Doctors and nurses

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I have not since my birth overnighted in a hospital, until this last November. Then my white-cell count crashed and I became neutropenic (no dirty jokes, thank you), and I had to spend seven nights in a nice local hospital.

It really wasn't so bad. I was often sedated, naturally. The noises at night can be a little unearthly, all kinds of hoots and hollers and cries, but if you think of it as an indoor camping trip, you won't be too far from the mark.

I learned a lot. I learned that morphine makes me see handwriting on the wall where there is none, and faces where there are none. I learned that only a qualified medical professional can tie and untie a hospital johnny from the back.

Most interestingly, I learned a lot about the difference between doctors and nurses.

If you want to continue the camping metaphor, you might think of the nurses as the flowers on the forest floor, and the doctors as the trees. Nurses are far more colorful; they can and do wear whatever colors they like. Doctors are monochrome - usually white. Nurses are everywhere; doctors sprout up only here and there. Nurses tend to be bright and cheerful (with a few exceptions); doctors are a little on the stiff-and-somber side.

Nurses fall silent when doctors enter the room. We all of us, patients and nurses and guests, wait for the eighty-five-dollar-a-word advice to fall, pearl by limpid pearl, from those doctors' lips. Nurses try their best not to impede the grave to-and-fro passage of the doctors from ward to ward, floor to floor, room to room. (Questions are met by: "I know they've begun rounds. I'm sure they'll be here shortly." The nurses try very hard not to get your hopes up; they can do just about everything, but they can't say the magic words that will pronounce you cured and get you into a speeding wheelchair headed for the exit.)

I was lucky, in that about every single one of my nurses and doctors was wonderful (with a few tiny aberrations, which you generally have to chalk up to being human). I did see one doctor come close to telling off a nurse for something - I think for using an alternate drug protocol; to be fair, I knew the nurse and know that she would never do anything to endanger the life of a patient, and the doctor looked young and sniffy and full of inferiority complex, so we will leave it at that. I know who I was rooting for.

At any rate, during my week in the hospital, I learned enough about medicine to pass some kind of premed exam.

Too bad I can't stand the sight of blood 'n guts. Otherwise I'd be a whiz of a doctor.

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Almost better

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Okay.

I am almost better. I am no longer in treatment, and they are no longer cooking my throat with radiation, and I can actually tell a difference. Chemotherapy is now also a thing of the past, and the nasty side-effects are subsiding. I am still waiting for some of the lingering stuff to pass: the fatigue, the come-and-go voice (I sound, when I speak, something like Tallulah Bankhead and/or Lucille Ball, with maybe a little mid-career Lindsay Lohan thrown in), the inability to swallow. (The latter is coming back a bit; I managed to sip some water and juice the other day without coughing, and I was very excited.)

Anyway. I am also writing again, so evidently my energy is coming back. I can’t promise a daily blog, but I can promise something once in a while – maybe once a week or so – until I am back to my usual rude vigor.

Aren’t you pleased?

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R words

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Wednesday, December 11, 2013 was the day of my last radiation treatment. I had my final chemotherapy treatment the week before, on Tuesday, December 3.

I am done with treatment. I am now in Recovery.

Recovery would be lovely if it took place in a day, or maybe two. It does not. As one waggish commentator said online: “The radiation doesn’t stop cooking you all at once. It keeps simmering for a while.”

Lovely.

Also, there are the naggingly minor side effects, like the sore throat that makes it almost impossible to swallow, and the bizarrely twisted sense of taste. (I long for real tastes, and for solid food. I was reading the biography of Muriel Spark the other day and found a mention of Muriel having drinks with Edith Sitwell – “iced gin with grapefruit juice” – that almost made me burst into tears.)

My energy is returning, which is not necessarily a good thing. I have lots of get-up-and-go, but very little to do. Christmas is useful, because I can use my time making lists, checking them twice, etc. I can organize books on my bookshelves. I can write little feuilletons like this one, when I can summon up enough brain cells to do so.

And I can day by day think about my improvement. I needed less pain medication today. My throat was less obstructed today. I slept a straight four hours last night!

So much for recovery.

There’s another R word that I don’t even want to think about right now, for fear of jinxing myself: Remission.

