Blog Down!

So, in the next couple of days I’ll make a final decision but as it stands, I’ll be shutting down this blog in the next month. I may shift my attention to another blog I have, a free one, but I have yet to determine that too.

Thanks to those of you who have been loyal readers over the past few years.

All the best,

Roger

Things Change

My last post was twenty days ago. I used to put them out every week, but things change.

When I started writing this blog in 2012, the year I retired from teaching at the College (NIC) I was focussed on working through my relationship with Ernest Becker’s books The Denial of Death and Escape From Evil. For me these books contained some profound truths about us humans, how we relate to life and death, how we organize our societies as competitions for God’s attention. It’s interesting that we created God as a projection of human values, a projection that we then use as a means of judging our actions to determine just how worthy we are of eternal life. We even, according to Becker and other cultural anthropologists, divided our social groups into moieties (halves) to set up the competitive structure by which we could establish winners and losers for God’s favour, which is nothing less than immortality. Countries and Nations are the logical expression of this thesis. 

We also, over the millennia, elevated man (that is, not woman) to the predominant social position. It took millennia to do that, but once the idea stuck, it got so strongly entrenched that it became normal. The idea that men were somehow superior to women infiltrated all aspects of culture. Women were, for all intents and purposes, relegated to slave status, gatherers of food, and bearers of children. The perfectly natural womanly monthly experience called menstruation where menses (blood and other matter) are released from the uterus was held against women. Blood reminds men of dying. When men fall in combat or by accident, they bleed and they die. Men don’t like that. So women bleeding regularly could not be good either. It is a huge reminder of death. So, many cultures isolate menstruating women, treat them with contempt and shun them. By extension, men could pretend that they were more ‘spiritual’ than women. Women were biological, men spiritual. Men were clean, woman dirty. This could not be more clearly demonstrated than in childbirth, a very messy and bloody process, proceeded by months of lessened capacity and followed by the need to nurture infants, a relationship of dependency that created an avenue for men to assert dominance. These tropes still survive to this day, in some ways stronger than ever. 

I’m still captivated by the ideas I gleaned from Becker, but after I was diagnosed first with pernicious anemia (in the 1990s) and then with multiple myeloma (in October, 2019) my focus changed, and this blog became a chronicle of my life with chronic pain and cancer. Old age, of course, plays a predominant role in my life, how I feel, and how much energy I can devote to any particular task. I don’t think anyone can understand the effects of old age on the body, energy levels and strength, until it becomes personal. I promised myself for decades that once I retired, I would do all the things I had no time to do as a working person. That was true for a time, but when I hit 70, things changed, and they continue to change. From now on I cannot expect things to improve. All I can do is adjust to my changing body with its lower levels of energy, suppleness, and strength. I think my mind is still capable of some surprises. That may be delusional on my part, but that’s fine. I guess I have the right to some minor delusions. 

So, I may be afflicted with cancer and old age, but I was trained in the social sciences and they still have a strong hold on my mind. I still think that we, as men and women, need to reconcile many powerful forces that dominate our lives. One of them is misogyny, the curse that lives deep in our psyches but is not based in biology. But what of basic biology? Well, let’s explore that a bit here.

At the end of my last post I said I would discuss penises and clitorises, so here we are:

Penises and Clitorises.

Most of us have one or the other. The fact is that they are very similar in structure and function. As the long quote below maintains, at the sixth week of gestation we all have clitorises. That’s not quite right. We all have a precursor to both the clitoris and the penis. That is, penises and clitorises arise from the same tissue in the early embryo. So, the pleasure men derive from penile stimulation is the same as women derive from clitoral stimulation. Depending on the chromosomal and hormonal environment we become either female of male, or both, or neither. To say that men and women are opposite sexes is profoundly misleading. We are not, as Alice Dreger so aptly points out in her book I introduce below.

For many years I studied love and sex and taught College courses on the topic just before I retired in 2012. It’s a truism to say that the sex act is a social act so it’s clear that we are social animals right from the start. Like for most animals, our sex lives and our social lives are strikingly interconnected. 

