starting to get checked off the list, today felt different.

Today wasn’t another scan. It wasn’t another surgery. It wasn’t another delay because insurance decided to remind me why everyone hates insurance companies.

Today was Day One.

I was back on the ninth floor of the Mays Building at MD Anderson, sitting in the infusion center on one of those hospital beds that apparently gives me a little PTSD from the months I spent there during chemo.

Thankfully, this visit was easy. One IV. About an hour. A nap. Then they sent me home, and I drove myself back to Austin.

For the next six months, I’ll take one pill every day for 21 days, take a week off, and then do it all over again.

Honestly, I don’t think this part is going to be that hard.

I also don’t have some overwhelming desire to suddenly start living differently.

I’m not going skydiving or Rocky Mountain climbing or doing anything else from that annoying Tim McGraw song about how you’re supposed to start living once you find out you’re dying. That just seems dumb.

Tomorrow I’ll go to work. Then I’ll go to the gym. Then I’ll probably eat some fat kid food.

Life is still life.

And if you’ve read this far, I hope that’s the biggest thing you take away from all of this.

I believe this trial is going to work.

I’ll spend the next 180 days assuming it will.

Tomorrow I’ll wake up, take my pill, and move on to Day Two.

It’s Tuesday evening. I had expected to start my clinical trial yesterday and have something of interest to write about today, maybe even something like the trial immediately giving me a superpower.

That is not what happened.

I didn’t start the trial. No superpowers. Not even the mildly inconvenient kind.

Last week I started driving to Houston at 5 a.m. for two different tests that were prerequisites for the clinical trial. Thank God for self driving, because by 7 a.m. I was already in that familiar state where you are technically awake but also absolutely not functioning at full human capacity. Waze was already telling me I was going to be 15 minutes late for my first appointment. I hate being late, so I called ahead and they told me it didn’t matter. An EKG takes five minutes. They can see me whenever I get there.

Which, in hindsight, is about as clear a warning sign as you can get without someone explicitly telling you today is going to be a bad day.

I’m not usually one to believe in foreshadowing, but that was pretty hard to ignore.

I got to the hospital at 8:15 and was done with test number one by 8:30. The first test was in the main building of MD Anderson and the second was in the Mays building. There is a long sky bridge between them and a coffee shop along the way in the Rotary House.

I stopped for coffee.

Hospital coffee has a very specific personality. I don’t think it is intentionally bad. In a hospital everything is either trying to save your life or trying to kill you. Coffee is doing neither, which honestly might be worse.

At the time I was too tired to fully appreciate the symbolism.

By the time I got to my second appointment I found out that insurance had not approved the test yet. My medical team was, as always, great. They were working on it, communicating, and doing everything they could.

I don’t blame them.

I do, however, blame the insurance company for things I probably should not write on the internet without cooling off first.

What followed was seven hours in a waiting room with no food, no coffee, no book, no Steam Deck, and no real answers about whether the test would happen at all. Just sitting there watching the day slowly turn into something I was no longer in control of.

Eventually I had to head home because Tugboat was home alone. I had originally expected to be gone for about six hours. I was on hour ten.

The drive home was mostly self driving again, which was probably for the best. I did make one stop for real coffee and three tacos from a place that looked extremely sketchy and somehow delivered exactly what I needed. So, silver linings.

The test I didn’t get was a cardiac imaging study using nuclear medicine. It is one of the last prerequisites for the clinical trial. Insurance denied it outright regardless of what MD Anderson said. Their reasoning was that an echocardiogram was sufficient given my age and fitness.

The subtext felt pretty clear. This is cheaper, so this is what we are doing.

The problem is that MD Anderson did not have any echocardiogram appointments available before the clinical trial cutoff date. So everything got stuck in that very specific kind of medical bureaucracy limbo where everyone agrees there is a solution but no system can actually produce it in time.

Naturally, I took this well.

There was a brief moment where I started mentally assembling the required ingredients for Molotov cocktails. That bourbon collection that had been quietly going unused for the last year, combined with all the medical supplies the hospital had given me over the last year that I had also not used, suddenly felt like they had a very specific and extremely unhelpful purpose.

I did not act on any of it.

Eventually my medical team was able to get me scheduled at The Woodlands for the test, which means I should still be able to start the clinical trial on Monday.

I am currently putting the metaphorical Molotov cocktail ingredients back where they belong. For now.

I have always disliked insurance. Not the people working in it, but the system itself. I am sure I do not see all of its complexities, but from where I sit it often feels like a system where cost becomes the only variable that really matters, even when it collides directly with time, access, and sometimes urgency.

And I will be honest, that part tends to pull on older memories. Things I don’t usually sit with for long, but that show up anyway when you are alone in a hospital waiting room for hours with nothing to do but think.

At some point the anger shows up. Then it just sits there. Until someone close to me reminds me that I am not really in a position to judge an entire system or every person in it based on the worst version of what that system produces. That is a hard thing to argue with, even when you are still annoyed.

There is a quote from Ted Lasso that kept coming back to me. Ted says something to Coach Beard along the lines of hoping that either all of us, or none of us, are judged by the actions of our weakest moments, but by the strength we show when, and if, we are ever given a second chance.

I don’t know that I have anything fully resolved here. I just know that idea sticks. That people are more than the worst function of the systems they are part of. And that anger, while very real, does not have to be the final version of the story.

Tonight Tugboat is snoring at the end of the bed like none of this happened. Monday starts one hell of a new chapter.

See you then.