Cancer Face

Lucky director John Carroll Lynch on a moment (and an expression) that changed the course of his life.

I was well. Then, I wasn’t.

It was not his fault, the doctor. I mean, I’m kind of paid to read people’s faces. I’ve spent a life as a storyteller and his face told a story.

At 49, I had decided to get in the best shape in my life. That wasn’t that hard because for a long time, I had been half-assed about fitness and no-assed about diet.

Maybe this had to do with facing 50. Maybe it had to do with the fact that my mother was in the last few months of her life. She had been struggling for air for a decade due to COPD. She was finally losing that battle.

Probably both.

So, I’d committed to an extensive regimen, P90X, was counting my calories and really getting on with it.

I went to my physical that January in excellent condition. I got blood work done. My weight (I’d lost 25 pounds – a toddler), eyes, ears, reflexes, stress test, all good.

My doctor called a few days later saying my PSA level was a touch over 4, meaning there was possibility of prostate cancer. I had a family history of the disease, so it seemed wise to check it out. We have a lot of cancer in my family. Lung, colon, prostate. Cancer likes the soft innards of the Lynch clan.

Still, I was way too young to have this old man’s disease.

Onto the needle biopsy. I was awake for this procedure. Had just a local anesthetic. My urologist explained that he would extract cells in a grid pattern from every quadrant of my prostate. I don’t know why, but when he said this – my prostate suddenly seemed huge. Like he was Sulu and Chekov mapping Planet Prostate Five in a grid pattern while Kirk sat in his big TV chair and watched on the monitor screen. Probably because I’ve watched way too much TV.

He also threw in a vivid image of what I’d feel and hear. While he took samples, it would sound and feel like a rubber band snapping on my ass, without the pain. Good description, you know? If I ever get to play a urologist, I am going to use that line.

The rubber band snapped me, over a dozen times? I can’t remember. And it was done. I went to work after. I can’t even remember where.

In a way, that speaks to the extreme bounty of my career. Most actors I know can pinpoint very easily the days they work and what on. I am blessed to say I don’t remember.

A week or so later, I was walking the hills in my neighborhood. My Fitbit told me I had gone 8,000 steps and 20-some flights of stairs when my phone rang. My manager had gotten me an audition, but it was in conflict with the follow-up appointment with the urologist. Like any actor, I called to change the urologist appointment.

You know what? That isn’t fair. I don’t want to throw other actors under the bus with me. Perhaps there are many actors out there with accurate and proper priorities. Where they would cancel or reschedule the audition, not the appointment with the guy who had just spent a good deal of time and effort climbing up your ass to see if you had cancer.

I was, at the time, not one of them.

So I called and explained to the doctor’s receptionist that I had an audition and could I reschedule. She said she couldn’t get me in later in the day and I might really want to keep the appointment, rather than delay it. I did as she suggested.

Now, I don’t know if she knew that the cancer face was coming, but after that phone call, I stood breathing heavily from the steep hill walking I had been doing. I looked around, laughed and said out loud to no one: “Wow, I so have cancer!”

But I didn’t know know. I could’ve been wrong. I didn’t tell my wife or children about the phone call. I just called my manager and told him to ask for a different day for the audition.

So the next day, in some way, I was probably already looking for the cancer face.

I know, I know. I started this essay with a claim that because I am an actor, I recognized the face. The phone call was a dead giveaway, right? Anybody would have read in my urologist’s face that cancer look as he opened the door to my exam room after that phone call.

Probably. But since I have only had the one cancer diagnosis experience so far and I am an actor, not a construction worker, policeman, fireman, sailor, biker, cowboy or Indian (in other words, not one of the Village People), I’ll never know. So just go with it, OK?

The next morning, the doctor opened the door to my exam room and I had cancer. It was so clear in his expression. His face didn’t read, “Just a quick delivery of the no-cancer news, and I’m off to my next patient.” No, it read, “This a long conversation where I need to deliver bad news and discuss treatment options.” And this he did, in a calm, hopeful and effective way.

But I was still a bit stuck on the face.

