Ant Under Glass. Should I Kill It?

I’m finding it fascinating how I’m so unable to write at the moment. Well, of course I can write, but I’m flummoxed when it comes to writing a coherent blog post. My age may have something to do with it, but there’s more to it than that. In the past couple of weeks I’ve started writing a blog post four times and for pity’s sake, I can’t complete even one. I guess I’m losing it. That’s not something I want to accept, but as we get older we all lose multiple abilities. It’s inevitable. Eventually we lose all ability. That’s when we die. Dead people don’t have abilities. 

In some ways, I think I’m getting gun shy. People are dying all around me and I’m just here waiting for the sniper to pick me off. I’m keeping my head down, but that strategy will only be good for a time. The Sniper in Charge (SIC) will find me. I have no idea how long it will take for her/him to find me, but it will happen. That has me distracted, very distracted. You may find that this blog post reflects that distraction. It’s anything but coherent. But here goes anyway.

I learned the other day from a very young blogger and her father that mindset is everything in life. To some extent I agree. It’s self defeating to go into a project with the attitude that “I can’t do that.” Of course most of us can do that. Yes, we can. But that attitude is contingent on age and other characteristics we have that may make it impossible to have a ‘can do’ attitude. No matter how much I may want to, making babies is not possible anymore for Carolyn and I. We are both beyond that project. 

The young person I’m referring to here is female. She and her sister operate a small sawmill as part of the family’s logging, lumber, and firewood business. They are both still teens and are very active in life outside of their work. In many ways, they are exceptional. They work in a family business. I don’t know how common that is these days but they may very well be the only young women in North America operating a sawmill of any size. Most people would consider that Man’s work. Her father declared in an interview she did with him in a recent blog post that they come from a Judaeo-Christian tradition and are actively Christian, in that they pray to God and all that. That fact gives them access to a whole community of like-minded people giving them wide acceptance in the community for their business and other activities. That’s just life for them. I’m sure they don’t see their faith and status as God-fearing White Folk giving them any kind of advantage in life. They would argue that they have just made the right decisions in life and people who make the right decisions in life create advantage for themselves by their very actions. There are various interpretations as to the accuracy of this kind of view, but it seems to work for them. It doesn’t work for a very substantial part of the population as sociology has clearly demonstrated over decades of research. 

Well, I guess mindset is important for me too. I can either whine and complain about the fact I have a cancer that won’t go away and will eventually kill me, or I can just get on with things and ignore my ultimate demise. I’ve commented on a recent post that death is akin to a wall. I see it clearly on the horizon, but why focus on it? Actually, it’s hard not to focus on it, but it doesn’t make sense to do nothing else. It certainly is distracting, however. 

I just captured a carpenter ant. I’ve got it on my side table under a shot glass. I can observe it moving about. It really wants to get out of this predicament and constantly looks for ways out. When I tap the glass it goes absolutely still. It’s a winged ant which means that it is at a stage in its life when it is bound to search out a new home. At this time of year they come out of the woodwork, literally. This ant seems very confused. This small prison it’s in is thwarting its destiny, which is, along with its buddies, to eat our house, which is made of wood, so lunch is served. However, I’m not particular enamoured with its destiny because we have conflicting interests. So, what should I do with this ant? I could easily kill it, or keep it imprisoned until it dies, or I could release it so that it can start munching on my house. Even if I release it outside, it’s still liable to find a spot to have a nibble. Obviously it cannot eat us out of house and home, but we know from past experience that it can, along with its buddies, cause a lot of damage. So what do I do? 

Help me out here. What should I do?  

Ant Under Glass

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. 

75 UP

So, this post is about what’s up with me now. I’ve reconciled myself with the fact of my frailty, which I share with all living things. It stands to reason that my body is not as it was twenty or even ten years ago. All individuals of all species, plant and animal have a life course. We’re all born. Even trees, but some of those individuals die young (like the trees that are being cut in the hills above Cumberland), some trees live out what must be considered the outer limit of life’s potential, in the Carmanah Valley, for instance, no thanks to BC’s forest industry. Some of us humans die young. Some die hacked to death in a stupid race war in Rwanda in 1994. Others die horrible deaths in the ovens of Auschwitz. Still others, of all species, die of inborn problems, with their DNA or or whatever. In the end we are all frail, even the biggest and toughest among us, and vulnerable. For most plants and animals eventually, the soft, squishy material that we’re made of becomes increasingly brittle and inelastic as we age and approach our inevitable ends. My squishy material is definitely becoming worn out. It still has some bounciness in it, but nothing like it had years ago, and there’s no turning back. But on with the story.

Being one who kind of likes living (even given what I write above) I dutifully injected B12 into my legs (alternating left and right) once a day for a week mid-January and since then I’ve injected once a week.*That should replenish my B12 levels and keep me going. It may take some time for increased amounts of B12 in my blood to make a difference to my energy levels, but I can be patient as I know that results will come. Of course, I’m fighting a losing battle. We all are. Death will catch up with me regardless of how much B12 I inject or how many chemo drugs I take. I find it almost funny that we talk about medicine, police, firefighters, paramedics, etcetera as saving lives. The best they can do, in reality, is allow life to go on a bit longer, to postpone death. In any case, I have my B12 situation under control.

