We can start with a gimme. Visual arts, painting, say. Out of any hundred people you drag off the street into an art history program, a fair proportion…for argument’s sake, let’s say 70—could memorize enough names, dates, styles, even technique details to get a middling grade—a C. At the same time, no matter what package of incentives, punishments, and pedagogical methods you string together, a much smaller number…probably well under 10—could produce even minimally credible canvases. It’s that difference—70 vs. way less than 10--that I mean by "knowing" vs. "doing".
Interestingly, the same delta doesn’t necessarily pertain, at least at a conceptual level, to the sciences. “Knowing” a science—that is, the vocabulary and grammar that makes up its description and verbal record—is challenging simply because of the volume of bullshit involved. And “doing” science is, theoretically, anyway, relatively simple. Science operates by experimentation. The best and most robust experiments are simple in concept. Hold all variables the same except for the one you are interested in. Vary that “interesting” parameter. If you’ve done your job right, differences in experimental outcome will be clearly attributable or not attributable to your variable-of-interest. Simplicity itself! That is, until you get down in the weeds. When your variable-of-interest is the velocity of certain subatomic particles, you need a 17-mile ring of high-powered electromagnets in a facility involving dangerous electrical power levels, vacuum environments, and near-absolute-zero infrastructure taking up a large chunk of high-priced real estate in alpine Europe.
My point is…uh…hang on a second, lemme think about this…Oh, wait, I remember. The point is that reading even a brief paragraph comprising a radiologist’s report regarding a patient’s cancer requires you to understand a boatload of specific jargon, or, as phrased above, “volume of bullshit”.
Which brings us right back to the weekly report of this weblog. On Monday, we went all the way to the hospital for a CT scan of my chest. We didn’t use the local radiology lab here because the last scan was taken at the hospital when I was there for pneumonia between Thanksgiving and Christmas. And then yesterday we met with the oncologist, for the holdover appointment from Thursday’s “massive” (maybe 10 inches) snow.
The entire radiologist’s report comprises precisely 13 lines of text. To read it, we need to know the definitions (most of the following are from dictionary.com, which nicely tacks specialized medical usage of words onto the normal people definitions) of “hilar” (the hole where blood vessels or nerves enter an organ, also called a “porta”); “mediastinal” (a septum or partition separating two parts of an organ); “nodular spiculated” (having the form of a spicule); “atelectasis” (incomplete expansion or collapse of the lungs); and “subcarinal” (no definition at dictionary.com or other rapidly available dictionary sites); among others. Perhaps we should turn to the 5 line “Impression”, which has more the flavor of a summary intended for medical professionals who are not cognoscenti of radiology.
The “Impression” says: “Overall improved lung aeration with diffusely scattered nodular and spiculated consolidation with atelectasis. New dense and ground glass right upper lobe consolidation. This could represent infectious/inflammatory changes or neoplasm. Continued follow-up imaging is recommended. Large right and moderate left pleural effusions have increased mildly when compared to the prior study.”
Basically what he’s saying is that my airways are surprisingly open, the pre-existing cancers are still there but they’re smaller and fewer, there are some new spots in the right lung that could be inflammation or scarring (as from chemotherapy or pneumonia) or new cancers, and that there is some fluid in the pleural cavity around both right and left lungs. I assume “ground glass” is a term-of-art describing nodules in the lung tissues.
So I discussed the meaning of all this, particularly possible timelines, with the oncologist. She, being a good and honest practitioner, warned that it is impossible to forecast temporal changes in my specific case. However, in her experience, individuals with generally similar conditions have gone a few months to a year before the disease has climbed back into the cockpit and fired up the afterburners. She also pointed out that my cancers (but not the rest of me) responded very well to the chemotherapy that followed the radiation that followed the surgery last year. Her point being that if I’m willing to put up with the hammering of the chemotherapy, it is likely to have a good therapeutic outcome so that when I get sick again, we’ll have a place to turn if I want to buy some more time to be alive. Given how horrifically ill the chemotherapy made me last year, I will certainly have to consider how much ugliness I’m willing to trade for more time on earth.
But that’s an issue we’ll deal with when the time comes. For the moment, I’m breathing relatively easily, I can take enough medication to sleep through the night without drowning in mucous, and I can function, at least minimally, like a human being (like I can get up and down, walk around, don’t need to haul oxygen with me for every excursion, and seem to be keeping my weight stable despite ongoing struggles with getting sufficient calories of the U.N. emergency rations ingested every day). Given that all three of my key doctors—oncologist, surgeon, and radiologist—believed I would be dead or, at best, clearly dying right around now, I’m at least a bit ahead of the game at this point. You can believe I’m gonna live ‘em while I got ‘em, because now I seriously know they’re not forever. But I’m gonna stretch ‘em out as long as I can, and I commend the same to you. Thanks for being here, everyone. Check back next week to see if my present good health is robust and maintaining, or fragile and fleeting. Where else can you get such a truly life-and-death documentary for the investment of reading a few paragraphs of online text?
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