It Might Get Messy

Last week, we touched on the primary therapeutic difficulty with cancer—distinguishing destructive “otherness” from happy and healthy “wholeness”. This dichotomy, of course, is the source of my present difficulties, which consist primarily of battling the horrific “side effects” of chemotherapy. The chemo drugs degrade cellular substructures. If they could be focused specifically on tumor tissue in my lungs and pleural membranes (the latter are sort of a sack inside which the lungs function, it is important that it be clear and elastic to accommodate healthy breathing), I wouldn’t have the struggle with gastrointestinal symptoms like nausea, vomiting, and dehydration. Unfortunately, in practice, the taxol drugs (I’ve had several different ones in the course of 3 flights of chemotherapy, I think the current one is “docetaxel,” synthesized during efforts to increase the efficacy of the original pine-bark derived taxol) gum up cellular replication throughout the body. The thing that makes them useful in cancer therapy is that malignant cells have higher metabolic rates than “normal” cells. Meaning that you can hammer the whole system (that is, the patient, or, in this case, “me”) to near death with the drugs and find tumor tissue differentially affected. As long as you don’t kill the patient with the drugs. Based on my experience (especially the 911 ambulance rescue incident), I’d say we’re working pretty damned close to that lethality threshold. 

But let’s not go there yet. Let’s revisit momentarily a place we’ve been several times before in this weblog: the moist, densely forested landscape of Europe after the last ice age. 

Human beings are obviously among the most adaptable species on earth. We occupy all landscapes, from desert to permanently flooded tropical waterways and wetlands. And when we first occupy a “new” landscape, we don’t just slip in overnight, keep quiet, and commune with the local flora and fauna. Hell no. We reconfigure things (by “things”, I mean structural and functional parameters of the ecosystem, stuff like biodiversity, soils, water regime, carbon and nutrient fluxes, topography, geology, and a host of others) to our liking, and settle in for the long haul. 

One key ecosystem parameter that’s given us trouble from our earliest evolutionary history to the present day is the presence of “others”. When Homo sapiens first wandered north from Africa 50,000 years ago, the “new lands” they found were already occupied by H. neanderthalis. Neanderthal people, as we now know, were smart, fire-building, tool-using people. They had been in place for hundreds of thousands of years. They were not easy to displace from what were then essentially their homelands.

So we (that’s the Royal We as in “we Homo sapiens”), didn’t bother to try to get rid of them, at least at first. Instead, we consorted (good word, no?). We had our hosts clean out the spare cavern at the back of the cave and convinced them to let us shack up. We interbred, to the point where H. sapiens carried a fair sampling of Neanderthal genes, and vice versa. Sweetness and Light prevailed. 

For a while, at least. Newly published genetic findings from a 37,000 year old H. sapiens body found in Russia [1] suggest something ominous (well, ominous to ME, anyway. The article at [1] was obviously written by someone with a solid reputation to maintain and unwillingness to speculate, whereas I have no reputation and zero credentials to protect and so am free to speculate away like Erich von Daniken on a mescal binge) suggest that Cro magnan (pre-modern H. sapiens) and Neanderthals went on something of a gene-exchange orgy. This period of inter-species breeding (which, BTW, is problematic for the definition of species in the hominids, since the threshold representing different species is supposedly a LACK of interbreeding) was short and confined to the first few thousands of years after Cro magnan moved into Neanderthal neighborhoods. Soon after these early encounters, interbreeding ceased. The load of Neanderthal genes in Cro magnan people was fixed early and did not change afterwards—we stopped inter breeding [2]. From that point forward, Neanderthals occupied increasingly marginal and isolated locations. Neanderthal and modern humans shared the landscape for 10s of 1000s of years, but apparently cordial neighborliness was no longer a feature of their relationship. Eventually, Neanderthal people went extinct and H. sapiens took over the show. And the rest, as they say, is history. Or, more technically, pre-history. Or whatever. The point is, Neanderthals were no longer our buddies. And it seems likely that, once the family feud was underway, Neanderthal people were in deep shit. Nothing has more potential for biological devastation than modern humans with an irrational grudge and access to weapons. 