In terms of myeloma, I’m off chemo drugs for at least a month. Myeloma protein is barely detectable in my blood so this is a good time to lay off for a while and see how things go. It would be grand to get some relief from side effects for a time. Next month sometime they’ll check my blood again to see what the status of my paraproteins(myeloma proteins) are. I can easily go back on chemo if the bloodwork shows a rise in paraproteins. During our last phone call my local GP/oncologist uttered the word remission. I hope he’s right but only time will tell.

Another thing has come to plague me. It looks like it’s true that nastiness comes in threes. I’m getting a CT scan on Monday of my left jaw. I saw an endodontist a while ago because of excruciating pain in one of my left upper molars. He figures I need a root canal. Well, that’s probably true, but because I had a lesion in my left lower jaw that required radiation treatment earlier this year, I wanted some assurance that this issue with my upper jaw wasn’t also due to myeloma. It may be that I should be more trusting, but the symptoms caused by a myeloma lesion and a rotten tooth are similar so I just wanted a little reassurance. I got that when I spoke with an oncologist at the BC Cancer Agency in Victoria last month. She ordered the CT scan the results of which will determine whether I get a root canal or more radiation. My, my. Life can be complicated.

In the meantime, I’m back to doing some drawing. I got a very cheap but good set of coloured pencils for my birthday last month, so I did a couple of drawings. Here they are:

Christmas cactus head on view.
Christmas cactus side view.

I have one more I want to do with the coloured pencils using a different profile. Then I want to do a couple more in watercolour on proper paper, and maybe in acrylic on a large canvas. I’ll have to assess my level of energy before I undertake a large(ish) canvas, but I seem to be getting stronger every day now.

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*If you haven’t read my post from January 13, 2022, you might want to do so now. It outlines my experience with B12 deficiency and pernicious anemia.

Happy New Year (sort of)!

The conventional thing to do at this time of year is to reminisce about events of the past year and pick out highlights and possibly low lights, in this case, of 2021. Well, I would do that except that my brain is quite mushy right now. I’m not sure why. It may be the chemo meds. They have a variety of side effects that vary from week to week. This week my meds may have decided to afflict me with a sludgy brain to go along with my barely functioning legs. 

Then there’s the fact that 2021 was, to be charitable, less than a stellar year. Chemotherapy and monoclonal antibody infusions every four weeks for a morning at the hospital can put a damper on life. Part of the problem with the chemotherapy pills I take every day is that I experience a surprising range of side effects. While all this goes on, I have a lot of difficulty writing. I can’t seem to hold onto an idea or a train of thought for any length of time. I’ve tried to put together a couple of blog posts over the past three weeks, but they’ve turned out resembling alphabet soup rather than carefully crafted narratives. Right now, I seem to be experiencing a slight window of lucidity, but that may just be self-delusion on my part. I have no idea how long this window will be open. You be the judge. 

Today is January 1st, 2022. The first day of the year is supposed to be infused with positive thoughts, merriment, and optimism. I guess saying that 2022 will not be the year that I die qualifies as optimism, or maybe reckless self-delusion. I turn 75 years old in a few days. I know I’ve written it before on this blog, but I say it again: How in the hell did that happen? It seems to me that I was forty years old yesterday. Now seventy-five? WTF. Following Barbara Ehrenreich (who is my age) I have noted in the past that I’m old enough to die. That’s true, but still, I have confidence that people will not have to publish an obituary about me in 2022. 

My memory has gone for a crap. I don’t have dementia, that’s for sure. But still, I guess that’s to be expected of a person my age. I retired from twenty-nine years of teaching at North Island College in 2012, but I had been teaching in the Lower Mainland since 1976. Since my retirement, I have somehow mislaid recollection of so many things. I do have this blog to jog my memory. I started it in late 2012 and have produced over 300 posts since then. That’s a lot of bits and bytes engraved somewhere in a computer hard drive or on the cloud, whatever and wherever that is. I think that the number of words I’ve clicked out probably amounts to at least a five-hundred-page book. I know that since my cancer diagnosis in the fall of 2019 I’ve put together the equivalent of a three-hundred-page book chronicling my experience with myeloma, its side effects, and chemotherapy with its side effects. Now, I’m not sure what I’ll do with this blog. Unfortunately, I have very little energy to do much of anything physical. The oncologists in my life are very reluctant to tell patients what to expect of a life with cancer, especially one like myeloma. Gawande is clear on that:

“Studies find that although doctors usually tell patients when a cancer is not curable, most are reluctant to give a specific prognosis, even when pressed. More than 40 percent of oncologists admit to offering treatments that they believe are unlikely to work. In an era in which the relationship between patient and doctor is increasingly miscast in retail terms — “the customer is always right”—doctors are especially hesitant to trample on a patient’s expectations. You worry far more about being overly pessimistic than you do about being overly optimistic. And talking about dying is enormously fraught.” (from “Being Mortal” by Atul Gawande)

I have found that with old age and a crumbling infrastructure, and as I note above, a lot of physical activity is out of the question. Coming to terms with that reality is very difficult, I can tell you.  Carolyn and I have done some camping over the years since our retirement. Sometimes we were accompanied by family. Most often we were out there by ourselves. We spent most of our time camping in Strathcona Park. I hope to be able to go camping again, but I don’t have a lot of strength and energy. That’s something I have to work on so that I can DO STUFF this coming spring and summer. 

