Archive for Queen Mary Hospital

Waiting Room, Cancer Centre, Queen Mary Hospital 19 September 2012

Posted in Uncategorized with tags , , on September 19, 2012 by spinoza1111

The Shaft, Queen Mary Hospital, Hong Kong, 19 September 2019

Listen!

Waiting Room

The doctor confirms that the cancer’s response to the hormone treatment is strengthening which would explain the return of the pain. But it’s still a puzzle as to where the cancer originates which is why I go under the knife today.

More precisely, under the needle, in a prostate biopsy. I had to self-administer local anesthetic and am now waiting with a row of Chinese men,

Like sacrifices before their watchful fires – Shakespeare, Henry V

waiting for the surgeon,

Some swearing, some crying for a surgeon… – Ibid.

…actually the only one to make any audible noise is me, and I only moan a little, for “’tis bootless to exclaim” (sorry, we’re off again: that’s Richard III).

And then the author goes under the needle…

…and the procedure went fine, for the surgeon had me narrate the deep and intimate pain numerically on a scale of one to ten, which is something I do anyway. Furthermore, they were playing Colonel Bogey’s March which I think these Chinese nurses play special for us Gweilo men to call upon the better angels of our nature when we’re buggered, as are the POWs in the film “Bridge over the River Kwai”. And I was buggered, if in a good cause.

It’s vulgar to say that I am up to my ass in Asians, but I don’t think it’s racist: prior to the procedure, I felt spaced out and nauseous, and also felt, perhaps, like Edward Joseph Nilges, “the Captain of the Month of May” (Captain, United States Army, 442nd Regimental Combat Team Nisei, KIA 6 April 1945), since one’s reconciliation to your particular version of Man’s Fate, the particular cropper to which you have come, is *amor fati* as you wait for the tannoy to say, instead of the Cantonese names, “Edward George”: to love your fate.

Like Robert Gould Shaw buried in a common grave with African Americans in the Civil War, you accept this. Like Clint Eastwood back a few months ago when he had a little dignity, before he started raving at empty chairs, you have “more in common with these Asians [improper expletive replaced] than your own ungrateful family”.

‘Course, much more of this, I might start talking to chairs, or playing Russian Roulette like De Niro in The Deer Hunter after his character goes permanently East, Asian. I need to write about this and maintain an even strain.

Written Off by Mitt Romney

To understand how evil Romney’s unscripted contempt is, for those of us in the 47% who don’t pay taxes and need things like Medicare, it helps to understand the distinction between “enumerating a set by extension” and “describing a set by intension”.

You can list your constituents by name (by extension) which in principle means you could add a constituent who isn’t rich (and who doesn’t suck up to the rich), but Romney in the sound clip made it clear that if you meet a certain “intensional” test (“failure to earn, inherit or steal a lot of money or not trying real hard to earn, inherit or steal a lot of money, or not at all times groveling before people who have earned, inherited or stolen a lot of money”) you’re a worthless dependent person who thinks she’s “entitled”, where words with a good or neutral connotation such as “progressive” or “entitlement” become perversely in a Republican hipster way, words used with a sneering smirk.

Note that as soon as we describe people intensionally it becomes impossible (well, almost impossible) to deny them a compensatory entitlement in John Rawls’ sense. That is…Rawls never intended his “liberalism” to be recreational, optional or possibly false. All serious philosophers want (contra that “skepticism” which is the label of the ignorant mob for its own ignorance) to produce synthetic a priori truths in reflective equilibrium with what we believe and each other, which means that once you recognize (for example) that a person who’s paid into Social Security from shit jobs for forty years has an entitlement, by law, you cannot evade your responsibility to him by labeling his right an entitlement. Why? Because it sounds like you not only have no notion of an entitlement, you also don’t have a clue about human rights.

Romney finds, like my father found sad to say at certain times in his life, low-income people to be unworthy of his attention.

At his worst my father was positively offended by loserdom, whether failure to make a lot of money, or any pretentious pretense to want to walk away from the game.

No real Republican after Theodore Roosevelt really did like the poor, even the poor who suck up to and directly serve the wealthy.

Our President Taft had not a little contempt, as my father had, for the breezy democracy of Teddy Roosevelt, forged in forests and hunting lodges in which Taft and my Pop never felt at home.

Thomas E Dewey, the infamous “little man on the wedding cake”, the groom-homunculus with the elegant mustache and little else, rather appealed to my father rather than Harry Truman, with his loose, sloppy and deconstructed tropical suits and Hawaiian shirts.

