1209 lines
62 KiB
Plaintext
1209 lines
62 KiB
Plaintext
|
File: hunting.txt
|
||
|
Cont: 13 days post-operative
|
||
|
Date: 10th Dec, 2003
|
||
|
Music: Electric Light Orchestra - Out Of The Blue, Discovery,
|
||
|
|
||
|
Preen really does remove tough stains fast. I tried it on the sticky
|
||
|
squares of gunk left over from where my i.v. lines were taped on, and the
|
||
|
stuff came off easily.
|
||
|
|
||
|
Woohoo, tomorrow I get to hoe into fatty foods again. I have missed
|
||
|
dietary fat a lot these last two weeks post-op. I am still a bit gaunt,
|
||
|
but since the bathroom scales exhibit neither precision nor accuracy, I
|
||
|
can't tell if I've lost or gained mass while, all week long, doing not a
|
||
|
lot more than sleeping and eating. My cheeks are a bit sunken, and the
|
||
|
little bits of fat on my arse are sort of caved in, as if all the
|
||
|
adipocytes were mysteriously poached in the dead of night by a feral
|
||
|
liposuctionist. Joss is right. There's no way I'm gonna give up cake
|
||
|
either. Or waste perfectly good hash cookies. OoohAhhh.
|
||
|
|
||
|
I am tempted to smear a massively fattening chocolate cake in lard, spray
|
||
|
it with olive oil, dunk it in WD-40 and oh, I dunno, roll around in it for
|
||
|
a few minutes before actually eating it, so I can have the fun of licking
|
||
|
it off my arms. Fat gets a lot of bad press, and I'm not gonna be one to
|
||
|
besmirch it. Where do you get your cell membranes, your tissue padding,
|
||
|
your clotting factors, your steroid hormone precursors, your lipid-soluble
|
||
|
vitamins, and your chance to experience puberty? Dietary laaaard, matey.
|
||
|
But that's tomorrow. My documentation at the moment is gonna be about the
|
||
|
last week, which was pretty much fat-free.
|
||
|
|
||
|
It's been a slow climb out of bed. Finally I can sleep on my belly, but
|
||
|
it's a bit tight, a smidge painful. I found my old navel under a crease in
|
||
|
my eleven inches of scar, which is healing nicely but is a tad uneven. I
|
||
|
don't know if this means I have two navels, but it probably doesn't. The
|
||
|
stitching is designed to dissolve in-situ after a few months, which is
|
||
|
good, I don't have to be exposed to any trauma and infection risk
|
||
|
getting it taken out.
|
||
|
|
||
|
Navel contemplation aside, I can walk the dog and have been doing so
|
||
|
partly to get the hell out of the house for exercise, and partly to
|
||
|
pre-emptively escape the dog's asphyxiatingly putrid farts which I
|
||
|
generally only find out about after it's too late to make an effort to
|
||
|
avoid them. I don't use the leash, tho. She wanders around, self-propelled
|
||
|
and voice activated, distracted only occasionally from her doggie
|
||
|
navigational imperatives to pick a fight with a cat or shove her snout
|
||
|
into any excreted olfactory intrigue abandoned by her kindred on the
|
||
|
manicured lawns of Blakehurst.
|
||
|
|
||
|
I've lost muscle mass - keeping active is the only way to restore it. Even
|
||
|
though I am eating like a fiend, I feel languid, decidedly
|
||
|
unenergetic. This is partly because my bod is allocating resources to
|
||
|
healing the wounds, and partly 'cos I've not been deriving energy from
|
||
|
dietary fat, so I've been converting proteins into glucose in order to run
|
||
|
my Krebs cycle. This is sort of wasteful and stupid 'cos it just reverses
|
||
|
all the effort my bod put into synthesising these muscles in the first
|
||
|
place, but it keeps me alive. There's another possible reason why my
|
||
|
muscles are disappearing but I'll get to that later.
|
||
|
|
||
|
Getting outside was also good since it let me intercept some short rays
|
||
|
from the big thermo' nuke in the sky. UV gets bad press, too... the
|
||
|
shorter wavelength stuff deserves it, thymidine-dimerising evil that it
|
||
|
is, but the slightly longer segments of that spectrum are an important
|
||
|
part of my calcium metabolism, the not-so-short-wavelength UV photons do
|
||
|
one of the molecular transformations required to produce the precursor for
|
||
|
calciferol.
|
||
|
|
||
|
|
||
|
I feel a bit old - in my present state, the dog outruns me, since I walk
|
||
|
at about the same pace as Dad does, and he's 70 and has a buggered knee.
|
||
|
My gait's changed, I'm a bit bow-legged when I walk because this cushions
|
||
|
the heel-shock of each footstep which otherwise upsets my guts; I'm a bit
|
||
|
bent-forward since the scar is slightly shorter than the length of gut in
|
||
|
which it's embedded, so my weight's thrown a bit forward of where it
|
||
|
usually is, and will be until I can stretch my abdominal muscles back to
|
||
|
their pre-slash length. Given time, these things will return to normal
|
||
|
with exercise.
|
||
|
|
||
|
On the weekend Dad and I went up to his offices to paint out some
|
||
|
graffiti... a half-litre tin of paint presents no serious weight to carry,
|
||
|
so I offered to do it. The building is wedge-shaped. On one side of
|
||
|
the wedge there was this graffiti:
|
||
|
|
||
|
Fuck off u arab cunts
|
||
|
|
||
|
and on the other side there was:
|
||
|
|
||
|
Fuck off u jewish cunts
|
||
|
|
||
|
If the writing on the walls is anything to go by, it appears Australia is
|
||
|
still egalitarian but nowadays it's because we hate everyone equally.
|
||
|
This graf appeared on thursday, on top of the sections of graf I had
|
||
|
painted out a week earlier.
|
||
|
|
||
|
By the time we got there, the jewish hubby of another person who works in
|
||
|
the building had arranged to paint out the `fuck off u jewish cunts'
|
||
|
section. I don't know if the other bit was left there accidentally or not,
|
||
|
but I suspect the former. I conjectured to myself that I could make it
|
||
|
completely equalitarian by leaving the fuck off and painting out the
|
||
|
remainder, but I painted it all out, not wholly convinced that
|
||
|
painting it over really would make it go away. The middle-east peace
|
||
|
process needs all the help it can get.
|
||
|
|
||
|
Later we went to get pizza (you find me a fat-free pizza and I'll show you
|
||
|
a foodstuff not worthy of eating) and opposite our local pizza shop were
|
||
|
about fifty uniformed cops waddling around a taped-off carpark, guarding
|
||
|
an equal number of spent 9mm shell cases scattered around the tarmac,
|
||
|
where a couple of dudes had decided to have a go at each other. If they
|
||
|
lived long enough to use fifty rounds they can't have been very good
|
||
|
shots, but then pistols are hard to aim properly in the calm of a firing
|
||
|
range, let alone in the heat of conflict.
|
||
|
|
||
|
This is not the same neighborhood as the one I grew up in.
|
||
|
|
||
|
Sneezes still hurt a lot, so I asked them not to put any pepper on the pizza.
|
||
|
|
||
|
|
||
|
Wednesday 10th:
|
||
|
|
||
|
I nosebled into my cornflakes this morning. I can't say it influences
|
||
|
their flavour very much.
|
||
|
|
||
|
I went to a restaurant, to attend the christmas party/dinner thingo held
|
||
|
for the handful of staff at the office, because today was the day I could
|
||
|
eat fatty foods again. Oohhh, and didn't I? I think the concerted effort
|
||
|
of ingesting about a cubic foot of penne boccianola knocked me over,
|
||
|
though. I hadda go out and lie down in the carpark before declining a
|
||
|
desert which I couldn't possibly deal with since I was stuffed to the
|
||
|
pylorus with FOOOOOOD, yay! Looking suspiciously like a pissed businessman
|
||
|
in my borrowed tie and shiny black shoes, I lay on the shaded concrete
|
||
|
between a couple of parked cars, gazing happily at the sky, lacking only a
|
||
|
puddle of explanatory vomit. I swear I could feel the oils and triglycerides
|
||
|
pumping around my arteries. Gaaaah. Bliss.
|
||
|
|
||
|
I spent some of last night trawling the electronic online oncology
|
||
|
journals. Blissed out and in the no-care zone on account of the chunky
|
||
|
lode of lipid laden nourishment I was in the process of absorbing, I
|
||
|
mentioned in passing to the oldies some of what I'd found out (you'll get
|
||
|
it in a paragraph below) about how this cancer tends to uh, progress.
|
||
|
I didn't catch their expressions, I was staring at the fluffy upholstery
|
||
|
on the ceiling of the car as we drove back from the restaurant.
|
||
|
|
||
|
|
||
|
Thu, 11 Dec 2k3
|
||
|
Music: Front Line Assembly - Mindphaser (four-track EP)
|
||
|
|
||
|
The narrow strip of my inner right thigh which was oddly insensate (fed by
|
||
|
a branch of the ileoinguinal nerve, which along with everything else was
|
||
|
stressed somewhat when my casing was opened up) has returned to normal.
