Roland the Headless Thompson Gunner “blew Van Owen’s body…from there to Johannesburg”. “There”, in this particular case, is former trade port turned tourist gateway Mombasa. The city surrounds a muddy estuary on the coast of Kenya and is a point-of-entry for tourists heading out to game parks, including Serengeti, Ngorongoro, and Tsavo. I’ve never been there. But Wikitravel (http://wikitravel.org/en/Mombasa) and other sources highlight health and safety issues without offering much in the way of attractions to offset such risks. Lonely Planet points out that its Swahili name means “Island of War”, and provides four tourist “attraction”—an old fort turned art gallery, a spice market, a mosque, and a 1902 courthouse also turned art gallery. The British Government advises against visiting, and suggests that if you are presently there, you should get your butt out. It may be that Nairobi and Kampala are effective competitors for the tourist pass-through business. Without the sticky silt, salt marsh mosquitos, and long history of piracy and street crime. If you will indulge my drawing conclusions without having actually visited (breaking my own inviolate…uh, or not… rule for technically credible scientific testimony (that is, under oath in environmental legal matters)), it sounds like a good place to keep off your itinerary.
But these are not the droids we’re looking for. My teenage years, in keeping with common practice at the time, encompassed numerous incidents with potential to leave me injured, sick, or dead. This “long list” includes the usual, ranging from driving while drinking to swimming in water heavily polluted by raw sewage. I can recall a few incidents, maybe half a dozen, where death was a lot closer than “usual”. Moments when the cold statistical odds of survival were well below 50%. For example:
• Wayne Hills High School faculty, including my father, used to take a group of students camping on a spring weekend to Lake George, New York. I usually went along, but with crippling shyness and my own interests (mostly involving reptiles, amphibians, birds, and fish) not shared by the older group from the Hills, I spent a lot of time stalking salamanders and snakes off in the wilderness. Once I crawled under a big hemlock to sort through the layer of needles on the ground beneath, only to receive a really nasty knock on my head. I’m pretty sure I was briefly unconscious. When I came around and found my attacker, it turned out to be a large, outdated and mostly rotted campsite sign from years past. With a six-inch long, rusty, sharp-pointed spike sticking through it on one side. If that spike had hit my skull rather than the spongy wood, I’m guessing it would have taken the rangers a couple of days to find my carcass.
• My fishing, hunting, and herping buddy, we’ll call him “Archer I” because he runs an archery business in Tennessee, and I were bored one summer day. We set up a “primitive weapons war” in a woodlot near Pompton Lake. After half an hour to construct weapons, we stalked each other, looking for the first shot. I used my pocket knife to fashion a sleek javelin. “I” and I (has a nice Rastafarian ring to it, doesn’t it?) spotted each other at the same moment. I chucked my javelin into the tree he was perched in, missing by several feet. He drew the short bow he’d made with a length of found twine and shot a beautifully crafted arrow he’d tipped with a sharp bit of quartz crystal and fletched with stiff leaves. The arrow struck the front of my cheek, ripped right on through, tearing a couple of inches of flesh on its way into my mouth. As it was, it took some fast talking to assure my parents all the blood was due to a simple accident. If that arrow had hit my eye, it would have entered my brain and dropped me in place.
• Same buddy—he was my outdoorsy friend—and I got somebody to drop us off with a jon boat on the Passaic River at the New York/New Jersey state line. We took a couple of leisurely days floating down to Pompton Lake, spending the night on an upriver island deep enough in the woods that our campfire wasn’t obvious. Along one fairly shallow stretch of river, I was reaching down from the bow of the boat grabbing freshwater mussels to add to my oddball collection of biological bits. There was an enormous mussel just about out of my reach, but I leaned way forward, and…bent at the waste as the boat ran over my head and torso, trapping me there, legs in the boat, head being scraped by the boat hull on one side and riverbottom rocks on the other. Even though it was quite clear to me that I was in a dangerous, potentially deadly, situation, I must admit I was cracking up laughing at the slapstick nature of things. Archer “I” managed to get the boat turned sideways to the current so I could extract my scraped-bloody head from the river. If things had gone the other way—say I slipped whole-body under the bow as the boat whipped over me and headed downstream—I might well have been unconscious and underwater, with “I” unable to rescue me until he managed to beach the boat somewhere downstream, hike back up to where I would have been drifting like Aragorn after the battle with the Warg Riders in Rohan, and, I have little doubt, dead.
