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.

Clocks

There are, at last count, 22 time-telling devices in my house, not counting the watches I stopped wearing several years ago, or the various phones, iPads and computers that litter my environment.  The clocks are on every floor and in every room. The kitchen alone, where I spend a lot of time eating toast and musing on the meaning of life, has five. Each bathroom has one; the bedroom has three, as does my office in the basement. There’s one in the garage, one in the laundry room, and one in the room devoted to music. A gorgeous 19th Century ormolu which is right twice a day dominates my living room, and in the entrance to my home is an art deco wall clock whose gears froze long ago and were replaced with a modern battery-driven movement. My doctor’s office has clocks wbhich tell me how long I have been waiting for him. If I am ion a room without a clock, I feel a vague, murky discomfort. I am completely aware of the passing of every minute of the day and I have no idea why.

Clocks exist mostly to remind us that time is slipping away. There will never be enough of it in one day, or in a year or, for that matter, in a lifetime, and yet we are obsessed with what is commonly regarded as the fourth dimension.  History is little else but the passage of time, and wisdom is thought to be a byproduct. Consumer purchase more clocks than they do just about any other household electronic appliance and in earlier days, a sign of a family’s wealth and standing in the community was its ownership of a timepiece.  

According to Discover Clocks’ website, “during the early centuries, monks and townspeople were content to divide a day into 12 hours of daylight and 12 hours of nighttime based upon the sun. Since the amount of daylight varies with the seasons, dividing daylight into 12 equal units made the length of an hour also vary with the seasons.

“When the first mechanical clocks were built in the 14th century, the idea of 24 fixed length hours became the norm in Europe. While the first mechanical clocks were used in the monasteries, as European towns expanded in the fourteenth and fifteenth centuries, civil governments wanted their own clocks to regulate life in the towns. The earliest clocks were built into turrets in the local churches or in specially constructed bell towers. Rather than keeping time with hands on a dial, many of these early clocks employed a hammer mechanism that struck the bell to announce the hour.”

Now clocks buzz, hum, sing the Star-Spangled Banner, turn on radios, and are used in bombs. They regulate our lives and indeed were once called regulators. We depend upon them to be angry when someone is late, or surprised when that same person is not. We set athletic records with them, we measure speed and distances and of course time elapsed and make value judgments, all based on an antique way of separating night from day.

For Aristotle, time was linked to movement and change; there is change because there is time, because all things that come to be and come to an end are in time. When we think anything is, the is we refer to is the dimension of time, and we can only truly grasp the instant we recognize as now. A now gone is history, a now not yet present is simple conjecture.

Aristotle’s definition of time is “a number of change with respect to the before and after,” in other words, something countable. And we are back to clocks.

Golda Meier once said, “I must govern the clock, not be governed by it.”  And William Faulkner believed, “Clocks slay time... time is dead as long as it is being clicked off by little wheels; only when the clock stops does time come to life.”  I like that.

 

Irritating Reads

Few things are more frustrating--literarily speaking--than bad books by good authors, and it’s been my ill luck to pick three in a row. You know the drill--the book is barely good enough to keep you reading, and even though it’s a complete waste of your precious time, there’s just enough plot, just enough mildly interesting characters to make you stick.  And all the while, you also recognize that as soon as you’ve put the thing down, you’ll curse yourself for the weak fool you are, a forlorn addict to words on a page.

 

The O’Briens by Peter Behrens last year was hailed by the New York Times Sunday Book Review as “a major accomplishment.” It’s not. It’s a frustrating novel that deals superficially with the lives of four generations of an Irish family, beginning in the early 1900s and ending in the 1960s.  Behrens has good style, an easy way with words, but this particular book paints two-dimensional characters that for the most part have few endearing traits, save that they work hard. They’re also drunks, debauched, wimpy on occasion and not particularly well-drawn.

