John Swinburn

My fascination with the absence of sound probably had its origin when I realized that, even in a place insulated from sound, I could hear…something. Whether it was blood coursing through the veins in my ears or constant, faint noises that mimicked distant crickets, I could was…and am…always in the presence of noise. I simply cannot experience silence. The knowledge that silence is forever out of reach frustrates me, because I so deeply desire to experience what silence is like. On the other hand, though, I want that experience to be under my control; perpetual deafness would be far more challenging, I think, than permanent noise. Even extremely faint sounds. From what I have been able to gather, sounds louder than 130-140 decibels are painful. Faint sounds of 20 decibels or less are at or near the lower limits of humans’ abilities to hear; but the level of barely audible sound produced by our breathing is said to be about 10 decibels. I seek the elusive absence of sound: zero decibels. Perhaps the sounds produced by a butterfly’s wings in flight is as close to silence as sound comes. The loudest sound ever recorded, according to Google‘s AI, was the eruption of Krakatoa in 1883, at roughly 310 decibels. But measurements above 194 decibels are considered blast waves, not actual sounds; how that level was determined to be the point of differentiation between sound waves and blast waves is beyond me. I am sure I could find out but, to use one of my favorite sayings, “the game is not worth the candle.” That is, the effort produces results that do not warrant the energy expended to obtain them. Put yet another way, my interests wane in direct correlation to the time I spend in pursuing them. Or, I am easily distracted by the nearest shiny objects.

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Inside the house, a variation of only 2°F can make the difference between comfort and discomfort. A temperature of 72°F can feel uncomfortably chilly, while 74°F can feel warm enough to be tolerable, at least. Add another degree or two and the air can make me feel like the ideal temperature is at hand. In the summertime, though, 74°F can feel uncomfortably cool; only by warming the air by 10°F can comfort be achieved. That’s just me, of course. And that’s contextual; the same temperatures and temperature variations can feel comfortable or uncomfortable, depending on physiological variables that are too complex for me to understand without conducting extensive research. And I’m not interested in doing that research today. All of this is a lengthy introduction to the fact that the present outdoor temperature is about 55°F and the forecast for the day predicts a high temperature of 75°F. I think a 20°F rise in temperature may seem like the universe is conspiring to roast me. There is no ideal temperature. Temperature is like everything else; its appeal is contextual. The context, though, is hard to measure and harder still to articulate. We have a hard time expressing certainties when there are none.

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We’re living through the twilight of American economic dominance.

~ Shia LaBeouf ~

Google‘s AI reports that the first fully synthetic plastic, Bakelite, was invented by Leo Baekeland in 1907. Baekeland’s Scottish rival, James Swinburne, made it to the patent office a day later. Had Swinburne made it to the patent office two days earlier, my surname (even though it lacks the “e”) might have been much more widely known. But, then, how well-known is the surname, Baekeland? “What if” questions are interesting but never can be answered with certainty. Roughly forty years after Bakelite was patented, the use of plastics began steady growth, with an exceptional growth spurt in the 1960s and 1970s. Today, plastics are ubiquitous and essentially eternal. I glance around my office and see plastics all around me: the barrels of pens and highlighters; the grips of scissors; my computer monitor; the body of my paper-shredder; the majority of the parts of desk chairs; the body and many other parts of my ink-jet printer; all the visible parts of my aging calculator; the cap of a protein drink; and on and on. What if plastics had never been invented? How different would the interiors of automobiles and airplanes be, compared to what they are like today? No one can provide reliable answers. Nor can anyone say with any degree of certainty how the English language might have evolved in the absence of Shakespeare’s contributions. “What if” questions cannot be answered with facts, but they provide fodder for the imagination. In other words, curiosity can generate fiction. But it also can lead to facts, like the existence of Bakelite.

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Almost every time I drive through an automatic car wash, two thoughts run through my mind: 1) are they better for the environment, or worse, than manual car washes? and 2) wouldn’t it be nice if high-pressure air driers (like in car washes), appropriately heated, were available for home showers? Not only would the home shower air driers dry one’s body (in luxurious warmth), the direction of their pressurized air could be directed to glass doors and shower walls, making the use of squeegees (to combat water spots) unnecessary. Towels might become anachronisms, too, if pressurized air were available. But would the energy required to power the air jets be wasteful? The differences between luxury and necessity are striking. Luxuries, though, have come to be expected…to the extent they often are considered necessities. In reality, necessities are rare; most of what we call necessities are, in fact, luxuries redefined. Humans in many cultures and societies have become demanding; to the point we cannot differentiate between what we need and what we simply want.

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I wonder whether the generally agreed (by psychologists and psychiatrists) definitions of anxiety and depression are legitimate? It seems to me the two states of mind represent differences in degree along the same spectrum. Yet I rarely (if ever?) read that anxiety can “mature” into depression or that depression can “soften” into anxiety. The symptoms of the two are described in ways that make them seem similar, but despite those similarities, professionals often insist the two mental conditions are unique. Professionals may have a deeper understanding than do I; they may differentiate between anxiety and depression in ways similar to how diagnostic specialists might differentiate between eczema and psoriasis. I have no business questioning medical professionals’ classification systems; unless, of course, incorrect classifications could put me at risk. At that point, I become a doctor of Googlish medicine.

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Silliness does not always wash away concerns. Laughter is not a guaranteed cure for worry. But they are better analgesics than perpetual weeping. Yet none of them can compare to dreamless sleep.

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I will spend as much time as necessary today (and tomorrow, if necessary) working on gathering and organizing materials my tax return. I would rather work on the tax return for the world’s richest man, in preparation for his lifetime sentence for tax evasion. But, alas, I must focus my efforts on my own 1040. Where is the justice, I wonder?