That’s sufficient examples to make my case. The other 3 or 4…or maybe 5 or 6…near-death experiences were vaguely similar. Skating alone late at night on thin springtime ice, passing out and whacking my head on sharp rocks…the usual.
Anyway. Why, I have no doubt you are asking, am I dragging you through these adolescent reminiscences? The answer, I’m afraid, has a lot to do with simple self-indulgence. It’s now been 7 months since my last chemotherapy infusion. My lungs and chest cavity are chock-full of temporarily inactive malignant lesions. Death has been on my mind, as I contemplate the end of this physiological armistice and the re-start of the medical war.
Oncologist Dr. T is confident that she has sufficient weapons at her disposal for us to fight a third credible battle with the cancers now scattered around my insides. Dr. H, surgeon, says “we can cut out anything that needs cutting.” I’m guessing the upcoming struggle won’t involve much surgery. If the CT scans are representative, there are no real points-of-focus for this battlefield. Rather, diffuse “lesions” are scattered, and their transition to malignancy will also be diffuse. Can’t “surgically remove” both lungs, much less the lining of the chest cavity.
Dr. N, radiologist, would be, I suspect, willing to take another crack at administering radiation therapy, should there be some way it might be useful. As he quietly told me after the second round of radiation, he gave me “way higher doses than other doctors would, just because…well, I thought I could.” Gotta admire somebody willing to do what needs to be done. I haven’t inquired directly, but I’m guessing I’m already approaching, if not already beyond, my “recommended” lifetime dose of radiation exposure. That’s the other great thing about Dr. N. In fact, the whole medical team. They are are focused, intensely so, on their patients. If I tell them I want to keep fighting, they’ll find some way to get me back on my feet, back into my armor, fitted with weapons, and back onto the battlefield. They are even willing, as they showed during my last round of treatment, to talk me into coming out of my corner one more time if they think I’m giving up too soon. I think that willingness, having the guts to take a desperately ill, weak, and unhappy patient who is ready to forego further treatment, give up food and water and die, and convince him that the war is still worth fighting, is the most impressive characteristic of this medical team.
Neither the docs nor I know when my life is going to be back in their hands. But every passing day shifts the probability function an increment closer to that time. Roland the Headless Thompson Gunner had it right. Throughout human history, mercenary soldiers were paid for what they loved to do—make war. Throughout MY history, I’ve loved to do a handful of different things—“ecologizing”, reading, writing, painting, cutting paper, making music, cooking, archery, traveling, teaching, et al. All these passions add up to a grand sum of BEING ALIVE.
But I have one up on Roland. In my case, the thing I’m fighting for—life—is its own reward. Not to mention being a sine qua non for production of marginal-quality paintings, photographs, pieces of music, etc. Which explains why I live ‘em while I got ‘em. I’ve been close enough to death (over the past 4 years that is, let’s just discount my teenage time if it’s ok with you) to know how easy it is to slip over the event horizon that will take me away from the family, friends, and activities I love so dearly.
And you all are a HUGE component of the arsenal that lets me fight this war. Thank you so much, everybody. I love you all!!!