Now, I don’t have to think about physical activity. We have a blizzard outside and snow 50 centimeters thick. So, I read. I have five books on the go right now. I’ll discuss them soon in a post!

Life and Death: How Absurd!

[This post was first published in June 2019, about four months before my myeloma diagnosis. Lately, I’ve been re-reading my posts looking for the best ones to re-post. This one is a particular favourite of mine, so here it is for you again. I don’t think I can express the ideas presented here any better now than I did back in 2019. I’ve been trying, but with no success. So, rather than continuing to beat my head against the wall, I decided to give myself a break and re-post this piece now. I hope you find it interesting (again). Just got news that an old colleague of mine just died. It seems we’re dropping like flies these days. Pretty easy to predict.]

We are born, we live and breathe for various lengths of time, then we die. Seems rather pointless, really. For as long as we know, and from all the historical records that we have unearthed or discovered one way or another, we can only conclude that humans have not ever been terribly enamoured with this situation.

Of course, most animals are averse to death, or at least to dying. Death itself isn’t particularly scary, it’s the getting there that we have a problem with. Even an ant feeling attacked will flee or fight. Of course, once it’s dead there is no issue. Not all animals face dying in the same way. Without being too anthropomorphic, some are stoic, some are frantic. In humans, some are even self-destructive but I’m not sure that death is what suicides want. Relief from pain and suffering is probably the goal more often than not, but in many cases, death seems the only respite, the only place where there may be peace. Of course, that’s silly because there is no ‘place’ after death. Death cannot be a respite from pain and suffering because we have no way of experiencing relief from pain in death. Death is the absence of sensation, of thought, or feeling; it’s the absolute negation of consciousness. Death is no thing. Before we are conceived we are also nothing, no thing. Life as we think of it as sentience, feeling, consciousness, starts sometime in our development. It’s hard to know when. In a way, death puts an end to the whole story.  Historically and linguistically, we have wanted to contrast living with dying, but they are not opposites. Death is the only way life can happen. So, why, generally, is it so hard for us to let go of life? Well, like all other animals we have a survival instinct, or an instinct for self-preservation. With rare exceptions, there seems to be an inherent drive in all animals to continue to live. I don’t think any species would get very far without it. It does present a problem for us, however. It means we go to great lengths using our big, unfortunate brains to deny death using whatever means we can, and boy do we have lots of means! Our cat is afraid of death. She skulks around wary of a stray cat in our neighbourhood we call Mean Gene because he beats up on our Princess Pretty Paws. Still, she hasn’t managed to institutionalize death denial. She just can’t take it that one step beyond immediate, visceral run-like-hell action. And when Mean Gene is no longer in sight, Princess is just fine. She is not anxious and preoccupied with dying. She’s still interested in her food bowl, however. 

What it gets right down to is the fact that as animals we reproduce sexually and engender offspring who are themselves immediately on a trajectory to death. Living and dying are the same process. Stop dying and you’re dead. Now that seems completely unfair. We are built to die! What the hell! Well, that just can’t be, damn it!

Over the millennia, we’ve created any number of ways to convince ourselves that we don’t really die, that although our bodies may perish, our ‘souls’ do not, and that makes us immortal in a god-like way, really. For us to be immortal we must be gods and by our earthly deaths experience apotheosis. Millennia ago, when we were still in our infancy as a species, we were awed by the powers of nature and our extreme vulnerability in the face of them. We decided that there must be some sentient power that controlled the forces of nature, the floods, volcanos, fires, landslides, and other deadly phenomena. Not only were there powerful natural forces, but they were capricious and unpredictable as well as uncontrollable.

In our silly wisdom, we figured out that maybe, just maybe, we could barter with the gods so that they would leave us alone. If we presented the gods with gifts, even living gifts (as in virgins thrown into a volcano), maybe we could obviate the damage the gods inflicted on us. It was fine to kill all the people in the next village, but leave us alone, please. Well, that didn’t always work according to plan, so an explanation was necessary. So, if our village was ravaged by a fire even though we had been really good and had made lots of sacrifices to the gods, maybe those sacrifices just weren’t enough. We just had to kick up the giving a notch or two. Sadly, we are still very much controlled by this narrative. 

 

18 Looking in the Mirror.

[This is a reprint of a post I wrote in January of 2020. I reproduce it here in honour of Elizabeth (Bunny) Shannon who was especially drawn to it. Bunny died of cancer last month. She was a friend and an extraordinary person. I am privileged to have known her]

When I look in the mirror I see an old man. I don’t see an old man with cancer. I just see an old man with a white beard, not much hair, and wrinkly skin. Melanoma (skin cancer) often leaves visible, sometimes unsightly and disfiguring lesions. I don’t have melanoma, although my father did. No, I have myeloma (bone marrow cancer) and its damage is all done on the inside, invisibly. So, I guess I can keep expecting people who see me say: “Wow, you’re looking good!” I guess I DO look good! Now, the last thing I want is to discourage people from telling me how good I look, so keep it up! However, the invisibility of my condition is deceiving. I remember when I was a kid my friends and I used to work on our cars. That was still possible when I was a kid. Often we’d stand around looking into the engine compartment (often of my 1956 Pontiac four-door hardtop) wondering what could possibly be wrong as if just staring at the engine would give us some kind of clue. The engine was always sparkly clean and there was nothing obviously gone awry. If I had money by some quirk of circumstance I might take the car to a mechanic. If not, we might borrow my dad’s tools and start taking things apart. That usually ended up badly. Yes, the most undesirable conditions in life are often on the inside, impossible to see or diagnose by just looking at the person or car in question. I find it best to consult mechanics when our car shows signs of disfunction. I find it best to consult medical specialists for treatment related to my body. I guess I could try to treat myself using any number of the ‘cures’ available on Dr. Google, but I would like to live a while longer, thanks. Besides, I’m not that desperate.