|
||
|
However, I'm still shooting blanks. This is apparently because some (sorry
|
||
|
I don't know the name for them) of the nerves involved in signalling the
|
||
|
emission of liquid rugrat precursor from the seminal vesicles into the
|
||
|
urethra prior to peristaltically forcing it out the end of my end, were a
|
||
|
bit upset when Paul peeled some of the cancerous pieces of lymphatic
|
||
|
system off them. Can't say I blame them.
|
||
|
|
||
|
This is something which, hopefully, will reconfigure itself in the coming
|
||
|
weeks. If it doesn't, well, heh - in a roundabout way, this creepy disease
|
||
|
will have blown any chance it had of inflicting itself on any descendants
|
||
|
I might have otherwise initiated between now and when it eventually carks
|
||
|
me, if it had any genetic propensity to begin with. Which I think it must
|
||
|
have. I can't think of anything I did to encourage this... I don't smoke,
|
||
|
expose myself to cadmium, coal tar, phenacetin, or most of the other
|
||
|
things by which RCCs (Renal Clear Carcinomas) are known to be provoked. In
|
||
|
the absence of some rather pointless DNA testing, there's no way to really
|
||
|
know if it's inherited. Cells are heinously complicated things. Run any
|
||
|
digitally replicating metabolism for long enough and some of it will
|
||
|
eventually turn metastatic under the damage load it accumulates from the
|
||
|
environment.
|
||
|
|
||
|
At this point, the litigious types among the readership would smell an
|
||
|
opportunity to enrich some bastard lawyers suing the medicos for an
|
||
|
negligent accidental sterilisation. If you are one of these people, ask
|
||
|
me over to your place so I can smack you one. I'm an ungrateful bastard
|
||
|
about a lot of stuff, but to sue the dudes who just extended my life by
|
||
|
chopping the renal equivalent of Benito Mussolini outta my flank is really
|
||
|
just beyond tolerable bad manners.
|
||
|
|
||
|
(I was gonna type saved, where you see the word `extended' above. But I
|
||
|
think, actually, that would be stretching the statistical truth.)
|
||
|
|
||
|
|
||
|
|
||
|
I went along to an oncologist on today. Dad went with me, and fell
|
||
|
asleep (upright - neat trick) in the chair adjacent while the cancer
|
||
|
specialist did the blurb. This is partly because dad's already come to
|
||
|
his own conclusions about what I have based on his own clinical
|
||
|
experiences of cancers which have made it into people's lymphatic system,
|
||
|
and partly because he spent a lot of the night doing surgery on someone
|
||
|
and he needed sleep. He's talked to oncologists before, anyway, and knows
|
||
|
what they tend to say. The only thing he inherited from his oldies was a
|
||
|
propensity for bowel cancer, which many years ago slew his old man, his
|
||
|
uncle and a few others besides. So every so often he gets a camera stuck
|
||
|
up his quoit and fed through his large intestine, to look for polyps and
|
||
|
adenomas and other things which, if left to their own devices, would kill
|
||
|
him. Not exactly Australia's funniest home video, but it's saved him
|
||
|
several times. He eats a breakfast which amounts to a soy milk solution of
|
||
|
woodchips and sawdust, since this is correlated with reduced bowel cancer,
|
||
|
but also causes reduced iron uptake and unpredictable raucous farts.
|
||
|
|
||
|
I listened intently, but, being a smartarse molecular biologist with an
|
||
|
interest in cancer long before I had any of my own to care about, I didn't
|
||
|
hear a lot I didn't already know. Sometimes, you can lose the primary
|
||
|
tumor and any mets (short for metastases - secondary tumors which
|
||
|
originated in cells flaked off the primary mothership in my now absent
|
||
|
kidney) die - there's some poorly understood protein signalling going on
|
||
|
between the primary and the secondaries, which, when blocked or removed,
|
||
|
tends to result in the mets failing to thrive.
|
||
|
|
||
|
Interferon at this point is about as likely to be useless as not, and even
|
||
|
if it is useful it'll extend my cark-by date by no more than a year, not
|
||
|
actually cure me, and probably make me sick as a dog while I'm on it. If
|
||
|
any mets I have are going to turn up, they'll do it anywhere... muscles,
|
||
|
skin, bone, brain, liver, you name it.
|
||
|
|
||
|
Yeah, blah. I can tell from what he doesn't say, the dude is not a
|
||
|
molecular biologist. In mathematics, the term "math-out" (c.f. white-out,
|
||
|
as in, snowstorm) is used to describe presentations so drenched in formal
|
||
|
notation as to be impossible to understand - which means the explanation
|
||
|
is a failure since nobody actually learns anything from it. The cellular
|
||
|
metabolism, and epidemiology of cancer cells is another subject in which
|
||
|
one could easily inflict a biological chem-out on a hapless layperson, and
|
||
|
I dunno if oncologists are trained to keep it simple just to help their
|
||
|
charges comprehend what it is they face, but I *wanted* the meaty, gritty
|
||
|
technical explanation.
|
||
|
|
||
|
I asked questions which should have raised the dude's radar about my
|
||
|
pre-existing awareness. E.g. I scanned the titles on the book spines on
|
||
|
the bookshelf... and asked "Hmmm.. Steven Rosenberg... hey, isn't he the
|
||
|
chap who did all that work with recombinant interleukin-2 and LAK and
|
||
|
tumor infiltrating lymphocytes in the eighties?" and even threw in
|
||
|
explanations about why what little he did say was correct, "Yeah, this is
|
||
|
unpredictable 'cos the met cells have accumulated lots of errors, add new
|
||
|
errors each time they do mitotic division 'cos their DNA repair and
|
||
|
copying systems are mostly broken, so it's hard to know what's gonna grow
|
||
|
and what isn't, or when, or how fast, right?" but, aside from getting the
|
||
|
occasional, "Right" and "Yes" it didn't provoke any improvement in his
|
||
|
signal-to-noise ratio. Maybe over the years he's copped negative feedback
|
||
|
from patients about the incomprehensibility of the actual machinery of the
|
||
|
disease when he explained it and now has adopted a strategy of keeping it
|
||
|
simple.
|
||
|
|
||
|
As ruthlessly insensitive an interrogator as I can be when I really want
|
||
|
to know something, I am not in the habit of asking medical people
|
||
|
unreasonable questions, such as, what are my odds, or how long have I got
|
||
|
to live - since there's no way for them to know and I can cull what I need
|
||
|
to know about these things directly from the scientific journals, which is
|
||
|
where they find out in the first place. There are some things we cannot
|
||
|
know. Time will tell me anyway, eventually, but I'd like to have some idea
|
||
|
now about wether to keep living, or to prepare for death.
|
||
|
|
||
|
The 'net is a corporately controlled wasteland these days, the information
|
||
|
superhypeway has tolls at all the interesting offramps. The stuff I really
|
||
|
wanted to look at is hosted by blackwell-synergy.com but it's
|
||
|
subscriber-only. I ended up trawling EMBL and a few other mol bio places
|
||
|
before digging out what I wanted. If I'm going to exercise any
|
||
|
selbstbehauptungswille it will help to know the enemy.
|
||
|
|
||
|
Actually, knowing the enemy might help you, the reader, get a clue about
|
||
|
why I'm not kidding myself that I'm gonna survive. You might not be
|
||
|
familiar with it. Cancer is the ultimate diesease, dynamically adapting in
|
||
|
real time to every new threat you might present to it - its effectively a
|
||
|
virus which also happens to run its own metabolism, which you gave it in
|
||
|
the first place.
|
||
|
|
||
|
So here's the condensed version, mostly cleansed of mol bio speak and
|
||
|
chromosome-jockey jargon, in approximately increasing order of
|
||
|
shitfulness.
|
||
|
|
||
|
Blokes get RCC (renal clear cell carcinoma) twice as commonly as women do.
|
||
|
|
||
|
Most people who get RCC get it after they're sixty (I'm waaay ahead of
|
||
|
the curve).
|
||
|
|
||
|
Spontaneous remission happens in about one percent of cases.
|
||
|
|
||
|
RCCs eat radiation for breakfast.
|
||
|
|
||
|
The usual cytotoxic chemo drugs (eg, peptide synthesis blockers like
|
||
|
cyclophosphamide, etc) and the immunostimulant chemokines aren't much chop
|
||
|
against it and make ya sick when you're on 'em. Actually, come to think of
|
||
|
it, attacking the tumors with nuclear emissions and chemo usually just
|
||
|
kills the weaker of the cancer cells leaving behind the really tough-arse
|
||
|
tumor cells which were strong enough to surive these attempts at being
|
||
|
nuked and poisoned. What doesn't kill it outright makes it stronger by the
|
||
|
usual Darwinian laws.