The pleasure we derive from intercourse, and especially from genital stimulation of any kind, including from masturbation, has profound social implications, but not all of us are capable of deriving pleasure from genital stimulation, the source of sexual pleasure. That follows from the fact that humans come in so many sizes and shapes. We vary in a hundred different ways including when it comes to our sexual organs. 

Before the sixth week of gestation (more or less) we are sexually undifferentiated meaning that there’s no way to tell whether an embryo is male or female. After the fourteenth week and the androgens kick in we begin to display our sexual organs. 

There is so much information available on this topic on the internet that I don’t even want to go there. A huge number of popular sites exist along with a large number of scientific ones. I just finished reading a (Kindle) book called Hermaphodites and the Medical Invention of Sex, by Alice Dreger (1998). The book explores the way things don’t always go as we expect in the womb. Yes, the vast majority of us either end up male or female, but that dichotomy isn’t as clear cut as it seems. A visual inspection of external sex organs may lead to the belief that a person is either male or female, but looks can be deceiving and it’s impossible to look inside the brain at the hypothalamus and the sexually dimorphic nucleus (SDN) to determine maleness or femaleness as the brain evaluates it. The quote below is from a popular website. It can give you some idea of what’s available now on the internet since Dreger published her book in 1998. It addresses a point I made earlier about our embryonic selves:

Everyone starts the same in utero.

What determines whether you’re born cis-male or cis-female are your XX or XY sex chromosomes. The XX pair is cis-female and the XY pair is cis-male. During gestation (the time between conception and birth), the genes on the sex chromosomes are expressed and the fetus becomes cis-male, cis-female, or (in some instances) intersex. These sexual differences are expressed as the penis and testes (cis-male), the vulva and vagina (cis-female), or some combination of the two structures (intersex).

However, in the first six weeks of a pregnancy, before the genes in these chromosomes are expressed, all budding fetuses actually begin as cis-female, meaning that everyone begins their development in the womb with a clitoris. (Wow, right?!) Then, one of two things happens due to “a low level of the hormone testosterone [being] released,” this structure grows into a penis, says Laurie Mintz, Ph.D. licensed psychologist, certified sex therapist and author of Becoming Cliterate. Or “when testosterone is absent, the tissues develop into a vulva (including the clitoris) and vagina.”*

[Check out this YouTube event for the experience of a transgendered man. Born a ‘girl’ he never fit in and was always a man in his mind: https://www.youtube.com/watch?v=nOmstbKVebM.%5D

So, enough for now. I still want to explore further the idea of sexual reproduction going back to early eukaryotic cells and the consequences for evolution of sexual reproduction. I also have a number of other related topics I want to explore along with continuing a chronicle of life with myeloma. Later.

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*https://www.shape.com/lifestyle/sex-and-love/genital-anatomy-penis-clitoris

One Step Forward and Two Steps Back

Sometimes I think that it would be good if life were simpler. For me, it’s anything but simple. Maybe my expectations are too high. Maybe I’m not being realistic. Maybe if I relaxed a little, all would be better. Maybe. Yet, the complexity just seems to expand, to encompass everything, no matter what I do, or don’t do. 

I’ve been off chemo meds for about five weeks, and I have until the end of March before I go back on them. At least that’s the current plan. There was never a plan for long-term withdrawal from my chemo meds. I haven’t had my blood tested for a few weeks, and it will be another three weeks before I get tested again. I’m of two minds about that. It’s quite possible that the bloodwork will show that myeloma has again taken up full-blown residence in my blood and bone marrow. It may also be that it shows that I’m still okay. It’s always a crap shoot and somewhat tense for that reason. 

More concerning for me is the fact that since my withdrawal from hydromorphone I’ve been in a lot of pain. It hasn’t attenuated much at all. I’ve been able to walk a bit two or three times a week, but any walking I’ve done has been painful. I generally walk around two kilometres, and that takes me half an hour. Not a blistering pace. 

