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Thus began Mr. Toad’s wild ride.
In the past I have written posts on the adventure of having two stage 4 cancers and the journey down the rabbit hole one takes as treatment goes forward. Three years ago I had surgery, radiation and cis-platin for throat cancer. Three years later my throat or oropharyngeal cancer is undetectable. Of course, this is good news. What remains of the experience are the lasting effects of intense radiation exposure in and around the target volume. I developed the normal array of after effects: stunted salivary glands resulting in chronic dry-mouth; periodontal disease and the loss of a few teeth; a substantial loss and distortion of the sense of taste; inadequate thyroid function requiring medication; difficulty in swallowing dry foods; radiation scarring on the neck; and lymphedema where 33 lymph nodes were removed from my neck. I’ve adapted and manage quite nicely to plod down the timeline much as before.
My situation with the stage 4 prostate cancer (Gleason 8) is stable. One of the treatments for prostate cancer is chemical castration. Since testosterone has the effect of accelerating the growth and spread of prostate cancer cells, the commercial drug Lupron is used to down regulate the production of testosterone. Loss of body hair and muscle mass as well as the onset of hot flashes were some of the highlights of my experience. A substantial nulling out of the sex drive happens as well. Effectively I spent about two years as a eunuch.
It’s been nearly a year since the Lupron injections have stopped. I’m getting a more strength and some body hair is returning. I’ll leave it at that. The radiation treatment was intense in the target zone, but largely without significant discomfort overall. The tricky part of external radiation treatment of the prostate is it’s proximity to the bladder and the bowel. Fortunately, modern IMRT equipment is capable of modulating the x-ray beam intensity as well as shaping the beam with a multileaf tungsten collimator as it rotates around the patient.
After 11 months since the last Lupron shot, my PSA has increased only slightly from being non-detectable. The return of testosterone after having it shut down for 2 years is a weird experience for a fella. But weirdness is normal in the world of cancer treatment.
Now we’ll pivot to a different topic.
A delicate parting thought for friends and family of those with cancer. Invariably a well intentioned friend or family member will say that their thoughts and prayers are with you or that a prayer group is holding you in the light. Another expression of sympathy might be that there is a reason for everything and that God has a plan for all of us, and as the story goes, our lives have purpose after all. Such sincere well wishes are expressed with the best of intentions, but for myself and other non-theistic people it rings hollow and offers little consolation. A prolonged and agonizing illness is part of some plan? Seriously? If a person set forth such a plan we would rightly consider this foul individual a psychopath worthy of punishment.
People express these sentiments when presented with an existential conflict- it is when the need to connect their belief system with
reality the observable world is confronted with the paradox of the divine sanctioning of pain, suffering and untimely death. The need is met by the supposition that there must be divine purpose rather than the unthinkable alternative of the illness happening in the stark emptiness of a godless universe. If such a universe existed, what possible purpose could there be in existence? Well, yada yada. I’ll take this topic up in a later post.
Here is an alternative for your non-believing friends and family. Consider renewing and expressing gratitude for their love and friendship. Confess what the person means to you and commiserate with their condition. Let your emotions flow. Hold their hand. A bit of listening goes a long way too. Mirth is always welcome- the regaling of past exploits, funny stories or people, jokes or the sharing of what experiences you have in common. A light heart and cheerful smile is always welcome in sickness and in health.
During the last year I have been away from the chemistry blogosphere and immersed in reading classic literature and acting in a few plays. I won’t take up bandwidth with a lot of details, but suffice it to say that I would urge young technocrats to spend a bit of time reading some classic literature or doing some artistic activity. In my case, I have a special fondness for 19th century literature. Not a minute I’ve spent immersed in Balzac, Pushkin, Gogol, or the earlier writings of Cicero, brings even the slightest regret for time not spent with chemistry.
Of course, my threadbare-epiphany is in no way novel and barely worth mentioning. Many people spread their wings and glide over the wonderment of new lands. For me, I have simply chosen to spend the time doing so. Scientific greatness is not in the hand I was dealt. There will be no reactions or campus buildings named in my honor. This is the fate for most of us, really. Only it takes some time to come to that realization. Loosening one’s grip on ambition is not gladly done. Those of us who have gotten advanced degrees are, in a very real sense, freaks who have a fiendishly tight grasp and a capacity for extended abuse (you know it’s true!).
The reality of aging is that in the footrace of one’s career, faster, younger and hungrier runners begin to catch up and surpass you. This is actually essential for the continuation of scientific progress and the extension of this age of enlightenment. The trick lies in not allowing one’s vanity to accentuate this natural progression in some humiliating way. The merits of silence become increasingly apparent with age to those who can manage it.