 

The book is unsatisfying because in North American literature, few subjects are more fertile than the tales of families, more if they’re immigrants.  When well-orchestrated and choreographed--Judith Guest’s Ordinary People, Philip Roth’s American Pastoral or Pat Conroy’s The Prince of Tides--the history of any family is fascinating and hard to put down; the best ones, such as Tolstoy’s Anna Karenina, are spectacular and almost cinematographic.

 

Behrens is no Tolstoy. Still, his first novel, The Law of Dreams, was a pretty spectacular fictional account of the Irish potato famine of the 1840s. I read it with relish after it got splendid reviews, and I was primed for another great read, which did not happen. At the end of the book, I felt as if I’d misspent quite a few hours of my life.

 

The same thing happened when reading Nelson DeMille’s latest, The Panther, which follows the exploits of John Corey, an irritating hero whose sense of humor is so misplaced and puerile you’ll groan. The book is set in Yemen, a country DeMille obviously dislikes with rare intensity, and deals with the search and eventual assassination of a badass terrorist who is drawn so meanly I was reminded of a mating of Boris and Cruella de Vil.

 

There again, the plot is just interesting enough to keep you turning the pages, though I often found myself turning them 10 at a time. I did like learning about Yemen, thought to be the Queen of Sheba’s home. Yemen is one of those countries constantly at war with itself, and the site of the terrorist attack on the USS Cole in 2000. It truly irks the hell out of me that the book debuted Number One on the New York Times hardcover fiction list. The Panther is a large book, too big by at least 150 pages of aberrant dialogue and snide writing.

 

And finally we come to Little Star by John Ajvide Lindqvist, a Swedish writer hailed as the scion of Stephen King. I don’t think so.  Little Star is another book with far too much space between its covers, a story that doesn’t hold water (or Akvavit, since were in the northern climes) and is irritatingly incomplete. The plot has holes a Volvo could drive through and manages to make both the Swedish police and the Swedish recording industry look like idiots. Why did I read it, you ask? In my defense, I’ve been known to read the fine print on cans of paint. With Little Star I stopped well before the ending, which was telegraphed and fell far short of expectations.

 

Jeez. If this keeps up, I may have to stop reading altogether.

 

 

 

   

Discomfort

Most of us, from childhood, are prey to some sort of chronic discomfort. It’s far short of agony or even pain; it is basically the feeling that something is amiss, not seriously so but just enough to be noticed. Splinters and ingrown nails, joints that twinge, knees that throb, backs that ache; our gastrointestinal system is allergic to wheat, or seafood, or artichoke hearts. Our bodies will not tolerate milk products or strawberries.  Bee stings and peanuts send us to the hospital; a sudden movement means we will be hurting and stiff for days. Exposure to too much sun burns us painfully, to too much heat creates rashes; in frigid situations our functions slow and stop. So we spend a life of being careful, of avoidance of the things we know or suspect can harm us.  We internalize this discomfort and it becomes part and parcel of our daily lives. Without knowing it, we are fortunate: our bodies do not remember pain. We are spared memories of every skinned knee and elbow, and on a much larger playing field, the recollection of pains associated with war, pregnancy or childbirth. This is a natural necessity. What woman would go through more than one labor if she could remember every twinge and wracking agony? And who, recalling the suffering of a serious wound, would want to engage in conflict?

And then, of course, there are the other discomforts, the emotional and psychic ones, the intellectual knowledge that something is not as it should be. We care too much, suspecting but not willing to fully accept that it isn’t the ones who care the most who wield the power, it’s the ones who care least. We develop ulcers, or high blood pressure, or heart murmurs. Sometimes it’s simply angst, that unbearable anguish of life trying to co-exist with the hope that the unattainable will be reached.