|
||
|
|
||
|
Surgery works well if the cancer is localised to a single spot. Chopping
|
||
|
it out was a good idea since there's now several hundred billion tumor
|
||
|
cells I don't have. I wish them all the very best in their new career as
|
||
|
incinerator fuel.
|
||
|
|
||
|
RCC tends to metastatise (as borne out by my histology report). About a
|
||
|
third of people *already have* cryptic (hidden) mets already when the
|
||
|
primary is removed. Most of the metastases appear within a year of removal
|
||
|
of the primary.
|
||
|
|
||
|
RCC metastatic behaviour is bizarre and unpredictable. The metastases are
|
||
|
genetically highly variant and as such are an immunologically changing
|
||
|
target - averaging about eight (!) changes per sample compared to the
|
||
|
genetic makeup of the primary tumor.
|
||
|
|
||
|
So I can go right ahead and vaccinate myself with the tissue taken from
|
||
|
the primary (or derivatives thereof) but this would train my immune system
|
||
|
to act against a target which is longer there, or only a few of the total
|
||
|
available targets. Arrr... I thought I had its number, but apparently I
|
||
|
do not. Well, not enough of it, anyway.
|
||
|
|
||
|
Not only are the primary tumor and the secondaries are not identical
|
||
|
genetically, the various secondaries (the actual metastases themselves)
|
||
|
are also not even genetically identical to each other, 'cos as they clone
|
||
|
themselves up, they make errors in copying their nuclear material before
|
||
|
passing it on to the next generation of metastatic cells.
|
||
|
|
||
|
<rant: molecular evolution, the comedy of errors>
|
||
|
|
||
|
Cancer is an information systemic process.
|
||
|
|
||
|
The sort of error-correction failures intrinsic to this genetic change
|
||
|
process are fundamentally the same ones which allowed the DNA in one of my
|
||
|
kidney cells to become cancerous (uncontrollably proliferative) in the
|
||
|
first place - breakages in the genes encoding for the proofreading
|
||
|
proteins in the DNA polymerases, failure of p53 to control the
|
||
|
cell growth cycle, failures to express proteins which do the
|
||
|
usual excision-repair and other processes typically used by cells to patch
|
||
|
DNA damage, that sort of thing.
|
||
|
|
||
|
The failure of these error-correction systems result in the breakages in
|
||
|
promotors / repressors for genes, or the breakages in the genes
|
||
|
themselves, which actually make a cancer cell cancerous: p53 failure,
|
||
|
inappropriate activation of telomere repair, inability to do apoptosis,
|
||
|
inappropriate constitutive proliferation, constitutive angiogenesis, etc
|
||
|
etc. So the errors accumulate, but they sometimes act in favour of the
|
||
|
cells in which they accumulate.
|
||
|
|
||
|
You would expect this. A tumor which didn't mutate (that is, one which
|
||
|
still had functional error-correction genes) certain parts of itself on
|
||
|
the odd occasion would eventually be spotted, and either be enzymatically
|
||
|
clubbed to death, proteinaceously perforated and abandoned to spill its
|
||
|
miserable cytosol into the surroundings, or actually engulfed and digested
|
||
|
alive (what's good for the goose, you might say), by various kinds of
|
||
|
macrophages which had recognised it as somehow proteinaceously awry. If it
|
||
|
didn't mutate, future generations of itself wouldn't learn any of the cool
|
||
|
tricks which enable it to punch holes in the immune system, sequester my
|
||
|
infrastructure and oh, you know, generally take over the world, which is
|
||
|
the natural ambition of all living things on the planet. The process
|
||
|
selects for its own viciousness.
|
||
|
|
||
|
The cells which do escape surveillance, get to be the surviving metastases
|
||
|
which turn you (well, me, actually) into a failing life support system for
|
||
|
an exponentiating army of nodules great and small.
|
||
|
|
||
|
The same "make errors, mutate to survive" strategy is used by viruses -
|
||
|
they exhibit error-prone copying when they invade cells. Usually viruses
|
||
|
carry a gene encoding their own error-prone polymerase, since the
|
||
|
DNA-copying polymerases in the invaded cell exhibit relatively high
|
||
|
fidelity, which is not in line with the virus' survival strategy of
|
||
|
producing thousands of slightly descrepant copies of itself - some of
|
||
|
which are real winners.
|
||
|
|
||
|
The error-proneness frequently cripples many of the next generation of
|
||
|
viruses (and tumor cells, for that matter - they are pushed over their
|
||
|
error-catastrophe threshold and die one of the many specific kinds of
|
||
|
biochemical process failure related deaths available to complex things
|
||
|
such as cells), but occasionally it generates a prodigy - one that can
|
||
|
reproduce faster, or hide from immunosurveillance, or which is resistant
|
||
|
to various drugs. When the prodigy spawns its own daughter cells, most of
|
||
|
them inherit whatever serendipitous molecular magic stumbled upon by its
|
||
|
forebear. Natural selection is the mother of invention.
|
||
|
|
||
|
Thousands of tumor cells, flawed by a misplaced nucleotide in a critical
|
||
|
spot, screw up and die, but that's the price evolution is prepared to pay
|
||
|
for the development of new cells which discover, by fortuitous accident,
|
||
|
how to survive in the changing immunological environment.
|
||
|
|
||
|
</rant>
|
||
|
|
||
|
|
||
|
As a result of this error-proneness, even generating a vaccine from any of
|
||
|
the lymphatic secondary stuff we chopped out wouldn't help terribly much,
|
||
|
inasmuch as it would represent only one of several possible targets
|
||
|
against which immunosystemic activity could be directed.
|
||
|
|
||
|
The bit I looked at several times before it really sunk in, and which I
|
||
|
would not believe except I know that tens of thousands of people had to
|
||
|
acquire, and die from, what I have now before the mid-1990's researchers
|
||
|
could get enough statistical confidence to publish this statistic, is
|
||
|
this:
|
||
|
|
||
|
|
||
|
About 80 percent of people with regional lymph node metastases (Stage
|
||
|
III RCC, what I have) are dead within five years of their nephrectomies.
|
||
|
|
||
|
|
||
|
There's a four to one chance I will be amongst the culled by 2008. I do
|
||
|
not know in which group I am. I will probably know with greater, but not
|
||
|
complete, certainty in a couple of years. Or maybe a couple of months.
|
||
|
|
||
|
I'm not a gambling man, since I've always construed gambling as a tax on
|
||
|
people who didn't understand statistics - the way to win was not to place
|
||
|
a wager. But if I had to put money on my chances of long-term future
|
||
|
survival, I'd be betting against it.
|
||
|
|
||
|
|
||
|
|
||
|
---
|
||
|
|
||
|
I popped over to Merro's place in Chippo. She's just had a lump
|
||
|
chopped out of her breast. I'm glad she found it early enough to remove it
|
||
|
before it spread into the rest of her. Lou fed me some yummie pasta, and I
|
||
|
nosebled into it, which is pretty rude. Poor Merro.... but at least she
|
||
|
paid attention to her family history. It's probably saved her life.
|
||
|
|
||
|
|
||
|
---------
|
||
|
|
||
|
Cool things about dying young: avoid all the stupid diseases of
|
||
|
old age... teeth falling out, arthritis, erectile failure, senility, and
|
||
|
the worst one of all, the crushing solitude of being alone when all your
|
||
|
friends are all dead of old age. And what a tax dodge!
|
||
|
|
||
|
|
||
|
|
||
|
The shittiness of the prognosis varies, depending where you look, and a
|
||
|
lot of the same numbers keep showing up everywhere, partly I suspect 'cos
|
||
|
these guys read each other's papers. Want a terrifyingly recent paper? Go
|
||
|
look at Campbell, Flanigan, Clark; Current Treatment Options in Oncology,
|
||
|
2003, 4:363-372
|
||
|
|
||
|
Median survival time, 6-12 months, 2 year survival rate 10-20%.
|
||
|
|
||
|
Oh, shit, I'm gonna die. 5 years I could cop. 2 really sucks 'cos half of
|
||
|
it will be spent getting weaker and feeling shite.
|
||
|
|
||
|
I chucked in that reference above since, sometimes, I have told people the
|
||
|
odds and they ask me, as if to dispute their belief in my ability to tell
|
||
|
the truth, where did I get that statistic? I could mention the others, but
|
||
|
you can find them as easily as I did. Go look for yourself. Would I lie to
|
||
|
you?
|
||
|
|
||
|
I notice there's not a whole lot I have discovered as concerns what the
|
||
|
survivors did differently to them who died. I guess it's hard to intervew
|
||
|
the dead for comparison purposes.
|
||
|
|
||
|
Two things slightly in my favour: this probability is based on 1) a
|
||
|
population of Americans, who eat poisonous crap in their foods (but I'm an
|
||
|
Aussie, so to a large extent, so do I) and 2) most of the people in these
|
||
|
studies are twice my age.
|
||
|
|
||
|
|
||
|
|
||
|
I've read enough for the time being. Time to think.