If you hike from the highway into the remote desert of central or eastern Jordan, you will of course be watching for wildlife and birds. And keeping your eyes open for the thin, dark shadow that might indicate the edge of a wadi—a drainage feature or canyon representing the landscape diversity that would increase your likelihood of finding jackals, foxes, hares, Palestine vipers, maybe a falcon (it’s been millennia since lions, tigers, bears and wolves lived there, and centuries since the last leopard, cheetah, ostrich, eagle, or antelope. I would have put hyenas in the latter group if I hadn’t talked to the Jordanian soldiers up on the Syrian border who killed one recently in concert with their Syrian compatriots). But eventually, even if you’re a crack biologist but geological dimwit, it dawns on you that there is something odd going on with the rocks underfoot in this stony region. Now that your eyes are open to it, you can see that the ground is covered, nearly completely in some spots, with simple stone circles. The circles vary in size from a meter or two in diameter to hundreds of meters. The largest are the subject of active research (http://www.dailymail.co.uk/sciencetech/article-2814715/Mystery-Jordan-s-Big-Circles-Ancient-stone-rings-desert-left-archaeologists-baffled.html). The smaller ones, which are scattered across the entire desert floor, don’t seem to have triggered any academic interest. Which is, I suppose, understandable. Given that they consist of fist-sized rocks resting on the ground surface, there is no way to tell whether they were put there by kids joy-riding to Aqaba from Amman in Dad’s 2014 BMW, Roman soldiers staking out sleeping quarters, or Neanderthal migrants hoofing their way out of Africa toward their destiny in Europe. Still, the circles as a whole represent a LOT of human activity. And there is something vaguely disturbing about them, given how abundant they are. People haven’t been able to live in these deserts in the millennia since Petra was a community of stone-workers who carved an entire city out of rock faces in such a fashion that every drop of dew or rain (back in the days when rain fell here) was collected and stored. Until recently, the Bedouin peoples were truly “migrants”, and seldom stayed more than a few nights in a particular spot in the non-watered desert. For some reason I got a little creeped out when I realized that these circles stretched off into the distance as far as I could see. Not sure why. Possibly watching the “Tremors” movies franchise one too many late nights… .
After I’d seen the circles, and after Nicholas and I took a sort of a Hunter Thompson-meets-Jason Bourne-via-Marx Brothers expedition from Amman to Aqaba through the heart of the stone-circle country, I got in the habit of asking anybody who seemed to know something about the desert: “What’s up with the stone circles?” People I asked included our driver, our driver’s brother-in-law (who stocked the back of the wagon with vegetables and fish, and brought a big thermos of spiced tea and one of spiced coffee to share), our government hosts, every academic of every field we met, people from the U.N., and every consultant we crossed paths with. Nor did I limit the inquiries to people we met in-country. While we were preparing our component of a big-ass report, I asked everyone we worked with or ever talked to over the phone. The universal response? “I don’t know.” And that’s it. No one among the dozens of people and hundreds of potential documentary sources I consulted had anything else to offer. Actually, the uniformity of the response—everyone said PRECISELY “I don’t know”—started to make me a little squeamish. You’d think SOMEBODY would have added a little variation to the chorus. Something like “I have no idea”. Or maybe “I don’t think anybody really knows”. Nope. Everybody said “I don’t know”. This seems benign enough, I’m really not sure why this bothered me. Possibly watching too many bad, late-night movies predicated on some variation of “Stepford Wives”. You know, the one where even though the characters look and sound human, their identical repertoire of responses reveals that they are pre-programmed aliens sent here to “take over” the earth.
Anyway. “What”, I hear you asking, “the Hell does this load of verbose crap have to do with cancer”? “Well,” I reply, “more than you think.” It has to do primarily with that honest and ethical “I don’t know” phrase. Here’s the deal.
We visited my Oncologist this week. Much like me, she is delighted with the status of my health. Particularly in the context of the cancer that has shuttled around my body from mouth and salivary gland to lungs, liver, chest cavity, and the remaining shards of lymphatic infrastructure in my torso. Also much like me, she would like to know more specifically where residual malignancies are, their size, and their potential to deliver the final swing of the Battle Ax that is going to put me in the vacuum-sealed specimen bag with preservatives, waiting only for a struggling couple of medical students to begin the dissection.
However. When I asked her directly when I should expect to be taken ill again, and also when I should expect to die, she gave us a simple and direct “I don’t know”. When she said that, my mind clicked back to Jordan and the ubiquitous stone circles. I like to think of my cancers as linking me to the powerful philosophers of Greece and Rome. Even if it by a stretched-paper-thin metaphor based on rocks in the desert.
Anyway. Undertaking (pun not intended, but now that I see it, I’m taking credit for it) the diagnostic procedures that would reveal the current distribution and condition of my malignancies comes with inherent costs and risks. As with most things in this entropy-powered universe, there is no Free Lunch. If we want to play, we’re gonna have to pay. Fundamentally, we need to understand and balance the cost/benefit aspects of the testing.