Because of the incessant pain I’m in I’ve had to backtrack and reconsider my decision to cease taking opioids. I took a slow release capsule this morning as a test and I have felt some relief. It may be that I’m dreaming in technicolour if I think that I can manage without pain meds. 

Speaking with my GP/oncologist last week was enlightening. He doesn’t think that the pain I’m having has anything to do with my B12 deficiency, opioid withdrawal or myeloma. He thinks it’s attributable to chronic pain, something I’ve experienced for decades. (I’m not sure I completely agree with him on that.) Thinking back over the past thirty years and it’s clear to me that I’ve had periods before I was diagnosed with myeloma or pernicious anemia when I’ve experienced extreme pain and other very strange symptoms like having a yeasty odour and having my skin welt up after drawing a dull object over it with not a lot of pressure.* In the mid-nineties I had a period of debilitating fatigue to the point where I could barely function. I was also depressed at that time, with good reason to be. 

The chronic pain that I’ve experienced throughout most of my life is associated as much as I can tell, with the consequences of surgeries I’ve had. The two main ones are a laminectomy (disc removal) and a nephrectomy (kidney removal). As well, I’ve had the odd accident on my bike and some running-related injuries. My neck has been a source of a lot of pain over the years brought on mainly by years of hunching over a computer terminal. I envy people who go through life with very little or no pain. There aren’t many of those in my family. I have siblings with MS and fibromyalgia. I have quite a few relatives with autoimmune diseases. It seems to run in the family. We’re also a long-lived bunch. That might be good, but it might not be so good too: all the more time to suffer from debilitating pain. 

The biggest and most distressing challenge I face right now is the weakness in my legs but I may get control over that with a low dose of hydromorphone and gabapentin. I need to move around. That’s a prerequisite for continuing to be able to move around. Being sedentary breeds inactivity and makes it harder and harder to get any exercise. Exercise hurts! Walking two kilometres brings on a lot of pain. Damn! 

And with the price of gas now, I think driving may be an even bigger pain in the ass than I’m feeling now in my ‘lower’ back. I feel that driving into Courtenay for a walk on the River Walkway is a bit frivolous when gas is $2 a litre. I can always walk around Cumberland for free. 

Tomorrow should be better for me in terms of pain. I expect I’ll walk a couple of kilometres tomorrow morning. The weather is supposed to be good. From Thursday on for at least a week it’s supposed to be rainy and cold. No reason not to walk, but it is less pleasant and I like pleasant these days. 

If you didn’t notice, and to end today’s musings, the title of this post works for some things, but not for life itself. Life never goes backwards, no matter how much we wish that it were so, no matter how many anti-ageing creams we use. 

My next post will be on why the penis and clitoris are such wondrous things and why they have so much in common. 

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*This is the strangest phenomenon. I would drag the handle of a kitchen knife over my arm and it would welt up for maybe three hours afterwards along the path of the draw. Has that ever happened to you? I’d like to know if you’ve ever experienced this. 

I’ve struggled a lot lately about whether my glass is half full or half empty. I’ve lived seventy-five years. Is that a good thing, a bad thing, or just a thing? 

Whatever. 

Lately, I’ve often mused nostalgically about my past. My present is not what I would have it be, but I’ll write about that below.

For now, I want to write about moments in my past that were particularly instructive for me. You all know that I have cancer. That’s not news. However, some of you may not know that I was diagnosed with kidney cell cancer in 2002. From what I was told, I had what they call a lesion on my left kidney. In this case a ‘lesion’ means a fairly large growth protruding from my kidney. They were loathe to do a biopsy because any puncture of the lesion or any attempt to remove the growth by aspiration was going to spread the cancer far and wide. So, they scheduled me for surgery. I was fortunate to have a very good local urologist perform the surgery with my GP attending (he’s an internist as well as a family physician).