Remission is the absence of cancer. My radiation oncologist (who is not normally the soul of Christmas good cheer) tells me, with his gargoyle’s grin, that he cannot see any sign of the original tumor in my throat when he looks down inside. (That is, of course, with the naked eye. He is not Superman and does not have X-ray vision.) This is excellent news, and I will be having several more tests over the next few weeks and months to confirm this. Back in September, when this whole cavalcade began, I had a Stage IV tumor (“roughly the size of a Meyer lemon,” according to another clever little Internet source) under or beside my left tonsil, along with an assortment of nastily swollen lymph nodes. Now – who knows? The whole kit and caboodle appear to be gone.

I say again: they appear to be gone.

We Reassure ourselves with the good cheer of our doctors that the treatments Really Really worked. We don’t ever want to go through that kind of treatment again. (The first month or so was nothing at all. The last few weeks were Repulsive.)

So here’s to the future, and to another day of Recovery.

And you know what? The new season of Ru Paul’s Drag Race begins in a month or so.

So I have something to look forward to after all.

(Also: doesn’t the rhino in the illustration above look like a hippo to you?)

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Chemo brain

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One of my cancer-survivor friends used the expression “chemo brain” in conversation to me very casually a few months ago. “I came back to work one day,” she said, “and I sat through a meeting, but I had chemo brain something fierce, so I just went back to my office and addressed envelopes.”

Now I know what she was talking about.

Kids, it’s not so bad. It’s like a mild harmless form of dementia. It takes my current charming state of forgetfulness and turns it into a comedy routine.

Example: I take a pill and then stare into my hand, wondering if I took the pill or not.

Example: I go blank in the middle of stirring something, come to, and wonder how long I’ve been stirring.

Example: I bought some kosher salt the other day, used it, put it away, and then spent ten minutes looking for it again. It was adorable, like watching your dog (or your grandfather) spin around in the middle of the room, hopelessly confused. I searched the same shelf four times! I even took everything out of a cupboard and put it back together again! (The next morning I suddenly realized that the salt was in the pantry closet, right where it belonged. Smart mommy after all!)

Ah, the sweet bafflement of the elderly, and those of us under chemical control.

Enjoy our antics, kids.

Someday it’ll be you.

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Update, Dec 1 2013

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I started my treatments (simultaneous chemotherapy and radiation) in mid-October; I get chemo every Monday (it takes about 3 hours) and radiation five mornings a week (each session is about ten minutes long). The standard protocol for this kind of cancer is seven weeks’ therapy, which brings us to early/mid December.

Weeks One and Two were easy. I was able to work almost a full schedule, and felt almost no side effects at all. (I did notice that Thursdays were bad days for tiredness, malaise, etc.).

Week Three began to get interesting. One evening I discovered that my beard hairs were falling out by the dozens, so I shaved the whole thing off.  My sense of taste went wonky – almost everything tasted awful, like cigarette ashes and cardboard. Acidic and spicy foods were literally painful. Ice cream was okay for a while, and marshmallows, but I was eating less and less because the flavors and sensations were so unpleasant.

Week Four: now I was feeling it. I got very dehydrated (my own fault for not getting enough water). My old friend the kidney stone decided he wanted some attention too, so now I was taking pain medication both for my throat and my kidney. Swallowing was now becoming very painful too; I was reduced to eating soup and crackers, and I knew I was losing weight. Still going to work most days, but seldom for more than a few hours; I was generally very tired most of the time.

Weeks Five and Six: finally decided to stay home full-time and rest. Using my feeding tube now – frankly, much easier and efficient than I thought it would be. My daily menu is six cans of Ensure Plus, two each for breakfast, lunch, and dinner, plus lots of water.

On Friday of Week Five, I got very listless and warm; Partner took me to Miriam Hospital, where they determined that my white blood cell count had crashed over a period of a few days, and I had an opportunistic infection (probably thrush). I spent seven days there, absorbing intravenous antibiotics and waiting for my blood count to get back to normal. (The number in question, my Absolute Neutrophil Count, was around 300 when they checked me in; 1500+ is normal, and anything under 500 is dangerous.)

Anyway, so seven days in the hospital. I was perfectly comfortable, and all of the nurses and doctors were wonderful.  Partner spent time with me mornings and evenings. My voice is terrible – sometimes I can’t speak at all – which made communication with the nurses and nurses’ aides and doctors very interesting sometimes. (I ended up using a “conversation book” – if I wanted to say something more profound than “yes” or “no,” I wrote in my little red notebook and handed it to the person I was talking to.)