Which brings us, perforce (I have absolutely no idea what “perforce” means or how to use it. This just seems like a place the word might have been inserted in a ponderous 18th century manuscript), to face the ominous implications of our interspecies relationship to Neanderthal people. 

Basically, we decided Neanderthals had to go and that we were the instrument of their destruction. We drove them to marginal habitats and went to war. Possibly we put them on the menu. In any case, we were no longer willing to engage peacefully with the original “others” whose lands we were rapidly expropriating. We were efficient, too. In only a few 10s of 1000s of years, Neanderthal were down for the count and not getting off the canvas. It was all over but the celebrating. Perhaps something like the Ewok’s “hey, we just saved the universe, let’s drink ourselves into a stupor and party hearty” party. 

It really doesn’t matter. What scares me about this scenario is the present turbulent geography of human beings on earth. Wars between “others” are ongoing and reshaping the earth. From Korea to Kashmir to the whole of Africa to the slums of Miami and Los Angeles, to Ferguson Missouri, people “not like the others” are battling each other. It’s making for dangerous and difficult times. Is it possible that our inherent dislike of “others” is genetically ingrained (or is it “engrained”? I have no real idea. But you get the point), and was fixed in our genome during the “Neanderthal Wars”? Because if so, keeping civil constraints on Vladimir Putin and his ilk (love that word), from tribal war lords in central Africa to tribal war lords in the Middle East to tribal warlords in _____ , take your pick,  is a much more difficult and biologically-driven task than we’ve acknowledged to this point. If there is an inherent human tendency to eliminate “others”, then the dark side of the relationships between colonizers and native peoples (think “Trail of Tears” here) is likely to remain dark. Which clashes big-time with modern technological capabilities to travel and communicate globally and easily. It may be 10s of 1000s of years before we straighten this out. And the “straightening” process may be icky in the pools-of-blood, killing fields, mass grave sense. Not to repeat myself. But: icky. 

Do you know what the difference is between Shiite Islam and Sunni Islam? Shiites believe that when The Prophet Mohammed died, his line of succession should have accrued within his family (and specifically his uncle Hussein, martyred at the Battle of Karbala). Sunnis (“Sunna” means “community” or “in group”, as in “not like the others”) believe succession rightly passed to The Prophet’s closest friends and advisors. Leaving us with a centuries old example of the power of “otherness” to provoke really stupid, counterproductive human behavior. 

Which brings us full circle back to the ultimate test of individual “otherness”, cancer and my present condition. At the moment, my physiology is working pretty well. Having put the last round of chemotherapy behind me by more than a week, I feel pretty good. Breathing is good and clear. Except for sudden leakages of mass volumes of mucous several times a day (which I try to stay ahead of by ingesting mass quantities of Benadryl), I’m really not in bad shape. We seem to have gotten a good balance between “otherness” and “oneness” in my medicines. 

Basically, I do not feel at the moment like I’m dying. I feel like an invalid, but one whose quality-of-life is more than sufficient to justify hanging around and fighting back against both the disease and its treatments. My primary difficulty now is ingesting sufficient calories per day so I don’t slowly starve to death. Haven’t mastered this one—I am slowly starving to death. But, I’m working on it. 

I will provide one important disclaimer. I look absolutely horrific. I am a wizened, hairless, misshapen, frighteningly changed person. I look, basically, like a guy who has died after a long battle with cancer. I do not look like Dave. I am in any case a dead man walking (and not walking too far—my leg muscles cramp after 50 meters or so). For those of you coming to visit and to help celebrate my Last Thanksgiving, just be prepared. I look shockingly bad.

However. I’m still in love with life, with music, art, photography, and, most importantly, with you, my friends and family. Just try not to gag when you first see me!

References

[1] http://www.reuters.com/article/2014/11/06/us-science-genome-idUSKBN0IQ2QK20141106

[2] http://theconversation.com/ancient-dna-sheds-light-on-the-origin-of-europeans-33907