|
||
|
|
||
|
----
|
||
|
|
||
|
|
||
|
"Sell out, sell out wherever you are, sell out and be like me,
|
||
|
with a quarter-acre suburban lot and a nice colour teevee.
|
||
|
I threw away my skateboard, and got a Commodore, my jingo!
|
||
|
I'm sittin' in it, right about now, with exhaust pipe in th'window."
|
||
|
|
||
|
-This Is Serious Mum - De Rigeurmortis
|
||
|
|
||
|
|
||
|
Um, no. Unleadded smells disgusting.
|
||
|
|
||
|
On Saturday I was typing in some responses to emails and I nosebled
|
||
|
unexpectedly, but it didn't show on my black shirt and camo pants. What
|
||
|
the hell's annoying my schnozz like this? I motorcycled to Newtown with a
|
||
|
fellow admirer of flab-o-genic foods and ate, amongst other things,
|
||
|
chocolate impregnated lard masquerading as cake in a quantity probably
|
||
|
sufficient to kill a starving elephant. Oooh it was good. I'm glad to be
|
||
|
motorcyclin' again, even though the lumps and bumps in the road provoke
|
||
|
stabbing pain in my internals. So I'm riding the machine in a manner more
|
||
|
like that of a horseman, standing slightly in the seat, taking load on the
|
||
|
footpegs instead of my arse, since the suspension is still configured for
|
||
|
my previous incarnation - a rider with tougher internals. I wanted to get
|
||
|
out on Friday but it was pissing cold rain all day, and saturday was a
|
||
|
blazing sunny day, so I whizzed out to visit the old granny matriarch who
|
||
|
used to send me shortbread biscuits when I was imprisoned in boarding
|
||
|
school back in the 1980's.
|
||
|
|
||
|
I go out and see her every so often when I'm near Randwick, 'cos it
|
||
|
probably sucks to be 91 and blind and arthritic and sciatic and more or
|
||
|
less abandoned by one's family. She's outlasted two world wars, a husband,
|
||
|
and bowel cancer. She loves it when I come over 'cos getting old and dying
|
||
|
in a building full of the unmistakable smell of disintegrating old people
|
||
|
weeping volatile nitrogenous compounds into their surrounds as their
|
||
|
metabolisms gradually collapse is a lonely excuse for a life. I am glad
|
||
|
not to be among them.
|
||
|
|
||
|
There is a certain cred she apparently derives amongst her aging inmates
|
||
|
for being visited by a scruffy leather jacketted motorcyclist, but more
|
||
|
importantly I bring news from the outside world, which she can trade with
|
||
|
the few people who see her. Word gets back to me, via the family 'fone
|
||
|
grapevine, that she loves my visits. Juicy goss is the currency of the
|
||
|
imprisoned. Imprisoned she is, and goss don't get much juicier than this.
|
||
|
|
||
|
I rode out there to tell her in person 'cos yesterday mum was doing her
|
||
|
suffering martyr routine. Mary rang her up enquiring as to my absence, and
|
||
|
mum didn't break the news. Good - I told her not to, in advance, last
|
||
|
week. Mum was now expressing to me that she would _just have to_ Break The
|
||
|
Bad News to ol' Mary about it and went through several permutations of
|
||
|
specious reasoning about this to me, all of which I flatly rejected, and
|
||
|
about which I eventually got cranky. She can only possibly be doing this
|
||
|
for the gratification of being the bearer of someone else's bad news. It
|
||
|
shits me that she asks me to show my angry red belly scar to various
|
||
|
friends of hers whom I have never really met. She got pretty cranky when I
|
||
|
told her the only reason I could think of that she was pulling this
|
||
|
`dutiful bearer of sorrowful news' routine (when she refused to tell me
|
||
|
when I asked her) was that she was gettin' mileage outta my illness. She
|
||
|
usually gets this cranky when I'm right, and I know it, and there's no way
|
||
|
she can wriggle out of it. When this happens, she lies to dad about it,
|
||
|
who generally chews me out later. Which he attempted to do, and failed, on
|
||
|
the grounds that it happens I'm right. She *is*. The question is why.
|
||
|
|
||
|
Maybe mum's doing this because she herself is in need of some support now
|
||
|
that it's finally sinking into her head that I am a condemned individual,
|
||
|
and have damned good reasons to not be walking around cheerfully. But she
|
||
|
won't tell me that. WHY wouldn't she just be straight up about it with
|
||
|
me? I'm being straight up with her about what I'm in for. Maybe she just
|
||
|
can't accept what's happening, even if she does understand it.
|
||
|
|
||
|
Mary took it pretty well, considering. Maybe it's because she's one of the
|
||
|
few people I will probably outlast.
|
||
|
|
||
|
|
||
|
Dec 14th, 2k3
|
||
|
------
|
||
|
Dad is a master of understatement. He comes in on sunday morning while I'm
|
||
|
still asleep under the doona, and says "Sorry to be a nuisance, but could
|
||
|
you swap the cars over? Mum's gonna take me to hospital, I've been
|
||
|
shitting blood since midnight."
|
||
|
|
||
|
For fuck's sake. This is precisely why I got a license to drive cars three
|
||
|
weeks ago but I'm useless anyway. I swapped 'em with some difficulty,
|
||
|
cranking my head around to reverse out the curvy driveway is another
|
||
|
recipe for laparotomy pain. Collect the set.
|
||
|
|
||
|
Normally I don't reveal the state of my old man's guts to the public,
|
||
|
since they're really not mine to talk about. But it sort of ties into the
|
||
|
generally shitful state of affairs around here.
|
||
|
|
||
|
Dad had a colonoscopy last week. A polyp (pre-cancerous lump o' bowel
|
||
|
wall) was successfully chopped out but he has now started bleeding out his
|
||
|
arse. It really sank in properly when I went for a leak (normally I piss
|
||
|
on the lawn, there's a drought on, and water restrictions have been
|
||
|
imposed) and saw a spray of his circulation coagulated to the gleaming
|
||
|
enamel of the toilet bowl. I brushed it off, and watched its reddish
|
||
|
tendrils sluice into the diluted pink pool below it.
|
||
|
|
||
|
They slapped him under anaesthetic, fed a catheter into his femoral
|
||
|
artery, and using x-rays navigated it up his aorta and down into one of
|
||
|
his mesenteric arteries, then eventually down into the spot where he'd
|
||
|
evidently blown a small vessel near the place from which the polyp was
|
||
|
excised. Once there they placed a small metal spring there to block off
|
||
|
the torn bit of arterial wall, pulled out the catheter, and closed him up.
|
||
|
|
||
|
Wow.
|
||
|
|
||
|
I checked him out in the ward later that day. He looked OK. First thing I
|
||
|
asked him was, "Are you bored shitless?" and he said "Yep." He woke up and
|
||
|
said he couldn't believe all this hospitalisation which has happened to us
|
||
|
in the last couple of weeks. He got out a couple of days later, but was
|
||
|
feeling pretty knocked about.
|
||
|
|
||
|
|
||
|
|
||
|
+++Pred's low cost retirement planning scheme+++
|
||
|
|
||
|
0) Give away porn, firearms. Why these two? Well, they're the
|
||
|
instrumentation of sex and death, defining boundaries of the human
|
||
|
experience, the great taboos, aren't they?
|
||
|
|
||
|
Firearms 'cos they're too scarce and important to bury. And, Evelyn
|
||
|
Waugh in Brideshead Revisited wrote a little vignette about teaching men
|
||
|
in the army how to top 'emselves, and rolled out a great one-liner:
|
||
|
|
||
|
"You'd be amazed how many chaps botch this apparently simple procedure."
|
||
|
|
||
|
and he's right, they're generally not reliable enough for suicide... if
|
||
|
Lorenzo Milam is to be believed, this is because the human animal is quite
|
||
|
hard to kill and when some people try to blast their processor out of
|
||
|
their skulls, they don't die, but just end up trapped in a shattered
|
||
|
carcass far more greivously fucked up than the one they were trying to
|
||
|
leave. I can't see how that would apply to such a monstrous projectile
|
||
|
instument a twelve-gauge, but fuck it, I'm gonna use ANFO anyway - seven
|
||
|
times the VOD, I'm legally permitted to use explosives, and it's
|
||
|
environmentally friendly, too ... no lead.
|
||
|
|
||
|
Porn 'cos, oh, I'd assume it'd be stressful for my oldies, ratting through
|
||
|
my stuff after I died, to posthumously discover things that imply I have a
|
||
|
sex life... probably about as shocking to them as it is to you when you
|
||
|
discover they had one, and though one is usually living proof of that
|
||
|
fact, it generally doesn't occur to one, and the bestial imagery is
|
||
|
probably a bit hard to take with one's parental faces on it.
|
||
|
|
||
|
1) Tell thesis supervisors that there's no point starting the phd next
|
||
|
year, since there is a significant chance I'll die, or off myself, in the
|
||
|
middle of it.