I was released on Friday, Nov 29 (ANC count 1000+), and am glad to be home. I’ve already resumed treatments; I have only eight radiation sessions to go, and one (or possibly two) chemo sessions. The completion date is still around December 11.

Good news: everyone agrees that the tumor and the accompanying lymph nodes are shrinking very rapidly. My neck is reddish and looks sunburnt, but everyone thinks the area looks very good. My throat’s painful, of course, and I generate mucus like an opened fire hydrant, but things could be worse. (The header picture was taken this morning a little after 3am. Notice that I have ditched the hospital pajamas. I think I look like Gale Gordon as Mister Mooney, getting ready to reprimand Mrs. Carmichael for something.)

Thanks to all for your kind thoughts and comments. 

The hundred-and-eight sorrows

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I am not a Buddhist really. (Just ask Dzongsar Jamyang Khyentse about that, and he’ll agree.) But I know some Buddhist doctrine, and it has actually helped me stumble through life.

How many different ways to suffer are there, do you think?

There are exactly one hundred and eight.

There are six senses in the Buddhist world view: smell, taste, touch, sight, hearing, and (the one we Westerners forget) the mind. Suffering can enter through all six of these.

What enters? The six stimuli: things we like, things we dislike, things we don’t care about, things that bring us joy, things that bring us suffering, things that make us feel nothing at all. Things we like may be bad for us (like alcohol). Things we dislike (like bitter medicine) may make us suffer, though they’re good for us physically. Things we don’t care about may be vitally important, but we don’t realize it. Joy is wonderful but it never lasts, and its departure causes suffering. Unhappiness is suffering itself. Indifference can lead to suffering later, through regret.

Six senses x six stimuli = 36.

All six stimuli can be past (remembering the six stimuli), present (experiencing them in the moment), or future (anticipating them).

36 x the three time periods of past / present / future = 108.

These are the hundred-and-eight sorrows.

In some Buddhist practices, there are commemorations of the number 108: 108 prostrations before the Lord Buddha, 108 circumambulations of his statue. Sometimes they ring a bell 108 times at the New Year.

Try this exercise: think of something you do, something you love or hate or don't care about in the least. It will be one of the hundred-and-eight.

How about smoking? I smoked for fourteen years. I liked the way it tasted back them.

So: (sensation: taste) x (stimulus: liking) x (time: past).

And now I have throat cancer, almost certainly as a result of those fourteen years of smoking. (See also karma.)

The one-hundred-and-eight sorrows go on and on, endlessly, so long as there’s a single unenlightened being in the entire universe.

We need to realize them, and name them, and let them go.

Then we can move on to whatever comes next.

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Love your enemies

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When my mother was undergoing cancer treatment in the 1990s, she went through all kinds of interesting states of mind, way beyond Elisabeth Kubler-Ross’s measly five.  Elisabeth would have been astounded. 

One of the most unexpected was the “I’m gonna tell you what I think of you before it’s too late” phase. We discovered that Mom was calling up people from her past and telling them all the things she’d been holding back for decades: how they’d disappointed or betrayed her, how they weren’t good enough for their wives/husbands, how they’d made bad decisions. (Myself, I was surprised that Mom had ever held anything back – she could be a real loudmouth when she was wanted to be – but apparently she’d kept a lot of opinions back after all.)

I am my mother’s son. I am full of grudges and unsettled scores. I am terribly self-righteous, just as she was. I only hope that, as the cancer treatment weakens me, I don’t succumb to Mom’s let-‘em-have-it mentality

This is why I was bemused by something that showed up on my Facebook wall a while back: a serious discussion of why you shouldn’t have enemies. To wit:

·        Enemies take up a lot of your valuable time – whether you’re actually taking revenge, or just thinking about it. (This is true, and I hate the idea of wasting time, especially at this point in my life.)

·        Your enemies probably aren’t worth hating as much as you think they are. (Maybe. Some of mine are pretty loathsome.)

·        Most of the world’s religions tell us to be kind to our enemies.

This last one needs some scrutiny. Certainly Jesus tells us to love our enemies. But the God of the Old Testament certainly didn’t mess around with anyone who got in his way. And many modern Christians seem to act as if they loathe whole squadrons of people.

