contact us

Use the form on the right to contact us.

You can edit the text in this area, and change where the contact form on the right submits to, by entering edit mode using the modes on the bottom right.

Castle Point Court
Glen Allen, VA 23060


Garth Callaghan

Napkin Notes Dad






The Napkin Notes Blog

7 Alternatives To Not Shaving For Movember 2015

WGarth Callaghan

I think that it’s safe to say that many men loathe shaving each morning, and “No Shave November” is a perfect excuse for men to forgo this morning ritual. Although social media has helped to explode this concept in the past few years, this ritual has its roots in 2003, when 30 Australians decided to raise awareness of men’s cancer issues, prostate cancer and testicular cancer. 

Although I admire the cause, I can’t help but feel that most of my friends and colleagues who skip shaving for these 30 days don’t really get much out of it except for talking about their manly beards. This doesn’t really help the fundamental cause and the cancer issues that face us men.  I hate shaving, and I think that my face is better suited to sporting a goatee than smooth skin.  I however, will not be participating in Movember this year, and I’d like you to think about some other things that could make a bigger impact in your world. 

Here is a list of things that you can actively do for Movember:

1. Check yourself – If we fundamentally look at Movember, we’re trying to protect guys from prostate and testicular cancer.  Do you know the signs and risk factors?  Do you know how to self-examine? Let’s start with raising awareness at home.  Fathers, testicular cancer is the most common cancer in young men between 15 and 35.  It is also highly treatable when found early! Have you talked about this with your sons? Prostate cancer is typically diagnosed in older men, and there is a 1 in 6 chance that you’ll be impacted by this disease.  As you reach your 40’s, you need to start talking with your health care providers.  Again, this cancer is highly treatable when found early!

2. Make or buy dinner – Do you know someone that is going through cancer treatments right now? Make them a healthy dinner, or go buy dinner from a nice restaurant and bring it home to them.  Cancer Patients (I prefer the term Cancer Warriors) have a lot to manage each day.  Dinner is important both from a nutritional perspective and a family time perspective.  Help ease their daily burden just once and provide dinner. 

3. Rake leaves – It is fall in much of the country.  If you know someone with cancer, grab a couple of buddies, some rakes and yard bags, and go to your friend’s home.  Unannounced.  Clean up the yard and take away the leaves.  It's even better to do this if your friend isn't at home. Don’t take credit.  Just do it.  Your cancer warrior friend has bigger battles ahead than dealing with their fallen leaves. 

“There is no limit to the good that you can do if you don’t care who gets the credit.” – Gen George C. Marshall

4. Donate $30 to the ACS – The American Cancer Society is the "Official Sponsor of Birthdays". Their mission is to help fight cancer in every way possible. They help patients, caregivers, and researchers. Take $1 for each day that you would not shave and send it to the American Cancer Society.  They are a fantastic organization.  They help cancer research for all body parts, too!

5. Don’t Ask, Just Do – Anything, really.  Do you have an idea to help a Cancer Warrior?  Act now.  Just do it.  Above all, don’t say to them, “Let me know if you need anything.” This puts the burden back on to the Cancer Warrior.  There is a lot to manage in their lives, and frankly, it’s easier for that person to shrink away from letting you know how completely overwhelmed they feel.  They need help with everything during treatment. 

6. Help the caregiver – Take the caregiver out for coffee, or a movie.  The caregiver is stressed, too.  The caregiver needs a little break.  Help them step out of this situation for just a little while.  Listen.  Show compassion.  Be a friend.  

7. Shave – Really, we don't look all that good with uncontrolled facial hair.   

There are many ways to prove your manhood.  Growing a beard for 30 days is passive. 

Be active.

Do something.


WGarth Callaghan

November 5, 2011

Although I had been writing Napkin Notes for many years, November 5, 2011 was the date Napkin Notes took on a new meaning. It was the day my life changed. Looking back, I might even be tempted to say that my life changed for the better in many ways.

Here's an excerpt from Napkin Notes:

CHAPTER 2: Sangria Red

“If God sends you down a stony path, may he give you strong shoes.” Irish saying

I lost sight of her again. I was running but she was faster. I had to stay on the path, but she was darting through the trees and the underbrush. I could not keep up. The path was too twisted and uneven. I was running up, down, left and right on the dirt. The afternoon sun was beating down on me through the golden and red leaves. My wife and neighbors were well behind me, but we were all yelling her name. I was doing my best to run ahead but I was already short of breath. I was scared. She hadn't been on her own like this, with so much freedom. I had to keep her within eyesight.

