Invasive? Whaddya Mean Invasive?

All told, I was happy with the results of the latest cancer test. No tumors, no area needing special attention. As always, I worried beforehand. There have been a couple of dozen cystoscopies in three years; only two have ever come back clean, and even after that, the cancer, that nasty, unwanted guest, managed to return.

The nurse has prepared me for the examination, and I think of the old joke: normally, when a woman handles me that way, a dinner and a movie were involved.

I’m lying on an examining table, wearing one of those paper horrors that never close right and show your butt. I am fixated on a small tear in one of the ceiling tiles. I focus on that because what is happening definitely does not feel good. Then I watch my doctor watch the screen depicting my innards as he moves a tiny camera up my urethrae and into my bladder.

“Looks good,” he says after a minute or two, and gives me a pat on the shoulder. He strips off his blue latex gloves and tosses them into the wastebasket. He adjusts his tie.

“I was worried,” he adds. “The last procedure found some new cells, invasive ones. So I was holding my breath… But right now it looks as if everything is all right. You’ll just have to be extra vigilant.”

I like my doctor. He has a toothy grin and the look of a somewhat frustrated bon vivant. He enjoys life and told me he brought in the New Year by drinking a little too much with his neighbors.  I answered that I was glad he wasn’t operating on me January first.  He said, “Oh no, the hospital is closed then.” Then he got it and went, “Ha! Ha ha! Yes! Ha!”  

I suppose that ethically, he had to tell me about the last surgery’s test results, and I’m grateful he didn’t pass that information on last March, because I would have worried for three straight months. But still, that news tarnished the silver cloud.

This being said, I’m particularly happy not to have to be put under again. I really believe that being anesthetized isn’t good for my health, and that essentially being put in a supervised coma—that’s how one doctor described it—nine times in three years could have negative and lasting implications. I remember reading about brain cell loss among patients with high anesthesia rates…

Today, though, I think I’m going to opt for being happy. I have every intention of making myself a prosciutto provolone mortadella sweet peppers camembert and baby tomato sandwich on a French baguette. There will be mustard and olive oil and vinegar from the south of France. I will eat half-a-jar of those tiny little pickles you folks call gherkins and my folks call cornichons. I will make an excellent salad with spinach, Belgian endives and macadamia nuts but, since I’ll be full from the sandwich, I probably won’t eat it right now. I’ll nibble on it later today as I watch the FIFA Women’s World Cup, which is the best televised sport of the decade. I will then drink a quadruple decaf espresso, and sleep the sleep of the blessed.

All in all, so far, a good day.

 

 

Battling Cancer: A New Strategy

Here is a statement of fact: When a man reaches a certain age, he will no longer throw underwear away, ever. These garments might be ripped, worn, moth-eaten, stained, shrunken or bagged out, and rendered elastic-free by too many washes.  No matter. We will keep--, no, we will hoard them, greeting them in the morning like old friend, Cloroxing them once or twice a year in a vain attempt to regain whiteness but actually only weakening the fibers.

What occasionally occurs, if a woman lives in the same space, is that she will throw them away when the man is not home. If she has a kind heart, she will replace them with new jockey shorts or briefs, again, when the man is not home. He may, or may not, notice the changing of the guards but in any case, the exchange will be wordless.

Today I have made a small step for mankind and a giant step for men by getting rid of every single pair of jockey shorts and boxers that have been in my possession for years, and perhaps decades, and replacing them with 15 pairs of brand new, assorted color undies from Target and Walmart. And while I’m on the subject, I will say openly that Costco deeply disappointed me with its extremely limited selection of men’s underthings, which occupied less than a third of the floor space devoted to women’s vibrantly colored and designed panties and stuff. There may be room for a discrimination suit here.

Anyway, the deal is that I have come to the conclusion that my bladder cancer was probably caused by my underwear. At least partially.

As readers of this blog know, two years ago this month I was diagnosed with this nasty disease. Since then, I’ve undergone a number of surgeries to remove recurring malignant tissue, generally followed by a form of chemotherapy called BCG. The Bacillus Calmette-Guérin treatment relies on the direct injection into my bladder of a solution containing sheep tuberculosis. On average, BCG eradicates cancer in 70 percent of those treated. I haven’t been among that 70 percent yet, but I’m still hopeful.

I might add here that I have not smoked or drank alcohol in a couple of decades. In the past six months, I have just about given up eating meat. I am juicing organically produced veggies and fruits daily and drinking the vile concoction in one, long draught. I no longer use artificial sweeteners, caffeinated coffee or tea, or any number of ‘white’ products: rice, flour, pasta, refined sugar. I have given up my membership of the California Sun Tanning Center.

What does this have to do with the wholesale trashing of an entire drawer of undies? Everything.

Giving up all these things, along with the BCG, should’ve banished my cancer for good. I was thinking that all this nasty stuff happening in my midriff should have ended by now, and as I pondered, I came to the realization that what encircled my loin(s) had remained unchanged for years! The underwear, by crikey!  The underwear!

Throwing out the old stuff was surprisingly painless. I packed everything in a trash bag and dropped it in the big outdoor garbage can without so much as a whimper. As I write, my new undies are bouncing around in the dryer, getting to know each other, and I’m hoping alliances might form in the chest of drawers.

I’m pleased because the entire process was a lot less painful than was surgery and BCG. I’m pretty sure this will work. It sort of has to. I don’t have anything else to throw away.   

Tales of the Juicer

My friends Julia and Maxey, knowing of my cancerous issues, recently lent me a juicer. Julia and Maxey are both smart and beautiful women who have been juicing for years. The machine now in my kitchen was Maxey’s when she went to college. It sort of looks like R2D2 with a spout and is eerily quiet for something that can reduce a giant, hard  carrot to mush. I have already had one nightmare where the juicer is chasing my cat while humming the Star Wars theme song.

Jack LaLanne’s name is on the front. You remember Jack, the original Hollywood he-man. He swam the Atlantic Ocean at age 105 and then retired to Malibu and developed his own line of healthy eating machines.

Jack’s creation weighs 15 pounds, has a 3600 rpm high induction motor and a stainless steel blade that would make Dr. Joseph Guillotin envious. It will take in kale, celery, apples, carrots and a variety of other veggies (I drew the line at beets) and spit out a copious, bile colored liquid, the taste of which reminds me of my initial venture at playing football (not a sport played often in my native France), getting tackled, and ending up with a mouthful of dirt.

The very first time I used the Jack Lalanne Pro Juicer in my kitchen, thick liquids exploded from pretty much everywhere and painted my t-shirt and shorts, as well as my kitchen ceiling, with small globs of orangish vegetation. The second time I was more careful. I made sure every aperture save for the spout was sealed, and the experiment went much better, though the taste was roughly the same. Friends have suggested I add lemon, ginger, vanilla extract and vodka (this from a truly clueless person) but not bananas (they’ll mush up the works) or yogurt. Also, once the juicer has done its work, the result must be drank (drunken) within ten minutes for maximum efficiency. What is left after juicing is a sort of multi-colored Brillo pad that I am sure could be converted into vegan burgers by people other than me.

