Atlantic coast of France, early 1945. With the invasion beaches selected for D-Day, intelligence gathering begins in earnest. An obvious problem pops up almost immediately, confirmed by overflight photography, local partisans, and daring and dangerous insertion of agents. The far end of Omaha Beach is a series of sea cliffs. Perched on the cliffs are German artillery emplacements, sighted perfectly down the beaches. Under those guns, the invasion will be a blood bath (which it turned out to be anyway, but that’s a different story). Multiple tools were available for dealing with the guns: aerial bombing, naval bombardment, direct assault. All were implemented—a measure of the military importance placed on the matter.
The hardest but most assured way of assaulting the guns fell to U.S. Army Rangers. Long before Zero Hour, the rangers were put ashore with minimal burden of food, water, and ammunition, lots of climbing gear, and thermite grenades intended to disable the guns the old-fashioned way—by hand. As the invasion started to scroll before dawn on 6 June, rangers were coming ashore in a series of SNAFUs that included misidentification of the objective (the lead boat mistook another cliff for Pointe du Hoc, 2 of the assault boats sank before reaching the beach, etc.) [1]. Soon after dawn, however rangers were hanging by vertical cables and carabiners on the cliffs, with occasional German small arms units shooting at them and working to impede their low-technology assault.
It was a harrowing venture for the rangers. As night gave way to dawn, it was clear just how vulnerable they were. Suffice to say (there is, of course, a series of long stories collapsed into that phrase) the rangers rather quickly made it to the top of the cliffs and the German infantry units were by then occupied elsewhere along the beach front. There was only one problem: the guns that were the object of the entire exercise weren’t there. What you had was units of an exhausted ranger battalion with a brilliant view of an armada of warships that dwarfed any naval assault operation to date, and nothing much to do with their hands.
Suffice to say (have I used that idiom already? Dammit the chemotherapy drugs must be affecting my brain…or it could just be my brain…) the rangers spent something of a surreal morning wandering around French pasturelands on the margin of the massive clash of arms on the invasion beaches. Several recent television series have discovered and used newly discovered film, plus re-enactments, to good effect to document the assault on Pointe du Hoc, I commend these to you next time you’re in the mood for some hoppin’ History Channel viewing.
Anyway, in keeping with the surreal nature of the misty morning, a couple of the rangers hiking away from the main group to try to get a grip on things discovered the guns from the sea cliffs in a farm woodlot, unguarded, with their ammunition stacked nearby. They disabled two of the guns with the grenades they carried, returned to the unit for backup, went back destroyed the remaining guns and ammunition.
Mission actually accomplished. Of course, now the rangers had the problem of being a small unit of invaders away from the primary area of Allied assault. Over the following two days, they encountered and fought with various German troops. By 8 June, 90 men remained alive and fit for duty out of 225 in the initial assault.
This is a classic and interesting bit of D-Day lore. I recount it here because I had a sort of a “where are the guns” moment at the hospital this week. Respiratory specialists at two hospitals decided, over the past couple of weeks, that my pleural cavity was accumulating fluid from my lungs and would benefit from being drained. “Drained” in this case means they take a very long, lethal-looking needle, stab it through the abdominal musculature of my back, and attempt (via real-time ultrasound observation) to get the needle point into the pleura without pushing too far and puncturing and deflating a lung. Once properly inserted, they use the needle as a conduit to pull excess fluid from the pleura for discard with the day’s load of biological waste.
Well, Cathy kicked my butt out of my hospital-style bed in front of the living room TV and got me safely into the car. We buzzed up to the hospital at GBMC. I was quickly checked in and wheeled to the operating room. Appropriate gear was compiled—ultrasound visualizer, sterile kit with scary needles and fluid bags to catch the bad stuff, etc. The technicians sat me up facing the wall with my back exposed to the bed. Selected a needle and squished the ultrasound gel onto my back. Silence for about 4 minutes. And the tech says “Uhh…there’s not a lot of fluid here. Certainly not enough to extract.” She went to get the supervising physician who confirmed her diagnosis. No fluid to extract.
Talk about your missing guns! Actually, I’ve been feeling really good lately. No shortness of breath, lungs painless and dry. I wasn’t surprised they couldn’t find enough runaway goop to continue the procedure. I was certainly happy they wouldn’t be cramming the knitting-needle sized shivs into my back.
But there is more. That my lungs are functioning sufficiently well to keep fluid from leaking out and into the pleural cavity means that the chemotherapy is actually working. Oh, it’s not a miracle. My lungs remain cancerous, nothing we’re doing now can change that. But that wasn’t our objective in pursuing the catastrophically difficult and painful course of chemotherapy. We’re working to give me sufficient quality-of-life to spend a few more good months with family and friends, to write, think, play around with guitars, pastels, and photography, to sit on the front deck and enjoy the autumn weather.
And we seem to be meeting that objective (finally). This round of chemo did not dump me into an ambulance or the emergency room. Rather, it has given me (some) renewed strength. And enough symptomatic relief to be comfortable perched on my bed, reading, writing, strumming, and watching TV.