Speaking of medical specialists, we saw my local oncologist today. I see him every five weeks. The result of our visit is that I will carry on with a second course of chemotherapy. We’ll evaluate how well it went in five weeks. My first course of treatment seems to have gone as well as could be expected. The little excavator in my bone marrow is slowly running out of gas and my red blood cell garden is growing again. I’m still exhausted and that won’t change for some time yet, but things are certainly going in the right direction for now. I think I just might be a model patient. So, where does this all leave me?

Well, I may be on my way towards remission. If and when I do go into remission, and that’s by no means guaranteed at this point, that would buy me some time. By that I mean that I may have a few years more to live, though inevitably, either the myeloma will kill me or some other condition will. I won’t be walking away from this situation, brush the dust from my sleeves and carry on. No, I’m on a one way street. So are you, of course, but I can see that damned barrier at the end of the street. I’m hoping that you’re still far enough away from it that you can live in blissful denial for a while longer. I don’t have that luxury. So now what do I do with my life?

That question came up in a recent Facebook thread, albeit expressed in a different way, but with the same effect, I believe. The question comes down to this: If you knew that you had a given amount of time left to live (six months, two years, whatever), what would you do with your time? Would you to be seized by an overwhelming sense of urgency? Would you be determined to cram as much activity and experience into your remaining time as possible? Or would you curl up in a fetal position in a corner of your bedroom quivering and whimpering while you await your inevitable demise? If you have the money and the energy you might want to get out there and travel the world. If you have a spouse, that might complicate things more or less because they may not want the same things you do and may not want to get caught up in your sense of urgency. The last thing you need when facing terminal cancer is marital discord. I think there’s a lot to be said for just carrying on with life as before.

If you have the energy and the money then good on ya. If you travelled a lot before your diagnosis then travel after. Your eventual energy deficits will tell you when to stop. If you were fairly sedentary, more into being at home and puttering around the yard, then that would be something you might want to continue doing. The stress of travel may not be that good for you. Looking around the Cancer Centre at the North Island Hospital this morning I didn’t see a lot of people with obvious enough vigour to engage in a lot of physical activity. In any case, back to my situation.

My exhaustion prevents me from doing much in the way of physical activity. If I do go for a walk I pay for it later. Travelling is impossible. At one point I thought it might be possible, say, to take a direct flight to Puerto Vallarta back and forth from Comox, but there are a number of contingencies that make that next to impossible that have more to do with arthritis and disk degeneration than cancer. Besides, I take chemo drugs once a week orally but also by injection at the hospital. For three or four days after I take my meds I feel crappy, really crappy so the chances of enjoying myself on a beach somewhere are slim to none.

So what do I want to do, and what do I actually do? Well, I want to work on our canoe, finish some paintings, do odd jobs around the property and visit family and friends in Vancouver and further afield. What I actually do is sit and lie down a lot. As I sit and lie down, I read, and sometimes I even write. At the moment I’m reading social history around the Middle Ages and doing a bit of research on my family roots in Normandy. That’s something I would have done anyway, but I do miss working in my shop and studio and going for long walks with Carolyn and our imaginary dog. My oncologist thinks I will regain my energy, at least as much as an old man can expect. If so, that would be great. I’d love to get back to canoeing, camping and puttering.

When I get closer to dying I will know it, and I expect I will have time to think about it, but there really isn’t much thinking that is productive about dying, at least not for me. I’ll know when it’s time for palliative care. I don’t want to live as long as the oncologists might want to keep me alive. I’ll make the decision when the time comes. I don’t think it will be a really hard decision. I know that beginnings are impossible without endings. My ending is a lot closer now than my beginning! That’s fine. Frankly, I’m much more concerned with my family than I am with myself. They are the ones left behind to mourn. But both of my parents are dead and we got on with life after their deaths. My family will do the same when I’m gone. That’s what we do as humans. Like it or not, accept it or not, rage against it or cower in a dark corner, the end result is the same. Don’t sweat it.

Trials and Tribulations

[Feeling a little disjointed today…]

If you’ve been reading this blog for any length of time, you’ll know that it’s all about me and my trials and tribulations around my experience with myeloma, old age, medicine, chemotherapy, and its side effects. Of course, I’m not completely self-absorbed, just mostly so. To be honest, it’s been a bit difficult to focus on anything else. Myeloma and its effects have taken over my (and my family’s) life. The pandemic hasn’t helped either. Both myeloma and the pandemic have severely restricted any social activity in which I used to take great pleasure. Driving is a challenge but not impossible. My neck seems to be getting somewhat better after the dexamethasone injection in my neck about six weeks ago. Now I fear that my time with Daratumumab may be coming to an end. I don’t know that for sure, but the neuropathy in my left hand is getting quite bad. Increased peripheral neuropathy is a side effect of Daratumumab and may be a signal that my body is rejecting the Dara. I talk to an oncologist in Victoria next month and we’ll certainly talk about my chemo treatments. On top of that I have a tooth that is dying if not completely dead. The endodontist I saw about that says I need a root canal and I should be on antibiotics for a bacterial infection just below that tooth. To be on antibiotics I probably need to cease chemotherapy treatments for a time. That’s another thing I need to talk to the oncologist about. So it goes. 