Ideally, only organically grown vegetables and fruits should be used.  This makes perfect sense, as juicing a chemical-laden apple or pear only means you’ll get a concentrated dose of whatever noxious fertilizer kills fish in agricultural run-offs. This means you have to shop in stores that charge 1000% markup for runty and splotchy (but pure) veggies. Luckily, kale is a mainstay of juicing, and, organically grown or not, it is inexpensive. I used to feed kale to my iguana who was so healthy he attacked me whenever I tried to be friendly.  Kale’s taste, however, is truly toxic. Imagine liquefied and concentrated topsoil, with worms.  Only the toughest can endure kale by itself, and even Julia and Maxey, hardened juicers both, have to mask its venomous flavor.

I’ve learned about the Dirty Dozen, conventionally grown celery, peaches, strawberries apples, domestic blueberries, nectarines, sweet bell peppers, spinach, kale and collard greens, cherries, potatoes, imported grapes and lettuce.  According to www.foodnews.org, “these tested positive for at least 47 different chemicals, with some testing positive for as many as 67. For produce on the ‘dirty’ list, you should definitely go organic — unless you relish the idea of consuming a chemical cocktail.”

The produce on the Clean Fifteen list “bore little to no traces of pesticides, and is safe to consume in non-organic form.” This list includes onions, avocados, sweet corn, pineapples, mango, sweet peas, asparagus, kiwi fruit, cabbage, eggplant, cantaloupe, watermelon, grapefruit, sweet potatoes, and sweet onions

So all right, now that I’ve made fun of Jack, juicers, juicists, etc. , here’s the thing: I’ve only used the machine four times and I feel better. Last night, for the first time in months, I slept an undisturbed six hours.  I expected some monstrous intestinal distress and haven’t had any.

Thank you, Julia, thank you Maxey!  I’m sold.

 

 

Done...

Is there anything more demeaning than a paper hospital gown? Every time I have to wear one--which has been far too often--I feel as if Cristo has attempted and failed wrap me. There was a middle-aged man at the hospital where I went yesterday morning, he was walking along the corridor looking for a rest room with his pale naked butt sticking out of the gown.

And what about catheters? I’m amazed no one has picked up their comedic potentials. They deal with pee, which is funny, and penises, which are always good for a laugh, and they make you walk funny and wear a frown as you do, because nobody, nobody, has ever smiled with a catheter inside them. Walking funny, we all know, is comedy gold. I’m sorry to say I’m not sure how much of this can apply to women while remaining politically correct, so once again being pc may lead to lost opportunities.

Yesterday, as the catheter implanted in me the day before was removed by a male nurse, I said all medical personnel should have to wear one of these humiliating devices at least one day out of the year. The nurse shuddered, said, “I don’t mind surgery; the only thing that scares me is having to wear one of those things.”

Also, I think Catheter would be a really great name for a little girl.  It sounds almost biblical: “And Catheter did say go forth and procreate safely because I am one with you, deeply held and the cause of relief and distress…”

So here’s what happened: It all went as planned. The day of the surgery, I got to the hospital at 6:15 a.m., driven there by my friend Paul who has now seen me through a half-dozen such procedures. I changed into a sky-blue hospital gown and was told to lie down on a gurney, shielded from the world by a curtain hanging from the ceiling.

A bunch of people came to see me.  Nurses, nursing assistants, two anesthesiologists, one anesthesiologist’s assistant, a person who put in the IV, and a guy pushing a mop around the hallway. The latter was possibly the friendliest of the lot.

I signed many papers, which is hard to do when you’re lying down. I didn’t have time to read them but I accepted the fact that if anything at all happened to me, including but not necessarily limited to an alien abduction, the hospital would not be responsible. I gave up my pants, undies, short, wallet and phone. I was festooned with little sticky pads attached to wires that went into a machine that beeped and burped. I went ahhh with my mouth wide open three times. I listened to the sounds endemic to a medical establishment, hurrying footsteps, rubber wheels on linoleum, pinging of machines, public address announcements, the wailing of an injured child, greetings from one nurse to another, telephones, faxes…

At 7:30 they hook up the IV and start the anesthesia drip (I’ll find out later they filled me with opiates, which truly pissed me off as I had specifically requested they not use opiates on me), and suddenly it’s 10 a.m., I am in the recovery room and I can feel the catheter scratching my urethra. My mouth is cottony, my eyes sandy and my groin hurts.

I wait. I wait some more.  Now that the operation is over, no one is particularly interested in my state of being. A nurse asks how I am, I say, “Just peachy…”

Around 10:45 the surgeon comes by.  This is unusual and I worry but he says everything went well, and it doesn’t look as if what he has taken out is invasive. Good news. Better news, he has already injected me with the chemotherapy solution. Intravenously, it makes you deathly ill, but shot directly into the bladder; there are few side effects save for a burning sensation that ebbs and flows.  I may not need to go through the six-week course of chemo.

It’s done.

Halleluiah.

The Drill

So operation number six is this Friday, yippee, which will be followed by decatheterization (neat word of extremely limited use), six weeks of sheep-tuberculosis chemo (I’m serious), a fair amount of bellyaching on my part, and a couple of weeks of squirmy discomfort during which I will stand up to type on an aged IBM notebook.

Here’s the drill. I get to the hospital, am asked about 60 questions four or five times each by a series of medical personnel that include but is not limited to the admissions person, the person who wheels me to a small, curtain enclosed space, a second and third admissions person, and the nursing assistant who hands me a light blue paper gown too small to be cinched and a plastic bag for my belongings. When I ask if I can keep my cell phone handy until I am wheeled away, the nursing assistant will get another person who will tell me that I can indeed, and explain to me the hospitals anti-theft and security procedures, even as she asks me to sign a release stating they are not responsible for the theft of my belongings while I am in their care.

Another nurse will ask me if I have any of about 30 ills or physical shortcomings including dentures. Also, what drugs do I take, are any of them illegal, and when did I have a drink last. I say 22 years and she looks at me strangely and shrugs.

There are a fourth and fifth person whose duties seem indeterminate--by now the uniforms have changed from light blue to green, or maybe puce. You can tell the rankings by the scrubs--the lower the status, the more likely the scrubs worn will feature cartoon animals, smiling sunflowers or dancing Fudgesicles.

Each time I am asked a question, the answer is noted on a nearby computer, and as the questions repeat themselves endlessly (last time I was asked what I am allergic to eight separate times), I wonder is somewhere nearby is a cloning center and they are, as we speak, building an ersatz Thierry with all my physical shortcomings, and why they’d bother.

Then I am left alone for anywhere from one to four hours. If I’m lucky, someone will come along and tell me the doctor will be there any minute, but they’re lying, he never is.

I can tell things are getting serious when medical personnel number nine or 10 comes to insert the IV and anesthesia needles. One goes in the crook of my arm, another on the top of my hand. The latter will leave a nasty blue bruise for a couple of weeks.