Comes now Mitt Romney, whose infelicity with the English language is of the same species as George Bush’s infelicity: both infelicities indicate a lack of compassion and empathy. Mitt Romney hates me because I went to Princeton to work and study in my thirties and didn’t take that rocket scientist job on Wall Street, or that law office automation job at Sullivan and Cromwell. And now I’m teaching Kindergarten. Shoot me now, Mitt.

Plants at the Bottom of the Shaft, Queen Mary Hospital, 19 September 2012

Advertisements

Queen Mary Hospital 31 August 2012

Posted in Uncategorized with tags , , on August 31, 2012 by spinoza1111

Listen!

“Everything: the minutely detailed history of the future, the archangels’ autobiographies, the faithful catalogues of the Library, thousands and thousands of false catalogues, the demonstration of the fallacy of those catalogues, the demonstration of the fallacy of the true catalogue, the Gnostic gospel of Basilides, the commentary on that gospel, the commentary on the commentary on that gospel, the true story of your death, the translation of every book in all languages, the interpolations of every book in all books.”

Borges, The Library of Babel

Well that Endoscopy was rather novel. I realized that as opposed to the other “‘scopy” (the ass probe) this was going to hurt a bit and feel strange. It’s a tube down your throat.

In the tube up your ass deal in July, I was given the wonderful anesthetic of Nepenthe, a drug that causes you to forget the procedure: it kicked in as the tube went up and the next thing I knew I was breaking my fast in the sun, and being assured that the procedure was over. But this form of anesthetic isn’t used for endoscopy, instead, simple Novocaine in the throat.

The endoscopy causes a struggle reflex as if you’re being force-fed (and if the US Army pulls this shit in interrogation, flag officers should go to jail: to do it to another human being without a medical reason is a violation of human solidarity, mutual recognition and dignity).

I controlled my reflex to minimize the pain and the risk of tearing the esophagus. With a child or drunk you probably would have to use sedation, but that might pose extra risks. I was able to take it like James Bond would.

And in the fug I hear amidst the nurse’s Cantonese, the Doctor’s Chinese/Australian English say, “big lesion”. Oh shit.

But it is good news in the sense I already KNOW I’m sick, and of a cancer of officially unknown origin (99% probability prostate), and the more we (my doctors and I) know, the better. Still, one reason I like anesthesia, from chloroform to laughing gas to booze to Nepenthe, is that I don’t have to be a gorked-out fly on the wall as the Doctors confab, and throw out theories such as “holy Mackerel, what a lesion! Damn!” or “ai-yah!!” or “this guy might be dead…naw he ain’t dead…yet”. I am the CEO of this effort and I want the executive summary once the doctors have sorted out the possibilities.

Something’s pushing against the stomach wall. A good sign is that it’s soft and not hard. We don’t know if it’s part of the known cancer but in general, one patient one disease (even in Aids, a meta-disease or empire of maladies, like cancer).

Perhaps I’m pregnant. Unlikely.

Not feeling any stomach pain. But, this may reduce the stomach volume, painlessly reducing appetite as a feeling of fullness, causing my inability to gain weight past 164 lbs.

So another outpatient procedure is scheduled. And I’m down for breakfast at the DeliFrance in the hospital, with Edith Piaf singing Non, Je ne regrette rien, where they try to give me a staff discount, bring me my food and call me Doctor (Doctor! Is there nothing I can take? Doctor! To relieve this belly ache?). I don’t mean to be smug but I am getting rather inured to this medical grind. Men must endure what might be their going hence as the King admonished Gloucester i’ th’old play. Sometimes I think that the real challenge would be living longer and figuring out what I want to do with the gift of more life as opposed to pissing it away, “poured out like water on the ground”.

Strangely my training in academic philosophy is actually helpful in this dark hour even though William Dunbar (see below) snarls in ancient Scots, at the “art magicianis and astrologgis”, that “them helpis no conclusionis slee”. For central to academic philosophy is something that screeching harridan Ayn Rand didn’t know: that to be meaningful a proposition has to be falsifiable: this is why miracles happen all the time.

People do go into remission because they love their wives and find the right things to say to their wife and to their God as in prayer. Or they survive because they are like me, alone, perhaps to protect the people I love against my intimate rage, and with a network of friends on an island, but, again, alone; there are many different ways to the waterfall. My way always single, others’ way with others. Both can be good.