And at this point, that is what we’re looking for. A few comfortable months before the cancer gets its legs back and finally wrecks my respiratory system. And you know what? I’ll take it!
Thanks for being here, everyone. Hopefully after all the slogging you’ve had to do through whiny, painful accounting of medical nastiness, this bit of good news will perk you up as it has me. With home-administered i.v. fluids to keep me hydrated, and a peristaltic pump to “feed” me at a rate my physiology can endure, I’m hoping this period of relative comfort will last a while. But however it works out, it’s good news and the first such in a while. My love to you all. Tune in next week for further Adventures in Cancer Land (trademark, copyright). I’m taking y’all with me right to the end. Talk to you next week!
References
[1] http://www.6juin1944.com/assaut/omaha/en_hoc.php
Back at undergraduate days at Rutgers, it took me the better part of 4 ½ years to sort out such minutae as whether I would really flunk out, what major and/or minors I might pursue, what I could possibly do with myself after I did get out, etc. I learned a lot about myself along the way. And, because I experimented with course after course and program after program, I learned a lot of wacky facts and research results.
In the early days of experimental psychology (a field I rather enjoyed, and took multiple courses in), researchers were, for some reason, surprised to find that constant application of “negative stimuli” to dogs (such as keeping the floor of their cages electrified to the point of pain) eventually caused them to give up trying to escape and simply lay down and accept the hell. It didn’t occur to the experimenters, apparently, that absent any recourse, the dogs were just gonna run out of energy. Cross reference Ghost Busters for outstanding commentary on psychological research, BTW, if you haven’t seen it in a while. Hilarious.
Anyway. I’m starting to feel like one of those dogs. On Wednesday this week I got out of the hospital after spending 4 days in intensive care and 3 more in the oncology ward. I was still not fully recovered from the prior chemotherapy infusion when it was time, yesterday, to go in for the next one. So I just shuffled on in to the infusion center and got my hit of docetaxel. While there, we found out my red blood cell count is seriously anemic, so early Monday morning I have to go back in for several units of whole blood—I think they concentrate the RBCs in it before administration.
In short, I’m a frickin’ mess. But I am, for the moment, still alive. Not kickin’ very hard, but trying to. Keep me in your thoughts this week, everybody. I’m gonna need all the help I can get to get through this round of chemo. With the little bit of incentive that the lung tumors responded, I’m just piling along for the ride, looking to see what happens next. And as soon as I know, you will.
Thanks guys. Hopefully I’ll be more lively and able to provide more interesting material next week. My love to you all!
Human beings evolved in Africa. Then, as they walked out across the Sinai, species-by-species and individual-by-individual, they stopped and occupied the desert wilderness of the greater Middle East. In fact, there are a number of easily accessible sites in Jordan where, even today, you can stroll around on the tell (a “tell” is a hill, an enormous mound, of layers of the ruins of settlements, built one on top of the other, over millennia) whose onion layers begin with Neanderthal and run through Byzantine, Egyptian, Greek, Roman, Muslim, civilizations right to today (of course, the time period we are discussing runs much longer that this, going back past Homo neanderthalensis to Homo habilis and beyond). At one remote site, with a donkey tied up to chunk of Roman blockwork, a woman squatted in a shady nook busily producing the big thin Levantine bread characteristic of the region. She gave one to Nicholas and I. Apart from the stone fragments that made it crunchy and dentally dangerous, it was incredibly delicious. I asked our driver if we could pay her. He said she would be angry and insulted. So we drove on. To this day, I hope he paid her something from his (hefty) fee for the day’s driving.
Umm…I wandered a little bit there…where was I trying to…Oh. I remember. The point is that the western Middle East is, oddly, given the ecosystem in place, essentially the earliest human landscape. By which I mean a geographic suite of ecosystems that shaped, and was reciprocally shaped by, people. In that context, however, the carrying capacity (number of human beings per unit area) was low 10,000 years ago, and it remains so. Water sources are scarce, and without water, no people. Arable land is scarce and patchy (which is why there are so many goats. Goats can prosper on land that could otherwise support scattered spiky shrubs and lizards. This is also, BTW, why vegetarianism makes no sense ecologically. Much of the land on earth is not suitable for plant crops, but animals can serve as a vector to convert what dribs and drabs of primary productivity there are to human biomass and activity).
I have seen big chunks of the desert in the western Middle East. In Kuwait, one day we drove to the Saudi frontier, the next, to Iraq. I spent some time in the vacation “hunting” camp of a senior Kuwaiti security official in the north of the country. We hiked across the anti-tank trenching created during the war, which put us within naked-eye vision of the Iraq border. From Amman in Jordan, we drove into the northern mountains to the guard stations on the Syrian border (one of the guards, our guide said after chatting up the guys with the guns, had shot a hyena the prior morning!). I also went way out into eastern Jordan, approaching Iraq (this was also the trip we visited the miles and miles of windrows of shot-up Soviet tanks, guns and trucks from the first Gulf War. But that’s another story. I gotta dig out those slides and get them digitized for you). And I went to Aqaba, on the Red Sea estuary, hard against Egypt and Israel.