In time, Anesthesiologist Number One arrives. We talk. I say I have a system that metabolizes the stuff really fast and in the past I’ve woken up during surgery. He or she asks me if I’m allergic to anything.  I repeat my concern. Anesthesiologist Number One nods, smiles, pecks something out on the computer keyboard and leaves.

A passing nurse’s aide asks if I need a glass of water and I say yes, but I’m not allowed to drink before the procedure.

Anesthesiologist Number Two essentially does a repeat performance of his colleague. I sign a second release saying anything bad that may happen to me here is no one’s fault but my own.

The surgeon appears. He is in full surgeon garb and rubbing his hands together which for some reason always chills me. He is a short, handsome, white-haired man in his late 50s, who has operated on me twice before. I have never, ever seen him smile. He apologizes for keeping me waiting--the patient before me had the bad grace of misplacing a kidney or a lung and it took a while to find it. The surgeon says he will see me in the operating room. I want to make a joke, we have to stop meeting like this, but I don’t.

A new nurse comes and starts the flow of anesthetic. I feel nothing. The world does not go black, it merely ceases to exist…

And then I’m back. My head hurts, my mouth is dry and tasting of something unpleasantly metallic. My throat is sore from the tube inserted there and now gone.  There’s a dull ache in my groin. The surgeon, I know from past experience, has already left the building, so I won’t know if the surgery was a success until post-op in three or four days. I am both hungry and queasy.

 
I am hopeful that maybe, just maybe, I won’t have to go through this again.

 

 

 

 

 

Well crap!

“Not bad,” says the doctor, looking at the screen, “Not bad at all.” There’s a long tube with a teeny camera attached and my innards are bright pink on the screen. “Yes,” he says, “this is g--. Oh. Well.”

“Oh. Well.” is the equivalent of “Uh ho,” which was my former doctor’s expression when he spotted something he didn’t like.

“I thought we were good, but there are two little tumors there. Not bad ones, though…”

“Surgery again?” I ask.

“Oh yeah.”

Doctors aren’t supposed to say, “Oh yeah” in that offhand manner, like they’re ordering the Turkey Mile High after the 18th hole at the country club.   

Well crap. This will be the sixth bladder cancer surgery in less than three years. I know the drill by heart, and I am sooo tired of it. Full recovery, where I feel myself again, takes about three months. The first two weeks are truly unpleasant. I won’t get into the details about how a full grown man feels when he has to pee every twelve minutes, which, all in all, is still better than having a catheter attached to my private bits.

I sit on the examination bed with the paper blanket on my lap. The doctor shakes my hand since we are, after all, partners in this endeavor, aren’t we? The nurse busies herself. I’m trying to collect my thoughts.  She says, “You can leave now.” I know, this and wish endless catheters upon her in her old age. I try to remember if this is the same nurse who once asked me if I was sure of how to spell my name.

Double crap. I had convinced myself this would go one of two ways: either I’d be clean and cancer-free for the third time, or the doctor would tell me he’d have to take out my bladder, and I would say, no, that’s not going to happen, because that’s something I decided when I was first diagnosed. I’m not going to live with a permanent tube draining the urine out of me. There are limits to impropriety. I was not ready for the “not bad, just a couple of small tumors.”

I go home, stop at Starbuck’s and buy a donut, which I swore a few months ago I would give up and, until just now, had managed to do. Not today. The donut tastes really good and I can feel each and every 280 calorie dancing in my mouth; a tango, I think. 

When I was first told about the cancer by a doctor who refused to use the C-word, I walked home from the medical office and stopped to eat something at two Starbucks, one pizza place, one Panera, one Caribou Coffee and one more pizza place. Then I got home and threw up. After the third surgery, I went through a depression as deep as a black hole. This, I learned, is not an uncommon side effect. In fact, post-surgical depression has its very own entry in the latest Diagnostic and Statistical Manual of Mental Disorders and more than ten pages of entries in Google. It was never mentioned by any medical personnel.

So come September 20, it’s back to the hospital, to the anesthesiologists who will lecture me on my refusal to take painkilling drugs, to the surgeon who will undoubtedly leave after the operation without letting me know whether it was success or not, and, I almost forgot, back to peeing blood…

Crap.    

 

   

 

 

 

 

Reprieve

The past couple of months have been pleasant.  Sure, the weather is by and large Washington-horrid, with temperatures in the high 90s and the humidity nearing solid level. You don’t hike, you swim through the vegetation. The poison ivy this year is particularly nasty, with vines thick as a wrist winding around trees, and the three-leaf clusters nasty underfoot. Deer have eaten the flowerbed in my back yard down to a nub, but I can’t get angry. The fish in my small pond seem happy, almost $500 spent at the vet’s showed my cat is healthy, and the mourning doves nesting in my dogwood haven’t filed for divorce.

People are still killing each other all over the world; political figures who should know better, don’t, as always; and me, I haven’t seen a doctor in more than two months and feel all the better for it.  

This being said, I don’t really dare hope that my recurrent cancer has gone for good. I’ve been told twice that I am cancer-free, and three times that I’m not. So this nine-week period has been a welcome hiatus, but now the fear is just starting to creep back.

Here’s the thing: my cancer, surprisingly, hasn’t hurt, not physically, anyway. The attendant pain has been due to the probing, cutting, burning, and post-surgical treatments; it’s been due to the chemo and the effect of having poisons injected into one’s system-- sheep tuberculosis, to be exact, which is so beyond-the-pall weird that I can barely cope with it. Sheep tuberculosis… I wouldn’t be surprised if I woke up one morning and started bleating.

The next tests are in three weeks. The last time I was scoped, some six months ago, the surgeon was looking at the screen which displayed the inside of my bladder and said, Uh oh. This is not a sound you want to hear from anyone in the medical profession.  I think I said, Uh oh what? But I knew. He pointed out several small areas that looked as if mold had taken hold, and a larger growth that was undoubtedly a tumor. Uh ho.

All in all, there have been five operations so far. The recuperation periods grow longer each time, which worries me. I’m convinced being anesthetized more than a half-dozen times in three years can’t be good for me either, all the while being grateful not to have undergone these procedures wide awake.

I find myself worrying uselessly. Am I more tired than normal? Am I sleeping enough, or too much? What’s that twinge in my lower abdomen? Why are my legs sore? And that slight raspiness in my throat? I can see myself slipping into hypochondria or some other schizoaffective disorder.

                                                                                                     
One positive thing: I’ve stopped looking up symptoms on the internet. I did that one day some months ago and among the possible reasons for feeling as I did was pregnancy. I’m realizing more and more that, though some sites are informative and well-researched, a lot more are not. And the fact is, each incidence of a disease, be it cancer or something else, will vary greatly from person to person. I have heard of people surviving pancreatic cancer and dying of melanoma. Odds vary greatly according to past health, age, gender, and even outlook.

So I’m grateful for the doctor-free time, for not sitting in waiting rooms, for not lying in a hospital bed waiting for the nth person to come and explain why the surgeon did not come and see me after the operation, and yes, I’ll be told of the results in a week or so.

It’s hard won gratitude, to be sure, but the alternative isn’t worth considering.  