It is amazing that Republican politics is all about capitalist self interest. Because very often one’s reason for living might be the Other. In Tina Howe’s excellent play Painting Churches, the aging Mother says of the aging and difficult father, I would have put a bullet through my head were it not that he needs me.

‘Course, the Republicans daren’t say that the self-interest of which they speak is that of a 19th century projection of the white man’s self image as a patriarch, who has a wife, children and slaves as “his”. But that’s what they mean. With the result that they have to get every single white man to vote, because polls are now indicating, for example, that only 0% of all blacks will vote for Mitt Romney.

That’s not a typo: it’s zero percent with a margin of error of plus or minus three percent which means, of course, that some blacks may vote Republican…this was an African American habit in WEB Dubois’ time…or on the other hand, new black people may appear to vote for Obama and against Romney. I am not sure how the latter would work. The point being that Romney’s base of support rather resembles Wiley E Coyote’s when WEC runs off the click while pursuing Road Runner.

Since I have of course no plan to vote for Romney, it’s game, set and match. Romney will save a lot of money if he just sits at home like Coolidge and not campaign because he will lose. But perhaps “thrift, Horatio” doesn’t matter when you’re as wealthy as he.

People also survive just enough to be profoundly happy without God like Ed Murrow, the newsman who spoke truth to Joe McCarthy and smoked too much but died serene…happy, in fact, because after so many years of four packs of Camel straights a day, Murrow found he didn’t have to smoke: I know from my own experience in stopping smokes, booze and Nicorette that being able to give up a trivial and nasty thing is one of life’s more under-rated joys. There’s something to be said for a drunken brawl as I have admitted. But there’s also something to be said, especially later in life, for going to bed early, like HL Mencken’s Calvin Coolidge, who turned the White House, Mencken said, into a “peaceful dormitory”.

But learning a little about the distinction between a proposition that can be falsified (a medical diagnosis) and a necessary truth (a mathematical theorem that has been proven) aids serenity in its own little way, along with better known techniques such as breathing and meditation.

Prayer? For me right now prayer feels like spamming…sending out messages with no hope of their being understood. Perhaps because my father never understood that I needed connection with him and my sons don’t understand this either, I pray perfunctorily to God or Nature more as a way of stopping myself from driving myself batshit than in hopes my prayers will be answered. I have long felt based on Emmett Fox’s book on the Sermon on the Mount that the best prayer is ontological, as in fiat voluntas tua, thy will be done, rather than “oh Lord won’t ya buy me a Mercedes Benz”.

But if God is as I understand him a Power greater than me then of course this Power will answer the prayer of the simple believer in Mary, qui Mariam absolvisti, who goes to Lourdes, and the Hindu who goes to the river to wash. This is an outdated 19th century view characteristic of British Liberals. It is considered both simple and patronizing of the masses whose whims are now sanctified by those who’d profit by sating those whims. It is also true and far better than the horseshit being spewed by power mad Christian, Islamic and Jewish daemons and salesmen, you ask me.

Don’t get me started you know how I get. It is now common knowledge among us bottom feeders that on the ground we can all get along whether Christian, Muslim, Jew or whatev, that we don’t need half the crap we buy, and that anyone who pays two thousand Hong Kong dollahs for a rolling bag needs his head examined.

There is some self-delusion. People say “I never shop at IFC Mall” but upon close questioning we find that they bought their Mac at the Apple store (it’s hard to find a new Mac with a knocked down price) and books at Dymock’s. What they mean is that they don’t go into City Super, the most expensive grocery store in the world, or Aldo’s for shoes.

But on balance the class system is real. Which is why it’s nice to know that gazillionaires also get what I’ve got. For all men are mortal, and we all treashah, as Jack Kennedy said, our children’s fuchah.

Workout Log 22 August 2012 & Queen Mary Hospital: Der Fliegende Hollander

Posted in Uncategorized with tags , , , on August 22, 2012 by spinoza1111

40 minutes freedance (frei-tanz) first thing to Journey to the Line, Sweelinck, L’Enfant, Morricone and Bach.

Queen Mary

Queen Mary followup visit. Between the July PET scan and 10 Aug CT scan the tumor in my left shoulder has shrunk. I thought it had changed yesterday was altogether less full of itself, less full of beans, more discouraged, softer, broader and more mobile. But I do not hate it. It is my Caliban that shall seek for grace hereafter, hopefully in the loo, excreted somehow. It is life and I am pro-life today, albeit not in the stupid way that makes women suffer. No, I like living things. The bugs in my apartment, for example. And of course grand-daughters.