Before he even started to speak, I suddenly imagined him, coming to the office that morning, cup of coffee in hand. He waves hello to the staff, sits down at his desk and looks at the files of the patients scheduled for the day. As he goes through them, he divides the files into two piles, the cancer pile and the non-cancer pile. And I was in the cancer pile.

I didn’t feel any different, of course. I was asymptomatic. So there was no discernible change in my body before and after he opened the door. But my experience of my body had changed completely. I was sick. Perhaps deathly so. I think I even laughed as he came through the door.

I do that at bad news. It can drive my wife crazy. It was just ironic to me. I had spent at least the past six months busting ass to be in terrific shape, and I was. All the working out, all of the calorie counting, all the energy of self-care were in stark contrast to his face. I was in the best shape I’d been in since I was 25. Except I had cancer.

Now, I won’t go into too much detail about what happened over the next few months. I was treated. I received a robotic prostatectomy and I have had no detectable prostate specific antigens (PSA) over the past four years. All good news.

I want to talk about the primary benefit of my cancer diagnosis. It brought me face to face with my mortality.

Here’s an example. It was suggested by my urologist that I read the book, How to Survive Prostate Cancer. (I am sure glad he didn’t recommend How Not to Survive Prostate Cancer.) I did so.

Reading this book made me feel a lot better. It was so clearly written and had a lot of action steps. There were things I could do. I could “work the problem.” (Thank you, Ed Harris’ Gene Kranz, Ron Howard and the screenplay of Apollo 13.) For example, the author suggested that a person with prostate cancer, might go to the social security website and look up their life expectancy. The task of looking it up is to do some simple math.

Here is the equation he suggested considering: A+C-L= + or -?

A is age. C is the time it is likely to take for your cancer to kill you. L is life expectancy

If the number you come up with is negative, treat the cancer.

Here was my math:

49 + 10 – 82 = -23

Treatment was recommended. But it did more for me: it eliminated the mystery. The government of the United States had a guesstimate about how long I was going to live. That was clarifying. My death isn’t a matter of if, but when, and I can see it on a .gov website.

You can do that today, by the way. Go to the social security website and find the life expectancy number for people born the same year as you. You don’t need to have cancer to do it. I recommend it. I know it sounds a bit scary to do this. But for me, it was clarifying and freeing. I have a time limit.

I look at it like soccer. Without the clock, soccer is meaningless. I know some people think it’s meaningless with a clock, but go with the metaphor.

Without the clock, soccer is just a bunch of people running around trying to get a ball into a net with their feet, forever. But with a clock, every charge toward the net becomes meaningful. Each action by the players might be the one that defines the game. And, like soccer, in life you don’t know when the game ends. There’s penalty time. The players know the game’s going to end, but not quite sure when.

The only mystery is when. And I can never know that. The cancer diagnosis made it clear to me that every moment is precious. Every second counts.

For a time, during my treatment, through my mother’s death, even through my 50th birthday, it was easy to keep that in mind. Then it started to slip away. It became harder to keep in mind.

Then David Chase’s observations from The Sopranos began to creep into my day-to-day. James Gandolfini’s Tony Soprano had been shot and was recovering. For a while, he’d been saying over and over: “Every day’s a gift.”

Then he admitted to Dr. Melfi, “Every day is a gift, but does it have to be socks?” And sometimes I feel that way. It can start to slip away, though, the important fact of my mortality.

But the “every day is a gift” mindset is worth fighting for. So I do. Maybe that’s why I wanted to make Lucky. He too is finding a way to keep his mortality in mind.

So, like Lucky, I do my best to stay with you when I am with you. I look at your eyes, your face. Even if it says I have cancer.

Because this moment will never come again.

A native of Colorado, John Carroll Lynch landed his first major film role as Norm in the Coen brothers’ Academy Award-winning Fargo. Since then, he has has had the good fortune to be directed by Clint Eastwood, Martin Scorsese, David Fincher, Miguel Arteta, Pablo Larraìn, Mick Jackson, Karyn Kusama and Albert Brooks, among others. On television, Lynch has appeared on many series, including American Horror Story (as Twisty the Clown), The Walking Dead, Billions, The Americans, Big Love, and six seasons on The Drew Carey Show as Drew’s cross-dressing brother Steve. He is honored to have made his film directing debut with Lucky.