WTF, Part II

Looking back, what is particularly galling are the wrong decisions made when no other options seemed worthwhile.  I had met my first wife while working for a well-known newspaper that frowned on married couples working together. Her career was farther along than mine, so she stayed and I quit--another decision of doubtful wisdom. At the end, our marriage turned disastrous. I was broke, unemployed and moved out to live in a rented room; it made perfect sense to give up my equity in a DC townhouse I had jointly purchased and helped rebuild from the ground up. Back then the only concern of any importance was to get my freedom back, and a four-story home in a doubtful part of town seemed a small sacrifice. That same house is now worth more $2.5 million dollars and in a sought after location. I’m not sure who owns it anymore but once every other year or so, I drive by. I forget how many minor injuries I sustained while rehabbing the place, but I do know I almost took a finger off while making baseboards on a router.  A bit of my blood will be there forever.

The past fades away, details lose clarity and get paler as time stagger by. For several years I traveled to faraway places that were both exotic and impoverished. Colors remain: I remember waking up in Nepal to a sky so blue it hurt the eye, while in Mali the horizon was washed and pale. In Bangladesh the road from Dhaka to Chittagong was a mosaic broken by floods and droughts. In Thailand, a man knocked on my hotel door and presented me a book full of photos of available women, all of whom, he said, were his sisters. I demurred, which I am pretty sure was the right choice.

When I quit the traveling job--in hindsight, perhaps another poor decision--I had just published a novel and was sure I was on my way to literary glory. A friend of mine and I spent an afternoon going from bookstore to bookstore and sneaking my oeuvre into the shops windows. The book got favorable reviews and was optioned for film by a director who, two years earlier, had won an Oscar. I thought of buying a white suit like Tom Wolfe, but luckily didn’t.  The deal never materialized and a month later I saw a bookstore employee tearing the covers of a stack of my novels. When I asked him what he was doing, he said this was standard operating procedure for books that didn’t sell. The covers were sent back to the publishers--less postage than the entire book--for refunds, and this way the books could not be resold. What the f---?

In the past few months I have felt as if a lot of the wrong decisions have come back not to haunt but to snicker. The pace of life slows but the days go by a lot faster, and choices made decades ago echo brightly. I occasionally have the sense that I am getting both transparent and immaterial, as if I could stand in traffic and it would go through me. I’m not tempted to test this newfound notion, and I don’t know if it’s a byproduct of cancerous facts or cancerous thoughts. I do know that I am tired of the drama that surrounds the disease, and that I am tired of being tired.

In light of this general weariness, it’s been important in the past few weeks to keep at least some facets of life on the lighter side.  I am rereading Wodehouse; at one in the morning of a sleepless night, nothing can best Jeeves shimmering in and rescuing the hapless Bertie.  I’ve been trying to write humorous stuff as well since my proximity to McLean, Virginia, is rife with possibilities.  This little town near the Potomac River has one of the highest per capita income in the country. There are 18-year-olds driving Aston Martins here, and a man with a terribly bad wig prances along in a half-a-million dollar Ferrari.  Beemers are poor-people cars and, not that long ago, an Asian couple tried to build a replica of Versailles about two miles from my house.  They went bankrupt and the place is now deeply discounted and for sale for $15 million. The funny thing is, someone, undoubtedly, will buy it.

Right now, I’m worried about the cicadas. They’ve waited 17 years to make an appearance in my neighborhood and they’re late; they should have been here a couple of weeks ago. The last time they came I was still married, still working for the UN, and taking care of my aging father.  It seems like a moment ago. What happened?

Surgery #5

It is the evening of the day. There will a thousand more evenings, and a thousand more days, but this evening, I have been told I am cancer free. I’m both grateful and wary. I have discovered that these tricky cells have an amazing ability to hide from plain sight, and then reappear, a neat and disconcertingly nasty magic trick. Three times, a surgeon has told me that surgery to remove this tumor or that patch of tissue has been successful. I have also been told, three times as well, that the cell mutation had returned.  

On the sunny afternoon of this latest intervention, I lost count of the medical personnel that came by my pre-op bed.

The first was a middle-aged Asian nurse with a strident command of English. She muttered at the computer displaying my medical records, shouted two or three times to unseen staff, then looked at my arms and mumbled, “Bad veins… Bad veins…” But it might have been, “Vad beins…”  

The second was not properly a medical person.  His name was Jack, he wore a well-trimmed navy blue one-piece coverall, and he ran a mop down the hallway and under my bed. He grinned and flashed a V-sign, which unaccountably made me feel better.

Then came two more nurses, a sort of Abbott and Costello team, who spoke about me as if I weren’t there. “His blood pressure is sort of high,” said one.  The other agreed. I refrained from asking if their blood pressure might be elevated if roles were reversed. The shorter one told the other I should put my surgical shower cap on. They were in agreement on that as well.  I asked if I might delay this until I was wheeled into the operating room but both were insistent. I put the cap on and took it off as soon as they left. None of the other people who saw me seemed offended by this.

There was a pre-pre-anesthesiologist who told me the pre-anesthesiologist would be along any minute now, which was an obvious falsehood. There was a nurse who walked by my bed, turned around and yelped, “Back! Back!” while making strange shooing movements with her arms.  It took a moment to realize she wanted me to slide up into my bed as my feet were hanging off the mattress. She adjusted the bed to lower my butt, raise my feet and make them higher than my head. When I said this was not a comfortable position, she got sort of miffed.

The pre-anesthesiologist arrived with the anesthesiologist whose cell phone rang four times in six minutes. A second anesthesiologist came and gave me papers to sign. I told her I wanted to avoid opiates which generally do not agree with my lifestyle and she said this shouldn’t be an issue.

Then I waited, and waited some more, and some more.   A nurse came and inserted one IV in my left hand and another in the crook of my right elbow. Another nurse looked on. A third one put the cap back on my head. Jack returned with his mop and bucket.

Each and every one, save Jack, asked me the same questions: Name, age, allergies, what was I here for, name of my surgeon, my primary doctor, did I suffer from sleep apnea, was Latex a problem, was I feeling all right?  (“Just peachy, thank you!”). Each and every one wrote something on a clipboard, entered some information on the computer.

The surgeon arrived to tell me what was planned. He did not use terms like “slice and dice,” which I appreciated (another surgeon, talking to an acolyte just before I was to be operated on a year ago, used the term ‘butchered.’ This was not reassuring.)

There were more people who gathered round; more questions, more answers. Someone patted my shoulder and the world went away.

When I came to about two hours later, a statuesque young nurse with a Colgate smile asked how we were feeling. Trying to impress and amuse, I said something like, “Me, I’m ok. You, I don’t know.” I am not at my best post-surgically.  IVs were removed. So was the surgical cap. I kept the little tan sock booties with the rubber treads on the bottom because, who knows, things like that can be useful around the house.

A week later, the body still hurts but the spirit is good. I’ve been told it will take about a month to properly heal internally. In August, another procedure will reveal whether, this time, the bad cells have taken the hint and stayed away. Let’s hope so.