The uptake of unusual, weird, and funny-looking cells continues from my groin to shoulder lymph nodes which doesn’t bother me too much since it is the job of lymph nodes to cart away shit. The problem is in my layperson’s understanding is that the lymphatic system doesn’t know where to put this crap. Perhaps my strong immune system is yelling at the lymph nodes not to deposit it anywhere, with the result being that the cancer cells are a sort of cellular Fliegende Hollander, sailing the seas of the lymph system, yearning for death, unable to find it.

A profoundly unscientific observation to be sure. The next step is to schedule the biopsy that will resolve the question of whether this truly is prostate cancer which is still not resolved, and we need to resolve it before deciding on chemical castration or the real de-balling which is the gold standard for prostate. It would be real dumb for me to get my balls cut off either chemically or for real (with perhaps a little Chinese box for them as was given to eunuchs of the Ming so they could be buried as men) only to discover that this isn’t prostate cancer, it is a rare cancer of the tear ducts of which some historians say Shakespeare may have died.

Anne who had a way with her, made Bill Shakespeare cry
And so after many a summer the sweet swan of Avon did die
Of a cancer not of swans, a cancer of the ducts
For which the doctors could do nothing even if you paid them lots of bucks.
Every secret thing shall be revealed,
And no cancer shall be concealed,
And all shall be well, all manner of thing shall be swell
When we start forgiving each other for our prone and prostrate sperm and tears
And take not the counsel of our fears.

My weight, somewhat unfortunately, has not increased and remains at 74.5 kg or 165 pounds, ten pounds under “normal”. But this means I still get to eat chocolate cookies from Just Greens our health food store and other between-meal treats. Prior to this debacle I never ate between meals and only ate chocolate with others, preferable in bed with an Other. Now I get to engage my solitary passion for chocolate. I should probably try to engage it in moderation although I have never been moderate in anything.

Shopping Note

Having the right luggage is like not dying. Well, not really, However, I am going to Thailand tomorrow, and I need to avoid a shoulder strap, for after many a summer dies the swan, or at least the swan will pound lumbar vertebrae into the sciatic ooze and then as we have seen there is hell to pay.

So I looked at top of the line Samsonite in IFC mall where we never shop: for who the hell spends 5000.00 on a bag? Even though that’s 650 USD, it’s absurd.

“Six thousand dollahs? And its not evun leathah!” – Joan Cusack, Working Girl

But I located an equivalent four wheel bug bag with the roller handle in Mong Kok for 2500 and I thought it was a bargain. I set the money aside.

But I was in luck, for my Tiger Mom client and I had a long session and meeting in Shenzen yesterday and, hearing that I’d budgeted such a foolish amount, she dragged me into the luggage shop in Lo Huo and talked the salesgirls down to … 300 dollahs….38 us dollars for a bag with a gazillion compartments, four wheels, that spins 360, that has almost zero dead weight and is perfect for my height.

Moral, go shopping with a Tiger Mom.

Workout Log 18 Aug 2012

Posted in Uncategorized with tags , , on August 18, 2012 by spinoza1111

Lamma Forest at Dawn 14 August 2012

Black and White Prospect of Lamma Island from Queen Mary Hospital, July 2012

20 minute free dance with weights to Journey to the Line and without weights to Glenn Gould playing Sweeinck. Developed a new move with weights that’s more aerobic including a stress-free plie and a rapid circular motion with the weight.

Queen Mary Hospital 10 August 2012

Posted in Uncategorized with tags , , , , on August 10, 2012 by spinoza1111

Anselm Kiefer, Der Ordnung der Engel: The Hierarchy of Angels

CT scan and a GI tract followup based on my June hospitalization for abdominal pain. The latter no problem since the hospitalization was caused by my being stupid about taking Ibuprofen. Received my PET scan images, not going to examine them since I don’t really know how to interpret them. Furthermore, they look like a bunch of cutlets of Me which is disturbingly culinary.