When I look in the mirror, I see someone I do not recognize. Pronounced wrinkles replace the once-smooth skin around my eyes. Unruly tufts of ultra-thin white wisps have taken the place of my “salt & sand” head of hair, courtesy of more than a year’s worth of chemo. My decidedly overweight body has shed much of the evidence of seventy-one years of accumulated overeating, leaving confirmation of inadequate exercise. I wonder which image represents the real me…the overly-portly, well-fed man or his shriveled remains? And I question whether the two men are, indeed, the same person or indecipherable echoes of one another. Do the same kinds of thoughts reside inside those two brains? Did those men take different roads in a yellow wood? Are the lives they led radically different from one another?

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I woke up from a different dimension this morning, a place hidden from all the other places in the universe. My role in that distant dimension was to translate nonfiction books written in every language into every other language—but without the benefit of fluency in any of them. A solution to the problem was provided by detectives responsible for a small city’s police department library. They suggested I use the multi-language flash cards carried by police officers. Those cards, which served as language prompts for alleged criminals to understand charges against them, could be used in place of full-fledged translations in connection with my translation tasks. I tested the cards by using them to transform a German text into Tagalog, in neither of which I was fluent. My task suddenly changed from translation to conversion; I was to arrange for Tagalog to become the universal language. With that adjustment, I suddenly wanted desperately to return to a dimension that was more familiar to me; I woke to the sounds of police sirens and gunfire.

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An eraser—the sort commonly found on the ends of number two pencils—was in my hand. I was not sure what I was to do with it, but decided I should erase some strings of text from an open book that sat on the desk in front of me. Just as I was about to rub a line in the book with the eraser, a teacher screamed at me in a panic: “Don’t do that! If you use that eraser, part of your life will disappear forever!” The teacher’s panicked shout startled me enough to make me yank the eraser from the page, thus saving my teen years from oblivion. Who would put such a dangerous weapon in the hands of an irresponsible child?

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I haven’t shaved in days, but only by rubbing my face or neck would that inaction become obvious. I’ve never had a heavy beard, but ever since chemo initially robbed me of my hair, my facial hair (and the hair on top of my head) has been slow to grow. And it has become white and much softer. I wonder whether my “normal” hair will ever return? How does chemo change one’s body chemistry to cause hair to fall out and, then, change color and texture as it returns? No one has ever explained the process to me; perhaps because they do not understand…perhaps they believe the process involves voodoo or magic or electro-chemical storms taking place just beneath the skin where hair follicles happily reside. “They.” Who are “they?” All people who have never explained the process to me? That would constitute all people the world over.  And those on the International Space Station. And people who were secretly involved in the first human moon landing and who have resided there ever since. Did you know about them? Of course not. They landed there in 1959, long before the publicly announced “first moon landing.” The Australian Space Agency was delighted that their competitors (the U.S., Russia, and Peru) kept the secret, of course.

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My mood this morning may seem overtly strange. That is because I am using a complex coding structure to communicate a message of truth and beauty throughout the space between the stars. But you can only see it at night.

Gentle breezes cause the wind chimes hanging from the deck’s cover to make soft, metallic tones. Strong winds and powerful gusts over the last few days accelerated and amplified those sounds, turning soothing notes into constant, jarring “clangs,” loud and assertively disruptive. Two sets of chimes, each of which makes its own unique sounds, respond with anger to disturbing blasts of fast-moving air. My brain reacts badly to the noise, placing shared blame on the weather, my ears, and the furious pieces of frenetic metal. I seek silence, knowing full-well that silence is an unachievable fantasy. Frustration with the world around me replaces the quiet appreciation that accompanies sleep. Finally, though, I surrender to the irrepressible noise; I hear the sound, but I seem no longer to be aware of it. Only when an especially fierce gust causes the chimes to scream loudly do I realize the clamor remains. I simply have gotten used to the constant disorder.

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Tomorrow, I will visit my local oncologist to discuss the possibility that I will participate in a clinical trial for a drug that has been tested, so far, on just two or three people. Normally, I would spend several hours at the cancer clinic, receiving chemotherapy. But, because commencement of the trial would require that I have gone one month without treatment, I will not get treated tomorrow. Instead, I will discuss the proposed trial and ask my oncologist questions about when—and whether—I could resume chemotherapy after the conclusion of the trial. And I will ask several other questions related to whether I should continue taking some of the ancillary prescription drugs she prescribed. So many questions…so many that cannot yet be answered. I strongly am leaning toward participating in the trial…assuming I am accepted. On the other hand, the idea of simply ending treatment has considerable appeal; but I would want to hear an educated estimate of how long I would survive without it. Yet I do not know how that estimate might influence my decision; this part of the cancer experience is new to me.

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The time is fast-approaching when I will have lived in Hot Springs Village for eleven years. It’s hard to believe I have been here so long. September, only a few months from now, will mark the tenth year since buying the Subaru Outback I drive (occasionally) today. My eleventh year anniversary of moving to the Village coincides with another anniversary…the last time I had Ethiopian food. Dallas had several excellent Ethiopian restaurants when I lived there; the entire state of Arkansas has none. Arkansas and Texas are alike in that the governors of both states are, in my opinion, right-wing lunatics. The majority of voters in both states voted for Trump in the last presidential election. I do not need, or even want, to live in a place where the vast majority of voters share my social and political and economic philosophies. But I would prefer an environment in which rational discussions, based on verifiable facts and defensible opinions, prevail over irrational screaming matches. How long has it been since political discussions were reliably civil? We allow time to slide by without capturing its most precious moments—moments of civility and kindness and caring and respect. As usual, this morning’s post is wandering in unpredictable ways in every direction, as if the writer had been TUI—thinking under the influence—or TWI—thinking while intoxicated. Neither is the case, but I can understand why a reader might think so.