By the way, I’ve just finished reading The Cancer Code (2020) by Dr. Jason Fung. Aside from being a practicing nephrologist in Toronto, Fung is a prolific writer. This book on cancer is fine although Fung focusses on tumor-based cancers and mentions myeloma only in passing. I quite like his analysis and where he ends up suggesting that cancer is subject to evolution and natural selection like any organism. He argues that in the past cancer was seen as a mistake, then as a somatic mutation, but he writes: 

“Cancer had always been considered a single genetic clone, so evolutionary processes were considered irrelevant. But the realization that cancers evolve was electrifying. For the first time in decades, we had a new understanding of how cancer develops. The entire field of science known as evolutionary biology could now be applied to understand and explain why cancer develops mutations.” (from “The Cancer Code: A Revolutionary New Understanding of a Medical Mystery (The Wellness Code Book 3)” by Dr. Jason Fung)

Daratumumab is a monoclonal antibody. It worked well for a time. I hope it works for a while longer, but it is destined to fail when it no longer responds to myeloma’s mutations. He notes that cancer cells act like prokaryotes or single-celled organisms and not like eukaryotes or multi-celled organisms. According to Fung, we are on the cusp of a major paradigm shift in cancer treatment, but it will be expensive. What do we do about that? 

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Just to remind myself that I’m still a sociologist, I’ve spent quite a bit of time lately reading and watching MSNBC, CNN, The Guardian, NPR, BBC, Al Jazeera, Ring of Fire, Beau of the Fifth Column, and other newsy YouTube videos. I check out some Canadian content, but the elephant next door is far more compelling than Trudeau’s antics or O’Toole’s foibles. I’ll come back to the US below, but before I go there, I just want to say that I’m reading a book by David Graeber and David Wengren published just last year called The Dawn of Everything. The book challenges everything we know about the “Western” version of history and is a refreshing read. For one thing it sheds value on indigenous ideas and ways of seeing as providing the real challenges to the philosophers (Locke, Hume, Hobbes, etc.) of the Enlightenment, Rousseau, and other incipient lefties. The authors reject the idea that indigenous peoples were the child-like innocents they are often portrayed as by European travellers and colonizers. They also challenge the idea that things can’t change, that we’re stuck with large scale, ridiculous, bloated states. Unfortunately, Graeber died on September 2nd, 2020, three weeks after this book was released. He was fifty-nine years old. That hardly seems fair.

I don’t know how many of you are interested in American politics. It can be a nasty, grubby place at times and unless you are steeled against media biases and distortions of reality, you might be left with all kinds of strange ideas about what’s really going on to the south of us. One thing is for certain, I’m getting just a little perturbed at the ignorance and stupidity of some American politicians in Congress who shout “socialism” every time Biden and the Democrats dare spend a dime on regular, run-of-the-mill citizens or on infrastructure. They want all the cash to go to the 1%. I’m still not sure how that benefits them personally unless they believe Milton Friedman’s ridiculous trickle-down theory by which if regular people as taxpayers give billionaires all the money that some of it will trickle down to them. That is such a bullshit theory. The proof of that is that it’s never worked and the concentration of wealth in the über-wealthy is clear evidence of that. 

Ted Cruz, Rand Paul, Josh Hawley, Marjorie Taylor Greene, Lauren Boebert, Jim Jordan, and their ilk in the Republican Party and sitting members of Congress obviously haven’t a clue what socialism is, or, if they do, they are being disingenuous about it. The truth is that it may be some of both. For these clowns, any money spent on bridges, highways, city roads, the electrical grid, wastewater systems, potable water, etcetera, is evidence of socialism. So stupid. They take the notion of individual initiative and investment to the extreme. But, of course, they just want to get re-elected and making outrageously false statements is the name of the game. They can always be retracted later when nobody is paying attention.  

I’d say that I follow American Congressional politics as entertainment, but it’s not funny. There is a fairly serious challenge to the status quo there from a far-right racist Republican cabal and some people seem to want to continue the Civil War of the early 1860s. I do take some comfort in the fact that there are over 300,000,000 people in the United States and that would be a hard ship to turn around. I have a lot more to say about the US, supply chains, the wane of capitalism, the rise of oligarchy (which is already close to the surface), and history. Stay tuned. 

I strongly recommend reading Heather Cox Richardson on Facebook. You’ll get a well-researched commentary on American politics from a classy historian. Check her out.

Sleepless in Cumberland

Yesterday was my day at the hospital for my monthly infusion of Daratumumab, the monoclonal antibody. It along with other flavours of monoclonal antibodies have changed a lot about how medicine thinks about and treats cancer, arthritis, and other nasty ailments of us fragile mortals. Along with my Dara, I also take some dexamethasone, only 12 mgs for the month, and a few other meds designed to protect me from viral infection. It’s the dex that keeps me awake as I’ve noted many times on this blog. 

