Queen Mary Hospital 9 July 2012

The folly of cabs: instead of Crazy Minibus I took a cab to Queen Mary, only for it to break down in Shueng Wan. I was dumped unceremoniously and freaked out, mildly, in an anger management episode while trying to flag down a cab. While Hong Kong taxis are inexpensive, they are driven by men who don’t speak English or Cantonese in some cases (who only speak Mandarin) who don’t always maintain their cabs.

So from now on let us take Crazy Minibus. When my back was in daily pain last month, I was intimidated by the idea of handling my laptop bag in a small moving space but it should be OK now.

In addition I can start taking an alternate ferry to Lamma Island (it is an indication of the depth of coverage of public transportation that this minor island is served by two ferries, operated by private firms with fat subsidies). Queen Mary Hospital overlooks Aberdeen’s bay, which is home to well known floating fish restaurants favored by older tourists and the Aberdeen channel separates the main island and Lamma. It is crossed by an older ferry which runs about every hour or so.

I am the only Westerner in the Cancer Center waiting room. I may need to learn Cantonese to communicate with staff better although senior staff including doctors have excellent English and communication skills.

In fact it may have been better to have a Dr Lau confirm Dr Jamieson’s bad news on 1 June, for it was without embellishment and nothing can really be worse than that verdict except some fixed number of “days to live” and these diagnoses are rarely given. Any new news is likely to be good.

Of course, having to switch to chemotherapy from my starter hormonal therapy would be unpleasant especially because the ferry rides to and from the main island would present me with the Nelson problem of sea-sickness.

Before last week’s nausea as caused by opioide pain medication, I hadn’t had to deal with nausea, apart from a few bouts of intestinal flu, since starting to run thirty years ago. Nausea considered as pain shows that there are different types of sensations that come under the term “pain” united only in a perception of the mind that these sensations are unwanted. But now is not the time to speculate in this creaky, qualitative as opposed to quantitative, 17th century way about pain.

In smoking I gave myself manageable amounts of nausea in order to somehow reconcile myself to office and stockroom jobs. The normal healthy body, after all, wants to go to Grant Park and make out with hot girls and then to the pizzeria to eat. But this was unsustainable in 1969 without legal tender, and the only way to legal tender was to work in a grey world of obscure machines that created price tags, registered precisely what time you started work, and sorted cards. Smoking reconciled you to this world.

Now of course I want the green world back because of course the grey world causes cancer.

The meeting with the oncologist went well although I learned there’s “uptake” (signs of carcinoma cells without tumor) above the abdomen. The “medical mystery” remains: the absence of a primary tumor, prostate or otherwise. My favorite theory, that my strong as bull immune system “nuked” the tumor only to release metastasis, is unproven but unfalsified according to Dr Wong.

In addition, metastasing prostrate often attacks bones which is why, early in this ordeal, I was given the bone scan. This found no bone problems: the sciatica is not caused by bone involvement it is caused by normal bone degeneration.

However, the doctor did mention a principle or rule of thumb. Unless proven otherwise the diagnostician assumes that for one patient there’s one disease, from an application of scientific asceticism and Occam’s Razor. This means it would be nice from a logical standpoint to link the sciatica with the cancer. But I would rather the sciatica be caused by an independent factor.

The palpable tumor in my shoulder stays. It will not be excised since there’s no point: excision would leave rogue cells and the “uptake” above the abdomen would not be hosed out.

Interestingly, this (female) doctor confirmed my belief that the doctors who I called “the urology boys” as opposed to the oncologists like her might be too hasty in labeling what I have prostate in the absence of a smoking gun. She also liked my term for them. I mentioned that Shakespeare may have had a rare cancer of the tear ducts according to some sources, although this is uncheckable.

But my complete lack of production of joy juice (sperm) experienced this month confirms prostate almost as much. It bodes well for my new mattress. Most single guys’ mattresses smell like dead fish after a year or so whether or not their release is willed or a spontaneous “nightly emission”, unless the mattress has a mattress pad.

So, as expected, then, no bad news, no good news. But it’s hard to imagine any real bad news apart from “you are actually dead, now” which would be self-refuting. DH Lawrence has a short story, “the man who died”: Ambrose Bierce has a short story, “An Occurrence at Owl Creek Bridge”, Wild Bill Hickock often ended stories with “why boys I died”, and in San Francisco in the 1980s I had a dream in which a voice said, hey, you, who fears death, are you sure you’re alive? I mean, is this living?

A decision point will be to choose to continue the hormone treatments at perhaps 1500.00 hong kong dollars a month or elect the “public” option which is, yes indeed, surgical castration. I am considering the latter since my identity is no longer tied up in male sexuality: I have creative outlets, little enough interest in relationships ad their downsides, grandchildren on the way, and I had a dream the first night I was in China. I’d been instructed to kill a cat but the cat said “I not die” and was transformed into a beautiful woman.

Dream. I was in Chicago at a hotel next to the Art Institute. Feelings of being a transient, a hotelmensch, a patient in a sanitorum or hospice which charges you a small amount per day. My new suitcase is small but I reflect that if you go to Laundromats it would be suitable for long trips. My war hero uncle writes of feeling content on his way back to his unit with one suitcase.

Hospice (terminal and palliative) care is available in Hong Kong for very little money (68 HKD a day.) I am simply not a candidate being basically so full of beans and zip; many cancer victims simply don’t go swimming first thing. But this means I have to figure out what this lease on life is for. I think it’s a combination of art, not so much as self expression as giving felicity or purgative emotion to total strangers, and helping strangers as I have been helped. People naturally want to even out the score when a stranger gives them potlatch or does something for them.

What seems not on is grabbing all the gusto I can: zooming off to the South Seas and getting drunk with a bevy of beauties. Yawn. For one thing, I did that already, didn’t I? I’d want to do it if I were diagnosed with cancer after a wasted life working for Prudential as a computer programmer but I haven’t wasted my life in this way.

My experiences at Queen Mary have restored my childhood love for the medical professions and I almost, but not quite, wish I’d become a doctor. Not quite…because when I asked the doctor today if she’d seen A Beautiful Mind she’d not: especially in China, medical training excludes the possibility of culture or a normal life in most cases. Certainly in my Dad’s case it resulted in a stunting of certain emotions.

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