The eye-of-God Bone Scan early in this crisis and to an extent the expensive Pet scan, were rather frightening. Today had a little more sang-froid for I separate getting the interpreted results from the manufacture of the results. I did tell a small lie since I wanted to get this CT scan done: I said I’d had breakfast before six but it was more towards seven. If the doctor confuses kidney bean curry and brown bread with a new metastasis one shall have to be Calm and ask him if it might be Food. It is very important as an outpatient to follow all directions as much as possible, for the alternative is an expensive hospital stay when you’re a goofball, and cannot follow directions in writing. I’d done so, but not on the meal timing.

Never thought I’d welcome a weight gain but found at Queen Mary today that I’ve gained seven pounds. Old weight was 158 pounds or 71.7 kg two weeks ago. It’s 74.9 kg and 165 pounds today but I’m still underweight: IDEAL male weight for my height (6’2″) is 175 but AVERAGE in USA is 230 pounds (wow that’s some serious meat on de hoof, Jackson).

I think I was down a quart even before La Debacle (May’s diagnosis of prostate cancer) since I’d adopted a program of eating less after the Pret a Manger closed in the AIA building on Hysan Avenue as a result of the Panic of 2008. Then, after the bad news, continued exercise, somewhat increased out of sheer panic in itself, coupled with a bungled transition to vegetarianism, caused a dramatic weight loss, negative love handles, and serious but unhealthy Hotness as we have seen here ha ha.

Let’s just get it back up to normal by careful diet that will but emphasize the rabbit food and roughage but also contain some meat and dairy. I simply do not know how to eat a completely vegetarian diet.

I see a Dan Ryan’s Chicago Grill Snarfburger in my future with a side of fries slathered in mustard as a special treat and I’m buying. I don’t think I’m on my way to 230 pounds but in my day I weighed 205 which was, according to my very svelte Manhattan doctor, “borderline obese”. He put me in Jenny Craig in 1990 and it was kind of fun. I learned some good eating habits and dropped down to 185.

The message of Beethoven’s Heilige Dangkesang im Lydischen Tonart is that a disease is the new normal and the good days are better than the bad days are bad as long as you note then and say, as did Beethoven apparently, like Wayne Newton, Dangke Schon.

The swimming once again reducing pain while walking so in general was full of beans this afternoon, so many indeed that I was concerned whether I was manufacturing too much testosterone and thereby overwhelming the Bette Davis drug (Flutamide). Found a USB/MIDI interface at a computer store on Des Voeux which the sales clerk was unable to find so got them to reduce the price in Hong Kong style. I need a usb midi so as to be able to inflict my proto New Age improvisations from 1972 on this blog and its loyal if long suffering fans once I am up to speed.

It’s wonderful to have a piano in my flat even if this is one of those little Yamaha jobs.

As in German artist Anselm Kiefer’s meditations on his childhood circa 1945, a Jahr Null (year zero) creates the “normal”.

Queen Mary Hospital 2 August 2012

Posted in Uncategorized with tags on August 2, 2012 by spinoza1111

Back to QMH to unsnarl two problems: a missed CT scan appointment and a followup appointment for esophageal and upper GI review that conflicts with work tomorrow. The partial return of sciatica makes me internally whiny and morose. How does one man up if one’s on an androgen blocker? You need deeper resources than Red Bull. Oh well, I got the appointments fixed. I don’t want to have to make a trip but this is impossible to do on the phone given language problems.

I don’t think you get a “family doctor” even at Memorial Sloan Kettering, and one point of contact could be a danger since he’d miss things that a team can see. With this team approach to my cancer and that of all other patients, second opinions are free.

It’s like last year’s financial problems at HSBC where my sudden unemployment and the fraudulent failure of my company to pay a bonus resulted in a massive debt. I was delivered through the mechanism of the bank like Charlie Chaplin in the machinery in Modern Times and came out with an agreement I can live with and to which I’ve adhered to.

I believe I can free up enough time & money for a Thailand spa retreat at the end of August. Until that time it’s Hung Shing Yeh beach which is more than what a lot of sick people get.

And yes, I’m to be a grandfather, and no, I am not going back to Chicago to be present at the birth of my grandchildren. This is because I have allowed my son to define the parameters of my being a grandfather, given that I was not his custodial father. Family values? Forget family, said Lao-T’se and there will be filial love. It’s a paradox that once you force feed family, the actual love stops, so Chick Fil A can go to hell. I was a better father when non-custodial since I was no longer looking for approval to my wife and could just appreciate being a Dad.

Queen Mary Hospital 9 July 2012

Posted in Uncategorized with tags , , on July 9, 2012 by spinoza1111

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.