Clearly this has been on Dr. T’s mind. While she completed a brief examination, she rattled off a monologue regarding these difficult cost/benefit tradeoffs. Doing a PET/CT scan to reveal the wheres and wherefores of my tumors comes with some inherent procedural risks including possibility of introducing an infection spot-on my heart where the “port” that provides access to my circulatory system ends; and potential for the radiation in the sugar cocktail to trigger a new malignancy. These risks are so unlikely that they can be discounted. But the more important question is, what would we do with the information we get from the scans? Dr. T’s monologue indicated that she would not re-start chemotherapy unless I was showing overt symptoms of the cancers. Since I’m very comfortable at the moment, and getting stronger and more functional every day, and my residual pain is well controlled, she would not put me through the hell that landed me in-hospital following every single treatment in the last course of therapy. Absent symptoms, treatment is counter-indicated. And, since my immune system is clearly sparing me from cancer symptoms for the moment, it is likely that when I DO become symptomatic, the distribution of malignancies will not be the same as they are presently.
The bottom line, or punch line, of Dr. T’s excellent monologue is basically this: curious as we are, there is absolutely no reason to conduct PET/CT scans at the moment. Simple curiosity is just not a compelling reason to test. We’re gonna have to live with “I don’t know” until the crushing pain, bleeding, and buckets of mucous return to remind me who’s in charge of things. Or who’s not. The latter would be me.
I agree completely with Dr. T’s reasoning on this. If this were an ancient Greek drama, presumably the gods would proffer some reward for the excellence of Dr. T’s monologue. She certainly gets as much verbal “reward” as I can offer every time we see her. Because she managed to give me 6 months (and counting) of relatively comfortable additional life despite the size and severity of my cancers. We go back to see her in a couple of months. If I’m symptomatic by then, we’ll plan on a scan to base (potential) treatment on. Of course, my physiological and psychological resources are finite, and it’s taken a massive investment of both to get me here even with Dr. T’s amazing medical skills. And if I continue to be asymptomatic then? Man, I’ll probably prostrate myself on the floor of the examining room, possibly with some incense burning and with a long, gentle raga from Ravi Shankar’s extensive library playing in the background. That would be 8 months of relative comfort and living life (no, that is not redundant. Many people fail to live while they’re alive, and I’m not in that camp. I was using ‘em while I had ‘em way before my cancer diagnosis), when, given the size, location, and intensity of my malignancies, I should have been dead quite a bit of time ago. Under the circumstances, that Dr. T was able to give me an “I don’t know” response to questions regarding the timing of the rest of my life, is a tribute to her and the other doctors and experts working my case at the Greater Baltimore Medical Center. And I really, really appreciate it!
I also really, really appreciate you all out there reading this wacky (and now lengthy, not to say “interminable”) web log. Thank you so much for the laughs, the love, the friendship, the wisdom, and…well, just for being here for me. I could not have gotten here without you!
A few spring flowers follow for your perusal.
So. Every day now, I wake up and ask myself if I feel like I’m dying. And lately, the answer has been a consistent, in fact insistent, “no”. Which, and I know how odd this sounds, is a bit difficult for me to deal with. But before we go there, we have to touch base with the building blocks that got me this far down the unpaved sand track into the pine woods of life.
By the time I got to college, I’d learned that BB King was back on the road playing 300 or more shows a year. Which meant plenty of opportunities to see him in exchange for transit cost to Manhattan. There was one night he brought “BB King’s Blues Barn”, a traveling show of underexposed and less business-savvy musicians, to Lincoln Center. I think that night my esteemed sports-writer friend Brian H. had defaulted (again) to the Rutgers Targum comp tickets. That was the first time I ever saw do-it-all Texas blues guy Clarence “Gatemouth” Brown. He played guitar. He played saxophone. He played fiddle. And then he sat down and BB came back on.