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We watched Conclave last night, a fictional story that follows the selection of a new pope after the pope’s death. I was unconvinced, when I started watching the film, that I would find it interesting. It did not take long before I was convinced. The ending took me completely by surprise. Whether viewers are Catholic—or religious or not—I think most people would find the film intriguing. Assuming the processes and protocols reflect reality in the Catholic church, learning about them from the film was an absorbing experience.

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The results of the brain MRI that was performed on me while in Houston yielded nothing of substance. No cancer, no other obvious abnormalities. Fortunately, the MRI did not reveal the thoughts that pulse through my head. Even if it had, I would not document them here. Some thoughts are meant to remain hidden forever in the thinker’s mind.

It’s not whether you win or lose, it’s how you play the game.

That quote is attributed to Grantland Rice, American sportswriter. Those words place honor, integrity, virtue, honesty, and “sportsmanship” above performance. In other words, results matter less than the righteousness of the way in which results are achieved. A slurry of words attributed to Pete Rose, the baseball player and gambler, convey an entirely different perspective, asserting that the person who uttered that well-known aphorism was “full of it.” Having never had children, I cannot say how easy or difficult it must be to teach them to embrace Rice’s philosophy, rather than Rose’s. But I think parents should make every effort to instill Rice’s attitude in their children.

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I have stopped watching the evening news. It invariably is a rehash of information I’ve already seen (despite attempting to avoid it) online during the day. My next quest for peace probably will involve steering clear of social media. Social media has become a deeply disturbing repetitive hybrid of anxiety-producing “news” coupled with increasingly rare posts that hold even a hint of interest for me. Burying one’s head in the sand is not one of the recommended ways of dealing with bad news and boredom—but when nothing else works, it’s worth a try. I think my growing affinity for isolation—seclusion, solitude,  hiding—is spurred on by numerous signs that civil society is in a period of sharp decline. It can’t be just me who is trying to escape the demise of civility. Many others must find themselves growing progressively remote; using both physical and emotional distance in the hope for protection against the ravages of social decay. At the same time, though, I continue seeking more candidates to become members of my “tribe,” outcasts who desire connections with people of like minds and perspectives. I envision small communities of people who value social connections utterly unlike the ones available through Facebook and Instagram and Threads and so forth—instead, real human connections based on common interests, curiosity, respect, civility, and kindness. A form of commune, I suppose, that provides both privacy and engagement in a comfortable atmosphere of mutual support and freedom of expression. Another fantasy. I’m full of them.

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Several times last night, as I tried to sleep, I heard Phaedra yowling loudly. Finally, at around 4 this morning, it occurred to me that she might accidentally have been closed in the hall closet or the pantry before we entered the bedroom (she is not permitted in that space, for fear she might exercise her claws by ruining the bed’s cloth headboard). But when I opened the bedroom door, she was waiting—loudly and impatiently—right outside. She must have spent a significant portion of the night in the same spot, highly unusual for her. Her behavior suggested she had not been fed for days…perhaps weeks…but the remaining dry food in her dish said otherwise. While I prepared her morning meal, she weaved around my legs and rubbed her head against my feet. She looked longingly at the canned food I was readying for her, expressing the urgency of her desire to be fed. This wee-hours howling is highly unusual behavior for her. She yowls and howls freely during the day and early evening, but not while we are trying to sleep. I hope this either is a one-time event or I can sleep through future unrest.

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I thoroughly enjoyed a British miniseries we watched recently and a two-hour film we watched last night.

The four-episode series, Adolescence, is a Netflix crime drama that focuses on a 13-year-old boy who is charged with the murder of a classmate, a girl. Each episode was filmed in a continuous take, prompting one of the actors, Ashley Walters (who played a police detective), to call the project the most difficult of his career to date. Though the first episode was a bit slow to grab my attention, the style of presenting the story and the unique way in which the drama unfolded quickly overcame that minor negative. The writing was excellent, the acting outstanding, and the theme of the series contributed to a first-class viewing experience.

The film, The Six Triple-Eight (also on Netflix), deals with the experience of an all-Black battalion of the US Women’s Army Corps (WAC) who were charged with dealing with an enormous (two year)  backlog of mail that was hurting soldiers’ morale throughout the theatre of war. Facing what appeared to be impossible obstacles in a racist and sexist environment, the women of the battalion met the challenge. Through discipline, creativity, and under the leadership of Major Charity Adams, they accomplished the objective of completing the task in three months, half the unrealistic timeframe of six months that they were given. Based on real events and people, this piece of historical fiction is both inspirational and entertaining.

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I sometimes daydream about sitting on desolate rocky outcroppings where a continent meets a rough ocean. Waves crash against huge stones, slowly turning the solid landmass into grey boulders and then into pebbles. Eventually, in my mind’s eye, the pebbles will wear down, into sand. In the interim, though, I watch the slow motion transformation of the intersection between land and water. I wonder how I came to be perched at the edge of two distinct worlds; one about which I know almost nothing and the other about which I know only a little more. Occasionally, a stranger comes upon the place where I sit. We engage in casual conversation, during which we discover that desolate places appeal to both of us. And that commonality creates a bond between us—two people who, otherwise, may be utterly unlike the other. Sometimes, in this reverie, I live in a small stone cottage just up the hill from the water’s edge. And sometimes I make coffee or brew tea to share with the stranger. Sometimes, the stranger is male; more often, she is a woman. These daydreams may be spontaneous or they may be the result of deliberate thought. They never have an “ending,” though. Perhaps that is intentional. Perhaps I want or need to know that rocky outcropping will always be available to me—a place I can take refuge when my emotions tell me I need a place to take shelter.

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Periods of the past come flooding back in the form of precious memories. But alongside those treasured moments are recollections of choosing between painful options, all of which left wounds that never heal. Foresight and hindsight collide in unpredictable ways that—with enough thought—could have been accurately forecast. Too little contemplation, too late, leaves a history strewn with shrapnel of unintended consequences and its accompanying regret.