So what’s an unbeliever to do?

Well, I normally don’t like Saint Paul, but in Romans 12:20 he comes up with the perfect reason to do good to your enemies:

Therefore if thine enemy hunger, feed him; if he thirst, give him drink: for in so doing thou shalt heap coals of fire on his head.

See? You can make your enemy ashamed of himself by being nice to him. And then, if he doesn’t make friends with you, he presumably goes to hell.

Doesn’t that make you feel better?

It does me a world of good.

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Smoking, take two

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(Note: this is a rewrite of a blog I wrote back in 2011, with maybe a few updates, in the light of recent events.)

Both my parents smoked. I have distinct memories of sitting in the front seat of our family car, with my father in the driver’s seat on my left and my mother sitting to my right, both of them puffing away, the ashtray overflowing. I couldn’t breathe. I finally spoke up about it when I was about nine or ten years, and it actually inspired my mother to quit smoking.

This, however, didn’t stop me from taking up the habit myself. I got a free sample of Lucky Strikes at Fenway Park in 1983; I smoked one or two of them; soon after I was in Morocco, and smoking a pack a day; soon after that I was in Tunisia and smoking two packs a day.

I kept this up until 1998. Remembering the family proclivity for cancer, I resolved to quite when I was forty, and I managed it, just a few months shy of my forty-first birthday.

I have been reasonably healthy on and off since.

And now, fifteen years later, I discover that I have throat cancer, the main risk factor for which is – ahem – smoking.

Go figure.

I freely acknowledge that it’s my own fault. I knew there were bad genes on both sides of the family, and I knew that smoking could only be bad for me. But I kept it up for fourteen years.

Foolish, naturally. Most of those fourteen years between ’84 and ‘98, I was just smoking out of habit; I even (as do most smokers) kept it up while I was sick with colds and the flu. I even smoked at meals. I was smelly and utterly obnoxious, and probably nearly burned myself to death more than once. I realize that now.

But I remember one beautiful morning in Tunis, before I developed my two-pack-a-day habit. I left the house around 8am, bought a pack of local cigarettes, lit up, and –

That first puff was heaven.

So it wasn’t all bad.

But it probably wasn’t worth getting cancer for.

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Sweet are the uses of adversity

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I am ailing. This is a shame. But there’s no reason I can’t get some benefit from it.

Once in a while, when talking to people, I just touch the side of my neck (where my tumor is) with people who know about my illness, and they become much more agreeable right away.

This is awful of me, I know. But what would a bad thing like cancer be without some positive side?

People are afraid of illness generally. A lot of people are unfamiliar with cancer altogether. One of my coworkers asked me the other day: “What would happen if you didn’t do any treatment at all?” (I had to explain to him that cancer is a death sentence if not treated; mine would probably metastasize to my jawbone and lungs, and I would die a very painful death within a few years at most. His jaw dropped, and his eyes were like saucers. He obviously had no idea it was that bad. Apparently he thought that cancer was like a bad cold – nasty, but you get over it eventually.)

People at work (who know about my condition) treat me with respect, for the most part. I don’t deserve it – I’m a horrible person in general – but then again, I’ve been in the office for over twenty-five years, and I deserve respect for my seniority if not for anything else. If it takes the realization that I’m seriously ill to make them pay attention, then so be it.

I love being treated seriously.

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Hair loss

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My friends all know about my cancer now, and their reactions have been very diverse. But the most remarkable of all – which I got from two different people, mind you – was: “So will you be losing your hair?”

The first time, it caught me completely off-guard. The second time, I had an answer prepared: “Probably. I can put it in a box and ship it to you, if you’d like to have it.”

Honestly, though, I wonder if I brought it on myself. (The hair loss, not the cancer.) I have bragged more than once about the nice thick hair that Heaven granted me. Only this last spring, two of my (younger) colleagues were commiserating about the fact that they were balding. “I don’t have to worry about that,” I gloated to them. “I don’t have the gene for it. Look at what a nice thick handsome head of hair I have!”

They laughed dutifully, but they were both glowering at me.

And, you see, Karma is now paying me back.

The radiation therapy, being directed very specifically toward the tumor in my throat, will cause only a little hair loss – perhaps part of my beard and some of the hair on the back of my neck.

The chemotherapy, however, will probably take care of the rest. In the words of one website: “You will very likely wake up one morning with all of your hair on your pillow.”