My Nephrectomy

When my time came for my nephrectomy (removal of my kidney) on February 17th, 2002, Carolyn drove me to the hospital early in the morning and left me there to find my way to the surgical unit. I wasn’t there long before they ushered me into the operating room. I was set at ease to see so many people I knew there, including a nurse who was a former student, my GP and the surgeon. I didn’t know the anesthetist although I had met him earlier in the hospital for a pre-surgical interview. 

So, taking my kidney out would be a straightforward affair if you knew what you were doing! Thankfully, the urologist knew what he was doing. In order not to spread the cancer far and wide, he opted to open me up using a 35 centimetre incision between my ribs on underside of my left arm to my midsection but lower on my body. They essentially cut me in half so they could gently lift my kidney out of my body without messing with the surrounding tissue and risking metastasis. I heard later that my GP was humbled by the process of cutting me in half and putting me back together. 

After the kidney was removed and they made sure they hadn’t left anything in there that shouldn’t have been there, they stapled me shut and sent me off to a room upstairs. I was there for a few days. I had a morphine pump to make sure I had no pain but it did have a governor on it so I didn’t overdose. That was kind of them, I think. 

I went home after six or seven days. We had just moved to Cumberland on an acre. There was lots of work to do. I couldn’t do any of it. Thankfully a number of my family members came over. There was lots of help and Carolyn was healthy, as she still is so I watched as my family and some friends helped us move in and get the yard together. 

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Visit to Cancer Care Centre 

We saw my local GP/oncologist this morning. These meetings are always interesting. I’ve been off chemo for a month and I’ll be off again for another month so that we can more properly assess how I react while not on the chemo meds. I’m also off hydromorphone (opioid), having gone through the nasty process of withdrawal over the past few days. I’ve never taken a very high dose of it, but I have been on it a long time. That makes it a bit of a challenge to stop taking it. I’ve also cut way back on gabapentin, which is a drug initially used for epilepsy, but has been used for all kinds of ailments since (maybe overused). I really have no idea how it’s affecting me because I have had such a mix of medications over the past couple of years that there’s no way I can tell what med is having what effect. It’s supposed to help with my peripheral neuropathy. Maybe it is. Maybe it isn’t. I really don’t know. It’s just a bit confusing and frustrating. 

I was in the Cancer Care Centre at the hospital this morning, as I said, to meet my GP/oncologist, and I saw a few of the usual suspects getting treatment. There was an older woman (probably a bit older than me) getting an infusion in Chair #4. I’ve seen her a number of times before. This time she was with her husband (I presume) who sat in a chair beside her. We nodded to each other. A young woman came by us as we waited to see the doctor. She was in Chair #3 I think. She was dragging her IV pole along beside her as she made her way to the bathroom close by, something I’ve done many times. IV poles, with bags of meds hanging from them with a line entering the arm somewhere, are on casters but they still rattle away as they are dragged along. I thought to myself: “This is my life. I share it with people I don’t know and some I do know, people who share my struggle to one extent or other. What we share is cancer.” But we also share the care and love that the staff gives us. Notwithstanding, every one of us will die. We may survive a year, two, ten, or twenty, but we must die. I’m not complaining about that. It is what it is.

I’ve spent a good part of my life studying life and death. I’m a sociologist, but I’ve not contained myself within that discipline. I’ve struggled to see the big picture of life on this planet and how life cannot exist without death. I know it’s something I’ve brought up before, but it’s always on my mind. 

We’re coming on to spring. My favourite season. Plants spring up everywhere. They count on the decay from previous years to fuel their growth. Life is not a cycle. It’s more like a spiral, with an inevitable end. To think of the seasons as cyclical is a mistake, a comforting mistake, I guess. I’m thinking we have a built-in biological aversion to death. From what I’ve observed, we share that aversion with most other animals. Life is the big draw, death and disease are the ultimate enemy. Our whole culture is built on that false premise. Silly us. 

This spring for me is not like the spring of my tenth year, nor of my fortieth year. I’m hoping this is not my last spring. I’m thinking it won’t be, but the future is promised to no one.