Archive for medicine

False Hopes

Posted in Uncategorized with tags on February 26, 2013 by spinoza1111

I AM, IN NARRATING MY EXPERIENCE WITH LATE STAGE PROSTATE CANCER, MAKING AN EFFORT AT ALL TIMES TO CORRECTLY IDENTIFY, USING CORRECT AND INTENSIVELY PROOFREAD SPELLING AND OTHER METHODS, TO FIRST (1) AVOID MAKING MEDICAL CLAIMS AND (2) AVOID BEING A REFERENCE PSEUDO-AUTHORITY ON TREATMENT FROM THE STANDPOINT OF THE PATIENT. BUT AT NO TIME AM I TO BE TREATED AS SUCH. USE WIKIPEDIA AND NOT ME TO INFORMALLY DOUBLE CHECK THE SPELLING OF DRUG NAMES, A LIFE OR DEATH MATTER AND USE INDUSTRY-SPECIFIC AUTHORITIES FOR ALL REAL MEDICAL PROOFREADING. OTHERWISE, YOU ARE ENDANGERING YOUR OWN LIFE, THAT OF LOVED ONES OR THAT OF PATIENTS!

The Leuprorelin Acetate injection was for me an injection of false hopes, for it appears that if I can narrate what happened as if had a telos, as if a macro narrative made sense, the cancer “observed” what was happening and counter attacked in force using its “reserves”. Cue Twilight Zone theme: cancers can act like intelligent beings at times. In response we have to act even smarter,

cf. Steven Wolfram A New Kind of Science. It may make sense to speak of cancers as systems with a telos and also to start speaking of instances of their cures as more systems with a telos. Cancer research should stop thinking in terms of the 19th century “cures” of bacteria based diseases. Here, we merely threw a “medicine” perceived as a foot soldier against an enemy which once defeated was thought unlikely to return.

But AIDS showed doctors how smart patients, acting more than gorks on gurneys could as a part of a telos take full responsibility for their care, saving their money for their medication and using their educations to better understand what was happening, and, in despair, “act up” and fight any way.

This three month period has been one in which the “good guys”, the non-cancerous cells of Me (which, to go out on an perhaps unprecedented limb may represent “God’s plan” for what Walt Whitman meant by “o helpless soul of me” here:

O powerful, western, fallen star!
O shades of night! O moody, tearful night!
O great star disappear’d! O the black murk that hides the star!
O cruel hands that hold me powerless! O helpless soul of me!
O harsh surrounding cloud, that will not free my soul!

For we must not speak falsely now the hour is much too late, and once you give a name to your “secular humanism” it becomes a foul thing: I was was filled with awe at Christopher Hitchens’ description, in almost real time similar to this memoir: but does that make me a Hitchenite? Damned if it does, for the Hitch merely repeated an old story we already know.

I could prophesy: will stretches of Hitch’s DNA be read out at Lessons and Carols realize that Hitchens is saying nothing more than “death is real in this way for me” and “behold in this way for me” as a “secular humanist” who is forced to use spiritual language at the crisis (devoid of myth-making) he’s saying exactly what the oh so religious person is saying. To do anything more than this is a mistake in style like wearing the wrong kind of hat.

end of unprecedented limb

I hope to workout for 20 minutes on the rowing machine today and will report either way.

A Fundamental Error in “Cancer, a Very Short Introduction”

Posted in Uncategorized with tags , , , , on June 11, 2012 by spinoza1111

In Hong Kong and on the public program you have to do the EZ-Klean procedure (about which the less said the better: Google it if you are curious) at home the night before the colonoscopy, and clean up after your Self.

Caution: this is not medical advice and should not be treated as such. I am a layperson uneducated in medicine and a cancer survivor of three weeks duration having been diagnosed May 25. But without pretension, I think, I can spot flaws in the philosophical implications of a medical choice. I believe that education in philosophy and logic is so missing from medical education as to moronize doctors speaking on issues that lie at the penumbra of their field, such that they can reason logically but only on a medical topic in a medical vocabulary. Whereas their pronouncements outside medicine are often moronic as here.

I generally like the Oxford Very Brief Introduction series because they are contemporary and very well-written.

Nicholas James’ Cancer: A Very Short Introduction is somewhat of an exception. Its information on medical options is first rate if opinionated.

But he’s dead wrong on holistic and alternative therapies.

He says they must be tested with the same rigor as new drugs and surgical procedures. Now, the problem here is that cancer, being incurable in most cases by way of verified drugs and procedures, is open ended.

Unless the holistic or alternative treatment “does harm” it may turn out, in a later state of medical science, to be confirmed scientifically as a cure. But hardly any such remedies do harm, for they are for the most part based on opposition to the most common form of scientific cure: tissue destruction through radiation and chemotherapy. They tend to be benign and natural, such as Linus Pauling’s overdoses of vitamin C or simply eating a rational diet as opposed to the crap I fed on up until, and not after, my diagnosis (crap that didn’t show up as obesity because of my thirty years exercise: crap that may have lain in wait.)