Delightful.

But, as I keep telling people: isn’t that what hats are for?

And, thank goodness, I look charming in hats.

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Check all the boxes that apply

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Partner and I got our flu shots very early this season. We’re both older, and I’d just been diagnosed with cancer, so we agreed that it was probably a good idea for the two of us not to get the flu this autumn/winter.

CVS (and many other pharmacies) offer flu shots for free (for those of us lucky enough to have health insurance). They have a cute little kids’-tea-party table and chairs set up behind a screen in the back of the store; you fill out a form, check a few boxes, and then the pharmacist gives you a little tiny jab. (Usually it’s administered by Alexander, the handsome Russian pharmacist. We were disappointed this year because he wasn’t available, but the on-duty person was a lovely funny person, and she was almost as good as Alexander.)

The form was routine:

ARE YOU ALLERGIC TO LATEX? (No.)

ARE YOU ALLERGIC TO EGGS? (No.)

DO YOU HAVE ANY OF THE FOLLOWING CONDITIONS:

·        HIGH BLOOD PRESSURE? (Yes, a little.)

·        HIGH CHOLESTEROL? (Certainement pas.)

·        DIABETES? (No.)

·        KIDNEY DISEASE? (Are kidney stones the same thing? Maybe a little. Okay, then I’ll say ‘yes,’ and explain if necessary.)

And then:

DO YOU HAVE CANCER?

I stared at the question as if it were written in Hebrew. “What am I supposed to say?” I hissed to Partner.

He glanced over at my form. “I think the answer in your case is ‘Yes,’” he said calmly.

Reader, I cannot tell you how difficult it was for me to check that box.

It got a little easier after that. ARE YOU ON MEDICATION FOR CANCER? (Not yet.)

And I gulped and gave the form to the pharmacist, and she glanced at it and gave me my shot.

So – you see? That wasn’t so difficult.

It’s just the idea, that’s all. “Cancer” is a hard word to say out loud, especially when you're talking about yourself. But, believe it or not, it gets easier to say.

Cancer is just a stupid condition, after all, like high blood pressure and kidney stones. It’s treatable. In a few months, I’ll be better, I hope.

And I’ll be around next year to have another flu shot.

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Feebleness

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I don’t start radiation treatments until Monday October 21, but already I’m exhausted.

What? You think I’m full of self-pity? Listen: I’ve had five teeth pulled, and a feeding tube stuck into my belly, not to mention the mental back-and-forth I’ve been going through.

The idea of cancer doesn’t bother me as much as it did a month ago. It’s just a fact of life – my life, anyway. I just need to get through the treatments (which should be done by early December, not really so long from now).

But the early procedures have made me tired, and the anticipation of my radiation and chemotherapy treatments makes me tired too.

I’ve been napping on weekends, which I never really did before. I think of myself as active and alert, but I find myself logy and weary now.

From my “Comprehensive Cancer” notebook, given to me by my doctors and nurses: “Think of your cancer treatment as a time to get well and focus only on yourself.”

This is very tempting advice for a lazy selfish person like me. To hell with other people!

But something else inside me just wants to go to bed with a book and a crossword puzzle.

From Stevie Smith:

Oh would that I were a reliable spirit careering around

Congenially employed and no longer by feebleness bound

Oh who would not leave the flesh to become a reliable spirit

Possibly traveling far and acquiring merit.

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Saints and talismans

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I have cancer, and this is no time for quibbling about what helps and what doesn’t. Lots of people of different faiths have said they’re praying for me, and I accept their prayers gratefully. Why in the world would I be stiff-necked enough to say: “Nah, I’m an atheist. Save your prayers”?

And I am not un-superstitious. I read Tarot cards, after all, and I look at horoscopes, and find profitable information in them. (Not the newspaper ones, kids. The real ones.)

So who am I to scoff at talismans and charms?

When my father was diagnosed with cancer in 1975, I was in my sophomore year at Gonzaga and just on the verge of converting to Catholicism. As you can imagine, I became very devout in no time at all. I attended mass almost daily, and said novenas, and prayed like a banshee.

Dad died anyway, in May 1976, despite all my masses and novenas. But it didn’t stop me from believing, deep down in my soul, that prayers and talismans are effective, if you only use them correctly.