So, instead of lying awake, allowing whatever thoughts I had rattle around in my brain causing no end of silly talk, I decided to read instead. Reading is a good way of filling in the night hours in what some people would call a ‘progressive’ way. However, I may need to revise the material that I choose to read at night. I haven’t read a lot of fiction in my life, focussing my reading time on sociology, anthropology, philosophy, and other sundry disciplines. I have read most of Kurt Vonnegut’s work, all of Emily St. John Mandel’s books and I did recently read several books by Kim Stanley Robinson, fictional accounts of the human colonization of Mars, New York under flood, and other similar topics. In his Mars trilogy one interesting commentary was on longevity. If people accepted a certain treatment, they could live hundreds of years instead of the paltry number of years generally allotted to our species. That fact, however, did not seem to mitigate the angst they felt about death and dying. In a book called Aurora, Robinson is at his most pessimistic about human excursions to other planets and their satellites in our solar system. His conclusions about the time it takes to travel from Earth to other planets are telling. Travelling to and back from a satellite of Venus, for example may take a hundred and seventy years or more with the need for cryogenic sleep. So, if you were one of the ‘lucky’ ones who won the lottery for space travel you would return to Earth after several decades of travel at a time when no one would know you, you would have no recognizable family and you would be relegated to the margins of society. I read Robinson at night. It was a bit hard to get to sleep after reading some of his stuff, but not impossible. Reading Barbara Ehrenreich and other non-fiction writers of her ilk is an entirely different story (no pun intended). Last night I finished reading her book Natural Causes: Life, Death, and the Illusion of Control. This book is firmly planted in reality. Problem is reality sucks sometimes. Ehrenreich is especially blunt when she writes about aging. Getting old is no cake walk. It’s not for the faint of heart although in our culture it’s not cool to ‘give in’ to the infirmities of age. Ehrenreich writes:

“But as even the most ebullient of the elderly eventually comes to realize aging is above all an accumulation of disabilities, often beginning well before Medicare eligibility or the arrival of the first Social Security check. Vision loss typically begins in one’s forties, bringing the need for reading glasses. Menopause strikes in a woman’s early fifties, along with the hollowing out of bones. Knee and lower back pain arise in the forties and fifties, compromising the mobility required for “successful aging.”” (from “Natural Causes: Life, Death and the Illusion of Control” by Barbara Ehrenreich)

And:

“Not doing anything is the same as aging; health and longevity must be earned through constant activity. Even the tremors of Parkinson’s disease can be seen, optimistically, as a form of health-giving exercise, since they do, after all, burn calories. The one thing you should not be doing is sitting around and, say, reading a book about healthy aging. There are bright sides to aging, such as declines in ambition, competitiveness, and lust.”*

So, we must always put a happy face on adversity, be positive about everything, and keep moving. I don’t think my nine hours a day sitting with my computer on my lap would be morally acceptable. But you know what? I’m finding it a wee bit difficult to feel positive about dying. A Cumberland friend, Howard Jones, who died recently spent his last few days in the hospital. He couldn’t breathe on his own much anymore. Months ago, over coffee he confided that he didn’t know how long he could continue on oxygen with a life very much reduced to sitting or lying in bed. He could no longer walk in his beloved forest. I meant to visit him in the hospital when I was there for my usual chemo treatment, but I was cautioned not to because of my compromised situation. I should have gone anyways. Now it’s too late. We did text each other, but that’s not the same as a face-to-face visit. One day, the day he died as far as I know, he was the one to make the decision to go off oxygen, thus ensuring his death. I think that Howard died a good death. 

The especially difficult decisions I know I will face in the near(ish) future will be whether I continue with the chemotherapy that has so far kept me alive. I will be thinking of Howard when the time comes. I expect that my (and my family’s) decision will hinge on the quality of life my treatments are now offering me and the intensity of their side effects. There is a question of how much benefit a few months of life can give in the face of much reduced quality of life. It will not be an easy decision. I love life, I love my family, my community and where I live. I am loathe to give that up, to know that the world will carry on without me. But it’s not like I or any of us have a choice in the matter. We all die. Some of us, however, are given the privilege of deciding when and how we die. 

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*I’m reading Ehrenreich as an ebook on a Kindle. The problem with that is that when I select a quotation to use on my post, it doesn’t give me a page number. I find that unacceptable and will see if I can find a work around. 

Slowly Falling Apart

For this post, I decided to create a collage of quotes and commentaries from books I’ve been reading lately. They range from comments on death and dying to philosophy, culture, and the future. So far in this blog, I’ve refrained from commenting on American Congressional politics, but I just may go there soon. I told my sociology students year after year throughout my college teaching career that the American empire would fall, as all empires fall, not from external conquest but from implosion due to unresolved, long standing conflict. The American empire, specifically, will fall because of commodity production that depends on longer and more complex supply chains and failing profits. America is falling on its own sword of profits. Supply chains and economic processing zones in a plethora of ‘developing’ parts of the world have been an issue for decades while only recently making it onto mainstream media commentary and news. I’ll explain in a future post.

US politics has to wait. It’s a mess down there but it’s a mess everywhere on the planet at the moment. Let’s move on.