We have been created inadequately, it would seem, by a maker who can best be described as an under-achiever; we are the unfinished designs by a being with Attention Deficit Disorder. It’s surprising that we’ve chosen to worship the architect of such flawed corporal entities, yet we do, and essentially beseech it daily to lessen our distress. All that fragility, it’s a hell of a way to live…

What we do to cope is create environments made to muddle through the discomforts. Sometimes it works, mostly it doesn’t. We buy plush homes and plush cars and what we euphemistically call comfort foods.  We seek comfortable relationships and discard those that fall short or do not offer the solace we need. We attempt to swaddle and be swaddled, and this itself furthers discontent. It’s downright amazing, the unhappiness we will suffer to ease a little discomfort. And so we create addictions--to food, sex, drugs, adrenaline and other stimulants or depressants, anything that make us feel good, to relieve that always-there disquiet. To get a little rest from it all.

Addicts of all stripe, if they’ve given the least thought to their situation, will tell you they do what they do because they are uncomfortable, and that at some point the substances they use did indeed relieve their ill condition. In fact, most addicts are constantly trying to re-live that moment--generally at the inception of addiction--when they were free, however briefly of their discomfort.

When he was asked the meaning of life, the Buddha is reputed to have answered, “Life is pain." More recently, Hollywood took up the cry in The Princess Bride. “Life is pain, Highness,” wrote William Goldman. “Anyone who says differently is selling something.”

Who’s going to argue with that?

Advice

I know a man who has an autistic child; he delights in retelling the story of being approached by a well-meaning neighbor who, seeing the child’s state, suggested, “You should bring him to a doctor.” We live in a world full of advice.

I noticed this as I leafed through my morning paper.  The Style section alone has Hints from Heloise, a column decades old that deals with home and garden how-to and, I’ve noticed, is obsessed with white vinegar as a ubiquitous household cleaner and a cure for the common cold. Miss Manners, whom I used to know when I worked at the Washington Post, examines post-Emily Post matters of etiquette and generally manages to respond to queries with both elegance and eloquence. Two other columns are essentially modernized versions of Dear Abby and Ann Landers. The questions posed are perhaps more direct than the ones Esther Pauline and her twin sister Pauline Esther had to answer in their time, but the gist remains the same: heartbreak, sociopathic behavior from those near and dear, infidelity, infertility and inability to communicate.

Most editorials and op-eds are essentially advice columns as well. People with a certain professional expertise (former cabinet secretaries and members of the Senate are always popular) tell us--and, they hope, decision-makers--the way any given situation should be handled and how the solutions they propose are far better than those of the author of adjoining columns. Pretty often, the advice is of the “you should see a doctor” ilk, that is to say largely brainless and somewhat insulting to the recipient.

More broadly speaking, highly-paid consultants, motivational speakers, teachers, psychiatrists, physicians, and preachers and their ilk are really nothing more than givers of moderately useful advice.

I’ve been given a lot of advice in the past two cancerous years. Some has been good (give up artificial sweeteners), some bad (purchase a $10,000 water purification system for my home) and some plainly thoughtless (live a day at a time and without expectations.) The strangest recommendation came back when the future was actively uncertain and a man whom I believe may be an accountant suggested I die before April 15 so I wouldn’t have to file my taxes.

My father’s sole bit of advice when it came to sex was, “Be careful.” Between them, my parents suggested “don’t trust anyone” and advised me (in French) that “whatever the situation, they’re gonna screw you.” “They” was never defined but always understood.

My favorite bit of advice is more of a statement: “People! They’re the worst!” These four words, voiced by Jerry Seinfeld during a discussion with Elaine, are on some days the best I can do.

To be honest, though, I’ve been known to give some advice too.  Herewith, the best of:

 

1. Don’t stand in the idiot spotlight. (If you understand this, it means you’ve been there.)
2. Don’t be afraid of your problems. Be afraid of your solutions.
3. Look at the past but don’t stare at it.
4. It’s “ready, aim, fire.” Not “ready, fire, aim.”
5. Don’t take anything away you can’t give back.
6. It’s better to give a resentment than to get one.
7. The only difference between fact and fiction is the footnotes.

 

Do you feel wiser now?