Workout 24 Jan 2012: O Voyager

20 minutes steady and intense rowing machine movement and a nice bath: on the downside, bad news on the cancer front.

The lassitude and reduced appetite I’ve felt over the past week at Grantham may not be due solely to too much bed rest. The cancer manifestation has returned with high PSA levels, in addition to lassitude and reduced appetite. Cancers tend to figure out our treatments in a systematic stepwise way. The next step for me may be chemo, or a sudden lifting of the hormone barrage (daily flutamide, and Leuprorelin Acetate injection every three months) which in some patients, surprises (?) the cancer cells so they diminish in number and strength.

I had great hopes for a hormone barrage even as WWI infantry were cheered by real barrages only to find that there were plenty of enemy left and they were pissed off. The cancer response may be, strangely, similar.

The complexity of cancer’s response is fascinating and Kantian-sublime to the philosopher even if the cancer is attacking him. The incurability of the disease, along with reports of people who at death’s door then survive like the Fisher King, with the Peacock’s beak poised to slay them, teaches us not, in Kant’s words, to build our hopes and fears on vanity; Kant had seen the consequences of such construction in the Lisbon earthquake of 1745.

As Doctor gave me this news I was seriously waiting for the fear to kick in but only felt my usual pain in the butt, the PITB that’s been my constant companion for several months, like the Companions of the Ritter (Knight) in the Durer engraving, Todt (Death) and Teufel (Devil). I only found my smile, my disgusting, long-suffering, Eric-or-Little-by-Little smile as I try instinctively to charm females with me being so brave and all. So where’s my Panic Room, and where does my true self emerge?

Durer Ritter Todt undt Teufel

Well perhaps my true self might be that smile and the Rager my father or more precisely a manifestation, and a singularly unfortunate one, of my Dad. I myself hate the Rager too.

As I was writing this the handless nurse dumped a glass of cold water on me by accident. The whole secret of life seems to be in how you react to something like that. There is a deeper meaning, for me anyway, in “the gates of Hell shall not prevail”.

…and as I was revising this the handless orderly dropped a mini cup of that damnable laxative that tastes vile and does not work on me. I used his error, however, to snag some alcohol pads useful for hand cleaning.

This tendency to be on balance reasonably cheerful could be just morphine’s euphoria. But I don’t think so, for endorphins have the same effect and the saint has her endorphins when she calls to mind the Noble Truth: that in suffering is the release from suffering at least for the purged.

Heavy matters. But you sure can construct a nice little Limerick based on those three words, morphine, endorphin and euphoria:

A disgusting old chap of Albania
Said, this Morphine gives me no end of Euphoria
But should I run out
I shall be Stout
And run about to generate Endorphins in Albania

Besides, I am on prescribed dosages. They are high as witness my tendency to get nauseous, and I don’t know how hopheads push the dosage to start seeing things…although my visions last Oct were benign when I used improper dosages I certainly don’t want to go back to that confusion.

Doctor allayed my fears about chemo as has Dr Siddharta Mukherjee in his excellent recent book about cancer and its treatment. Our media view of cancer is formed by the treatment of patients prior to 2000 such as Gilda Radner, and their sufferings under crude chemo which does try to destroy the weaker cancer cells by attacking all cells. The thought of getting this type of chemo, BARFOLA or something like that, as an out patient and then a jolly ferry ride o’er the billow with me spewing me guts windward is itself barfoprogenetive.

Thinking philosophically about pain seems a useful way to endure at least mild pain. Pain is not “sense data” because pain is incommensurate with sense data in that pain seems to be a type of knowledge. But there are even types of pain incommensurate with other types of pain, most famously, nausea. I believe Wittgenstein deals thoroly with these conundrums in Philosophical Investigations. Might be worth a reread as opposed to idle speculation and reinventing the wheel.

But precisely because of the suffering of Ms Radner and many other chemo patients, since 2000 many less intense and less barfy therapies have been introduced. The key ratio m/n is m=number of days on chemo and n=number of days off and so we focus on reducing that number. I think that further, n could be analyzed into g+b: “good” days without cancer symptoms and “bad” days so we could also reduce b. The “sweet spot” in m/(g+b) would be m and b equal to zero, of course: nothing but g. We could then evaluate treatments as to how close they came to m and b=0. Of course, I would do this only for myself on entering chemo-land; I do not know if it’s already in use.

But, “them helpis no conclusionis slee” as Dunbar says of “surrigianis”, “art-magicianis” and “astrologgis”: so,just like him, I have to trust in God when all is said and done:

Sith for the deid remeide is none
Best is we for death dispone
After death that live may we!

Details at eleven: we have to Turn It Over. We’re not constituted any other way. To be reassured is to need further reassurance, so we need to take the first reassurance and then act or be still as the situation warrants.

“O voyagers, O seamen,
You who came to port, and you whose bodies
Will suffer the trial and judgement of the sea,
Or whatever event, this is your real destination.”
So Krishna, as when he admonished Arjuna
On the field of battle.
Not fare well,
But fare forward, voyagers.

TS Eliot


5 Responses to “Workout 24 Jan 2012: O Voyager”

  1. I hesitate to say I ‘enjoy’ your posts as they are based, in the main, upon your suffering, and I always feel uneasy about hitting the ‘like’ button for this reason – however your meditations upon your current situation are deep and poetic and illuminating. I wish more people were reading! I don’t know if you mind one way or the other, but I am reading with great interest.

  2. I hope you’re right about chemo being less barf-orific. Sounds like you have your situation as well in hand as possible.

    • spinoza1111 Says:

      Seems that way. Story of cancer treatment (radiation in the 1920s, aggressive breast removal in the 1930s, chemo in the 1970s) seems in Mukherjee’s book to follow the same pattern: wild enthusiasm followed by integration of the therapy not rejection: radiation still in use.

      My only experience with barf management was back in my drinking days: you know, tickle the back of the throat to get it over with, spew with the wind on boats not against it unless you want a facial, etc.

      • This may help, Zofran is the most often prescribed drug for chemo nausea, as I’m told. It does -nothing- for many people. If that’s the case demand phenergan. It works.

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