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A few years ago, I briefly fostered a dog—Bob—who was a 50 or 60 pound Mountain Cur, a short-haired breed. He was a delightful dog, but his need for a lot of exercise and his tendency to pull me when I took him for a “walk” were enough to convince me he was not the dog for me. A smaller, less muscular, more sedentary dog would be more my style, I decided. Not long after I arranged for Bob to be sent to Connecticut to a waiting family, I was introduced to another dog, A.J. He was a tiny Shih Tzu who had been adopted by a woman, who would soon become mi novia, several years earlier. A.J. was gentle, friendly, and a non-shedding long-haired dog to whom I took an immediate liking. But he was already getting old when I met him and was suffering from ailments that would soon require him to be euthanized. We went without a pet for some time, but one day mi novia saw a Facebook post about a kitten, available for adoption at the nearby recycling center—she decided the kitten would be the ideal pet and I reluctantly agreed to adopt her. Soon thereafter, the cat showed signs of being pregnant; the veterinarian dealt with that and “fixed” the young cat. Since then, the long-haired, hyper-shedding kitten has taken over most of the house and leaves massive amounts of white fur on every surface. I am told cats tend to live long lives, so we can expect Phaedra (her name) to live for many more years. The lesson in this tale is that when one has had few pets and when one’s agreement to get another is “reluctant,” it deserves plenty of time for consideration before one’s agreement is confirmed.

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When I woke this morning, I was already tired. That fact made me think about the requirement for me to make frequent 8-hour trips to Houston if I participate in a clinical trial for drugs intended to slow the progress of lung cancer. The first month of the trial would require me to make four 16-hour+ round trips. Flying would involve a bit less time per trip, but the hassle would mimic or exceed driving. I suppose I could relocate to Houston for a month, but the cost of a hotel would be astronomical. I’ll just have to get used to the idea of a lot of highway travel, if I move forward with a clinical trial. Unless, of course, there are volunteers just ACHING to serve as my transportation. 🙂

Selecting a cancer treatment option legitimately feels like a life or death decision. But the choices do not have clear consequences—only that one may extend one’s life (or not) and the other(s) have have the same potential effects. The selection requires coming to terms with the fact that every available option may be the wrong one. Or accepting that none of the options may be right. How one comes to terms with reality is unclear; perhaps it involves a simple flip of a coin and, then, reliance on chance.

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My thoughts ricochet inside my head as if they encountered no substance to slow them as they bounce off the inner surface of my skull. I cannot seem to capture any of those fleeting ideas and attitudes for long enough to fully explore them. They tumble and dance by with such speed that I can barely grasp even the subjects on which they focus, much less any substantive details. Tangled threads overlap one another to the extent that every idea is at least partially hidden, making it impossible for me to understand my own thinking. If I could sleep, I would, but the buzz of random thoughts is too loud to permit it. I have spent the majority of an hour and a half trying to calm my brain enough to allow me to write coherently. Instead, my brain is a collection of frenzied noise that blocks messages intended to guide my fingers on the keyboard.

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One of the questions posed to me by a clinical trial coordinator in Houston was: “Do you ever wish you could go to sleep and never wake up?” I said “no,” of course. But the thought has entered my mind on occasion. It’s a selfish thought, one that does not acknowledge the cruelty of the idea. Yet eternal absence of emotional and physical pain—the permanent elimination of consciousness—sometimes seems exceptionally appealing…though not sufficiently so to act accordingly. This morning, mi novia heard from a friend in California who is experiencing extreme pain caused by cancer. When that level of pain becomes part of one’s daily life, I think I could more fully understand the desire for an “endless sleep.”

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In a little while, mi novia and I will go out for a mocha frappucino and a pastry…or something equally appealing…leaving the house empty for the housekeeper. Having the housekeeper visit every two weeks makes life considerably more pleasant. Not only are the floors clean and the house dust-free when she finishes, her presence sends us out of the house for a while. Getting out for a bit is enjoyable. If the outdoor temperatures were several degrees warmer and if the winds would remain calm, I might enjoy a short walk. That time will come.

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Almost two hours have passed…still nothing consequential flowing from my fingers. There will be another time when coherent ideas will flow…just not now.

If I had no sense of humor, I would long ago have committed suicide.

~ Mahatma Gandhi ~

My exploration of possible options with M.D. Anderson (MDA) continues today; two scheduled telephone meetings with representatives of the Clinical Center for Targeted Therapy to discuss two clinical trials for which I may qualify. Monday, I expected to be in Houston at least through Tuesday, but learned—for the immediate next steps—I could continue via phone and my MDA patient portal. So, we drove back home yesterday; another grueling 8-hour drive. It is entirely possible I will need to return to Houston next week to continue the vetting process…assuming I decide to continue exploring clinical trials. If I join one of the clinical trials, the first month of my involvement will be intense, requiring me to spend from one to three days at a time at MDA. Thereafter, I would be required to go to Houston at least once a month during the course of the trial. I think. In reviewing the protocols for one of the studies, the complexity of clinical trials became exhaustingly clear to me…yet a bit difficult for me to fully grasp. MDA decisions about my suitability for the clinical trials will follow my own decision about whether I want to move forward. If I say “yes,” the trial sponsors and researchers will still need to confirm that I fully conform to all requirements of participants. I think I already wrote that another option would be to transfer my “standard” treatment (perhaps including genetic treatments) to MDA, which would require me to relocate to Houston for the duration. I have ruled out that option.