We were camping, an activity I didn't particularly enjoy. On a hike with our friends, our dog Noel had dashed off in pursuit of something and was nowhere to be seen. We had rescued her less than a year before. Noel had been in a local pet shelter for 59 days. This nearby county shelter was not a "no kill" shelter and after 60 days, the animals were euthanized. She was saved from that fate by F.L.A.G. (For the Love of Animals in Goochland), a local animal rescue group. Noel barely looked like a dog when we met her. She was just fur and bones. The fur that she did have was patchy and sparse.

Noel had clearly been on her own for some time. She was skittish around most people and appeared to be deathly afraid of me. Lissa and Emma were certain. Noel was the dog that we had to save.

I didn't want a new dog in our home. Lucy was my dog. I had chosen her and loved my German Shepherd - Rottweiler mix for thirteen years.  Lucy had died just four months before Lissa and Emma ambushed me with rescue dog pictures. I was still grieving and didn't want to have room in my heart for another pet. 

I continued running even though my lungs felt like they might explode. Bailey, the neighbors' Golden Retriever, was keeping up with Noel and I could just see a yellow ball of fur up ahead. All I could hope was that Noel wasn't that far in front of her.

Finally I saw the dogs slow, some smell halting their joy run. I was able to catch up and put the leash back on Noel. I let out a huge sigh of relief, thankful that the rest of our weekend wouldn't be spent wandering the wilderness, hoping to somehow bring Noel home.

 Our neighbors, Mike and Cheryl Bourdeau, had invited us camping, one last getaway before the cold of autumn set in. At least it was camping in a cabin and not in tents. I could handle staying in a cabin much easier than sleeping on the ground. We were celebrating Cheryl's birthday and that night Mike had a fantastic dinner of steaks planned. We toasted the birthday girl with red wine and ate gourmet cupcakes. We played games and thoroughly enjoyed each other’s company. The evening came to a close too quickly. As I was preparing for bed, I needed to use the bathroom. As I stood peeing, I watched in shock. My urine was sangria red.

I couldn't begin to think what was causing this. There was no pain. There was no other indication that something was wrong with me.

I commenced freaking out.

I found Lissa and told her what had happened.  I grabbed my phone and tried to look up potential causes. There was hardly any signal. I stepped out on to the cabin porch, held my phone above my head and tilted it at just the right angle to get some data signal. Blood in your urine was called gross hematuria. I read through potential causes.  At the end of a very scary list were two causes Lissa and I hoped could be the answer: vigorous exercise and an excessive amount of beets. Not only had I been running earlier, trying to catch Noel, an activity that isn't a normal part of my routine, but Cheryl's birthday treats involved a Red Velvet Cupcake from a gourmet shop. Though I never would have guessed, Lissa suggested that the shop might have used concentrated beet juice to color the cupcake. We calmed ourselves down, enough to sleep, hoping that it was a freak occurrence and not something to truly worry about.

It would take another three weeks to verify I had a 13 cm (grapefruit sized) tumor enveloping my left kidney. I would have surgery on December 20. I would come home on December 22 and start a new part of my life: Cancer Warrior.

Family Picture taken on November 5, 2011.

So, it's come to this...

WGarth Callaghan

So, it's come to this, I thought to myself... 

I sat in the doctor's office and was having a three-way discussion regarding side effects. I seemed to have been slipping back into a disturbing pattern. I was getting pretty sick more and more frequently. I had high hopes as we started summer. We adjusted my meds down, and I stopped getting sick. I felt more human. It didn't last. 

We came up with a good plan. I'd proactively take some anti-nausea meds a few days before my "scheduled" throw up days. Maybe that would push off that side effect. 

As my wife, the doctor, and I wrapped up the conversation, I started to get ready to leave. I thought we were ready to go. 

I head Lissa ask, "Oh, and do you think we could get a Handicap Parking Permit for Garth?"

What?!? I am not handicapped! Yes, there are days that the fatigue wins, and walking can be tiring. There are many days that I kick the fatigue's butt and I feel like I could run a race. I do not see myself needing a special parking permit. Well, not on most days, anyway. 

So, it's come to this... 

The paperwork was ready before we left the office. The DMV visit was uneventful, and a few days later I received my permit. I leave it in my truck, just in case. You never know when it might be useful. 

