Destigmatize Decaf: A Conversation with Comedian Jesse Case, Part One

Artwork courtesy of Jesse Case

And now, something completely different. I had the opportunity to talk to one of my favorite podcasters this weekend. Jesse Case is a comedian from Nashville, Tennessee, and after some television appearances and successful tours, he's been living in Los Angeles for several years. Jesse is wickedly funny, incredibly self-aware, and if his appearance on the Kevin Nealon Show is any indication, he's destined for success. And then in 2013, Jesse got really sick. Like, shitting-twenty-times-a-day sick. He details the entire story on the first episode of his podcast, Jesse vs. Cancer. Jesse was diagnosed with stage IV colon cancer, or as he calls it, "ass cancer of the ass." I heard about Jesse and his show when he was mentioned on Too Beautiful to Live, my favorite podcast. Jesse recently made an appearance on TBTL.

I'm a bioethics graduate student. I sit in the the library waxing philosophical on clinical ethics, but I don't know what it's like to deal with illness every day. On a whim, I emailed Jesse and asked if he'd be willing to chat with me. He agreed immediately. What resulted was a deeply personal conversation, from both sides, and what I hope is the beginning of a friendship.

I thought about what I was going to write about after recording our conversation, but I ultimately decided to let the words speak for themselves. I transcribed our call, and his voice translates as beautifully in the written word as it does on his show. What follows is part one of that conversation.

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Kelly: I've been listening to your show, and you've talked about some things that have been really interesting to me. You were telling your story about being diagnosed, and essentially, your doctors had to rule out every other thing before landing on cancer.

I don't know how, as a person who is not that much younger than you, I'd be dealing with this kind of diagnosis. What did it feel like actually having the worst case scenario? Did you ever suspect that there was something really wrong with you?

Jesse: The only time I ever had that suspicion, really, was the first time I sought treatment. I didn't have insurance and was in the process of getting insurance, but it was such a nightmare getting all that lined up. Like, it took months. I explained on the show just about how the financial stuff got assigned, and there's so much red tape. I wound up going to a free clinic. I had so much pain in my abdomen that one day, I just passed out in the shower it hurt so bad.

I realized this was a huge problem, and they gave me antibiotics. The weird thing, though, is that my symptoms still responded to antibiotics. Sometimes, in rare cases cancers can do that. 

K: That's essentially what cancer is, just inflammation in your body. 

J: All of the inflammation stuff is normally viewed as something else, like ulcerative colitis or Crohn's disease. I went to this free clinic, and that was the only time I had the notion that they just didn't care. I'm just this dude in a hoodie and jeans, and I was probably wearing a beanie. They just thought I was some junkie. You come in complaining about pain, and they thought I was seeking drugs. The first thing they told me is that they weren't giving me any pain medicine. 

They were just so awful to me at this place. It was kind of this weird experience because my mom is in the healthcare field, and she's actually very, very good. She's a doctor of nursing, so her patient satisfaction ratings are through the roof. She's like a big deal. 

K: That's why I want to go into that field, so I can work with people. Doctors can be really fucking awful, sometimes. 

J: Right, exactly. I have this standard of bedside manner that I'm used to, and then, it was the first time experiencing what it's like to be poor. This is weird because it isn't even like a healthcare thing, but like a white privilege bullshit thing. There have been times when my car is broken down, so I'm on the bus, and I still, in hindsight, view it from outside. Like, "This is interesting, I'm on the bus." What a weird way to view that. This is a lot of people's reality. This is mandatory for them. 

K: I used to take the bus a lot when I lived in DC.  I would feel separation from every single person. I don't take the bus in New York ever because I don't really need to, but I would have the exact same thought process, even though I would do it quite frequently. 

J: It's very weird. And it occurs to you that this is so many people's reality, that this is it, this is what they deal with. It was a terrible experience dealing with the free clinics, but it kind of lit of a huge fire in me of just trying to affect change in some way. Even if it's just through whatever skills I can bring to the table, which happens to just be being a comic. I was like, "Well, this is isolating and terrible. And this needs to change." Not even so much the actual treatment, but just the the cattle call of it. I know you were saying you see so many faces every day (you can read my thoughts on that here), with dealing with cancer or even just being in New York, it's the sensory overload of it. It's sensory overload being in that city. 

K: And I live here now. I love it so much because I was really unhappy with my life until recently. New York and I were sort of meant to be. But it is overload. I have to get used to it.

J: I always wanted to live in New York. I went to LA because it's cheaper. 

K: It's a myth that New York is super expensive. 

J: I'm realizing that now. Los Angeles and I are not the same. I've always been an alien there, and I'm very skeptical of people that like it. People there really love it, and I'm like, what are you guys talking about?

K: Me too! LA is so fucking weird. I've actually spent a good amount of time there, and I do not understand it. 

J: This whole thing that I've been going through has been such a revelation of needing to not waste my time. Not necessarily even to do something productive, but just I need to quit living my life like I'm going to be happy later. I think so many people have that assumption, like, "Oh well, I'll put up with this dead-end job for thirty years because then I'll be happy when I retire." But then, you're just wasting your life.

K: One of the things you said on TBTL that really stuck with me was that having cancer is awesome because you're living life the way that you should be, taking every day at a time. That spoke to me, this idea of having to have something happen to you to be like, "Oh, I'm going to get out of this job I hate, and I'm going to happy for the time I have left."