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Robert Sapolsky is one of my all-time favourite guys. He has a number of his Stanford University lectures on YouTube. He’s a neuroscientist who specializes in stress. He worked in the field for many years with Olive baboons in Africa. I have a video in which his work with the baboons is featured. On the topic of the human condition he writes:

“we are now living well enough and long enough to slowly fall apart. The diseases that plague us now are ones of slow accumulation of damage—heart disease, cancer, cerebrovascular disorders.” (from “Why Zebras Don’t Get Ulcers: The Acclaimed Guide to Stress, Stress-Related Diseases, and Coping (Third Edition)” by Robert M. Sapolsky)

Now, ain’t that the truth! If you check out Stats Canada’s vital statistics you’ll find out that cancer is the leading cause of death in Canada. Actually, life is the leading cause of death everywhere, but as far as the observable evidence of bodily decay and death goes, cancer is determined to be the immediate major causes. Writing this makes me want to go back and binge watch Sapolsky on YouTube. Not only does he have a lot to say, but he says it in such an engaging way that binge watching is entirely feasible. I’ll be sharing more from Sapolsky later, but now on to another very different writer.

This is a quote from another book I’m reading that I want to share with you. Talk about falling apart! Robinson is a contemporary novelist writing in the sci-fi genre with dystopian tinges. He writes:

“Say the order of your time feels unjust and unsustainable and yet massively entrenched, but also falling apart before your eyes. The obvious contradictions in this list might yet still describe the feeling of your time quite accurately, if we are not mistaken. Or put it this way; it feels that way to us. But a little contemplation of history will reveal that this feeling too will not last for long. Unless of course the feeling of things falling apart is itself massively entrenched, to the point of being the eternal or eternally recurrent individual human’s reaction to history. Which may just mean the reinscription of the biological onto the historical, for we are all definitely always falling apart, and not massively entrenched in anything at all. 31 India” (from “The Ministry for the Future: A Novel” by Kim Stanley Robinson)

Most of this quote will be difficult for you to fathom because it’s out of context. It’s the last sentence that really matters. To help you out a little with the context of this quote, the ‘order of your time’, in the first sentence means that in the course of your life you feel out of control. You can’t go back, you can’t stay still. You can only go forward towards your death. This applies not only to us as biological entities but also to our cultural and social constructs which also are bound to come and go in a generally disorderly way. We cannot be ‘massively entrenched’ in life because daily existence makes a lie of any attempt to avoid moving toward death.

Now, more from Robinson in another of his sci-fi novels set far from Earth on a ship and a moon.

“Existential nausea comes from feeling trapped. It is an affect state resulting from the feeling that the future has only bad options. Of course every human faces the fact of individual death, and therefore existential nausea must be to a certain extent a universal experience, and something that must be dealt with by one mental strategy or another. Most people appear to learn to ignore it, as if it were some low chronic pain that has to be endured. Here in this meeting, it began to become clear, for many of those present, that extinction lay at the end of all their possible paths. This was not the same as individual death, but was instead something both more abstract and more profound.” (from “Aurora” by Kim Stanley Robinson)

Robinson is not a great writer in terms of composition, but he is a very perceptive commentator on the human condition. His novels are all about the fragility of humanity in the face of evolution and death, both on an individual and social level. Death denial is a consistent theme in human history and as a goal, has engendered a mass of immortality tales with “supernatural” characters as diverse as Zeus, Jesus, Shiva and a mess of lesser gods. These characters are our heroes who will save us from death if only we believe in them. But then we come face to face with evolution and biology which care not a wit whether we believe in them or not, and which just carry on.

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So, what about falling apart?

It’s clear that average death rates have risen consistently over the decades on the planet although in the US they’ve been falling for some demographics. Falling or not, on average we live well into our seventies. In fact, Stats Can tells me that if I live to be seventy-four I can expect to live another fourteen years. These are average life expectancies, of course. Millenia ago, living to thirty-seven years of age was considered average. People died of things then we seldom die of these days (such as appendicitis).

Sapolsky understands that the longer we live the more things can go wrong in our bodies. That’s self-evident the longer we live. If we get injured while young we can expect to heal and then just get on with things. As we (I) get older the healing process slows down.

There are a few very fortunate people, especially in the world’s richest parts, who suffer very little as they get old. I don’t think I know any of those people (well, maybe one or two). That said, there is an inevitable decline in capacity as we age. That doesn’t mean we should stop living and simply prepare for death because we know it’s going to happen. For me, I have much reduced capacity. At seventy-four I have maybe a quarter of the capacity I had at fifty. But a quarter is better than nothing. I still have shit to do! I’m falling apart, yes. In fact, I can’t fall much farther, but that’s fine, I still have a way to go.

And the beat goes on…

Yes, it does. Sonny and Cher knew what they were singing about what seems like a lifetime ago now. I don’t know why, but the fact that Sonny died slammed up against a tree on a ski slope in Lake Tahoe the day after my birthday (January 5th) 1998 has my current attention. I guess it’s because his is a good example of a quick, unpredictable, death. Sonny had no time to sweat it. Death just happened to Sonny. No time to ruminate about it. Go Sonny go! I must confess that in some ways I envy Sonny his quick release.