For years I carried two holy medals on my keychain: Saint Dymphna (who guards against mental illness) and Saint Peregrine (who guards against cancer).

Somehow both of them disappeared from my keychain some years ago. And look what happened!

I found Peregrine and put him back on my keychain a few weeks ago, and told him to get back to work.

Also: Partner, being a cradle Catholic and understanding my state of mind, recently gave me a medal of Saint Blaise (who guards against afflictions of the throat).

Whatever happens now, I’m prepared.

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Sufferers, losers, and survivors

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There’s a language which appears to have grown up around cancer and cancer patients and cancer therapies. I think I’m considered a “sufferer,” although I’m supposed to be “battling cancer” also. Biff! Bam! Ow!

Those who have managed to overcome their cancers are “survivors,” and I approve of this term. Cancer, as one of my doctors told me the other week, usually comes to people as a terrifying and sudden bolt from the blue. “One of my patients,” she said, “said it was like mowing your lawn on a sunny day, and then suddenly a big truck comes screaming into your yard and crashes into you.” Something like that you can only survive; there’s no other word for it.

Here’s the expression I hate, though: “he/she lost the battle to cancer.”

Sorry, kids. My mother and father did not “lose their battles,” nor did my sisters, nor my niece, nor my aunts and uncles. They sickened and died, as does everyone sooner or later. Most of them were diagnosed very late in the course of their illnesses, so they didn’t have much chance to undergo successful treatment.

Much is made of “positive attitude,” and how it improves your odds. Certainly, psychologically, I see the point. It’s impossible, as one of my survivor friends told me not long ago, to think about cancer all the time; it makes you crazy and gloomy. You need to cheer yourself, and reassure yourself that not everything ends in tragedy. As yet another doctor said a few weeks ago: “If you look at prognosis statistics – and you probably already have – don’t let them worry you too much. You’ll either be one of the people who live, or one of the others. There’s no way of telling.”

My mother was a terrible patient, but she lived seven years after her diagnosis at age seventy-two. Her cancer never quite finished with her; she underwent repeated bouts of chemotherapy over the years, and each was a little harder for her to deal with; finally, in her seventy-ninth year, it was just too much for her. She began to decline seriously in September, and by November she was gone. Along the way, she exhibited every behavior you can imagine: self-pity, fear, anger, selfishness, mean-spiritness. Also kindness. Also a strange late-autumn sweetness.

My sister Susan, diagnosed in her forty-sixth year, was an angel. She suffered miserably with her cancer, but I never saw or heard her angry or upset. She spent time picking out her own coffin and the clothes and jewelry she’d be wearing at her own funeral. She was a wonderful person, and I kick myself that I didn’t see more of her and call her more often during her last few years.

My sister Darlene: I don’t know. We weren’t close. But I think she made great use of her last years: she underwent a clinical trial, and she did community work right up until the very end. She was always tough, and a good citizen, and I salute her.

My poor niece, who died only a few years ago in her forties, was surrounded by her family, and comforted by her faith.

None of them were “losers.” They sickened and died, but they were by no means “losers.”

So don’t speak to me of the “battle against cancer.” Cancer’s not an ideology or a bad guy or a rebel army. It’s a disease, that’s all.

We’re all terminal, after all. None of us is coming out of this alive.

All that really matters is how we use the time we’ve been given, cancer or no cancer.

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Reading list

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As of this writing, I’m still pretty bouncy: I’m working, and living a normal life, and walking to work, and eating relatively normally. In a month or two, however, I will be pretty house-bound: the radiation and chemotherapy will make me tired and achy, and there are dozens of other unpleasant side effects which may manifest also.

I will need distraction.

So I am pulling together a stack of books to read as the year darkens and as I become less active.

I pre-ordered Thomas Pynchon’s “Bleeding Edge” from Amazon, and got it a few weeks ago. I’ve read a few pages, but Pynchon’s a difficult read, so he’ll be good for a dark November day.

Also a book of stories called “Sesqua Valley & Other Haunts,” recommended to me by my Internet friend Flora Gardener in Ilwaco, Washington. The author, Wilum Hopfrog Pugmire, is an acquaintance of hers, and the stories are part of H. P. Lovecraft’s Cthulhu mythos, so I’m looking forward to them.