So, it's come to this...

I look at that permit each time I drive somewhere. I see it as another challenge. Can I choose to NOT use it this day? Can I beat this? Can I choose to be stronger than this sickness? 

Damn straight I can. 

In Liebe, dein Dad

WGarth Callaghan

Garth remembers some of his time in Germany.

Hat tip to Alex Kulle, Thomas Rodeck, and Craig Parsons. I am sure you never expected this picture to make it to the internet!

Month 19

WGarth Callaghan

I had an MRI last week and got my results a couple of days ago. I quickly shared the news with my wife, Lissa. I told Emma once she returned from school. I dutifully shared the news with my mom and sister. I shared the news with my close friend and neighbor, Sheryl.


The liver demonstrates the small 6 mm hypointensity in segment 6 (series 16 image 17). This is unchanged from previous examination.

Read More


WGarth Callaghan

I'm at St Mary's for an MRI. I have two thoughts in my head this morning:  


1) The Napkin Note post will be late today. I'm sorry. I did write it, but had to get here early and didn't have time to post.  

2) Why is it that I don't know how much my MRI will cost until after I get the bill?!? Is there any other good or service that Americans purchase without having a concrete idea of the cost? 

First Day of 10th Grade

WGarth Callaghan

Napkin Note: 

Dear Emma, 
I am so proud of the young woman you have become! You're smart, compassionate, witty, and athletic. Good luck, sophomore! You've got this!! 

Love, Dad 

Pack. Write. Connect. 

10 Words or Less

WGarth Callaghan

It's hard to imagine that after all of the sales at Staples, Target, and WalMart, it is really time to think about heading back to school! In fact, I was reminded of this on Monday when I saw a news story about students in Lousia County. It was their first day of school on August 10! Holy Cow!!

Sometimes staring at a blank napkin at 5:30 in the morning and coming up with something to write is a daunting task. I know. I've written about 4000 napkins and even I get writer's block from time to time.

Here's the catch - your child doesn't care how eloquent your note is.

Read More

"Hands Free Life" Book Review

WGarth Callaghan

I was honored to be asked to review a copy of "Hands Free Life" by Rachel Macy Stafford (Hands Free Mama) earlier this year.

It took one day. I only could allow one day to read "Hands Free Life: Nine Habits for Overcoming Distraction, Living Better, and Loving More". I was busy being a dad, a husband, and cancer patient. I knew I was distracted, but there was a purpose. I was on a mission and I acknowledged my limited time left. As I settled in to read Rachel's words, my heart stayed in my throat the entire journey. She gets it. She knows we're distracted and it's not just the amount of screens we have in our lives. It's our incredibly complex, crazy, and somewhat out of control lives.  

Rachel Macy Stafford will help you reconnect and build strong relationships. Even if you make a moderate amount of effort, your family will thank you for strengthening your relationships! Once again, I owe Rachel a big "Thank You" for bringing relationships and family to the forefront of everyone's minds.

The book is coming out next month. Pre-order a copy today!

Barnes & Noble:
Indie Bookstores:

Six Words Revisited

WGarth Callaghan

I sat at my desk with tears running down my cheeks. Although my spirit has been battle hardened, there are a handful of things that can still bring me to tears today. I was reading an email from Karen Schwartzkopf, the editor of Richmond Family Magazine. She had chosen which except from my book, Napkin Notes, to use in the June edition for the DadZone column.

Read More

Which Doctors

WGarth Callaghan

I've started my fifteenth month of treatment. I'd have to say at this point it's not really treatment anymore. It's prevention. What we see isn't getting any smaller. It's not growing or spreading. It's stable.

The question remains, "Am I going to be healed, or is this as good as it gets?" Am I just waiting for inevitable spread which would eventually harm me beyond repair?

There are a handful of viable treatments I could try. There are even some things that aren't quite yet approved, but worth getting my hands on.

My course really depends on which doctor I want to believe. In which doctor do I put my trust?

One doctor had a frank conversation with me just a few months ago. He stated that the median lifespan of someone in my condition is about 12 months. We could give ourselves a +4 since we're using Votrient, my current treatment. So, 16 months. My metastatic diagnosis started in Feb 2014, if we're using the best case scenario dates. This doctor didn't even want to talk about a 3-year lifespan until we were able to effectively deal with the cancer we could see. He also gave me a 100% chance of having kidney cancer cells floating around my body. A dangerous situation.