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The number of people seeking care at M.D. Anderson Cancer Center is staggering. Several thousand people every weekday receive treatment and/or counseling and/or undergo tests related to every conceivable type of cancer. The weekend numbers are smaller, of course, but significant. Sitting on a bench in one of several lobbies/gathering areas (in one of several large medical buildings), just people-watching, is an education in and of itself. People of every size, shape, and color pass through; some drift by slowly, some scurry, some look lost or confused, and some seem to know precisely where they are headed. The staff members are easy to identify; scrubs or white jackets. Most, though, are not staff. Most are patients and their family or friends, looking for help in slowing or stopping the progression of debilitating or deadly cancers. Many have gone to MDA as a last resort, after having been treated unsuccessfully or unsatisfactorily elsewhere. Some of them were stunned, almost paralyzed, when they were diagnosed with cancer. Others were disappointed with, but not overwhelmed by, the diagnosis. Without knowing anything specifically about any of the people passing by, it is safe to assume that the range of emotions behind their faces is extensive…from terror to acceptance to exhausted resignation.

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The sky this morning is beige, the result of unrelenting winds drawing dust into the atmosphere. There could be other causes, of course; brush fires, forest fires, chemical mists dispersed by strong breezes, smoldering landfills set alight by arsonists or children playing with matches…the list could go on for all eternity. I’m going to stick with dust and high winds. The same high winds that buffeted the car during yesterday’s long drive; those winds that attempted to overturn trucks loaded with spindly pine logs or undocumented families seeking a safer environment than they had in their home countries. I often wonder what semi rigs are hauling in the big boxes behind them. In all probability, most of their loads are legitimate commercial cargo. But some of them might be transporting massive loads of semi-automatic rifles destined for right-wing insurrectionists or stolen cartons of cigarettes on their way to smokers who believe the cost of tobacco products is too high, thanks to taxes and corporate greed. And there may be at least a few big rigs carrying packages of fentanyl and methamphetamine hidden beneath pallets of almost-ripe tomatoes.  The optimist in me sometimes hopes many of the trucks are full of missiles and heavy artillery on the way to left-leaning patriots preparing to overtake and overwhelm the right-wing insurrectionists.  Seriously, though, I would love to know what each of those semis are carrying. A sign on the back of the trailers would do the trick: “Levi’s jeans” or “piñatas” or “tweezers, paper towels, hand soap, butane lighters, marijuana gummies, canned tuna, and whole human blood.” But the wind probably would blow the signs away. Another hope dashed.

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I barely noticed the changes in terrain and vegetation as we traveled to Houston last Thursday. But snapshot memories of the drive illustrate the transformation…from hilly pine forests to coastal plains littered with scrub brush and oak trees. And redbud trees, already well into their beautiful shows. Light green lace on the tops of big trees along the route proved that Spring is about to announce the termination of Winter. News reports already confirm the ravages of powerful Spring storms. Weather forecasts predict more to come. When Nature expresses anger building into rage, all we can do is take shelter; hide from the fury.

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Only time can protect us from the future…for a little while. Nothing but amnesia can protect us from the past.

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Time to wander into the week…find out more about the M.D. Anderson plan. In reviewing the volumes of data they have amassed about my medical history, I learned that I am no longer as short as I was…I am shorter! A full 1¼ inches shorter than at the peak of my youth. There was a time I would have been quite self-conscious about my shrinkage, but reality no longer hits me so hard—especially reality over which I have no control. Based on my reading of the doctor’s notes from our Friday meeting, the limited remaining treatment options might involve gene mutations…somehow. Apparently, I have one such gene mutation that could make me a candidate for gene therapy. I am sure I will learn more as time slips by.

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Fortunately, the costs of the trip down here are within my means, even the cost of replacing my windshield. Just as we reached the outter fringes of Houston, a pebble/ rock hit the windshield, creating a small crack. Simply another annoyance to add to the pile of irritating circumstances that I sometimes allow to get under my skin.

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I could write about switching hotel rooms because of the toilet being so low that anyone taller than 4’3″ would be unable to safely use it. Or I could complain that this lovely hotel’s temperature is kept at 55 degrees Farenheit. Or I could describe the attire of most of the hotel’s guests (cowboy hats and boots…thanks to the fact that the Houston Livestock Show & Rodeo is in full swing. I wish I could write about visiting my niece and her husband, who live in Houston, but I have felt so weak and lethargic that I decided to spend my free time sleeping, to the extent possible. Next trip, I hope.

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Time to shower and get dressed for the day. It’s going to be a long one, with a brain MRI beginning at 6:15 late this afternoon. I’m ready to go home.

The view from the 15th floor of the Houston Hilton, looking west, is deceiving. If I didn’t know otherwise, I would assume the string of tall buildings springing up from the distant horizon and growing more dense in the view to the right is “downtown.” And I would assume the vast stretch of trees and occasional rooftops between me and those high-rise buildings are in the suburbs. But I know better. The tall buildings follow alongside or near freeways that encircle or pierce into downtown. The “suburbs” are a mix of high-priced residential and commercial areas. Just below me and to the right are mansion-sized homes with pools. Out of my view, to the left and right and behind me, is downtown, the Texas Medical Center, big sports facilities, Rice University, and an astonishing blend of obscene wealth and abject poverty. Just another big American city.

I lived in and around Houston for roughly eight years…from about 1977 to 1985. The traffic was almost unbearable then. Driving into the city on Thursday, we saw a traffic back-up several miles long, caused by a single wreck. The prospect of dealing with such matters on a daily basis would drive me into an inescapable depression. Had city planners and funders acted in full support of good, comprehensive mass transportation…100 years ago and continuing to the present…the stresses of Houston traffic could have been reduced to a fraction of what it is today.

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Sleep is my refuge from a sharp-clawed world.

I met with several oncology staff specialists yesterday, but missed an x-ray I was not told was scheduled. Nothing on the books until Monday…a meeting with a researcher to determine whether I qualify for one or more clinical trials and a brain MRI to determine whether some noticeable stumbles the doctor saw in my gait might be caused by migration of cancer to my brain. The MRI is scheduled late (6:45 p.m.), suggesting they will want me here on Tuesday. Ach! I guess I will have the x-ray on Monday.

