Nadir

8/24/07

“The Bush administration, continuing its fight to stop states from expanding the popular Children’s Health Insurance Program, has adopted new standards that would make it much more difficult for New York, California and others to extend coverage to children in middle-income families.” 8/21/07 New York Times

On my mind: What do China and Utah have in common? Greed. Marx had it right. Capital is the ultimate ideology. The China story, as I recall, had to do with their market in organ transplants. It was reported that the harvesting of organs was being done in conjunction with public executions of condemned prisoners. Immediately after, and in some cases before, the executed had expired, medical teams would rush in and harvest eyes, skin, kidneys, hearts, livers and whatever else the highest bidder might pay for. Think about this, you are being eviscerated while still alive. In this particular story the emphasis was on the skin being flayed from living victims. So, what does this have to do with Utah? In a similar example of how profit knows no morality, the Murray mining company has too quickly decided the workers are dead, or at least entombed, and it’s time to move on. Much like the hapless prisoner whose skin is commodified even while he dies an agonizing death, the miners are given up to the altar of commerce even as new and unsafe holes are being dug. How craven are the wheels of progress, of industry, of capital.

“Napping is tiresome.”
-- R. Louis Tessier

“I was like, ‘Oh, we got hit. We got hit.’ And then I had blood on my face and the flies were landing all over my face. So I wiped my face to get rid of the flies. And that is when I noticed that my fingertip was gone. So I was like, ‘Oh, O.K.’
“So that is when I started really assessing myself. I was like, ‘That’s not bad.’ And then I turned my hand over, and I noticed that this chunk of my hand was gone. So I was like, ‘O.K., still not bad. I can live with that.’
“And then I went to wipe the flies on my face with my left hand, there was nothing there. So I was like, ‘Uh, that’s gone.’ And then I looked down and saw that my legs were gone. And then they had kind of forced my head back down to the ground, hoping that I wouldn’t see.
“Alive Day Memories: Home From Iraq” – HBO Documentary

Dear Dr. Ahmed:

It’s Friday, August 24th, and I just came from a blood draw (it’s the nadir in the 3 week cycle). After our cell phone conversation yesterday, I thought it might be best if I composed my thoughts on e-mail. Regarding my meeting Kaminski, maybe it’ll happen maybe it won’t. Truth be told, the story of my cancer is losing its newness. The emotional swirl of being sick, researching the disease, bringing attention to the cause, and lobbying for better health/cancer care is slowly fading into the mundane, day to day reality of morning elation, mid-day optimism, late afternoon malaise and evening resignation. Life goes on. Someone gets cancer, there is a pause in their worldview, and life moves on, with or without them. I’m 10 days into the second cycle.

So how’s it been? While I only have the first treatment’s experience to draw upon, I can draw some conclusions. The ten day point signals the beginning of an emotional period in which the late day fatigue and stress of life (finance, family, romance, health) conspire to thwart all optimism. The depressed feeling that one is ill becomes inescapable. Not accidentally, the 10 day depression point immediately follows the cessation of the 4 day steroid regimen. The energy affected by the prednisone gives way to an emotional crash where, in the words of Hamlet, life seems “stale, flat, and unprofitable.” Yesterday my tongue and throat were sore, the gums and mucous membranes in the mouth, rough and irritated. The same crazy bald head in the mirror who’s ready to save the world now sees through sad eyes. Nobody knows what it’s like. I’m not done with lobbying Kaminski.

Let me try to clarify my point about the medications. Sometimes I have specific pain. Gout, for instance, can be excruciatingly painful. The throat and tongue can get so tender that talking (and I love to talk) becomes a moot point, and oftentimes embarrassing since the constriction affects a kind of slurred speech. In these cases the pain medication acts in a very specific way. Now I don’t know if it’s beneficial for a drug to mask symptoms. It may be that the pain that keeps us off of our feet, or the irritation that prevents idle chatter, or the sensitivity that keeps us from eating spicy foods, is a good thing, in that it prevents us from doing more harm to ourselves.

My point is this: the medication (oxycodone) that allows one to be comfortable in the face of these very specific side-effects is also reducing the psychological consequences of suffering these aches and pains. The pain being gone makes me feel physically better, and the absence of pain makes me feel stronger from the perspective of attitude and psychology. The knowledge that I have and can take the pills on a prescribed basis, whether the pain is specific or otherwise, gives me a sense of security. The cessation of pain makes me feel better emotionally. As much as we’d like to think it, the mind and body are not discrete entities. Physical and psychological wellness go hand in hand.

Long story short: I think your policy of prescribing a three week supply is sound. No, I don’t have a history of addiction, yes, I’m aware of how tolerance and intake have to be balanced. This is what I was alluding to about the double issue of being miserable from, a) the lack of pain medication, and b) the effects of the chemo. Yes, I would like you to provide me with another prescription, either today or Monday, and, No, this won’t be an issue again.

Peace - Randy