One doctor thinks I am doing well. If he didn't know I had cancer in my medical history, he might overlook the lesions on my MRI. He thinks I should consider lowering my Votrient dosage to increase my quality of life. I might even want to consider reducing my dosage to zero.

Most of my doctors won't consider a different treatment path until we see growth or spread. I should keep taking the Votrient until it stops working. (And it will stop working.) Once we see material growth or spread, we can consider an alternative.

Waiting seems incredible passive to me.

I also know that each day with Votrient is generally not a fun day. I can tolerate the meds some days. No days are "great" and most days are below average. Some are utterly awful. I really don't know how much longer I have it in me to keep taking this drug. I also think it's keeping the cancer from growing and spreading, but that's it.

A friend shared his thoughts on this with me last week. "Stable is dying." I immediately knew what he meant. I am driving down a road. I have no brakes. There is a cliff in the distance. But I am stable. Everything is ok today.

Stable means dying.

Here's what I plan on doing:

Genomics - I am having my cancer's genome sequenced. There's a small chance we could see something that would help direct my best path for treatment.

PD-1 or PDL-1 - "Programmed cell death protein 1"  Now that's the way to label a treatment! This treatment is mostly in late-stage trials, but a few were approved for use in the U.S. in the last 6 months. I just need to find a doctor that will get me in the program. We'd need to see if I can take both treatments concurrently.

Vaccine - The University of New Mexico currently has a Phase 3 trial testing a personalized vaccine for metastatic kidney cancer.

Wow. That's some cool stuff.

Which Doctor?

I guess whichever one wants to sign up to treat me. Any takers? Call me.


Health Update

WGarth Callaghan


It's time for a quick health update. 

I had an MRI last Sunday and met with my oncologist on Thursday. 

There's no material change. We still see the same lesions on my liver that we've seen for a year. There's been no change since June 2014. 

We will check back again in about 8 weeks. 

We're discussing a lot of options and alternatives. The meds have been hitting me pretty hard lately. I'm tired. We need to fix that. 

I need to get back to the softball game. Have a great night!


Across Frontiers

WGarth Callaghan


I love the time in which we live. I spent part of my morning collaborating with Hanna, the translator who is working on the Polish version of Napkin Notes. 

It was an eye opening discussion. I think it will make me focus on clarity and continuity as I write. 

I also found a big mistake! I'm not sure how I made this mistake, but it's right there on page 191. Can anyone pick it out? 

Pack. Write. Connect.

#43 (Star Wars Shirt, that is)

WGarth Callaghan


There was a surprise package in our mailbox today. I could see my sister's return address when I pulled out the envelope, but this wasn't from her. Her dear friend, Carmie Stanek, was in Florida recently. She knows my love for Star Wars shirts and how I use them to "stay different" at the doctor's office. It's my 43rd Star Wars shirt.

Thank you, Carmie! This is my new, favorite Star Wars Shirt. It makes me look forward to my next appointment!!

I always wear Star Wars shirts to each and every medical appointment.

What do you do to make yourself remembered?

No Change - Again

WGarth Callaghan

I lie in bed as I write this. I'm tired today. I didn't get nearly enough sleep last night and I'm greatly looking forward to closing my eyes soon. I've found that a good 11-hour sleep is best for me. It certainly cuts in to my family time, but both Lissa and Emma understand my need for extreme sleep lately. 

I had an MRI and a CT scan last week. I also had an MRI in December,  it I didn't share the results. I wasn't hiding anything, but December was a pretty busy month for us and the results were mediocre in my mind. 

No change.  

My MRIs have shown now change since June.  



I still have metastatic kidney cancer. It hasn't grown. It hasn't spread. 

It hasn't gone away, either.  

I know I should be excited, but I'm not. "Stable" isn't winning.  "Unchanged" doesn't beat cancer, and that's all I want to do. I want to beat cancer so badly I can feel it in my bones. 

It's not going to happen today, but it will happen. I'm all in. 


Thank you you for walking on this journey with us.  

Mom's Turn

WGarth Callaghan


I had a very bad night and didn’t get out of bed this morning. My wonderful wife, Lissa, made Emma’s lunch and wrote her a Napkin Note in my place. How’d she do?? 

PS - I think it’s pretty awesome! If you think she did a good job, please leave a comment for her! 

Pack. Write. Connect.