If I were to have M.D. Anderson take full charge of my treatment, I would have to relocate to Houston during the course of treatment. That’s not an option I would consider, so it’s either a trial or nothing, at this point. The doctor concurred with my Hot Springs oncologist that the latest PET-scan showed the cancer worsening. No one can tell me what that means, in terms of time. Most of what I’ve read suggests “improvements” in survival rates/times with new treatments tend to be modest. But I don’t know what that means…survival improvements from what base?

I have mixed feelings about whether spending time seeking unknown extensions or spending that time enjoying whatever time is left. Both are unknowns…weeks, months, years. I thought this process would give me a spurt of optimism. It seems to be doing just the opposite.

Time will tell.

We are sitting in the main building of M.D. Anderson Cancer Center, passing time until my requested arrival time of 11:30. The Texas Medical Center is enormous…many, many buildings representing medical specialties from the most common to the rarest of the rare. To say the monstrous campus, comprising a huge chunk of downtown Houston, is impressive would be an understatement. On one hand, the enormity of the healthcare facilities is spellbinding. On the other, I feel like a tiny bubble in a vast ocean…with so many bubbles, the energy that can be devoted exclusively to me must be miniscule. I realize, of course, that is an unrealistic perspective. But it is how I see the world among this sea of people looking for options.  I will find out soon, within a few days, what they recommend for me. If not for her incredible support and generosity with mi nova’s time, this undertaking would be considerably more taxing. I am a lucky man, indeed.

The blank page stares at me again this morning, like yesterday, but I have no mocking, sarcastic comments at the ready to make light of the situation. Instead, I gaze helplessly at the screen, hoping the gears of my mind will begin to turn. A thousand ideas fly past, either too fast for me to snatch them out of the fog or incomplete, as if they died before reaching maturity. None of them can compete with the solemnity of reality. The gravity of life on Earth is far more burdensome than any one of—or all—those fleeting or unfinished ideas. Yet, still I watch the computer monitor for signs that my fingers have erupted into a flurry of activity, spilling thoughts worth considering as I emerge from countless dreams that belong to someone else. But…nothing appears. My hands—motionless, except when I am not glancing at them—look like they were carved in marble by a remarkably talented sculptor. Their wrinkles and veins and sagging skin seem almost real, but they do not betray any signs of life because…they were carved from stone that was created a million years ago. Hands frozen in time; in a perpetual state of inertia. It only makes sense, then, that the gears of my mind were created at the same time and devoid of movement. Therefore, hope for intellectual action is misplaced. Time spent wishing for stone to come to life is time wasted.

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I should have spent the last little while packing, instead of ruminating about matters over which I have limited control. Packing for a short trip, though, does not take long. Clothes take the least time. Pills and snacks (mandarins and celery and hummus and grape tomatoes and such) require more thought about placement to ensure easy access.  Immediate access to facial tissues, AKA Kleenex, is especially important this morning, thanks to the recent return of nosebleeds and an overly-productive pair of nostrils. It just occurred to me that underwear, socks, travel communications devices and rechargers, toiletries, medicines, travel snacks, and other such necessities should be stored in lightweight containers suitable for “grab-and-go” packing. Even refrigerated snacks should be placed in travel packs in the refrigerator, so no additional packing would be required. Getting ready for travel would take a fraction of the time required in the absence of such gear. I suspect I could create such purpose-designed travel gear and sell it in airports and drugstores and online. The amount of money such products could bring in is mind-boggling. That cash could be our ticket out of here. Imagine, a private island in the South Pacific…swaying palms, fabulous climate, great food, and enough military-grade protective weaponry to dissuade the most aggressive super-power from even attempting an incursion onto its shores.

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I will be carrying a very important pocket hug with me on this trip. Depending on a variety of factors, I may or may not blog for the next several days. If not, I’ll label my time away as a mental sabbatical.

Searching for something to think can be an exercise in extreme frustration. No matter where one looks—even in hidden creases and beyond promising bends in the psyche—only emptiness can be found. Emptiness saturates the past, present, and future, as if everything worth thinking has been stolen or burned into ashes or purified into nothingness. Even the edges of the container in which emptiness is found present themselves as perpetual distance, unreachable except by thought—which has disappeared into a moment of time which cannot be experienced, except in shattered fragments. Broken pieces of thought, unrecognizable and impossible to understand, may not have any real form; they simply may be expressions of empty nothingness caught briefly in an imaginary wave of artificial energy. Time, a sheet of non-matter with no form and no substance, trickles by…a new disruptive layer that pretends to be related to experience. But in the absence of something to fill the emptiness or add substance to the nothingness, time has nothing to disrupt—so it slides by without giving any warnings as to its presence.

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The opposite of emptiness is a complex, invisible near-solid gel consisting of tiny broken bits of everything so closely bound together that the smallest atoms cannot fit in the interstitial spaces between them. Thinking through that clutter of heartbreak and hatred is akin to breathing…in an environment consisting of pure liquid mercury. No one who has not experienced that environment is capable of explaining it more clearly. Given its inherent hostility and raw anger, only the most morally corrupt creatures have the capacity to describe it…and they are perpetually busy deconstructing human social webs and familial affiliations.