|
||
|
|
||
|
2) Walk into superannuation company, and ask for my (teeny amount
|
||
|
of) money. Which the govt will tax at 30% on the way out. Assholes.
|
||
|
|
||
|
3) Detonators are seriously restricted, so construct and test a few of
|
||
|
them with which to subsequently initiate the half-kilo of ANFO with which
|
||
|
I will check myself out.
|
||
|
|
||
|
|
||
|
I got a call from a Melburnian acquaintance who ran an interesting thought
|
||
|
process past me over a horrendously costly wankerphone connection - she
|
||
|
was saying to herself, it occurred to her, now that many of us are in our
|
||
|
thirties - who's gonna cop it first... we're getting into that age group
|
||
|
where we start to get heart attacks and diabetes and so forth.
|
||
|
|
||
|
Well, I dunno, obviously someone has to cop it first. I've outlasted
|
||
|
several of my high school classmates, who have died from, amongst other
|
||
|
things, accidental incineration, vehicle crashes and suicide.
|
||
|
|
||
|
I pointed out, the people who cop it first, are the ones who die of the
|
||
|
stupid childhood diseases which most of us usually survive. We only think
|
||
|
we're the ones to cop it first since being killed hasn't happened to us
|
||
|
yet, so it's the first time it happens _to us_. I exclude the deaths of
|
||
|
foetuses due to accidents and disease, and also infants before they can
|
||
|
speak, since I don't consider them people so much as mere precursors to
|
||
|
them. One values a human for the personality which, years after their
|
||
|
birth, appears within them, not for the cheaply manufactured meatware
|
||
|
chassis in which it lives or the chunk o' neural net on which it is
|
||
|
executed. "Sleep, scream, puke and crap" doesn't constitute much of a
|
||
|
personality as far as I can tell.
|
||
|
|
||
|
The ones who really cop it first from cancer are never given names, much
|
||
|
less shown to their mothers, much less even spoken about except in the
|
||
|
scientific journals. These are the teratocarcinomas, hideously
|
||
|
unconfigured, partly differentiated lumps of immortal tissue which due to
|
||
|
various developmental accidents never got its act together to become a
|
||
|
foetus, but became a tumor instead before it was even born. None of us who
|
||
|
live long enough to learn to talk can really claim our life sucks when we
|
||
|
get clued up about this sort of stuff.
|
||
|
|
||
|
|
||
|
|
||
|
|
||
|
|
||
|
Someone else, a dear acquaintance, emailed to me:
|
||
|
|
||
|
>> I don't want you to die.
|
||
|
|
||
|
And I replied:
|
||
|
|
||
|
> I don't particularly want me to die either. But look at it this way. At
|
||
|
> least now, to some extent, I have a clue how I'm probably gonna. In a few
|
||
|
> weeks, I'll have deduced my odds from the literature, and know how long I
|
||
|
> have. Most of us never get to find that out, it's a sort of luxury to
|
||
|
> know. Compare this to my expected mundane exit mode as a motorcyclist in
|
||
|
> Sydney, I'd be lucky to get two seconds of impending fatality awareness,
|
||
|
> and that'd be long enough to think, "OH SHIT I'M DEAD!" which would
|
||
|
> really shit me - two seconds is not long enough to say all the important
|
||
|
> things one thinks one has to say when one's on the way out.
|
||
|
|
||
|
At least it wouldn't shit me for very long, and would spare my immediate
|
||
|
audience some things they didn't really want to hear, like the somewhat
|
||
|
sardonic rants I've thrown at my keyboard this last few weeks.
|
||
|
|
||
|
She slipped me the address of a woman whom, it so happens, is a medico who
|
||
|
happens to be a competent biochemist with a clue about cancer and
|
||
|
nutrition.... it's her mum! But I'm chewing over wether or not to make a
|
||
|
move there. The emotional tangles are tricky. I'm gonna have to think 'em
|
||
|
over. For about a nanosecond. My miserable arse is on the line here.
|
||
|
|
||
|
|
||
|
A consequence of the way cancer sorta-exponentially progresses is that
|
||
|
most of the statistically condemned, if I assume myself to be amongst them
|
||
|
for a moment, will be dead not in the first or second of their remaining
|
||
|
five years, most will cop it in the forth or fifth year, or maybe a little
|
||
|
later (you have to dig up the 10-year survivability stats to know that,
|
||
|
but given the smaller number of remaining people in the sample, the stats
|
||
|
aren't as certain). But it depends on wether or not I have mets
|
||
|
already. If I do, they're probably not gonna be in my chest or guts, we'd
|
||
|
have spotted 'em on the MRI and CT scans. Which leaves arms, legs, neck
|
||
|
and head.
|
||
|
|
||
|
|
||
|
|
||
|
|
||
|
|
||
|
"I couldda stayed at home pal, and lived a joyless life,
|
||
|
but where the fuck's the fun in that? Superannuation, wife,
|
||
|
the whole fucking package - for me it never suited.
|
||
|
A softcock life, and limp death? Go and get fucking rooted."
|
||
|
|
||
|
TISM - "Attn Shock Records: Faulty Pressing - Do Not Manufacture"
|
||
|
|
||
|
|
||
|
I'm a bit paranoid now, about the appearance of mets. I get lots of stupid
|
||
|
little skin bumps every year anyway, and now I view them through more
|
||
|
apprehensive eyes (when I can see them). They bespeak the existance of
|
||
|
ones I cannot see and cannot find, 'cos there's a few billion places to
|
||
|
hide a couple of nanolitres of new metastatic growth in a body like yours
|
||
|
or mine, which occupies about the same volume as a couple of kegs of beer.
|
||
|
One generally finds out about 'em when they do something stupid like cut
|
||
|
off a nerve or a critical artery.
|
||
|
|
||
|
Which brings me back to chat about ... immunology. If my immune system's
|
||
|
any good for anything, it is recognising molecular patterns. What *is*
|
||
|
there, specific to the cells of my personal home-grown suicide bioweapon,
|
||
|
that I can train my lymphocytes to lock onto, to rid me of these fuckin'
|
||
|
tumor cells? What crucial thing do they have which normal cells do not?
|
||
|
|
||
|
There may not be anything for them to get a lock onto. Nevertheless, I'll
|
||
|
find it amusing to entertain the conjecture for a little while.
|
||
|
|
||
|
Tumors appear, and change, *because* of errors in their DNA copying and
|
||
|
repair processes. This happens because there's damage to the genes which
|
||
|
encode for these enzymes, or because they aren't supplied with the
|
||
|
co-factors they need to do their complicated subatomic, information
|
||
|
systemic exercises in molecular recognition, atom abstraction and electron
|
||
|
pushing (do read Tom Schneider's J. Theor. Biology 148, pp83-123 for a
|
||
|
good information theoretical description of enzymes... yes, the laws which
|
||
|
run computers are also responsible for running life). The solution to the
|
||
|
latter problem is to eat foods containing these co-factors (things like
|
||
|
transition metals... copper, zinc, that sort of thing, well, duh). The
|
||
|
solution to the former problem is trickier - tucked away in the nucleus,
|
||
|
DNA with broken genes on it is never seen by the immune system - only the
|
||
|
broken proteins for which it encodes. DNA repair, by the way, is not very
|
||
|
good... a repaired strand with broken code sequences on it is not
|
||
|
detectably broken, as is a physically broken strand. DNA repair enzymes
|
||
|
are not that intelligent.
|
||
|
|
||
|
Exploiting cell mediated immunity is probably the go.
|
||
|
|
||
|
If the tumor cells didn't cook up MHC-I or MHC-II presentation proteins
|
||
|
due to some brokenness in their system, they were probably smashed long
|
||
|
ago by CD54+ cells, which pay close attention to the presence of these
|
||
|
proteins on all cells (and which, I might add, is the reason that
|
||
|
herpesviruses fake these proteins in the cells they have invaded - so the
|
||
|
NK's don't smash 'em. Tricky bastards.).
|
||
|
|
||
|
If it's possible to get a lock on the precise sequence of fragments of
|
||
|
broken varieties of DNA polymerases, and/or DNA correcting enzymes, then
|
||
|
we're a lot closer to home. I could vaccinate myself against cells with
|
||
|
broken DNA repair / DNA replication proteins, *if* these proteins are
|
||
|
chewed up by the cytosolic proteasome complexes and fed out to the cell
|
||
|
membranes for recognition.
|
||
|
|
||
|
But enzymes are complex things. One would have to be very specific about
|
||
|
which fragments to vaccinate against, and where they are chopped
|
||
|
(decisions made at the amino acid sequence level). Nor is one allowed to
|
||
|
toss around pCpGp DNA sequences on one's vaccine with gay abandon, either,
|
||
|
since one's vaccine tends to be chopped up faster (though it also exhibits
|
||
|
greater adjuvancy).
|
||
|
|
||
|
If the tumors are expressing no broken error-correction protein fragments
|
||
|
then this approach won't work. What else would they possibly be serving up
|
||
|
for recognition?