The most consistent aspect of this large and ancient “human” landscape is that it is nearly devoid of people. Yeah, there are scattered Bedouin encampments pretty much anywhere, family groups with a big tent, big pickup truck, and plenty of satellite antennae to grab television for nighttime entertainment. But not many people get by as itinerant Bedouin these days. Rather, there are a few small villages, far fewer large ones, and a couple of cities—Amman and Aqaba. With a couple hundred liters of spare fuel in back, you could drive off into the desert for days and not see another human person, beyond the red and white Bedouin camps off in the distance.
And that’s the reason I dragged you all the way through the above rambling essay. When you’re watching the news on TV these days, talking head after talking head is spouting off about how terrorist “army” ISIS or ISIL or The Islamic State is a new kind of existential threat to the West. The heads draw this conclusion from the ease with which these people spilled out of Syria to run over and “occupy” big chunks of Iraq. The heads tell you that this is a new and more terroristic kind of terrorism because ISIL is “taking over” big swaths of land [queue colorful map behind the commentator with ISIL lands in red, everywhere else in other colors]. And that prior terror groups like the Taliban and bin Laden weren’t trying to acquire real estate.
But here’s the thing. Any bozo with a RAV4, a couple cans of gas, and a Kalashnikov can run over and “occupy” big swaths of Middle Eastern desert. Hell, you could drive in a circle hundreds of kilometers in diameter and not see another human being. You could put up flags and “No Trespassing” signs. As my trips to desert frontiers of multiple countries suggested, ISIL actually occupies a tiny fraction of those big, colorful wall maps the news people are using. And an exercise in “connect the dots” is how the government and news outlets attempt to foment panic in the masses: “They’re coming for us. They’ve taken over Syria and Iraq. Soon they’ll be on our doorstep… .”
This, I suspect, is pretty much bullshit. The Islamic State has taken over and brutalized villages throughout the region. But they don’t have possession of large areas of ground. That’s left to the Bedouin who, except for the TV and the trucks, have owned and operated the deep deserts since well before the time of Christ. The Middle East is a complicated place, there is no doubt about it. But ISIL is just one of many groups claiming, fighting for, or dreaming of, making that desert exclusively their own. But there is no way that is happening.
My own landscape this week would also have to go in the “complicated” category. It started two Wednesdays ago. I collapsed in the foyer and couldn’t move. Scared the hell out of poor Cathy, who immediately called 911. The ambulance arrived in incredible time—maybe 10 minutes at the outside. The two women on board were around 40 years old. They both operated with military precision. One of them had a weathered desert look to her skin. I’m guessing the pair of them had spent recent time stitching up marines in combat zones. They did an awesome job delivering me to the emergency room.
My acute problems had to do with intractable dehydration (I couldn’t keep even small sips of Gatorade down) and associated imbalances in my electrolytes. I was pretty sick. In fact, they stashed me in the Intensive Care Unit for the first four days, moved me to Oncology Ward for the last three. Now, this was not my usual hospital. It’s the local shop—all three of our kids were born there.
They did a great job. I was so dehydrated it took the whole first four days to fix that. Then, being good doctors, they noticed my chronic respiratory distress and started to address that. After a couple days they realized my respiratory issues were from the cancer and not pneumonia or a fungal infection. When they cultured up my sputum, it sprouted what the impressed nurses said was a very impressive microbial diversity. Finally it clarified for the docs that they were not about to repair my breathing, that they needed to hand me back to GBMC for that.
Thus, I’m home. And am feeling much, much better. The oncologist at Howard County General (local hospital I spent the past week in) looked over the charts and tests and said that the chemotherapy is clearly working. You can’t imagine the wave of relief that coursed through me at that point. Gonna make it easier to take the beating from the next chemo infusion knowing that I’m not just making myself desperately ill every three weeks for nothing. Quality-of-life during these final months of my life is the primary objective we set for the treatment. And it seems like we’re going to meet that objective.
So, YYYYEEEEEEEEHHHHHHAAAAAAAAAAA from Cancer Land (trademark, copyright) this week. Much more will be going down this week. I see doctors, have tests, generally keep working on hitting back at this disease. I’m feeling more and more akin to an aging boxer who keeps getting into the ring, getting his lights punched out, waits three weeks and climbs back into the ring. But when I’m feeling good—like I am now—it is more than worth it.
I leave you with that bit of optimism, my friends. Hope you are all well. Live ‘em while you got ‘em—they aren’t forever!
Unless it already has. Just a quick update this week. Wednesday the EMTs scooped me off the floor and delivered me to the ER. Today is Saturday. I’m still in the hospital. My fluids and electrolytes just about straightened out. Weakness, discomfort, and some fear remain. Although improving.
No idea when I get outta here. I will give you a better update when I can. Thanks all!