But that wasn’t the first thing that popped into my brain when I read about King’s death. That would be the night Frank Jank and I fought our way in to the Wolman Skating Rink in Central Park, gorgeous evening, and King rocked the place. About 20 minutes ago I got Frank’s reminder email. Which also reminded me that that might have been the night I discovered Garland Jeffries, who warmed up the crowd for King (actually, neither Jank nor I are certain about the show that introduced us to Jeffries. Frank thinks it might have been with Bonnie Raitt, I suspect it could’ve been J. Geils. My gut feeling is that it was indeed King. Forgive me for this slip in my memory. Whoever the headliner was, Jeffries played a great set. 40 minutes of really creative stuff, and I was hooked. Eventually acquired everything he had out on vinyl. Then, switching to CDs, could find nearly nothing by him until 5 or 6 years ago in Montreal, where the music shop had European releases that pretty much covered his material. A quick check on Amazon just now documents that Jeffries hasn’t stopped working in the interim, and now has tons of stuff available.
But BB King, of course, was…no, IS—so many people learned so much from him and his music that his death just means we all have to keep that ringing guitar tone in our minds and, like a character in a William Gibson novel, King will be right there, alive and playing—THE Man.
Of course, King is so familiar to us pasty white people that we tend to forget he started out in the segregated South. One story comes to mind. After taking a few year’s break from long-range touring, King started a national tour in San Francisco in the 60s. On the way into town, the limo passed the front door of a theater where a line of long-haired, marijuana-smoking white kids snaked into the street and around the block. “Wow” King said to his manager. “Who’s playing THAT show? Who are they waiting for?” Manager got a chuckle. “They’re waiting for YOU. This is the venue!” King called “bullshit” on his manager, but did indeed play to a packed house of polite, appreciative, knowledgeable blues fans.
King changed more than music—he changed PEOPLE. And always for the better. And I think he meant so much to so many that his death, miserable as it is for those of us he’s left behind here, won’t matter one bit. His music and his life will march on, right along with us, as long as human beings inhabit this corner of the mystery universe.
Which brings us right back to my own issues with life and death. Here’s the thing. It took quite an investment of intellect, emotion, and logistics to get things teed up to where I felt I could die with a clean conscience. And it is necessary to continue to make those investments as long as I am alive. Keeping such intense psychological and emotional consequences alive and kicking requires enormous personal and professional resources. And requires that I revisit the bad things along with the good on the check sheet in my brain, with all that implies. And I must project the status of my portfolios of reading, writing, music making, drawing, painting, photographing. The commitment needed to recognize and appropriate high-value work from among the zillions of papers, books, and music CDs is difficult and challenging. But I’m afraid it’s necessary as a means to come to at least partial closure on important aspects of my pre-cancer life.
I transitioned my good clients to the best talent in the company, people who could mop the floor with my comparative skills. I got my family prepped as best I could, doing all the interlocking bits of financial and physical and personal foundations that tie us all together. I tried to do the same bridge-building with as many friends and colleagues as possible, keeping everyone as plugged-in as I could. I consulted repeatedly with my doctors, working to get each individual’s perspective on the range of medical issues, from the horrendous pounding of the treatments to when I should expect to die, and what dying would entail. In brief, I had to sort out a boatload of Leggos to build the conditions that would make it OK for me to step off this conveyor and into oblivion. It was physically and mentally very hard for me to let go. And it was physically and emotionally very difficult and exhausting to identify and compile the physical scraps of my life—partially finished book manuscripts, pen-and-ink drawings, music and musical instruments. Hard and difficult work.
And then I DIDN’T DIE. Medical team had me pegged to cash out in late autumn, with maybe a stretch outcome over the winter. And here I am now, breathing clearer and stronger than I have in years, apparently unimpeded by cancer. The doctors mapped for me the physiological breakdowns and signs and symptoms I should expect as the last of the chemotherapy treatments was administered and I was on my own, sharing my body and mind with another being. That doppelganger with whom I share my corpus only operates in one direction: along a difficult footpath toward decline and death. Shockingly, to me and my doctors, every day I live now feels stronger, less sick, more “normal” than my life has been in the 4+ years I’ve been dealing with this. Of course, one day more-or-less soon, the lesions in my lungs and chest cavity will wake up and kick the vector of my life into the other direction—away from life and back to the rocky path of death. But until my body struggles along that path, I’m taking advantage of the circumstances to cram as much life as I can into every moment I’m alive and feeling mysteriously, impossibly, good and getting better.