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Why, I wonder, do I find myself at a loss for words…and at a loss for thoughts…on a day when the skies are blue and a sentence of silence has not been imposed on me? A Norwegian fisherman, Kolbjørn Landvik knows what I am going through. He and Calypso Kneeblood and I—all three of us in our early 70s—have been through the ferocious winters in northern Canada, where we learned we are no longer young and strong and hearty. Søren Kierkegaard wrote, and I quoted him about two years ago: “I see it all perfectly; there are two possible situations— one can either do this or that. My honest opinion and my friendly advice is this: do it or do not do it—you will regret both.” But Søren did not take into account that one of the situations might involve taking one’s own life or dying in some other way. My opinion is that regret does not follow one into death, so Kierkegaard’s advice was faulty. Unless, of course, he knows more about death that I know. That could be the case, inasmuch as he has died and I have not. We can never know…unless he was right and I might one day learn that regret does, indeed, follow one into death. That would make death a rather unpleasant, and awfully eternal, experience. Until proven otherwise, I’m going with my first hunch on this matter.

The points at which people are willing to risk imprisonment, torture, or their lives in the fight for freedom and self-determination vary. Most people whose lives have not been badly upended by the cruelty of a dictatorial regime probably have a greater tolerance for political and social discomfort than people who are targeted by authoritarian abuse. By the time the abuse hits home for them, though, their options are limited. They can challenge their own imprisonment and torture, but with little hope of success. They willingly can give up their lives for the “cause,” but without any assurances that the “cause” will triumph. I wonder what would cause me to risk my freedom and my life in an effort to derail an autocracy? How bad would my day-to-day experiences have to get to prompt me to make a full-throated attempt to restore my freedoms…or the freedoms of people whose safety matters to me? After nearly a lifetime of rejecting the idea of gun ownership as a means of personal protection, it occurs to me that the time to amass a stockpile of defensive weapons is well before they are needed. Now, watching a budding dictator as he tramples civil rights and treats freedom as a right reserved for the rich and powerful, I am in the mood for acquiring surface-to-air missiles, shoulder-launched munitions, and nuclear weapons. And, of course, shotguns and rifles and an assortment of handguns, grenades, and other devices capable of doing severe damage to unfriendly, weapon-wielding beasts who want nothing more than to hurt or kill me. Civil war is anything but civil. Perhaps the “weapons” we need are injectable chemicals that cause recipients to slide into pleasant, happy, non-dangerous mental states. States in which the desire to hurt or kill is replaced by a deep appreciation of poetry and painting and sitting by a fireside engaged in conversation over a nice glass of cabernet sauvignon.

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I have a vague recollection of being asked, in an email message, to join a few other members of my church in reading some of my poetry as part of a Sunday service. The event may well have already come and gone; I am relatively sure I read the message and set it aside, planning to return to it later. But I didn’t. And now I feel guilty for having forgotten to reply. I probably have been branded a non-responsive curmudgeon. I have gone to church only a few times in the last year or so; I try to avoid crowds while I’m undergoing chemotherapy because my oncology team tells me the chemicals dramatically reduce my ability to fight off all sorts of infections. But I doubt I’ve told many people that’s the reason. I should make it a point of filling them in—I might be viewed as less of a curmudgeon and more as a dutiful patient.

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This afternoon we plan to get together with a small group of friends for drinks and light snacks at a local restaurant. I will avoid hugs, though I truly like hugging and being hugged…again, the dutiful patient. These are friends from church…the same church I have not visited much of late. It still surprises me to hear myself say it: I belong to a church. No way! Oh, yes, way. But it’s not a church that demands I adopt beliefs I find offensive or intellectually stunting. I’d still like to call it something else…a “gathering” or a “fellowship” or a “place to make friends.” I need to nap in advance of the get together, lest I fall asleep in my chair at the restaurant table.

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Humans tend to believe we are the only creatures who think. But we are willing to concede that dogs and cats have dreams, which we begrudgingly acknowledge are evidence of thought. But we dismiss the idea that trees and bushes and fields of grass and many flowers think, as well. The problem, of course, is that we have a hard time understanding that thinking among vegetation is an entirely different process than among humans. For one thing, trees and shrubs apparently do not have a firm grasp of human language…not English, not Mandarin, not Spanish nor German nor French nor Icelandic nor any others. We cannot conceive of thought without language, despite the fact that Helen Keller stands in direct opposition to that ill-conceived bias. Not only can vegetation think, vegetation can feel…emotions, like ours, but completely different. Pine trees, for example, experience emotions in a way humans experience heavy doses of marijuana gummies. Birds, by the way, can communicate with trees and bushes and grasses either using bird language or vegetation language. Which should tell you…yes…trees and their ilk can hear and understand (and even “speak”) bird-talk. Though they call it “chirpster.”

Not long ago, as I neared a small but tangled highway intersection on the edge of Hot Springs, Arkansas, I was struck by the similarities between humans and ants. Not their physical appearance, of course, but the deliberate nature of their frenetic behavior. Like ants engaged in the collection of food or some other keenly focused tasks, people on the move appear driven to accomplish…something. Watching lines of cars swoop around big curves leading from one roadway to another, I wondered whether the drivers actually think about their objectives or, instead, simply respond to environmental cues—like zombies. People seem to be mindlessly performing tasks to which they are assigned: drive from point A to point B; exit the vehicle in a grocery store parking lot; purchase celery and a slab of salt pork; hand a five dollar bill to a derelict who is returning shopping carts to the front of the store. Maybe, though, these vacant behaviors are not mindless. Perhaps they are meticulously programmed in the same way some ants are directed to change direction in mid-stream, bumping head first into hundreds of other ants with critical jobs to perform. What could those contrarian ants be thinking or feeling? Have they received signals from supervisory ants, telling them to do an about-face? Or have they just remembered they failed to leave instructions with ant larvae about how to progress to the next stage of development? It’s the same with people, I think. We could just as well be ants. We seem to need tasks to perform, jobs to do, functions to fulfill. But, if we lack purpose, we wander around in parking lots, collecting money in return for keeping shopping carts readily accessible. Or we offer ourselves up as clerks in clothing stores, where we dutifully fold shirts and slacks that lazy, arrogant, imperious people leave scattered about. It’s a damn good thing that people and ants cannot rust. But corrosive paralysis may be just what we need to understand why we sometimes act like our minds are made of wet paper.