Also Rick Riordan’s latest “Heroes of Olympus” installment, “The House of Hades,” which arrived in the mail only the other day. Okay, it’s young-adult, but who cares? Riordan writes very well, and it’s an entertaining story. I had a hard time putting it down after I unwrapped it; I made it through the first twenty pages, just enough to see that it’s good, and sighed, and put it down.

Also a pre-calculus book given to me by my student employee Ralph, who listened to me complaining that my Coursera calculus course was too difficult for me, and realized immediately that what I needed was pre-calculus. When I’m sick of fiction, I can relax with some numbers and formulae.

Also: “The Power of Now,” by Eckhart Tolle. My friend Joanne sent it to me, and I’ve browsed it, and it’s not bad. If it teaches me to live in the moment and relax a bit, then I will have really learned something.

Also it’s probably time (as Flora reminded me a few days ago) to reread E. F. Benson’s “Lucia” books. I first read them in college, and fell desperately in love with them. I haven’t reread them for years. I’m long overdue.

Also: I can listen all the music I've collected over the years. And I can finally watch all the pre-Code movies I have on the DVR. And . . .

I’m not saying this will be fun.

But I think I’m looking forward to some downtime, and some serious (and not so serious) reading.

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Radiology 101

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When you have radiation therapy on your head or throat, they create a clever little mask for you, like so:

You wear it during the (brief) radiation treatment. It keeps your head in place without twitching, and it’s marked so that the doctors and nurses can tell where to aim the radiation.

I had the mask made yesterday. The nurses took a sheet of perforated plastic and heated it in warm water to 150 degrees until it softened; then they put it over my face and molded it to my features until it hardened.

Then I heard the word “tattoo” mentioned.

Then, all of a sudden, one of the nurses lunged in and jabbed me in the middle of my chest with a needle, and made an insignificant little mark. That’s the tattoo that’ll be used to help them place the mask and aim the radiation.

All these years I’ve put off getting a tattoo. Now I have one, and it’s a stupid red dot, right where no one can see it.

Also, regarding the radiology mask: I desperately wanted to take a picture of it when it was done, but they took it away too quickly. But I imagine it looked something like this:

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It only hurts when I laugh

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It was a shock when, a few weeks ago, my radiologist told me that I needed to have a feeding tube installed. “You may or may not need it during your treatment,” he said, “but we prefer that you have it put in now, because you’ll be very weak later.”

So, terrific, hooray for the protocol. Feeding tube installed, 4 October 2013, approximately 9am.

Jesus, it’s big. I was expecting something small, like the nozzle on a can of WD-40. Instead, I now have something like a garden hose implanted two inches above my belly button.

Getting a hole punched in your belly hurts for a few days. I suppose that’s a silly thing to say, but (for whatever reason) I wasn’t really expecting it. I spent the weekend aching and cradling my belly, walking with a hunch, wondering how long this was going to go on, and assuming (of course) that it would be the rest of my life.

Over the last few days, the incision has mostly healed. I am now able to walk upright and almost normally. But some movements that involve the abdominal muscles – especially getting up from a seated or lying-down position – still give me a twinge.

Also: I can now burp without pain! Also, I can cough!

Sneezing is still a little painful, however.

Also laughing.

Oh this is the last straw. I can’t laugh? Whom do I need to talk to about this?

As James Thurber said when his blindness prevented him from seeing a beautiful girl embracing him: “Dear God, this goes just a little bit beyond a joke.”

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Why I could never be a medical professional

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A few days ago, I was lying on a gurney, lightly anesthetized, waiting to be taken into an operating room to have a feeding tube implanted. They’d parked me in a hallway; I was like a plane idling waiting to take off at an airport. (To be honest, I wasn’t so much idling as eavesdropping on doctors’ telephone conversations and studying the pattern of the ceiling panels.)

The receiving nurse, Rose, introduced herself and patted me on the shoulder (to reassure me, I think, and also to reassure herself that I wasn’t going to be difficult.) Then she busied herself with the ten thousand other things that seem to be going on in her department.

Then two new characters appeared: a fortyish woman, very pert and charming, and a tall younger woman, trying very hard to look bright and eager. They presented themselves to Nurse Rose. “Hi,” the older woman said. “I’m Professor Dunbar from the nursing school, and this is Katie, our nurse trainee.” She giggled briefly. “We want Katie to have an endoscopy day.”