So I thank all of you from the deepest, most intense, aspect of my heart. I am absolutely certain that without you guys thinking about me, praying for intercession with the God you worship, without your visits, without your wonderful commitment to our friendships, I would indeed be dead right now.
You’ve done your part—added substantive time to the end of my life. Now it’s up to me to use that time creatively, positively, in endeavors worthy of your love and friendship. Also up to me to make certain, as best I can (perhaps by example), that I use ‘em while I got ‘em, because I know from experience that they are NOT forever. Go forth, my friends, to hone your sense of humor, your intellectual breadth and depth, your strength and clarity of thought, your commitment to building a better world, indeed a better universe. I love you all. I am deeply in your debt!
A long time ago, in a galaxy far, far away, I worked for a company called “Failure Analysis Associates”. Over time, somebody in the senior management team had the genius light bulb moment, waking up in a cold sweat on a late night realizing that perhaps the corporate name, and such marketing materials as the annual “Disaster of the Month” calendar, might just possibly maybe potentially could suppress sales to the theoretically large pool of potential customers who considered their problems to be below the “disaster” threshold.
Said management genius (those of you who have worked with me will know that “genius” is not a term I apply lightly or often to management) kicked things into motion. The corporate management team sprang (“sprang”?! Is that a word? It doesn’t look right. But the only alternative I can think of, “sprung”, doesn’t look good either. Perhaps I should use “leaped” as a substitute…ahhh, no, fuck it, I’m going with “sprang”. Which admittedly sounds like the name given to a popular wallaby in an Australian petting zoo…) into action. Soon a consultant was hired to invent and vet a new corporate brand. I cannot at the moment recall the entire short list of possibilities they came up with. One potential name was “Scieneers”. Another was “Exponent”. The latter won out. My opinion was (and is) that Exponent was an excellent choice.
California-based Exponent was at that time sitting on a mountain of cash earned by hard work on a number of high-profile and technically challenging projects. The destruction wrought on 9/11, other airplane crashes, train derailments, and a large number of consumer product safety cases were bloating up the portfolio. When things finally started to settle down, the case load shrank (“shrank”?! Is that a word? Doesn’t look…etc.) to something more realistic and less inclined to drive the practitioners to heavy drinking and off-the-grid living in remote corners of Joshua Tree National Park.
Anyway. The newly named corporation set about using its buckets of Benjamins wisely (those of you who have worked with me will know…etc.). Diversification was needed. The entity that is now Exponent was built and operated almost exclusively on projects involving performance of products of hard engineering. Exponent had a very large market share in this arcane field. As the portfolio of engineering issues grew, it was necessary to invest in senior technologists, support technical staff, and corporate overhead staff to take care of business (literally). Every new staffer made the company better at performing in its market niche. But. Every new staffer also put pressure on market share—the company needed large sums of money (much of it spent on those new staffers) to maintain its power in the marketplace. But revenue growth via more of the same-old same-old began isolating the company, making it a technical boutique. It wasn’t difficult to look ahead and realize the financial risks inherent in a business model focused-like-a-razor…uh, I mean laser… on a finite and intensely competitive core-business.
So they went shopping.
Among the fields-of-endeavor they explored were life sciences. There was much overlap of natural resource failure analysis, impact assessment and prediction, toxicology, energy development, chemistry and biology of pharmaceuticals, ecosystem functioning, and other aspects of environmental stewardship. Once management had this focus in mind, they acted quickly. Triaged environmental consultancies worldwide. Via hard work and focus, the company I (and several other people who regularly read this blog) worked for (some regular readers…you know who you are!...remain, having survived the capitalist analogy of being dragged off the bank of the watering hole and into the depths by an enormous Nile crocodile) bought out several environmental consultancies to add diversified muscle to the heavy-lifting work on engineering failures.
Environmental consulting was an obvious endeavor to add to the company’s portfolio. It was a natural fit in the technical package offerings. Management went diligently at the task of adding environmental power.