Procedure No. 5

Oh hum. Another procedure tomorrow, the fifth one to be exact, and I should be used to this by now but I’m not.  There’s still something deeply disturbing about being put under and having someone snip away at your innards.

It has gotten to be routine.  My friend P drives me to the hospital and drops me off. I sign a ton of papers saying the medical authorities are not responsible for a single thing, including somehow breaking my teeth. I strip down, put on the paper robe that leaves my but bare-naked, slip on the disposable slippers and hair net. I wait. I wait some more.

One or two young nurses insert tubes in my arm and poke at the veins in my left hand. At some point Anesthesiologist No. 1 comes in and explains that I will be put under, which I sort of already know, and I respond that because of my medical condition, I will need an extra-large dose of whatever they plan to use to knock me out. He/she smiles, nods, says of course, and leaves; a half-an-hour or so later, Anesthesiologist No. 2 makes an appearance to tell me what Anesthesiologist No. 1 said earlier, and IU repeat myself: high dosage, please, etcetera.  So far, so good. Nurses No. 3 and 4 ask me if have eaten anything in the last 12 hours, and if I have a living will. No and yes. And will someone come and pick me after the procedure?  No. I plan on riding my skateboard back to my house. That seldom gets a laugh.

I’ve been through this drill so many times I feel as if the medical staff should invite me to Thanksgiving dinner at their home. I am on first-name basis with half the nursing crew and on a daily basis I get friendly little emails from them reminding me of what I am allowed and not allowed to do before and after the operation.

It’s too dangerous to be overly optimistic. I’ve been declared cancer-free twice, and not-so-cancer free three times, so the law of averages dictates that the chemo process should have worked and I should be OK after this round, but then the very same laws shouldn’t have let that guy living in the Florida swamps win the lottery three separate times over two years.

“The older I get,” says my friend D, “the more I think it’s all probabilities.”  I tend to agree, even though even as I write I know I’m on the prayer list of several good people, and I deeply appreciate it. Being an aging hippy, I believe in both good and bad karma and the tendency for one to offset the other.  And being an aging Buddhist as well, I’m aware that the faith recommends an awareness  of the Three Poisons: Lobha, greed or desire, is attraction to something we think will gratify us. Dvesh or dosa is anger, hatred, animosity, ill-will, aversion. Moha is ignorance or delusion. Many Buddhists believe that the Three Poisons, together or separately can have a deep effect on one’s health.

Me? I don’t know. Certainly greed, lust, anger, hatred and ignorance are poor servants, but can they actually conspire to make us sick? Probably. Ulcers come to mind, as do panic attacks and a hellish wealth of other nasties. But cancer?  At any rate, I’ve always thought I’d been waging the good fight against lobha, dosa and moha for years, though in retrospect I may have been winning the skirmishes while losing the war.

Crap. It’s far too complex for a simple mind.

But here’s a good part my friend O reminded me of yesterday.  Say the surgeon really messes up and worst comes to worst, I’ll come back as a human. Why? Because I have had the honor of seeing the Shenshiyiqiewaerdala Dalai Lama in person, and according to legend, that’s one of the bennies of being in the holy man’s presence, even briefly.

So I’ll come out of this weighing a few less ounces. Getting little pieces of you snipped out may possibly be the worst diet plan in the world.

Ha, I Say

So this may be the best card I have received in many months. Sent by my friend Lisa who gave up life in the big city to be in some godawful alligator- and toad-infested Floridian backwater where the sinkholes and poodle-gobbling Burmese pythons abound, not to mention 12-foot-long Komodo lizards that have taken over bankrupt housing developments.

Personally, I find this card hilarious and to the point. I’m glad a card-maker (this is by That’s All and a portion of the proceeds will benefit the fight against ovarian cancer) has come to terms with the fact that yes, us cancer folks do feel we’re better than you… We are noble, we face adversity with a firecracker grin, we are, in a word, beings made superior by the abnormality of our nasty, invasive cells. Think of us as Christians battling heathen Saracens.

 

In other words, deal with it.

 

(Oh god, it's so sad to know without a doubt that somewhere, somehow, someone will read this and take it seriously and send me either an insulting comment or suggest I drink three glasses of carrot juice a day. If you are this person, I can only recommend restraint of pen and tongue. Really. Have a nice day.)

 

 

Ah...

“Well,” said the The New Doctor, “bladder cancer can be fatal.”

            Ah. There it is, the statement never openly made before, never really even hinted at. “We can take the bladder out,” he continued. “But that’s a serious change in quality of life.”

            “No.” I’d given this some thought ever since being diagnosed more than a year-and-a-half ago. “No. I don’t want to do that.”

            “Ok.” TND didn’t argue. “The thing is the tumor was very close to the entrance of the bladder and so it’s conceivable the cancer spread to the colon. I didn’t do a biopsy of the colon during your last surgery, so now we’re going to have to do that.”

            Ah. More surgery.

            “Let’s have you go through the scheduled BCG treatment for six weeks, starting Monday. Hopefully that’ll work.  Then two-and-a-half months from now, we put you under and go in again.” So, chemo again.

            This is not good. Five surgeries in 20 months, five times under full anesthesia, each time waking up with a catheter. I hate catheters. The last bout with the scalpel left me debilitated and five weeks later, I still have not recovered my energy. I also went through a two-week long post-surgical depression that bordered on the suicidal. A woman friend whose health history is far worse than mine told me it was the depression she feared the most, not the surgical procedures. Another friend, a man slightly older than me and far more accomplished, said he had questioned his entire life’s meaning and found it all wanting after an intervention to implant a Pacemaker. Strangely, at no time was I told by medical personnel that depression was a common side-effect of surgery though when I mentioned it to TND, he was unsurprised.

            And then, there’s the fact that I’m old school. Being ill in those never-discussed nether regions is embarrassing. I don’t do urinary tract and intestinal stuff well; this is not the stuff genteel people discuss. Plus, my digestive structure and I had an understanding: Put relatively good stuff in it and it would not balk, nor need much attention paid to it. Now there’s something terribly wrong with the system; it’s failing me, betraying a never- stated trust. I’m shocked, angry, resentful. Eighteen months ago I was told this was a good cancer to have, if there is such a thing. It was non-invasive, easily treated; the original doctor had gotten all of it and after the second surgery called me on the phone to tell me I was cancer-free. Now I’m not.

            Some decades ago when oncological surgery was messier and far more invasive than it is now, my father underwent an operation for colon cancer. For weeks he was forced to wear a colostomy bag and I saw the effect it had on him. He became a shadow of himself, abashed and embarrassed by his lessened stature, and even my mother found it hard to be as supportive as she should have been. My father recovered. The doctors stitched him up and within a few months he was almost his former self.  Almost, but not quite. Something changed within; a terminal tiredness set in and the joys he was familiar with and could depend upon deserted him. I swore back then that I would never subject myself to wearing a waste-collecting bag, ever. There was no reason to think I would be put to the test.

            Recently someone asked me how it felt, this invasion that ideally should happen only to others. It’s a worthwhile question that forced me to step away from the engulfing fear that wakes me in the middle of the night and that plays hide and seek with me most of the day.