|
||
|
|
||
|
Telomerase. Vaccinating against this might also make me immune to my own
|
||
|
gametes. Dumb idea... I don't need my 'nads to fall off just now, thanks.
|
||
|
|
||
|
A broken version of p53? Nah. Real Tumors surf around sayin' "I don'
|
||
|
have to show you any steenkin' p53" because they don't *care* about
|
||
|
controlled cell growth.
|
||
|
|
||
|
I threw this together to comprehend an immuno approach to attaking cells
|
||
|
with broken DNA copying enzymes.
|
||
|
|
||
|
Allele of
|
||
|
DNA error consequence of therapeutic targetting
|
||
|
correction
|
||
|
protein
|
||
|
|
||
|
|
||
|
No allele <--- no DNA polymerases, so tumor can't proliferate. Ha ha!
|
||
|
|
||
|
A few errors <--- lymphocytes target friendly cells as well as tumor. Bad.
|
||
|
|
||
|
Many errors <---- lymphocytes target cells with shit DNA copying fidelity,
|
||
|
that is, tumors. Good. Contradiction: need to target the
|
||
|
vaccine against conserved sequence in such a gene. As if
|
||
|
you're gonna find one in such an error-prone
|
||
|
environment - though one might find such a sequence
|
||
|
fragment it is unlikely to be common to all the mets.
|
||
|
|
||
|
Lots of errors <--- tumor cell falls off its error catastrophe cliffside,
|
||
|
doesn't need to be immunologically dealt with, ha ha,
|
||
|
eat shit and die.
|
||
|
|
||
|
|
||
|
Maybe they're getting by without error correction anywhere, poised on the
|
||
|
lip of their error catastrophe threshold.
|
||
|
|
||
|
The background to all of this is that it isn't gonna FIX EXISTING ERRORS,
|
||
|
only increase the likelyhood that cells exhibiting them are going to be
|
||
|
immunologically destroyed. Anyway, I might just be fixing a symptom here,
|
||
|
not fixing the actual cause of the disease. Besides which, the whole
|
||
|
technique is patented up to the moon... I don't have much time to do it
|
||
|
either - I'd have to drag together a PCR thermal cycler, an
|
||
|
electrophoresis rig, some bacterial cloning and mammalian expression
|
||
|
vectors, a pile of restriction enzymes, blah blah blah.
|
||
|
|
||
|
|
||
|
|
||
|
|
||
|
It dawns on me that my entire cogitating on these molecular processes and
|
||
|
therapeutic approaches is, in fact, a refusal to face the inevitable.
|
||
|
|
||
|
"You hear that sound? That is the sound of inevitability. It is the sound
|
||
|
of your death, Mr Anderson." - Agent Smith, The Matrix
|
||
|
|
||
|
|
||
|
|
||
|
When I wrote earlier that tumors select for their own viciousness, I
|
||
|
didn't mention that some of the fuckers actively hide themselves in
|
||
|
proteins like fibrin to prevent immunosurveillance (this is the
|
||
|
cytological equivalent of the Klingon Cloaking Device - if lymphocytes
|
||
|
can't "see" the tumor, they can't kill it). Some emit proteins which
|
||
|
suppress immune activity (IL-10 and TGF, etc) and they also mess with the
|
||
|
chemokine signalling pathways of the lymphocytes (mainly pumping out "Kill
|
||
|
yourself" signal proteins into their vicinity) in such a way as causes the
|
||
|
immune cells to enzymatically blow their own brains out (well, their own
|
||
|
nucleus, actually), before they have a chance to attack the tumor cells.
|
||
|
|
||
|
|
||
|
Not only that, cancer literally eats you alive. It *hollows you out* at
|
||
|
the molecular level. Tumors like to run their energy metabolism on glucose
|
||
|
(not ketones, not fats). They usually do this anaerobically, too, so they
|
||
|
piss lactate into their surroundings, the processing of which is a further
|
||
|
waste of my energy reserves (the Cori cycle is energetically wasteful).
|
||
|
But the really evil thing is, they dump signalling proteins into their
|
||
|
immediate circulation, which then spread throughout my body, telling my
|
||
|
every cell to turn on gluconeogenesis, which is the biochemical synthesis
|
||
|
of new glucose from existing proteins in my body. Cancer _tells_ the rest
|
||
|
of my body to turn itself into food to supply the tumor. It remotely
|
||
|
reprograms the behaviour of the very meat of which I am fabricated,
|
||
|
telling that meat to deconfigure itself into nutrients for additional
|
||
|
tumor growth.
|
||
|
|
||
|
Bastard.
|
||
|
|
||
|
|
||
|
Millions of people die every day of preventable diseases, ones easily
|
||
|
knocked over by nutrition, clean water, drugs which work really well. But
|
||
|
this ain't one of those. If there was ever an enemy worthy of its
|
||
|
victories, this would have to be it. Cancer is a probe into the
|
||
|
configuration space of possible diseases. One is compelled to fight a war
|
||
|
of attrition against a hoarde of different armies, all armed and armoured
|
||
|
differently, all of them carrying around the same molecular software
|
||
|
library wherein is encoded every trick my body might use to fight it off.
|
||
|
It is a hundred different versions of the same disease, which is why the
|
||
|
silver fuckin' bullet - falsely advertised every so often in newsprint -
|
||
|
does not exist, why terminal cancer patients undergoing surgery are often
|
||
|
carved open and the surgeons take one look inside, and immediately sew 'em
|
||
|
up again 'cos there's no point, and they starve to death, eaten alive by
|
||
|
their own reprogrammed flesh.
|
||
|
|
||
|
What good a sword against the fog?
|
||
|
|
||
|
My reading list is getting huge, I'm wearing out my retina in the process
|
||
|
of uploading the contents of chunky immunology texts into my brain, they'd
|
||
|
bore the shit out of you, unless your life depended on 'em. It helps that
|
||
|
I know the biochem lingo in advance. But this reading is eating into my
|
||
|
email and conversation time. I guess most diseases exhibit that propensity
|
||
|
where they forcibly focus your entire attention on them.
|
||
|
|
||
|
As happens, right now, ow, there's a strange, faintly painful lump at the
|
||
|
bottom of my neck, nestled just above the medial aspect of my left
|
||
|
clavicle. If I jam a thumb in the hollow behind my left
|
||
|
sternocleidomastoid and use my index and middle fingers above the
|
||
|
collarbone I can gauge its dimensions. It is approximately golf-ball sized
|
||
|
and has no business being there. Natch, it's just above where we CT and
|
||
|
NMR scanned last month. Sly bastard. I'd invite mum to feel it but given
|
||
|
the state of her sharp, manicured nails I don't know if I'd die of first -
|
||
|
blood loss or bacterial infection.
|
||
|
|
||
|
If this is a met, I'm gonna have to move fast to biopsy it, or chop it
|
||
|
out, or um, get the fuckin' ANFO before it does something stupid like, oh,
|
||
|
invades my carotid artery and strokes the left side of my brain out. It's
|
||
|
the festive season and all the cancer choppers have gone home. There may
|
||
|
be less time than I had reckoned.
|
||
|
|
||
|
I look around at the stack 'o biochem and immuno' texts around me. It
|
||
|
occurs to me that I am not gonna live long enough to read my way out of
|
||
|
this.
|
||
|
|
||
|
There sure as hell isn't anything symmetrically matching me on the other
|
||
|
side of my neck. So I'm stage IV after all - which sucks a lot. I have
|
||
|
less time than I thought. Shit.
|
||
|
|
||
|
"It's only a lump - you've gotta love that,
|
||
|
when the tests are done, the results are back.
|
||
|
Unleadded's got cheaper. A seat on the wing.
|
||
|
When at last you're sure - she keeps looking."
|
||
|
|
||
|
-TISM `You've gotta love that.'
|
||
|
"Attn Shock Records: Faulty Pressing - Do Not Manufacture"
|
||
|
|
||
|
--------
|
||
|
|
||
|
Starship Predator, Captain's Blog:
|
||
|
18122003
|
||
|
3 weeks postop.
|
||
|
|
||
|
I haven't been keeping a log very well so the following will be just a few
|
||
|
anecdotes. I'm obviously not Alexander fucking Solenhytzin.
|
||
|
|
||
|
----
|
||
|
|
||
|
I went around to Fee and Jase's cafe (Glow, on the arse end of King St,
|
||
|
StPeters), where I used to hang out and eat when I could afford it (their
|
||
|
food's a bit more dear than the old Three Feet was). They asked me where
|
||
|
I'd been for the last couple of weeks and I gave 'em the compressed
|
||
|
version, which come to think of it is getting pretty compressed since I'm
|
||
|
sort of mentioning a lot, and it saves time - something of which i am
|
||
|
acutely aware is running out. They're pretty hard core christians, living
|
||
|
a righteous life in fear of the big bad judgement at the end, and after I
|
||
|
clued them into my impending death and godless atheism I wondered if they
|
||
|
thought I was gonna go to hell for my sins.
