It Might Get Messy

I was reminded recently of a trip I took to Cape Cod as an undergrad at Rutgers. A couple of faculty members set up a 1.5 credit course titled “Geology and Ecology of Cape Cod”. We spent a week camping on the Cape, a group of about a dozen grad students and me. I didn’t know any of the grad students very well, and they didn’t know me. One night I spread out my sleeping bag under some hemlocks at the edge of the firelight while the grad students sat up drinking and conversing. Eventually their talk turned to me. I had spent every bit of field time sloshing in the cold water grabbing specimens, and earlier that day I caught a couple of big black racer snakes, interrupting their mating to show the class (one of the instructors was a vertebrate zoologist). The consensus among the grad students was that I was “like a football player who went a little crazy” (I wrote the quote inside the front cover of my field guide to mollusks). 

The weird thing about it was that that was PRECISELY what I was at the time. A few years later, working on my doctorate at Georgia, I exploited that “crazy” love for field work. I spent two years driving a university vehicle around the southeast, collecting small mammals, herps, and birds, studying their relationship to parasitic (and medically important) mites. “Chigger” mites are pestiferous in North America, where sitting on a pine log can get you a load of mites that will make you itch miserably and swell up like you ran into a patch of poison ivy on steroids. In the tropics, chigger mites vector a number of serious diseases, explaining why the U.S. Navy was interested enough to fund esteemed Dr. C, my major prof, for research on mite ecology.

Of course, chiggers are not the only arthropod pests in the woods and fields of the deep south. On one trip to Sapelo Island off the Georgia coast, I managed to acquire a shitload of tiny, angry ticks. One evening I counted them as I removed them with tweezers. Actually, I quit counting when I got past 300. I also stopped picking them off, and simply went to sleep.

A couple of weeks later, back on campus, I started to have nasty headaches (and, except for occasional migraines as a child, I NEVER got headaches), painful joints and muscles, and running a low-grade but slowly climbing fever. The campus clinic drew blood samples that revealed Rocky Mountain Spotted Fever, a tick-vectored rickettsia (rickettsiae…I think that’s the pleural…are rather like bacteria without the tough cell wall surrounding their protoplasm). Before I got too sick, they slapped me onto antibiotics and cleared things up.

At that time, tick-born diseases were all the rage. Lyme disease had been discovered just a few years prior (possibly released in North America from a U.S. bioweapons laboratory, see Lab 257: The Disturbing Story of the Government's Secret Germ Laboratory by Michael C. Carroll, 2005). The panic was far from the equivalent of the present hysteria over Ebola, but it was definitely in the Zeitgeist. 

That was also when Superfund was just getting started, and environmental cancers were of great concern. Of course, in retrospect, we know that cancers “caused” by uncontrolled hazardous materials in the environment are very rare (and generally limited to radioactive wastes or asbestos). By far the greatest triggers for human cancers are lifestyle choices and/or bad luck. 

Whenever new doctors quiz me regarding basic background information, they are invariably shocked to find I have never been a smoker. My tongue, throat, and lung cancers are typical smoker’s diseases. My parents were both heavy smokers, but in truth the linkage of cancers to second hand smoke is only weakly significant (the latter in the formal, statistical sense). I’m afraid my own lifestyle choices are the source of my present difficulties. Ethanol (beverage alcohol) is a potent carcinogen. And I drank buckets of beer, wine, whiskey, whisky, gin, and rum. I also self-medicated chronic mouth infections with copious quantities of Listerine mouthwash, which is also high in alcohol content. I have to acknowledge that all those bottles of silky, creamy viognier and thick, syrupy zinfandel are highly likely to have triggered that tumor at the base of my tongue, the one that started it all. Having spread to my parotid gland, and eventually into my lymphatic vessels (despite the doctor’s best efforts to remove as much of my lymph system as possible from the line of fire) and lungs, there is little doubt about how I got to my present condition as a dying invalid.

With that big picture under our belts, I can update on my status. In general, I am doing as well as somebody with terminal respiratory cancer and ongoing treatment with powerful chemotherapeutics can do. I’m on oxygen when I’m sitting around, but I can lose the O2 to walk. Although I can’t walk very far or for very long. Until the past few days, my pain was well controlled by my pharmaceutical regimen. Pain level has crept back up lately, but as Cathy points out, I have access to a couple more tabs of dilaudid per day. That will certainly tide me over for a while. A couple months ago I actually felt good enough to go off a skin-patch delivered opiate called Fentanyl, which is a long-acting formulation (compared to the dilaudid, which is high-powered but fast-acting). I may have to go back on the Fentanyl if the pain doesn’t re-subside, but that’s not really a hardship.

So, all in all, there’s not much to report from here. Which, all things considered, is a good thing. The next bit of excitement—or at least trepidation—comes next weekend. Chemo on Friday. I’m hoping to hell I won’t be back in the emergency room on Sunday. 

We’ll just have to see. Tune in next week for all the exciting news! And in the meantime, use ‘em while you got ‘em. Because they are NOT forever!