The drastic (and risky) expansion of technical expertise into the environmental field rapidly became a success story. Now the company also had options during lean times. The company could lean on one class of work when the other became difficult. Successful identification, exploration, extrapolation, and maintenance of a high-quality environmental consultancy superimposed on the existing corporate technical structure was a real challenge. But fast thinking and commitment made it work. Exponent had successfully bridged human and environmental performance, along with costs of failure and benefits of success in specific projects.
Such as conducting a detailed analysis of the New England Patriots’ game ball deflation issues for the attorney hired by the league to address same. Exponent did a good job. Their work is an appendix to the report itself, and is available at https://nfllabor.files.wordpress.com/2015/05/investigative-and-expert-reports-re-footballs-used-during-afc-championsh.pdf .
And what is the connection between the balls controversy and cancer? Well, I have read the report, which claims to prove that a couple of dressing room attendants deflated the Pats’ balls after they were inspected by the designated official but before they were used on the field. It turns out that the seemingly simple question—did the Pats doctor the balls—is much more technically challenging than you would think. And the answer is less clear-cut than it seems it should be. It ends up being very much a weight-of-evidence phenomenon, yielding findings of “could have” and “might have” rather than “did”. And based on this weight of evidence assessment, drastic and controversial actions will be taken by the league (or not, which would be equally controversial).
We’ve talked about the inability of modern medicine to unambiguously diagnose many cancers, and the massive uncertainty surrounding treatment when it IS diagnosed. There is an action analogy here. My doctors have to treat me going forward based on a highly uncertain weight-of-evidence. My lungs are full of spots that could be the yield of the drastic and dangerous treatment technologies, or they could be incipient cancers. Any actions we take in response to their presence at the moment would have enormous uncertainty. Given the powerful and destructive nature of available treatments, we have to get the guesstimates yielded by the weight-of-diagnostic evidence right.
I’m guessing right now that there are even-up odds that my lungs and chest cavity are nurturing terminal cancers vs. more benign alternatives. The outcome of the diagnostic uncertainty is completely dependent on making the right choices. If they are benign and we treat, the treatments have a pretty high likelihood of killing me outright. If we assume they are benign and we don’t treat, I’m highly likely to die painfully and quickly if they are in fact malignant.
The lawyer author of the deflated footballs report draws his primary conclusion—regarding Tom Brady’s knowledge—with a level of uncertainty described as “more likely than not”. It’s a 51% chance.
Punishing Brady will be difficult and controversial, given the wobbly certainty of his likely involvement. But at the end of his suspension, however long it is, he’ll still be alive. Even if the findings are erroneous. My diagnostic uncertainties are precisely parallel—about a 51% chance. But the outcome of getting the analysis wrong in THIS case is that I’m dead if we get it wrong. Quite the tightrope walk.
Oh well. That’s the status of the science of cancer management at this moment. When my kids reach my age, I’m betting the diagnoses in cases like mine are close to full certainty. Meaning the odds of their dying of treatment OR cancer will be very low. Sigh. It’s quite the slog up the slope of this bell curve. I sincerely hope that before long, cancer victims won’t have to make the hike.
Anyway. Use ‘em while you got ‘em, my friends. They are NOT forever!
Let me start by apologizing to the many of you out there in what I like to think of as “Docviper Land” to whom I owe email. I’ve been struggling a bit with sidebar illnesses resulting not directly from my cancers, but from the lifestyle changes forced on me in response. This has gummed up my politesse, and set me back in response. I’m getting on top of my medical issues, finally, so you’ll hear from me soon. My apologies for falling so far behind.
OK. The past couple weeks were packed with weird-ass happenings. A major earthquake in the Himalayas shifted the Indian plate 3 meters under and raised the Asian plate 3 meters up, meanwhile wreaking havoc in the impoverished mountain villages, trashing Katmandu, burying parts of the Everest base camp at the start of the climbing season, and stranding climbing parties higher on the mountain, cut off by avalanches from the downmountain trails. Closer to home (22 miles to the meter from THIS home, in fact), the fragile social fabric of Baltimore started to come unglued when city cops arrested a guy for no legal or even plausible reason, then severed his spinal cord, killing him. A State’s Attorney filed charges against 6 officers, triggering what is likely to be a complete mess on the streets next week as pro-cop and anti-cop forces clash amid work stoppages, slowdowns, and criminal opportunism. Even closer to home—as in right here in the living room—the death of my elder MacBook Air necessitated the purchase of a replacement. Turns out that Apple “updated” their photoprocessing software. They took a simple, robust, user-friendly, effective kit and replaced it with a dysfunctional load of crap. As this is prime spring photo opportunity time, I’m rapidly filling the memory cards in my camera with pictures I can’t offload and process. On top of my medical “issues”, this contretemps is really pissing me off. Which no doubt contributes to my sudden need for increased rations of pain killers, sedatives, and tranquilizers. Or, as I like to phrase it, $%&*&^%$#$%^&*!!!.