|
||
|
|
||
|
Jase (brow furrowed) > So what do you do now?
|
||
|
Pred (laughing) > Hang around and die.
|
||
|
|
||
|
We had a spliff, I no longer give a millionth of a shit what it does to
|
||
|
the tennis-court's worth of delicate alveolar surface through which I have
|
||
|
been doing surfactant-mediated gas exchange for the past three decades.
|
||
|
Cannabis makes me giggly, and when I walked out, my face hurt from
|
||
|
excessive grinning. No wonder it's illegal. Too much cheap fun.
|
||
|
|
||
|
-----
|
||
|
|
||
|
Hope is a dangerous thing. It's what keeps you alive when you really
|
||
|
should know better.
|
||
|
|
||
|
I suspect most people staring down this circumstance do their damndest to
|
||
|
convince themselves they're gonna make it out alive, but there's a
|
||
|
niggling suspicion in the back of their heads, which says they are gonna
|
||
|
die. In some ways I am taking the reverse attitude - I'm pretty sure I am
|
||
|
gonna die, but there's this corrosive, strange hope, that I might escape.
|
||
|
It's not that I cling to it, but rather that it clings to me, like that
|
||
|
fuckin' glue I had to get off my arms and neck with Preen last week. I'd
|
||
|
rather the luxury of cleanly resigning myself to this business of death
|
||
|
than wandering aimlessly in the indecision which comes with misplaced
|
||
|
hope... only to have death sneak up on and spank me like primary
|
||
|
school teachers used to when I hadn't done my homework.
|
||
|
|
||
|
This is not helped at all by many of the people I talk to, when I tell 'em
|
||
|
what I have, and the dolorous odds which I have culled from the
|
||
|
literature, are almost uniformly self-delusional, or put a happy spin on
|
||
|
it, even when they have obviously no fuckin' idea what I'm up against, and
|
||
|
even after I precisely describe what I am up against. They just can't seem
|
||
|
to believe it.
|
||
|
|
||
|
This falls into one of two camps: One is, the `you'll be in the 20% that
|
||
|
survive' crew (this, of course, is a permutation on the same sentence
|
||
|
mentioned to all thousands of people who have already died of it). The
|
||
|
other is, telling me about some rello of a friend who had some bastard of
|
||
|
a cancer chopped outta them and was sent home to die, and then underwent
|
||
|
remission. I imagine they're not gonna tell me about the friends and
|
||
|
rellos who, felled as expected, are now in the ground.
|
||
|
|
||
|
Others tell me to visualise a nice place I want to be in five years, which
|
||
|
I think is meant to give me something to aim for, to motivate me to hang
|
||
|
around. However, I can't, in the light of western civilisation's
|
||
|
inevitable impending collapse from energy starvation due to the
|
||
|
energy unprofitability of the remaining hydrocarbon reserves upon which it
|
||
|
is absolutely dependant, which would have occurred within my normal
|
||
|
lifetime anyway. I kind of think I'm lucky to have a ticket out. I have
|
||
|
leaked this news to a couple of people and they can't wrap their heads
|
||
|
around the un-negotiable, inescapable thermodynamic inevitability of this
|
||
|
situation either. For reasons totally unrelated to my carcinogenation, the
|
||
|
future still sucks.
|
||
|
|
||
|
I'm starting to realise that they're telling me this "you'll survive" and
|
||
|
"be happy" stuff so as to convince themselves, in my presence, that I'm
|
||
|
not gonna die, or that they can convince me to go to the effort of trying
|
||
|
to be rid of this disease, maybe for their sake as well as mine.
|
||
|
|
||
|
|
||
|
The one exception to this is happy-face approach is Diode, with whom I
|
||
|
started the Sydney Cave Clan more than ten years ago. Cancer smote his dad
|
||
|
Milo in the mid 1990's. I went on one of Milo's final bushwalks. Diode
|
||
|
came around a couple of weeks ago with a load of books (Hacking the X-box,
|
||
|
in particular, was a great read, but there were also some great books in
|
||
|
the crate, including one about the history of taxation) and I'm glad at
|
||
|
least he knows there's no point telling me `good luck' and has the guts to
|
||
|
say so. I agree. But he's sending me these emails now which make me
|
||
|
cranky, suggestin' I should not just glue myself to the search engines, I
|
||
|
should get outside and be happy. Which goes against my geeky, somewhat
|
||
|
curmudgeonly nature. I am grateful, at least, that he's got his head
|
||
|
around what I'm in for. I guess he got the clues when his dad died.
|
||
|
|
||
|
|
||
|
The receptionist at the dentist asked me why I cancelled my future
|
||
|
appointments, and I told her that although I thought their service was
|
||
|
excellent, my teeth are, at this stage, almost certain to outlast me
|
||
|
without any additional care whatsoever. At least I'm going out with a nice
|
||
|
set o' choppers.
|
||
|
|
||
|
|
||
|
----
|
||
|
|
||
|
Explosives are a fast, reliable, but violent, messy way to go. They don't
|
||
|
leave anything pretty to look at. They're dependable. Back when was
|
||
|
getting my explosives licence, the forensic ballistics crew came and
|
||
|
showed us what explosives do to a human. I saw the photos of what happened
|
||
|
in the 1980's when the family law court judge's wife opened the front door
|
||
|
to a load of gelignite, it flung her down the corridor and through the
|
||
|
brick wall at the end, into the next room. Tore her limbs off.
|
||
|
|
||
|
She wouldn't have known what hit her, and at 3500 metres a second nor
|
||
|
would I with the relatively slower blast front intrinsic to detonating
|
||
|
ANFO, but I mean, what a fuckin' mess for the rellos to look at. Come to
|
||
|
think of it, a waste of good dentistry, too. Maybe I should seek a more
|
||
|
appearance-preservative approach for everyone else's sake.
|
||
|
|
||
|
|
||
|
|
||
|
---------------
|
||
|
|
||
|
XML invited me over for another round of watermelon consumption (this is
|
||
|
not a codeword, it just means we eat watermelon) and frantic, damaging sex
|
||
|
- she bites and it's all I can do to stop her anchoring her teeth into my
|
||
|
neck, shoulder or whatever other chunk of musculature onto which she can
|
||
|
lock her jaws. Normally I wouldn't care but I'm a bit fragile just now. We
|
||
|
shagged ourselves into near crippledom prior to my hospitalisation I was
|
||
|
faintly apprehensive. The watermelon was deeelightful. I asked her why it
|
||
|
didn't have any seeds and she said `it's sterile'. I empathised with the
|
||
|
watermelon, both from that perspective and from our shared ill fortunes to
|
||
|
be being eaten alive. My rigging was still sort of broken from a
|
||
|
neurological perspective and I was not entirely sure that the laparotomy
|
||
|
scar had enough integrity to withstand the rigors of the act. It
|
||
|
hurt from the mere touch of a tee shirt, and probably wasn't gonna be
|
||
|
entirely amused with someone else's bod pressed against it.
|
||
|
|
||
|
This turned out to be correct, so there was a certain amount of gymnastics
|
||
|
involved to push the pain:fun ratio into mutually enjoyable values. We
|
||
|
discovered some uh, very mutually enjoyable values, actually. My
|
||
|
reproductive plumbing appears to be working again (Murphy's Law would hold
|
||
|
of course, so I was cloaked in latex as usual) which is a relief, and we
|
||
|
both got off, shaking, flushed, reeking of fucking, nerves burning,
|
||
|
crushed against each other. Yeah, the scar hurt a lot but I didn't much
|
||
|
care. It felt totally weird when she ran her fingers along it - delicate
|
||
|
tingling bliss interfingered with momentary stabs of agony. Ahhh... great
|
||
|
shaggery is one of the things most worth living for, and one of the best
|
||
|
gifts one can give to another human, but it has that irritating aspect of
|
||
|
giving me more reason to live, which is what I don't want - I can go out
|
||
|
cleanly. I don't wanna feel like I'll miss anything when I go.
|
||
|
|
||
|
-----------------
|
||
|
|
||
|
The Ice Cream Factory crew, who exist under the same sheet of tin as does
|
||
|
the bulk of cat.org.au's infrastructure, threw a party on Friday night.
|
||
|
It's a weird thing to be at a party where everyone has heard on the
|
||
|
grapevine that yer dying. It sort of kills the mood.
|
||
|
|
||
|
|
||
|
"Often, private schools, what they do with the drugs, they you know, uh,
|
||
|
they bring in a criminal, right, a guy in gaol, you know, he's out of gaol
|
||
|
now, he's lookin' really bad, and uh, they put him in front of the class,
|
||
|
and you know, they talk about how they used to get onto heroin and
|
||
|
that, and then they had to break into houses which led 'em into the
|
||
|
criminal scene which meant they got into bank robbery and they were still
|
||
|
hooked on heroin, then they went to gaol. And he said they interviewed the
|
||
|
kids after, and the kids are, he said, what the kids are thinking is, this
|
||
|
guy's had a fucking great life, he's fuckin' far better than my dad, my
|
||
|
dad's a boring fuckin' prick, and look at this guy, you know, if I - if I
|
||
|
had to pick between him and my dad, I'd want his life, and look at him
|
||
|
now. They all say the same thing - look at him now, he's alive and he's
|
||
|
getting paid to go around and say how bad drug use is."