Why do we all have this attitude? I don't understand that. The inciting incident for me to get my shit together and to just be a happy person was when I was in this relationship that ended (That's the origin of this blog - you can read the first post here). He was the first person I ever loved, and it was so intense. He met my family. I thought we were going to get married and have babies. That was the plan. It was discussed. He had a lot of issues, and one day he just called me on the phone and put on this voice I didn't recognize. And he said, "I can't be in a relationship any more with you. This is just too much for me to handle." And he hung up the phone. Two minutes later, we were over. I haven't heard from him since then, and that was almost a year ago. I lost it. Luckily my parents lived close by at the time, and I said, "You need to come pick me up. My world just fell apart." I was Tobias Funke-style, crying in the shower. 

J: Oh yeah, I've been there. I've literally cried in the grocery store after a break-up, and the thought that triggered it was, "She ate food." That was the thought. It wasn't even a specific type of food. Just, she ate food. You know, breaking down in the cereal aisle. 

K: My ex really hated the idea of decaf coffee. I'll drink it sometimes, and I understand that everyone in the world judges you when you order decaf coffee. I have anxiety problems, but sometimes I just want to taste coffee because the effect is psychological. 

J: Also, not 100% decaf. That should be your argument. Like, "Dude, this is still 20% caffeinated. It's a lighter coffee." 

K: Destigmatize decaf.

J: I agree!

Side note: I was walking home from the subway tonight, and there's a diner a block away from my house with a neon sign that says, "DEATH TO DECAF." Damn you, hipsters. 

K: I'm so sick of people judging me when I order decaf. Every anxious person in the world in the world needs to get on this movement. Anyway, what triggered real sadness for me after this break-up was that someone I was out to lunch with got decaf. And I had to hold it together because I remembered this decaf coffee conversation with my ex.

That whole scenario was part of why this changed needed to happen. I said to myself, "You're whole framework for being is gone. But wait, that's a problem. One person should never be your entire framework of who you are, anyway." I did all this self-reflection and realized that I wasn't happy in my job, and DC wasn't the right place for me. I couldn't see that before. I have such an interesting relationship with Washington, DC, because I grew up there, but it's such a transitory place. People are there for six months, or nine months, for an internship and then they go. Everyone there is this one kind of person that I am not.

I got into grad school, and I thought, "Alright, this is what I'm doing now." I get stressed with things, but I just think I'm more mindful. Life is pretty good. It's almost like I'm expecting for things to get difficult or for me to be unhappy. I feel like everyone is talking about how unhappy they are all the time. The expectation is at this age that you should be really sweating it all the time, and I really don't want to be living my life that way. 

J: That's the whole thing about mindfulness, that you have to disconnect yourself from the narrative you give yourself. And if you actually look at things objectively, what's happening right now in front of you, it's never that bad. 

K: But you're saying that as a person with stage IV cancer. You genuinely think that now?

J: Genuinely think what?

K: You've never had a moment where you were like, "Wow, this is awful." I'm just trying to wrap my head around this idea of constantly being aware of your own mortality. I live my life thinking that I have a lot of it left to live. And your concept of time must be so different now. 

J: Look at it this way. Even on paper, from a narcissistic angle, there are pros and cons to both. If you were writing down columns of pros and cons, there are a lot of things that instantly went out the window. I'm not going to have to see my parents die. I don't have to worry about saving money. There are all kinds of weird things, where I was just like, "Well, that's cool." That sounds really fucked up, but it's true. These have been huge anxieties in my life I get to let go of all of a sudden. 

K: Realistically though, how much time do you think you have?

J: Well, I might not be terminal. I could survive this, my prognosis keeps getting better. This surgery will determine a lot. But I mean, this is the first time I've really considered life afterwards. It looks like now that's a possibility. And that's recent. That's only been in the last month I've started viewing things that way.

I discussed it a little bit on the podcast, but I'm worried that my philosophy, these things I've realized, will go back to the way they were before. And I make it sound like I was some douche before. That's not me; I never was. This is such an enhanced version of weird mindfulness. If I live through this, this will be the best thing that's ever happened to me, which is weird, because right now, clearly, it's the worst thing that's ever happened to me.

You and I click in the anxiety field. I've been really high anxiety my whole life. It comes from your world being too small. As you were saying, it comes from letting one person determine your whole framework. That's letting your world get really small, and that creates anxiety. But I think that I have this weird thing where my whole life most of my anxieties I keep wondering, "Is this my fault? What can I do about this?"

K: Me too. 

J: Even if it's a weird phobia, even if you're on a plane, and there's turbulence, and I'm like, "okay, could I have not gotten on this plane? Is there something I could do if I go to the cockpit?" And where you're dealing with something that it a heavy just in nature as cancer... I completely have nothing to do with this. This isn't based on something I said to someone when I was seven. It's just completely not my fault, and it's the first time in my life where I've actually been a victim. Even if that's not technically true. I'm sure I have been a victim before, but there's been no wonder of what I could have done to cause this. There's no what ifs. And I think that opens some pretty immediate acceptance.

For more, look for part two of this conversation this Thursday. Until then, listen to Jesse vs. Cancer on your favorite podcasting app or at jessevscancer.com. New episodes are out every Sunday. Follow Jesse on Twitter (@jessecase). Please also consider donating to Jesse's show - after he covers the costs of production, all of the proceeds go to the indigent care list at the Vanderbilt-Ingram Cancer Center in Nashville, where Jesse is currently getting treatment. Click the "Donate" button at the top of the page.