But enough of this grumbling. It is indeed spring. Trees are leafing out, weather is warm, birds are migrating, vernal pools in the Patuxent River floodplain are packed with tadpoles (as Colin and I confirmed yesterday). My health remains remarkable for someone in my condition. While dealing with ups and downs of pain, breathing difficulties, and nutrition, I have not, at least to date, notably worsened (is that a word? Looks funky…). In stark terms, my terminal cancer has not begun its march toward that inexorable terminal end. Sure, I get uncomfortable by late afternoon, stuffed with thick mucous and background pain. But my evening meds seem to take care of it, so if I make it to 5:30 pm, I quickly put my physiology back in balance.
And then can enjoy a quiet evening. Let’s wrap up this week with some recommendations for cool things to relax to at the end of the day. Those of you approximately my age remember those nights in the late 60s and early 70s, probably heading to the Dairy Queen in somebody’s rustbucket junker, listening to AM (gasp!) radio. With the same AM station playing in the DQ. Great music for its time, and diverse. Dead Man’s Curve. Help Me Rhonda. California Dreamin’. Eve of Destruction. Good Vibrations. Midnight Confessions. Classical Gas. Holly Holy. Arizona. Bridge Over Troubled Water. Cracklin’ Rosie. Indian Reservation. Never Rains in Southern California. These and hundreds more, the background music to the drip, drip, drip of hormones into your adolescent circulatory system. You laughed, you cried, and, admit it, you still smile when you think about the girl slinging shakes and cokes in the DQ.
What you may not know is that all those songs, and indeed many hundreds more, were all done by a small, tightly knit group of musicians from Southern California known as “The Wrecking Crew”. For a good 10 or 12 years, if your producer wanted a hit, he locked your touring band out of the studio and hired The Wrecking Crew to give you the juice you needed. Well, it turns out that someone has finally gone back and crafted the history of the Wrecking Crew, the people, the clients, and their life and times. There’s a 2012 paperback by Kent Hartman titled simply The Wrecking Crew that is a delightful, fast read. You’ll learn more stuff that you thought you knew (but didn’t) and have a great time reading it. PLUS, on 16 June this year, the film version of the history of the Wrecking Crew will be released. I’ve already pre-ordered my copy. Granted I could be dead by then, depending on what’s going on deep in my thoracic cavity. But I’m taking the risk. Gonna be worth it. And, should I wrap up my life soon after, it’ll have that nice bit of symmetry and circular closure. From hormonal dork to cancer-ridden…uh…dork. See how symmetrical that was?
One more thing. And this one I’ve watched twice already, and still felt compelled to get my own DVD copy. Along with all that music from California, beautiful hit tunes were pumped out of Muscle Shoals, Alabama by what eventually turned out to be two studios, dug deep in the segregated south, stirring kettles of white musicians and black geniuses and firing hit after hit into the broadcast booths across the country. Aretha Franklin, Percy Sledge, Wilson Pickett, Jimmy Cliff, The Staple Singers, R. B. Greaves (“Take a Letter, Maria”), not to mention the Stones, Rod Stewart, Paul Simon, Allman Brothers, and (again) hundreds more. Snag a copy of “Muscle Shoals: The Incredible True Story of a Small Town with a Big Sound”. Less than $10 on Amazon, and worth a whole lot more.
So there you have it, sports fans. You can avoid the cancer, but take advantage of my obsessive media consumption. Rock and roll, everybody. Use ‘em while you got ‘em, because they are not forever. Even if you do have good books to read and documentaries to watch while you’re waiting for them to catch up with you… .