This cancer business has the effect of telescoping one’s life in the sense that the end-game once obscured by the haze of time begins to take shape as would an approaching stranger in the fog. It is the fear of this approaching stranger that causes the afflicted to grasp for any and all treatments, clinical or mystical. At some point it should become clear that spending down your retirement and impoverishing your survivors is destructive and selfish. But you cannot rely on your physician to help with this. Your final act as a mature adult is to decide when to call off treatment. This is not accepting defeat. It is acknowledging biological reality.
Cancer has a large head-game aspect and one’s internal monolog must constantly chant the importance of living in the moment and keeping a cheerful attitude. Those around you will be grateful, even if they do not outright say so.
Update: I sit and write at a desk piled with pdf printouts of patents, journal articles, a Phi-Tec 1 handbook, and a great heap of process safety data and reports. I help coworkers find and study patents for their R&D due diligence. The bigger task is running a thermo lab for determining the thermokinetic safety of bulk chemical processing. These two topics, patents and thermodynamics, would induce instant unconsciousness for most folks. An acute boredom-stroke followed by involuntary somnolence and collapse to the floor. Oddly enough, I rather dig these topics- especially the thermodynamics. A single fellow covering these two widely differing topics is entirely a(n) historical artifact, unlikely ever to be repeated.
Several months following throat cancer treatment, my energy and curiosity are back although I still cannot eat solid food due to impaired salivary glands and taste buds. The head-and-neck-onco-doc says it’ll take 1.5 to 2 years for the spitter to come back online. It is like serving a sentence in the Nestle warehouse living on Boost. I enjoy food vicariously watching the Food Network. This is what the term “food porn” means- watching others enjoy a sensory and emotional experience with food.
The year 2014 will see me spending more time with the urology oncologist. At the last appointment he promised to help keep me on the top side of the grass as long as possible. I have to hold him to it.
So, here I am wide awake trying to recall what the Ambien molecule looks like. I’ll probably have to look it up.
Later this morning is my 3rd chemo treatment of 6. Something is knocking me down. The x- radiation plainly has been doing what it does best- giving a 3-D sunburn. The throat is developing mucositis and Is crazy sore. Blistering should start soon.
I’m using magic mouthwash, comprised of lidocaine, benedryl, and Maalox. This pharmacy concoction has the snotty rheology of melted ice cream. The throat issue is definitely interfering with getting enough calories for body weight maintenance. Have lost ca 10 lbs to date. I’m gonna get a talkin’ to from the dietitian today.
Other than sore throat, the next unpleasant drug side effects are those from the anti-nausea meds. The anti-emetic meds prevent one from hurling through a sore throat. They are also very effective at constipation. So, one gets to know the offerings at Walgreens.
Sleeping in reaction mass
Please stay home today
Growing from amber liquor
Wistful as hoar frost
Give it a try and post your lines on the ACS Chem Haiku website. 化学俳句
Nothing too unusual here. Just some bismuth crystals sitting on my desk. A metallurgist friend died recently and his family passed along some of his samples to me. Virg was a great guy. He knew how to conduct himself with decorum like a civilized human being. I don’t confer this praise on everyone.
I think many people find some kind of solace in the orderliness of crystals. Nature has seemingly betrayed the prevalent trend of disorderliness to produce a latticework of pristine stuff in appealing shapes. Crystals appeal to our innate desire for symmetry and rectilinearity. We subconsciously associate symmetry with goodness and calm. Properly stacked goods in your basement suggest orderliness. Shoes lined up in the closet or socks neatly arranged in the drawer provide a reassurance that something in life is at least predictable.
Crystallinity infers a repetitive array of subunits asssembled under the austere constraints of efficient stacking. It represents subunits held in confinement and subject to limits on motion.
Crystallinity is in a sense sterile and lacking in diversity. Living things are not crystalline for the most part. Crystallinity is static and devoid of the many necessary degrees of freedom needed for life. Living things often have superficial symmetries, though on closer inspection something inevitably cracks the symmetry. Humans have a bilateral symmetry across a line taken from the head to between the feet, as do butterflies and hippos. Internally, though, the symmetry is less than obvious. Our genetic polymers of DNA have a gross secondary helical symmetry as do some peptides, but even that yields to partial symmetry when the monomeric units are accounted for. Sure, there are instances of crystallinity in living things. But living things require a fluid internal environment to allow molecules to collide and react.
If you take crystallinity as an allegory of perfection in the sense of a way of being- that is, orderliness and freedom from defects- then you might conclude that a perfect being would be constrained by symmetry or the attributes of perfection. It would seem that the attribution of perfection in a being might pose the possibility of limitation.
Instead of getting wrapped around the axel philosophically, perhaps we should gladly rejoice in the lack of perfection in ourselves and the ultimate absurdity of perfection in the fanciful dieties whom we imagine control the vibration of every molecule in the fleas that ride on the tailfeathers of every sparrow.