“That’s fine,” Rose said. “The nursing staff is okay with it, and you don’t even have to ask the docs, because they’re okay with it too. All you have to do is ask the patients if it’s okay.”

She and Professor Dunbar slowly turned to face me, with sweet smiles. Katie didn’t know right away what to do, but caught on quickly. “Hi,” she said to me brightly. “Is it okay if I observe - ?”

“Of course,” I said.

As they wheeled me into the operating area, I heard Rose tell Katie: “This isn’t the usual thing – not an endoscopy or a colonoscopy. This is the implanting of a feeding tube. You won’t be seeing many of these.”

I lay in the operating area for about fifteen minutes, listening to the nurses chatting around me. They’d faced me toward the clock, and all of them were behind me, so I had a hard time connecting names and faces; there were at least four of them, I think, including Trainee Katie. Rose showed Katie the various kinds of equipment they’d be using, and now and then a new nurse would introduce herself to me and ask my name and birthdate. My blood pressure was through the roof, and I kept having to reassure them that, yes, I’d taken my medication that morning, and that my through-the-roof reading (190/90) was unusual for me; before my diagnosis, I was usually more like 135/85.

Then my gastroenterologist came into the room. I find him cute: he’s short and stocky and has a sharp expressive face. He kept leaning with one elbow on my gurney as he talked to me. I could tell that this was just a routine procedure to him, and I was very comforted by that, and by his casualness, and by the way he insisted on shaking my hand, even though I was draped with all kinds of tubes and sensors.

It was over in an hour or less. A little after that, I was revived in the post-op area and given cranberry juice.

Also, I had a huge plastic tube sticking out of my midsection.

I keep thinking about Katie, the nurse trainee. No doubt she learned something that morning, watching my feeding tube being implanted (it’s a quick process, but a very involved one). How did she feel about it? Did she wince when they made the incision into my belly?

I’m fascinated by medicine, but I know I could never be a practicing doctor or nurse.

The things they see! The things they have to do!

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Something light

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Since being diagnosed with an unpleasant medical condition, my attitudes have shifted subtly. In just a few weeks, yet!

I don’t think I need any philosophical lucubrations about life and death at the moment. I think what I need right now is some diversion.

So out the window with “Crime and Punishment” and the Book of Revelation.

I’m overdosing on the movies of the 1930s, especially the musicals. I’m currently watching “Love Me Tonight,” with Maurice Chevalier and Jeannette MacDonald, circa 1932. It’s well-written and cute, with some chirpy little songs.

If I wanted to be dark about it, I would point out that every single person in the cast is almost certainly dead by now: debonair Maurice and squeaky Jeannette, goofy Charles Butterworth, sardonic Charlie Ruggles, clever Myrna Loy.

But when I watch this cheery little film, they’re all as alive as can be, and having a wonderful time.

How about “Gold Diggers of 1933”? Delightful. And all of them gone: Ginger Rogers, Aline MacMahon, Ruby Keeler, Joan Blondell, Dick Powell, Warren William, Guy Kibbee.

But the film is like new: cheerful and tuneful.

This is the medicine I really need.

To quote “A Funny Thing Happened on the Way to the Forum”:

Nothing of gods, nothing of fate;

Weighty affairs will just have to wait.

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Reasons not to die

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I am sick at the moment, but it’s not terminal – yet. It’s curable, according to my doctors. I just need to be faithful to my treatment schedule. And everyone says that you have to maintain a Positive Attitude.

For me, it comes down to this: I don’t want to die.

Here are some reasons why not:

·        I don’t want to (as I said). Isn’t that sufficient?

·        Mom keeps appearing to me in dreams in which we’re going on a long trip together. I loved Mom dearly, but she was not especially nice to travel with. If I can put this trip off, I will.

·        People need me in the office. They need me to pay the phone bill and order stupid irrelevant office supplies and listen to them complain.

·        My student employees need me. (Or rather, I need them. I need to tell them stories.  They pretend to be interested, but that’s okay by me.)

·        Most of all: I don’t want to leave Partner alone.

This is the most beautiful time of year in Rhode Island. It’s sunny but cool, and the colors are very full: the green of summer and the shades of autumn are all together at once.

I’m glad I get to see a New England autumn one more time.

I don’t mean to be morbid. But still: one has to be realistic.

Just one more time.

(And many more after that, I hope.)

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