It Might Get Messy

It Might Get Messy

There are two dichotomous approaches to engineering design: “fail safe” and “safe fail”. “Fail safe” devices are intended to never fail—to be “safe” from failure. The classic example, of course, was nuclear weapons systems during the Cold War. The odd doctrine of “Mutual Assured Destruction”, coupled with use codes that were essentially impossible to bypass  proved, in retrospect, to be fail safe. Of course, the idea of fail safe is that the alternative—failure of the system—would be so gruesome that the entire complex of physical and social parameters that make up the system were devoted to non-failure. 

At this point, all of you should be picturing Slim Pickens in Dr. Strangelove, riding earthward over central Russia on the single warhead that managed to penetrate the fail safe bulkheads. Note that the Washington Post this week, in an otherwise exemplary story on public health, stated that “social isolation increased the likelihood of death among the elderly by a stunning 26 percent”, implying, it seems to me, that social interaction renders humans “fail safe” from death. Hmmm, I said to myself. Clearly I need to figure out how to join that remaining 74% who apparently don’t die even if they DON’T have “social interaction”. 

Reality, of course, must as always rear its ugly head. Humans are a “safe fail” system, designed via evolution to survive many engineering insults up to the approximate level of being hit by a Peterbilt semi on a high-speed roadway.

One problem with being an enormously complex safe fail system is in the number of non-lethal things that go wrong. What keeps the system safe fail is that these less-than-catastrophic contretemps are repaired before they reach the total failure threshold. 

And why am I subjecting you to this rambling discourse on the philosophy of risk management? Because every time the doctors think they have a grip on my physiological problems (and therefore necessary treatment planning), something unexpected pops up. Last week I showed you a photo of the enormous hematoma draining from my thigh. While I was stuffed into the claustrophobia tube test getting my MRI to delineate the known tumor, a shriveled, ugly-looking lymph node showed up. Given that I’m not supposed to have lymph nodes in my neck any more, having one growing to visible size is intensely disturbing. Monday I head for the hospital to have this raisinous lymph node biopsied in case it needs to be factored into the treatment plan.

Meantime, the MRI yielded some interesting pix of my throat. I’m not precisely sure where the tumor-of-concern actually is, and I won’t have a chance to ask the doctors until later in the week. However, if you will examine the following MRI images and look along the curved inner edge of my oral cavity (the back side of the dark hole niftily labeled "A" for "anterior"), you can see what looks like a coating of light-colored, slightly swollen tissue running along that edge. I think that might be the tumor.

 It’s diffuse, and weak, and at the moment looking less than vigorous. The idea of starting radiation and chemotherapy treatments immediately is to catch the malignancy while it remains in a weakened, incoherent condition. Hitting it hard while its down maximizes the opportunity for successful treatment.

Unless, of course, there’s another failure point hiding elsewhere in the system. Like a dried-raisin lymph node, rising from the dead to threaten to spread the cancer throughout my body. At that point, the image of the Peterbilt on the highway, or of Slim Pickens riding the bomb, take on a whole new level of reality. A level I don’t like.

Anyway, this week in addition to this cancer blog, there’s my professional piece at http://www.aehsfoundation.org/ (lower left on the home page to click through to the blog) which is reprinted for your convenience at http://www.sustainablebiospheredotnet.blogspot.com/ . The next draft chapter in the urban ecosystems book—8th street, I believe—is up at http://docviper.livejournal.com/ . Some brief music commentary—regarding the Be Good Tanyas—is at http://theresaturtleinmysoup.blogspot.com/ . Have a good week, everybody. I’ll be in and out of hospital, having various tests and getting ready to have my ass kicked by the radiation once again. And finding out if the radiation can be confined to the edge of my palate, or if it has to be expanded to include a treasonous lymph node elsewhere in my neck.