Moving on, in my last post I told you that there was no longer any trace of multiple myeloma in my blood. I’m happy about that, but I must attach a disclaimer to that fact. The multiple myeloma will return. As I’ve repeated over and over, multiple myeloma is incurable although it is treatable. My oncologists have suggested to me that myeloma is a lot like type 2 diabetes in the way that it is treated by the medical profession. 

So, I can reasonably expect to make it to my eightieth birthday, although, frankly, longevity is not the holy grail here. And, of course, the six years from now until my eightieth year are not years owed to me. They are purely hypothetical time, years I might live, and years I might not. Moreover, as far as I know, after I’m dead, I won’t be able to regret anything about my life, how I lived it and for how long. “I” will not be so it’s ridiculous to speculate on what “I” might do after “I” am no longer. After I’m dead, “I” enter my immortality stage. 

I was not going to explore the whole business of mortality in this post, but I changed my mind. Bear with me. I just want to introduce here some ideas that I’ll come back to it in an upcoming post. These are not simple concepts to grasp, but, if you make the effort, it may help you understand life and death as I see them. So, here we go:

Humans are mortal, but only as long as we’re alive. To be blunt about it, it’s only when we are alive that we can die. Once we die, we are no longer mortal, we now become immortal, that is, we no longer change, and we consist only of what others remember of us. Our lives are complete. Simply put, immortal means not mortal. Well, once we’re dead, we are no longer mortal, by definition. We’ve arrived! We’ve become immortal! That doesn’t mean that we will live on forever in some form or other as defined by most of the religions that exist on this planet. No. “We” exist, after our deaths, only in the minds of others. 

My definition of immortality is clearly not the one espoused by most religions. The Abrahamic religions, for example, get around the problem of death by coming up with the idea of the soul. According to Christianity, the soul is the immortal aspect of human existence and is continuous before and after death. The body may return to the planetary store of compounds, atoms, and molecules, but the soul, well, the soul lives on in some kind of ill-defined relationship with a deity, “God” in the case of Christianity.  My definition of immortality does not acknowledge the bicameral nature of the person as consisting of body and soul. I see no evidence for the existence of a soul. Therefore, it does not ‘fit’ into any explanatory scheme I concoct. 

I could go on and on about death and dying as most of you well know, and as I promised I’ll get back to it in a subsequent post, but for now I’ll drop the philosophizing about immortality, death and dying and take up an issue that I’m currently faced with given the fact that we’ve tamed my myeloma. 

A few months ago, while I was still struggling with active myeloma, the pain in my bones was severe, and it was compounded by peripheral neuropathic pain. At that time a priority for me was pain relief. It still is to a large extent, but now, my priority is to see how far I can go in weaning myself off pain medications that were crucial for me for the time I was under the full effect of myeloma.  Now, I’m on two prescription pain medications and I take acetaminophen when I think of it. I was on three prescription pain meds until just recently, but I quit one of the medications cold turkey. Along with several annoying side effects, one of the more insidious side effects of that medication is dry mouth. My sense of taste was affected. I could barely taste some of my favourite foods and some I could not taste at all. I was anxious to try life without this med and as it turns out I’m quite confident that I’ll be fine without it. 

That leaves me with two pain meds. Gabapentin is a med I take for neuropathic pain. I’m currently cutting back on it to see how it goes. I’m not going cold turkey on Gabapentin, but I am determined to eliminate it from my pantheon of drugs. Hydromorphone is the drug that is the backbone of my pain treatment. I take it in slow-release form twice a day to deal with the daily predictable pain I get from myeloma’s excavations of my femurs as well as from sciatica and degenerative disk disease. I can also take hydromorphone in what’s called a pain breakthrough mode. That is, if the slow-release form of hydromorphone isn’t doing the job, I can take a more fast-acting form of the drug in any amount I feel is needed. I have taken breakthrough hydromorphone, but only sporadically, and as a last resort. I take as little of this drug that I feel will do the job. Taking more than a few milligrams of breakthrough hydromorphone leaves me hallucinating, not something I enjoy.  

The problem is that I’m seventy-four and at my age, the degenerative process is well under way. There’s no stopping it, and it’s not satisfied until it’s done. At my age, just about everybody has back pain and sciatica. These are conditions endemic to the species. It serves us right to have evolved from an arboreal species to one that is bipedal and an upright walker. Monkeys don’t have back problems. 

So, my challenge at the moment is to reduce my intake of pain meds to the point where I get pain relief without experiencing all the negative side effects of the various meds involved. So far so good. We’ll see how it goes.

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I’m writing this post on one of the hottest days of the year so far with tomorrow promising to be even hotter yet. Thankfully we have air conditioning, so the house is staying at a very acceptable 24.5˚C. Outside today, according to our weather station, the temperature has topped out at around 40˚C. Tomorrow, the prognosticators have promised us temperatures of 40˚C at mid-afternoon, so the beat goes on. 

I’m not complaining about the weather. The weather is what it is. It doesn’t respond to our needs, but instead requires that we respond to it if we’re not happy with it. Good luck with that. On to the next post now. Maybe I’ll take less time to get it out than it took me to get this one out. No promises. 

Check out this article Carolyn found for me. It’s a great discussion of chronic pain:

https://www.theguardian.com/australia-news/2021/jun/28/sufferers-of-chronic-pain-have-long-been-told-its-all-in-their-head-we-now-know-thats-wrong?CMP=Share_iOSApp_Other