The alternative procedures necessarily lie outside of formal testing because most of their proponents do not want them to be subject to the cynical two-person game: private greed versus government regulation increasingly under assault. The testing is not only scientific it is a social process which changes the outcome, and has a disturbing error rate – although it doesn’t, admittedly, kill people (except in a way masked by the fact that cancer is, after all, incurable, and harm may have been done).

The penumbra of alternatives such as not going negative in interpersonal relations is like the criminal economy to the economist: the economist or medical scientist herself makes negative assertions about the criminal economy or alternative therapy that cannot, in themselves, be subject to the same rigorous checking that she demands of people who write about the criminal economy, or push alternative therapies for cancer.

The fundamental error is positivism in Adorno’s sense. When he used the word, he didn’t mean the more sophisticated forms of Positivism such as Logical Positivism with its verifiability, or Sir Karl Popper’s falsifiability. He meant a crude variant, the original variant: Comte’s assertion that the world operates to physical laws that we know (physics, apart from the ugly postulation of the ether, was considered finished in 1890 at the end of the Comtean century.).

But, since many philosophies generate folkish misinterpretations, Comtean positivism became Dickens’ Gradgrind’s folk positivism, in which the only true assertions are those that are verified. This makes the set of true assertions even more narrow than that of Logical Positivism, in which the only true assertions are those that are verifiable in principle.

James, the author of the Oxford Very Short book on cancer, is unreflectingly a folkish Comtean having no education, independent of medicine, the logic of whose vocabulary he’s a master, in philosophy and logic; indeed, an academic at Hong Kong poly recently warned me, in my academic job search, not to say I taught logic. Embed as James is in the system of careful verification of new drugs and surgical procedures, he won’t make room for benign procedures, often chosen by the patient, outside the scientific stockade.

Now the problem is that most cancers are still incurable: that what matters to the patients, We The Living, We The Cancer Survivors are (1) a shot at a cure, whether scientific or alternative and (2) life extension, grandchildren, and quality of life. We are a third type of scientist, for there are the theory boys such as theoretical physicists, and then there are the appliers of science such as software engineers and doctors and finally, there is the Object of medical science: the patient.

But it takes again an Adorno to remind us that in the sciences of “man”, of which medicine is an example with no pure theory at all (because apart from animal medicine, medicine is about the Object-patient, a person) the Object wishes to be a Subject as well as an Object, whence the activism of Aids victim and cancer patients…an activism in the latter case is diverted by elites into the American Tragedy of no health insurance (while it’s been talked about since Truman), or the British system and its strange Post Code lotteries which James describes, and which set patient against patient in the same waiting room…because one’s come from Amersham and the other from Tooting, and one or the other gets the better drug or procedure.

The patient who would be a subject, who takes responsibility with EZ-Klean and in my case thirty years of running which has pounded my L4 into my L5 spinal vertebra and given me painful sciatica, not caused by my cancer, but who thereby avoided sickness while supporting his kids, who chooses alternative therapy without avoiding medical procedures, isn’t a scientist, of course, he’s a Person engaged in a Fight to the Death for Survival and Flourishing.

And grandchildren.

This person should not be told, implicitly or explicitly, that alternatives are useless because not verified for they are verifiable and falsifiable, in the latter case especially if they do harm. And the sterling reputation of Oxford University Press should not be wasted on such an opinionated, and, in its last chapter, incorrect book.

My doctor-father is of course spinning in his grave where I hope his Beautiful Soul rests in peace. He would not agree with my views on alternative medicine.

But at a deeper level, my father did, in the 1930s, study philosophy and logic with pleasure at university, and continued to study philosophy until the end of his long and noble life. He would start ordinary medical lectures at non-teaching hospitals with references to Aristotle and Galen, and link these to the latest neurosurgical procedures of which he was a master. Non-western doctors, in my experience at Swedish Covenant, admired him for their Chinese, Hindu and Muslim cultures were more closely linked to the Confucian, Vedanta and Q’uran traditions of respect for precedent, compassion for suffering, and love of the natural world of those traditions, yet my Dad spoke from his Roman Catholic tradition, respecting life (including the often overlooked right to life at the end of life) and above all doing no harm…say by destroying the self-esteem and self-respect of a patient by treating her as an Object and mocking her alternative therapy in a superior tone.

It will come, as Albany says in Lear. The reversal of enlightenment, from falsifiability, to verifiability, to verified, and from there to Fundamentalist religious terror, and the victims will be the patients, targeted as they are, post-2008, by “austerity”. And We The Living (to steal shamelessly from Rand, who doesn’t deserve the title of philosopher nor her phrase) will eat whole grains and forgive each other. We will eat bread and salt and speak the truth.

My butt hurts not at all. Here. In this moment. “For all is always Now” (TS Eliot)