An Avid Reader

WGarth Callaghan

I snuck the Christmas present from underneath the tree. I just had to see what was inside. Of course, I knew that it was a small box of books. My parents had sent me this as one of my gifts. The Customs Form on the box listed: cookies, candy, clothes, and books. I could tell by its shape and weight this was a box of books, probably three paperbacks. I desperately needed to open this present undiscovered.

By the age of 16, I was a master of Christmas sneakery. I could touch, feel, shake, and when necessary, open a present, in order to guess the gift. I hadn’t been totally surprised on Christmas morning for more than a few years. I even discovered my mother’s “Master List” which showed each and every single present purchased. I tried not to look at that list. Using that list was unsophisticated and almost like cheating. My techniques required finesse.

If I couldn’t guess the present from feeling it and shaking it, then I resorted to opening it. That was always risky, but using a sharp knife with the proper technique, I could slit the tape and slide the present from within its wrapping paper confines. The tricky part was getting it back in without tearing the paper. My mom tended to wrap presents tightly, and the slightest misstep would cause a rip that would expose my spying activities. Future Christmas sneaking was dependent upon my successful repackaging and taping up the presents.

This Christmas was different. I was sixteen and away from home. I was living in Germany as an exchange student. I hadn’t read a book in English for months. I was starving. I was used to reading more than a few books a week, and I couldn’t read that well in German. I was still reading children’s stories and comics as I learned the language. But at that moment I held something more powerful than the Holy Grail in my hands. I held genuine, printed in English, fresh off the press, BOOKS!

I wanted to exercise as much caution opening the present here as I did back in my own home. Would my German host family understand my deep desire to have my present early? What would they think of me being such a sneak? Did Germans even try to guess their Christmas presents early? Those questions were quickly tossed aside as I slit the tape and carefully pulled the boxed set out.

Dragons! This was going to be fun. The Dragons of Autumn Twilight. I couldn’t imagine what words were inside, but I didn’t need to wait long to find out. I quickly found another paperback that was a similar shape and size. I replaced the stolen book with this facsimile, rewrapped and re-taped the present, and put it carefully back under the tree.

I took the book to school and read in each of my classes. I propped up my textbooks in each class to hide the fact I was reading something else. Most of my instructors didn’t call on me often. I was, after all, the American kid who didn’t speak German all that well.

I read, and read. Sometimes I didn’t notice class had ended until there was a shuffling of students. I would quickly pack my paperback away until the next class.

I fell in love with the characters in this trilogy very quickly. Both dragons and magic leapt from the pages of the book. Each character had a richness in personality that I hadn’t experienced. I was quickly drawn in to their world. I could smell the spiced potatoes they ordered at the inn and felt the fear of the heroes as their world seemed to crumble around them.

I finished the first book all too soon. I repeated the trickery with the second and third books, and in three short days I had read all of the books. A tear had been shed, not because I was finished, but because a beloved friend had died in this story. I had finished using up my Christmas present. Some would say I ruined the surprise, but I was just as surprised as I would have been on Christmas morning. I just enjoyed my gift a little earlier than my family imagined.

As luck would have it, I fell ill. It started with a small pain in my stomach. I couldn’t tell what it was, but I knew I didn’t feel well. The pain grew worse as the days passed. Eventually, I couldn’t walk without pain and was limping as I was buying some presents for my host family. I finally told my host mom, Elke, that I was sick. She fetched my host dad, Dieter, who poked and prodded my stomach for a bit. I winced in pain and was whisked away to a local doctor.

The doctor performed a few tests and seemed to rapidly give instructions to Elke. I only understood two words: sofort and Krankenhaus – immediately and hospital.

I paged through my German-English dictionary and found the word: Blinddarmentzündung – appendicitis. I was prepped for surgery and experienced the fun of hospitalization in Germany. My appendix was removed the next morning without much fanfare. 

As I was recovering, I was told to expect to be in the hospital for at least a few days. I would spend Christmas hospitalized. My host parents brought in a small Christmas tree to decorate my area. They also brought my presents. One by one I opened them. A t-shirt, Oreos, maple candy, peanut butter, and ... the books. My host family excitedly exclaimed, “At least you have the books to help pass the time here.” 

And that I did. I read them again, twice. I never let on that I was a sneak and had already read them. 

Napkin Note

WGarth Callaghan


Napkin Note: 
Dear Emma, 
When you were born, I saw that you were perfect and I loved you. Then I saw that you were not perfect, like me, and I loved you even more. 
Love, Dad 

Pack. Write. Connect.