            What it feels like is all-encompassing. Its reality is everywhere, inescapable, the foreign presence in your home of an unpleasant guest who was never invited but somehow snuck into a basement bedroom. I might not feel the cellular invasion, but I know it’s there, blind and mindless but eager to spread. And then, for a while, if I’m engaged in a good book or conversation, when I’m writing, when I’m playing music with friends or walking in the woods, it goes away. Life returns to normal for minutes at a time, though rarely for as much as an hour. And then fear returns.

             I suspect I’ll get over it, but right now, that’s what it feels like.

           

PSD

And so, four days after the latest cancer surgery, things remain a bit iffy. From hospital sign-in to release, the procedure was flawless. I counted a total of 27 people who came to speak to me. The most interesting of the lot was a lady who asked to see my driver’s license to make sure I had not sent a proxy to the surgery, an interesting concept I had not given thought to but will certainly consider the next time around.

Everything was clockwork, and when I was sent home in late afternoon, I was grateful for the economy of movement displayed by the hospital, but surprised that, once again, the surgeon had left the premises without telling me exactly what the procedure had achieved. This I will not learn this until next Thursday, leaving me a full week to address fears and concerns.

There’s not too much discomfort but when the pain arrives as it does in waves of three, I have to grit my teeth and hold my breath. Luckily it passes quickly. I haven’t wandered too far from my house though I did make an emergency trip to Subway for a couple of foot-longs. Friends have been kind, but I have not really been kind to them. I have no wishes to see anyone, to be reassured, to discuss options and an uncertain future.

What I have done is submerge myself in writing. I am rereading Clavell’s Shogun; I have ordered Updike’s Rabbit tetralogy on Amazon; I am watching reruns of The Office. I am debating whether I should once again try to master Halo on the X-Box.  I am reminded of Jimmy Buffet’s great line, “my nose runs, my feet smell, and I don’t love Jesus.” That sounds about right.  

On a whim I Googled post-surgical depression (PSD) which seems to be a bona fide disease, so maybe that’s what’s going on. It has led me to avoid the phone calls and texts from concerned acquaintances or at best respond monosyllabically. I’ve not opened the door to three drop-by visitors, and watched five complete seasons of The Office, which after repeated viewings still make me laugh. I plan to do nothing tonight save segue from Shogun to Noble House and further figure out the mysteries of Netflix which, after much trial and error, I managed to install in my house.

I have supplies, unlimited gallons of tea and coffee, eight assorted muffins and a complete make-your-own-enchiladas kit, both gifts of concerned friends.  Also, four packs of frozen shrimp and eight cups of instant Thai soup.

I might just stay indoors for a long while.

 

 

 

Surgery and Housecleaning

I sweep the kitchen stoop, dust bookshelves, vacuum the living room and under the bed where there’s enough discarded fur to make a spare cat. I empty the trash; scrub out the toilet bowl and Ajax the sink. I am going to the hospital in three hours for the fourth cancer surgery and although this small cleaning frenzy is ridiculous—I will probably be home tonight or tomorrow—it’s also necessary.  Call it the clean-underwear-in-case-of-an-accident syndrome. On the very off-chance something unfortunate happens, a slip of the lancet, say, or a stoned out anesthesiologist who turns a valve the wrong way,  I want to make sure my home is presentable.

Actually, it’s simply something to do. I am packed—toothbrush and dentifrice, spare socks, loose sweat pants, iPad, phone, chargers, one pack of gun (forbidden, I’m sure) and two books—and I have read as much as I can. Words on a page crawl and for once cannot hold my interest.  No food or liquids since last night so even the morning newspaper-and-coffee ritual has been interrupted. I have checked emails, paid all my bills, fed the cat extravagantly, emptied the recycle bin, started the recalcitrant Jeep and let it idle for ten minutes. I have left a hidden key my good neighbor. Again, just in case. This is all familiar territory.

I remain scared.  There’s a small ball of dark anticipation in the pit of my stomach. The next 24 hours will be spent in the domain of the depersonalized medicine practiced these days. There will be a host of anonymous nurses and aides asking the same question over and over. I will tell an indifferent anesthesiologist that, since I am in recovery, I metabolize drugs more rapidly than your average non-addict. I will say I would rather not wake up in the middle of the surgery, as has happened twice before when I was not dosed properly. Last year, I got into an argument with the anesthesiologist who told me it was all in my mind. I said no, it’s all in my liver, the organ that deals with drugs of all kinds and, in my case, goes through restricted substances like a house afire.

I abhor the entire process and keep a tenuous hold on gratitude.  All this is meant to heal, not harm.

I leaf through the New Yorker, field a few text messages from friends wishing me well. Almost forgot to empty the bathroom wastebasket; do that. Wipe down the kitchen counter and scrub out a tomato paste stain from the last time I made pasta. Look longingly at the espresso maker.

Ok. I’m ready.

No. Wait. I’m not.

 

Writing About People, Places & Things

So after writing some 500 blogs on varying subjects—some with a modicum of wisdom and others not—I recently culled what I thought were the best hundred or so entries and created a collection titled Writings About People, Places & Things. I edited the thing, formatted it to the demanding specifications required by Amazon’s Kindle, bought a photo and created a cover, and on Thursday lofted the thing into the ebook universe. It’s available at http:/tinyurl.com/alg3nyy.

I did this partially because I believe some of the writing is worth keeping, and largely because in a couple of days I will go in for the fourth surgical procedure to arrest a cancer that apparently does not wish to be arrested. Though I am trying to enter this latest foray with a positive attitude, I have to admit the whole thing is getting old. I was initially diagnosed more than 18 months ago, declared cancer-free and then not-so-much cancer-free two times following a battery of follow-up tests. This, I know, is often the way cancer works, and it has left me, scared, depressed, and resigned.

The one positive aspect of this situation is that I have been writing more than ever.  I have three uncompleted projects that need attention and I am determined to finish them within the year. I plan to demand St. Martin’s Press shower me with dollars and an international book tour, but if the editors there do not consider the works worthy (inconceivable, I know, but the world is a strange and unfair place) I will self-publish.

If you are reading this blog, do me a favor: please download or sample Writings About People, Places & Things on your Kindle, Nook, PC, or pad. Write a review and help me foster some interest among readers. I’d really appreciate it.  Thanks!

Assessing the Vehicle

A long time ago, someone told me my body is just a vehicle that gets me from point A to point B—or maybe I read that in some New Age book. Nevertheless, it’s an image I can live with, and, pushing the analogy a bit, I can recognize that the minute I drove my vehicle off the new car lot, it begins to depreciate. We basically start aging from the moment we’re born, and a goodly part of our existence as functioning humans is spent keeping decay at bay. I fact, it strikes me that it’s a wonder most of us survive to any age. If look back over the past few years without major illnesses—Bell’s  palsy (WTF?), shingles, allergies and infections; a few weeks of flu and a back that once every three years goes out of whack. There’s been stupid stuff like a Weed-Whacker incident leading to a scratched retina, and another gardening event involving a dozen-or-so mud dauber stings. I had a motorcycle accident many years ago when I hit an eight-point stag, and when I was still drinking, I fell off a roof while playing Frisbee.  Surgeries prior to the cancer included a hernia, a deviated septum and a shoulder fixed with arthroscopic procedures.

