Actions and Ideas

Early yesterday morning, I received a phone call from M.D. Anderson Cancer Center, following up on a referral from my oncologist. A consequence of the conversation is that I am scheduled to meet in Houston with an M.D. Anderson oncologist one week from today. That consultation, coupled with an oncology team review of my medical history, will help determine whether I qualify for participation in an oncology clinical trial. Another phone call, a little later in the day, led to an appointment for another consultation with a radiologist late this month. I did not expect such immediate action on my oncologist’s referrals, but I am pleased with the speed of follow-up and grateful to her and her staff for acting so quickly.

I do not yet know how much time I will need to spend in Houston; could be just the day or two or more days. A phone call to register for the appointment, scheduled for this coming Monday, should clarify what to expect.

The Texas Medical Center in Houston is enormous and the city’s traffic is justifiably infamous, so we have decided to get a hotel room close to the location for my appointment—I want to minimize the stress of traveling on Houston streets and freeways and getting lost in a maze of hospital buildings and corridors. Though not quite what I envisioned for a fun-filled road trip, the drive to and from Houston will have to suffice for now.

I am under no illusions about the potential results of participating in one or more clinical trials. But the uncertainty of the responses to various “standard” treatments makes the exploration of as-yet untested options more appealing than they might otherwise have been.

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Historians interpret the past through a lens both clouded by hindsight and polished by understanding. The problem is that hindsight and understanding often are too closely linked to allow the free flow of factual insights. Key to the concept: interpretation. Assertions about the meaning of acts and omissions in times past are merely opinions informed by perspectives that may or may not be comprehensive or valid. None of us can be certain about what others think…today. The uncertainty grows exponentially with the introduction of time and cultural distance. We may believe we understand the thought processes that drove an anarchist, for example, thanks to having read what he wrote. But reading involves interpretation; and writing involves selective sharing of one’s thoughts. Time inserts shifting ideas and attitudes into the mix. Information claimed to be history, then, may simply be near-fiction tainted with half-truths and unjustified beliefs. Evidence of this chaotic misunderstanding is rampant in today’s media. We cannot agree on the “meaning” of what we observe today, much less what occurred in the past. And not just the “meaning.” “Facts” are regularly subject to relentless challenges. At some point—and it may already have passed—we will be unable to believe what we see with our own eyes.

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Ethics can get in the way of understanding. For example, a well-designed study in which groups of identical twins are separated at birth and reared in completely different, carefully controlled environments, could go a long way in enhancing our knowledge of the relative influence of Nature versus Nurture. Such a study, though, would almost universally (and rightfully) be condemned as an ethical breach of the most serious order. Hundreds or thousands of other ethically unsavory experiments could provide enormously valuable insights into human behavior, but the harm they could do to study participants is judged to far outweigh their value. Yet ethics and morality in human societies are neither fixed nor universal. Societies and cultures transform over time; behaviors that are prohibited today may have been perfectly acceptable a few generations earlier…and vice versa. Like so much else, human morality and ethics are contextual; dependent on culture, timeframe, evolutionary era, and more.  At any given point in time, though, we treat morality and ethics as if they were immutable—rigid realities not subject to social transformations. Looking back just two or three generations, that obviously is not the case, but we pretend it is. I suspect we collectively feel more than a bit of shame in allowing ourselves to modify our unshakeable beliefs—certainties we feel at our cores—to change. By denying their flexibility, we protect ourselves from all but the most hidden embarrassment when we allow our minds to change.

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My sense of weakness and fatigue yesterday may have come over me in response to Monday’s chemotherapy; the timing seems about right. But it could have been a mental reaction to the results of my PET-scan. The results did not hit me particularly hard—I was half expecting them—but they were disappointing. They triggered thoughts about mortality and regret and curiosity about what the progress of lung cancer will sooner or later do to my body and how I will deal with the decline. I would rather erase those thoughts from my mind, as they are not exactly pleasant, but so far I have not been fully successful in that endeavor.  Despite trying hard to do it, I cannot seem to empty my mind of an elaborate web of wide-ranging thoughts. They are not just thoughts of cancer, death, etc.; they include vague memories of high school, fights on the playground at my elementary school, train trips with my late wife, visiting Schenectady with mi novia, finding that my first car, a Ford Pinto, had been damaged in a hit-and-run in a parking lot in Austin, and a thousand other things. Madness! I guess I am just wound up, in one sense, but tired and worn out, in another. That must be what is making my mind crank through massive volumes of past experiences (most of which I rarely ever remember).

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I woke later today than yesterday but, still, it was 3 hours ago. So, another  brief nap may be in the offing.