|
||
|
|
||
|
TISM - "Attn Shock Records: Faulty Pressing - Do Not Manufacture"
|
||
|
|
||
|
|
||
|
|
||
|
The kind person who manufactured those cookies I didn't get to use last
|
||
|
month, didn't warn me how kick-arse they were. And, I use the magic weed
|
||
|
on average about once every year so I'm not desensitised to it. I had one,
|
||
|
about two inches square, an eighth-inch thick, on am empty stomach. Two
|
||
|
hours later I was absolutely stoned off my brainstem, to the point
|
||
|
that anything remotely amusing made me laugh so hard I thought I'd tear my
|
||
|
stitching out, which wasn't helped my the repetitious mental playback of
|
||
|
an ancient Sesame Street song, sung by the Cookie Monster... C is for
|
||
|
Cookie, that's good enough for meeee. Nor was my sudden tendancy to laugh
|
||
|
at how funny it was to be this stoned helping me either. I had to crash in
|
||
|
a bed somewhere. An unspecifable time later, mysterious Cookie
|
||
|
Manufacturer found me sprawled there, face hurting from smiling too much,
|
||
|
almost too stoned to get my clothes off. We then proceeded to shag each
|
||
|
other's brainstems out. The pain-muting effects of the cookie might have
|
||
|
helped, but I have gotta go easier on this scar. My smile muscles ached
|
||
|
for most of the next morning. Stuff the cookie monster. P is for pussy,
|
||
|
that's good enough for me. Too.
|
||
|
|
||
|
|
||
|
This would appear to be a tale of drugs, sex, death and anarchy, but you
|
||
|
shouldn't get the idea I'm normally some sort of drug-munchin' studly root
|
||
|
rat - though I could learn to adapt to the life. I sure as shit don't feel
|
||
|
especially energetic or athletic and I look like something released from
|
||
|
the morgue for unexpectedly waking up when stabbed mid post-mortem. The
|
||
|
last woman I mentioned my impending exit to immediately told me she 1) was
|
||
|
frigid and 2) she'd love to shag me. Who am I to refuse such an offer...
|
||
|
but I can't figure it out. Are dying men supposed to try harder in the
|
||
|
sack, or appreciate it more? Or to be closer to their emotional sides? Do
|
||
|
some women like the guarantee of a short-term relationship which I imply?
|
||
|
Is there some special insight or into life, or some unusually candid
|
||
|
conversation that one expects to extract from a self-proclaimed impending
|
||
|
stiff-to-be? I thought necrophiles were at least supposed to wait until
|
||
|
their love interests got around to carking it. But, in the face of all
|
||
|
this sudden carnal generosity, I'll feel like a lying bastard if I *don't*
|
||
|
die.
|
||
|
|
||
|
---------------
|
||
|
|
||
|
I'm thinking more than infrequently about Joss, over there on the other
|
||
|
side of the planet, probably angsting about me, though I hope she isn't. I
|
||
|
had the strange thought that I should chop off my hair and mail it to her.
|
||
|
It's symbolic of me in some ways - thin, frayed, knotted, unorganised, and
|
||
|
already dead, after all. But I lack an address. And anyway it'd be risky
|
||
|
from various perspectives, both emotional ones, and, knowing my hair, from
|
||
|
a quarantine point of view. The Brits would be well within their rights
|
||
|
incinerating it as soon as it crossed the channel.
|
||
|
|
||
|
----------
|
||
|
|
||
|
Dad wandered home with some interesting scars on his bonce, since he's
|
||
|
just had some squamous cell carcinomas frozen off his ears and forehead.
|
||
|
Fuckin' cancer. Mum's the only person around here who hasn't got it and
|
||
|
she's been smoking tobacco for since the middle of the second world war.
|
||
|
I've conjectured to her that this is because there isn't a tumor on earth
|
||
|
that could survive living in the toxins which have accumulated in her
|
||
|
body. Maybe I should start on cigars.
|
||
|
|
||
|
-----------
|
||
|
|
||
|
Sunday 21 Dec 2003
|
||
|
|
||
|
Diode and I went down a drain we visited a decade ago. I've not been down
|
||
|
in the dark, earthy-smelling bowels of the sururbs for some time. It was
|
||
|
stinking hot, so drain exploration was just the thing to do - a fine day
|
||
|
under Revesby. It has grown a new section. We pestered frantic Christmas
|
||
|
shoppers in the carpark by making announcements into their vicinity in our
|
||
|
best security guard voices, from the safety of secluded gutter grilles.
|
||
|
|
||
|
"Trolley Control, attention Trolley Control we have a Code Six shopping
|
||
|
trolley violation, send backup to sector four, suspect is a white male
|
||
|
beergut, trolley is adjacent to a black Nissan Eczema, registration
|
||
|
SUX823, repeat, subject is armed with beergut, assume dangerous."
|
||
|
|
||
|
Some of our exits were blocked by locks on various grilles, or bolts
|
||
|
screwed down more tightly than our fingers could open, or because cars
|
||
|
were parked on top of them.
|
||
|
|
||
|
I found some tools in the debris at the bottom of the pipes - a beautiful
|
||
|
pair of pliers, barely corroded, and a philips-head screwdriver, etched by
|
||
|
years in the anoxic sludge, but salvagable. We ended up climbing out a
|
||
|
grille in the back yard of a house while the Maori occupants were playing
|
||
|
footy in the back yard. Their pit bull gave us more hassle than they did,
|
||
|
since they were standing around gaping at the two grotty freaks drenched
|
||
|
in old spiderwebs who appeared in their yard as if straight out of the
|
||
|
air. We climbed over their front fence to get out, 'cos they'd lost the
|
||
|
keys to the side gate. Arrr. Recreational trespass, just like the old
|
||
|
days.
|
||
|
|
||
|
|
||
|
-----------
|
||
|
|
||
|
Malibu Stacy suggested we name the tumor. We named it after Microsoft's
|
||
|
founder, Bill Gates III.
|
||
|
|
||
|
Tumorsoft - which hospital do you want to go to today?
|
||
|
|
||
|
I'm eating for two again. I'm avoiding carbohydrates. I love carbs...
|
||
|
they're in pasta, bread, just about everything I (used to) eat. So my diet
|
||
|
sort of sucks again, mostly protein - fish, chook, various fruit'n'veg -
|
||
|
but at least I can eat fats (which are effectively hydrocarbons with
|
||
|
various moieties chemically appended, so are processed in different
|
||
|
biochemical pathways to the sugars). The reason for this is I suspect
|
||
|
Bill, the secondary tumor taking over my neck is running with a broken
|
||
|
electron transport chain, as many cancers do since their mitochondria are
|
||
|
kind of broken, so can't oxidatively metabolise lipids or protein for
|
||
|
fuel. So I'm trying to drive my metabolism into ketogenesis, which means I
|
||
|
will be running on fat and proteins, exhibit hypoglycemia, feeling like
|
||
|
shit, stinking of acetone and hopefully starve the bastard to death. Yeah,
|
||
|
as if I'm gonna think about that in a few days when I fight my way up the
|
||
|
road system to my cuz's place for the family din-dins on the 25th. Put a
|
||
|
load of carbs in front of me and I'll a-guts it. Some days I just don't
|
||
|
give a fuck if what I eat helps to shorten my life. I'd rather just enjoy
|
||
|
the food, but sometimes I just feel as if by the mere act of eating at
|
||
|
all, I'm helping myself along towards the cemetary. Anyway I'm gonna try
|
||
|
and get Bill chopped out this week.
|
||
|
|
||
|
It's sunday night, I have to have a shower and wash the cobwebs outta my
|
||
|
hair and the Drain Stench off my feet. I want to get away from the
|
||
|
terminal .. um, keyboard. I might write more in a few days.
|
||
|
|
||
|
If you've made it this far, you've suffered nearly eleven thousand words.
|
||
|
Congratulations. It probably wasn't good fun to read. Some of you will be
|
||
|
offended because I employed the word fuck at least sixteen times, and
|
||
|
quoted other people using it in addition. However, I like the word, its
|
||
|
occurence here is not really that excessive and seeing it once more won't
|
||
|
kill you. I've also used words you had no idea existed, so don't accuse me
|
||
|
of leaning on it due to a depauperate vocabulary. Have a merry fuckin'
|
||
|
christmas and a happy new fuckin' year. What's that? I'm innumerate?
|
||
|
|
||
|
Fair call.
|
||
|
|
||
|
|
||
|
|
||
|
<predator>
|
||
|
|
||
|
The next file will be at conway.cat.org.au/~predator/bill_me.txt
|
||
|
|