Talking with friends over the weekend, I began exploring seriously what may happen in a near future I had not given much thought to. Yikes. This cancer thing may take me out…

Now that’s an eye-opener. It requires the sort of serious, objective contemplation I’m not at all sure I’m equipped to do. What I have found out is that I am now on the cusp of the 50 percent survival rate. Could be better, could be worse, and I can still get hit by a bus tomorrow.

I'm a big believer in the right to die. In fact, I plan to have "Do Not Resuscitate" tattooed on my chest before too long and my will has a clause forbidding caretakers from taking extraordinary steps to lengthen my life. This is not meant to be morbid. I'm simply a proponent of dignified exits with no interest in spending on hospital and medical care whatever I may have accumulated during a lifetime.

To me, insisting on life while striding through the gates of death is the ultimate selfishness. We don't like to talk about death and dying and we don't want to face the fact that our health care system is a money-syphoning sham. As one physician put it, "No one wants to talk about what we really need: a good kick in the ass and rationing care for our terminal patients."

S.K. Jindal, a physician and author for the Indian Journal Of Medical Ethics, writes, "Technological advances in the last few decades have made us believe that death is an unnatural event and that life can be prolonged at will. This has resulted in the adoption of life-supporting measures, which are sometimes antagonistic to the very dignity of life. Death is an inevitable conclusion of life. The dignity of death therefore is as important as that of life. The fortunate few die without much suffering, but most people face either the debility of old age or an incurable and progressive illness." He goes on to examine the 'right to refuse' issue. "A most contentious subject relates to the decision of patients to refuse life-prolonging treatment. The law generally gives adults the right to refuse treatment; however, [a medical practitioner] must often decide whether a dying adult is competent to decide or even communicate his or her decision.

"Legally speaking, adults are presumed to be competent to make decisions unless there are reasons to suppose otherwise. The right to refuse treatment is firmly established in British medical practice standards--it was upheld even in a patient diagnosed as psychotic who refused amputation of his gangrenous foot. In the United States, the Supreme Court in the Cruzan case is one of many which asserted the principle that individuals have the constitutional right to refuse treatment even if this may result in the person's death. This right has been reiterated in several other judgments even where patients did not have life-threatening illnesses."

Me, I simply refuse to have an everyday life that involves tubes draining liquids or solids from my body. My oldest sister, who six years ago died from bladder cancer and preferred life at all costs, was in constant pain and a shell of her former beautiful self by the time she passed away. I really don’t want that.

This, hopefully, is mindless conjecture. The surgeries and chemotherapies may indeed make everything all right again, but bladder cancer, as it turns out, has a nasty habit of commng back time after time, and each recurrence lowers the survival rate.  

I am reminded of the of the passing of Sir Edward Downs, the former conductor of Britain's Royal Opera, and his wife, Joan, who at 74 had been diagnosed with pancreatic cancer. The couple, married 54 years, decided they wanted to end it together and secured the services of Dignitas, a Swiss concern that orchestrated their deaths. It was a painless and inexpensive affair when compared to the end-of-life care Joan would have had to go through and the suffering Sir Edward did not want to bear living without his mate. That Sir Edward was not terminally ill became a serious issue, debated endlessly in the British media. In the end, it became a question of accepting or rejecting Sir Edward's "typically brave and courageous" choice, according to his manager. Personally, I think the conductor--and anyone else of sane mind--has every right to choose the moment of one's demise. After all, if we are not given a choice of when to be born, shouldn't we be given the choice of when to leave? And when is the right time to retire the vehicle?

 

A Year Later

So yesterday marked the end of the cancer treatment phase where a virus (really, not a virus, it was a bacteria; there was some confusion there but it turned out to be the latter) was injected into me by means that reverse natural functions. A collection of different medical people did the deed, some of whom were more gifted than others.

Every Monday for the last six weeks, I have gone to the office of my health care provider, dropped trou and traded witty comments with folks—all women nurses—whose senses of humor were strangely missing. This may have to do with the chore they were performing. I do not imagine that there is much joy to be gained from it, at either the giving or receiving end.

My understanding is that whatever live little thingies were forced up my urethra went into pitched battle with the cancer cells.  Hopefully the former won and I will emerge from the experience a better man.  But I’m not sure yet. There are more tests scheduled for the future.

It’s been an interesting year. I was diagnosed with bladder cancer eleven months ago after a pretty long period where I complained almost monthly of recurring UTIs (Urinary Tract Infections) and was given varying doses of antibiotics that seemed, at least temporarily, to do the trick.  

Then one morning, a fleeting expression crossed my GP’s face as she brought up the results of blood tests done the day before. “I’m going to send you to the urologist,” she said. The she smiled, hit Escape on the keyboard and the screen went blank.

It took three weeks to get an appointment, and two more before The Good Doctor there (TGD) did a cystology. This is not a fun test. Basically, a long tube with an attached camera is snaked up the urethra to inspect the area. I was lying down with a television screen overhead showing what the inside of my bladder looked like when I heard TGD says, “Uh ho.” He manipulated the camera and I clearly saw three small tumors, pale little raised things that obviously did not belong in my bladder.  Then TGD added, “I’m going to have to biopsy that…”

Silly me. I thought he could do it on the spot, maybe with a clever pair of little scissors attached to the snaky thing, snip-snip and we’re done, but no…

Another two weeks and I am in the pre-op room, needles and tubes coming out of the crook of my elbow and the back of my right hand. I am scared. In fact, I am downright terrified. Cancer runs in my family. My mother, my father and one of my half-sisters all had it. I am told by the anesthesiologist that the medical facility will not be responsible if my capped teeth are somehow dislodged during the procedure. I remember that when I was interning at a rehab for medical personnel, anesthesiologists were our prime clients. They have a high rate of addiction to the controlled substances they routinely handle; this does not inspire confidence. Will my guy maybe sneak a little toot before the procedure and forget to turn one of the valves on or off?  

I sign a form acknowledging that the facility is really not responsible for anything that may happen to me while in their care, up to and including death and I think this is beginning to appear less and less promising. TGD makes an appearance in full surgical gear and asks how I am feeling. Peachy keen, I say. He nods, “Good, good.”

Sometimes later I wake up. There is a catheter in me, attached to a bag that is strapped to my leg. My friend Paul drives me home, asks if I’m OK and I say yes, more or less. My innards hurt.

I have been given two bags into which my urine will drain, because my bladder has been poked and sliced and is in no shape to do its duty. There is a large home bag that holds, like, gallons, and a much smaller traveling bag good only for a couple of quarts. With this smaller attachment I am supposed to be able to go shopping, eat with friends, be social, but I am thinking I will never leave my house again, ever.

My entire body is sore; I feel just like I did after a motorcycle accident of years before. Joints and muscles and even bones are unhappy and complaining. Peeing—something I have admittedly taken for granted my entire life—is now excruciating.

Life is not good right now…

 

 

Jokes

This is my favorite (clean) joke:

A woman at the beach is watching her toddler son play in the surf when suddenly a wave picks up the child and carries him out to sea. The woman, desperate, falls to her knees and implores God, “Oh please, please bring my child back!”

The wave stops, reverses itself, tosses the boy gently into the air and he lands in the woman’s arms. She looks at him, then up at the heavens and snarls, “He had a hat!”

This is my second favorite (clean) joke:

A man sees a sign in front of a house: "Dog for Sale."
He rings the bell and the owner tells him the dog is in the backyard. The guy goes into the backyard and sees a black mutt lying in the shade of an elm tree. The dog looks up and says, "Hi! Nice day! You gonna take me home?"
The man is astounded. "You talk?" he asks.
"Yep," the mutt replies.
"So, what's your story?"
The mutt looks up and says, "Well, I discovered this gift pretty young and I wanted to help the government, so I told the CIA about my gift, and in no time they had me jetting from country to country, sitting in rooms with spies and world leaders, because no one figured a dog would be eavesdropping. I was one of their most valuable spies eight years running. The jetting around really tired me out, and I knew I wasn't getting any younger and I wanted to settle down. So I signed up for a job at the airport to do some undercover security work, mostly wandering near suspicious characters and listening in. I uncovered some incredible dealings there and was awarded a batch of medals. Had a wife, a mess of puppies, and now I'm just retired."
The guy is impressed, goes back in and asks the owner what he wants for the dog. The owner says, "Ten dollars."
The guy says, "This dog is amazing. Why on earth are you selling him, so cheap?
The owner replies, "He's such a liar. He never worked for the CIA."

I haven't heard a new joke in years. I'm not talking about throwaway one-liners, which are both common and, for the most part, uninspired. I am talking about a full-fledged joke with a strong lead-in and a walloping punch line. 

According to the About Jokes website, the first semblances of the “Joke” is said to have been originated in ancient Greece around 1200 BC by Palamedes, who legendarily outwitted Odysseus before the Trojan War. Flash forward to 10 BC when Roman playwright Plautus suggests the use of “jest books” in some of his works. Other Romans, such as Melissus, begin compiling collections of jokes. Then, in 5 AD, the Philogelos, the earliest jokebook known to exist today, is written.  It containing 264 “jokes”, some of which are duplicated in a different form throughout the book, suggesting that it is a work containing two combined volumes. Though the Philogelos disappears from existence, humor is still seen through folktales in Islamic culture, which makes its way to the southern Mediterranean countries. Around 1300 AD, the “Joke” is reborn during the Renaissance, and in 1452 in Italy, Italian humanist Poggio Bracciolini (1380-1459) creates his best known book of jokes, the Liber Facetiarum or Facetia. This collection contains 273 humorous anecdotes, jokes, jests, puns and bons mots – taken from his travels around Europe. This is the first time a humorous work of this kind is published in Europe.

In recent times, the joke has been replaced by the sitcom one-liner, which generally doesn't have much going for it, which in turn explains why television comedy depends on a  very fast series of one-liners that barely leave watchers the time to appreciate the wit. We are served a bad banquet of for the most part not very funny observations, most based on insults (think "Yore Mama's so fat...")

Luckily, I don't watch much TV. as a matter of fact, I stopped watching comedy offerings about the same time Michael left The Office.   

My all time favorite joke right now?  Considering my present health situation, it's this one: Jacques goes to his doctor after a long illness. After a lengthy examination, the doctor sighs, looks Jacques in the eye and says, "I've some bad news for you... you have cancer and it can't be cured. I give you two weeks to a month." Jacques, shocked and saddened by the news, composes himself and walk from the doctor's office into the waiting room. There he sees his son, Alain, who has been waiting.

Jacques says, "Alain, I have cancer and I've been given a short time to live. Let's head for the bistro and have a Cointreau or two." After several Cointreaux, the two are feeling a little less somber and soon are approached by some of Jacques' old friends who ask what the two are celebrating. Jacques tells them they’re drinking to his impending end. He tells his friends, "I've only got a few weeks to live; I've been diagnosed with AIDS."
The friends give Jacques their condolences and they all have a few more beers. After his friends leave, Alain leans over and whispers,  "Papa, I thought you said that you were dying from cancer. You just told your friends that you were dying from AIDS."
Jacques replies, "I don't want any of them sleeping with your mother after I'm gone."

 

 

Surgery, etc.

On Thursday at 9:15 in the morning an anesthesiologist will insert an IV into a largish vein in the crook of my left elbow and pump into me an elegant mélange of chemicals that will knock me out. I will be under long enough for the surgeon to excise whatever cancerous nastiness has taken occupancy in my bladder, and then I will come out of it feeling nasty, peevish, soiled and angry. The last time I went under and then came to, I insisted on having a bacon-cheeseburger. I don’t remember if I actually ate one, but I wanted it badly.

Since I will be non compo mentis when I awake, the surgeon will tell my friend Paul, who took me to surgery and will remain in the area, what the operation entailed, if it was successful, and what I should be doing for the next few hours and days.  Paul, in turn, will tell me.

I don’t like going under. Thursday will mark the fourth time I’ll have been anesthetized in a 12-months period, and I’m convinced no good can come of this sort of unconsciousness. I understand the necessity of the procedure—where I to twitch, the surgeon might accidentally puncture my bladder, which would be, to quote him, “a not good thing.” Still, I worry about a massive brain cell die-off, which I understand is not uncommon in people who go under too often. I have no brain cells to spare, and even though modern science has demonstrated that the cells repair themselves, I think mine are very, very slow to do almost anything, and the repairs are likely to be as swift and effective as a those done by a Washington, DC, road crew.

I have noticed that medical website minimize the dangers of full-body anesthesia, telling me that serious side effects are uncommon in people who are otherwise healthy and can be easily managed. The side effects, not the people.

Here’s what I know: General anesthesia suppresses the normal throat reflexes that prevent aspiration, such as swallowing, coughing, or gagging. To help prevent aspiration, a tube is inserted down the throat, in order to protect the lungs from stuff coming up from the stomach, hence the usual instructions to patients not to eat or drink anything for a certain number of hours before anesthesia.

Insertion or removal of the tube may cause respiratory problems such as coughing or gagging, as well as an increase in blood pressure and heart rate. There’s also the possibility of damaging the teeth and lips, swelling in the larynx and attendant sore throat and hoarseness. After the first operation, I found I couldn’t swallow without pain for about three hours.  

I’ll probably have nausea and vomiting after the procedure—that happened with the first two surgeries—but that will go away after I take antiemetics.

Actually, here’s my main concern: waking up during the surgery. That has happened to me twice before many years ago when the anesthesiologist poo-pooed my worries that my once-addicted liver has a tendency to assimilate anesthetics a lot quicker than the same organ in normal people. I make it a point to tell my history to the person administrating the drugs, but I do remember not that long ago having an attending nurse argue with me on the subject.

Now I simply hope that the anesthesia specialist will pay attention and prevent a premature awakening. After all, this ain’t brain surgery.