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I may have set a sleep record yesterday during the day and through the night. Nobel Prizes are awarded annually in the areas of physics, chemistry, physiology or medicine, literature, and peace. Disappointment washes over me like a tsunami whenever I consider the fact that there is no Nobel Sleep Prize. Why would there not be? Who made the decision to leave sleep out of the mix? Wait, maybe it’s not the Nobel Prize I’m after; perhaps it’s the Guinness World Record for Sleep that’s missing. Either way, it’s unfortunate that someone forgot to include such an astounding feat in the record books. 

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My alarm clock must awaken me no later than 9:30 this morning, just two hours from now. I have to be ready for my M.D. Anderson registration, which will take place at 10 by way of telephone and online portal. In the interim, though, despite my record-breaking sleep, I need to crawl back into a deep slumber. I assume the intensity of my need for sleep is the result of my most recent chemo or the settling in of anxiety that’s more acute than I originally thought. Oh, well. Sleep is healing, they say.

Had time not plunged forward in the wee hours of this morning, the moment I am experiencing right now would have been labeled 4:21 A.M. However, thanks to what seems to me a rather arbitrary shift, clocks added an hour. Or lost one. I cannot decide whether the adjustment amounts to a gain or a loss—or a simple change in perspective. I can decide, if I choose, to assign greater importance to various other changes in the world around me. And that’s enough of that.

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I spent quite a bit of time yesterday afternoon uploading to my M.D. Anderson patient portal copies of my health insurance cards, prescription plan cards, my Arkansas driver’s license, medical history information, etc. Those tasks were assigned to me in preparation for  tomorrow morning’s phone and portal meeting with hospital registration staff. The hospital had already gathered an extraordinary amount of data about my medical past and present; surgeries, hospitalizations, immunizations, illnesses, etc., etc. By the time I meet with the oncologist on Friday, he will have access to vast stores of information about my body’s engagement with the planet on which I live. Understanding that reality, I wonder whether he will consider me a person seeking medical help or just the physical manifestation of a data dump. Not that it matters a great deal.

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My trip to Houston will give me the opportunity to visit at least briefly with my niece and her husband. When I return from Houston, my sister will arrive to spend several days with us. Just a few months ago, my brother and his wife came up from Mexico for a visit. And my Houston niece and her mother paid us a visit not too long ago. My late wife’s sister, who lives close by, makes a habit of spending time with us almost every week. I truly enjoy spending time with my family. In an ideal world, I would be able to accommodate all of them at the same time in an attempt to replicate moments in time when all of us were able to spend time together. But the real world is intent on inserting time and distance between families and friends. The extended family as a single unit is rarely tenable these days. Mobility and the unyielding desire for independence are quick to loosen family bonds.

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Yesterday afternoon, during a brief period of hunger, I fantasized about what would have been the ideal meal at that moment. Baba ganoush, hummus, an assortment of olives, twisted feta, pieces of warm pita, dill pickles, some crunchy raw vegetables, pickled beets, and a glass of dry red wine. I have no idea whether the components of my ideal meal pair well together; only that the combination sounded delightful to me. We had/have few of the components on hand, so I had to be satisfied with celery dipped in hummus, plus a few crisp, seed-filled crackers. And I was. This morning, I wanted fruit. So I had blueberries, strawberries, sliced apples, and segments of mandarins. Though I wanted papayas and watermelon and mangoes, too, I was happy to eat food that was actually available. Would that I always will be able to modify my wants to reflect what I have.

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The computer clock tells me it is almost 6:30. My hands and feet tell me they are uncomfortably cold. My mind suggests I return to bed, pull the covers over me, and try to sleep again.

Sixty years ago today, the first 3500 combat troops arrived in Vietnam to defend the U.S. air base at Da Nang. I do not know whether any of those troops were among the 58,220 U.S. military fatal casualties of the Vietnam War. But a quick search tells me the total number of U.S. military fatalities from that war was greater than each one of the current populations of Prescott Valley, Arizona; Everett,  Massachusetts; Gallatin, Tennessee; Saratoga Springs, Utah; and Bothell, Washington. It boggles the mind; numbers greater than the entire populations of small cities. Every soldier’s death must have reverberated through families and entire communities, leaving gaping holes that could never be filled. Estimates of the number of Vietnamese soldiers and civilians killed during the war range from 970,000 to 3 million, leaving shock and grief across an even larger cross-section of people whose lives were upended by state-sponsored violence.  The collective number of physically and mentally wounded victims of the war must be unimaginably larger than the number of deaths. I wonder how the citizens of countries that were embroiled in the war were persuaded that the killings and injuries were justified? Is propaganda that effective?

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Around 6 yesterday afternoon I developed a severe case of heartburn; among the worst cases I can remember experiencing. Chewing a mouthful of Tums had no immediate palliative effect, but the discomfort slowly became more tolerable during the course of several hours in bed. The Polish dog I had for yesterday’s lunch and/or the bean burrito I ate for an early dinner may have been responsible for the pain, but I do not recall such foods causing me such discomfort in the past. This morning I continue to deal with the aftermath of heartburn; a feeling of fullness almost to the point of being bloated. I may regret drinking espresso; had I been thinking more clearly when I woke up, I would have limited my liquid intake to water. I did not sleep a full 11 hours last night and this morning, but I was able to sleep for a good bit of that time. Still, though, I am tired. I may have to try to nap again.

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At what point would “replacements” for failing human body parts be considered “too much?” Perhaps a better question would address the point beyond which replacement parts would transform a human into a human-machine hybrid or something clearly not fully human. Whether the replacements are biologically identical parts harvested from other people or are created from non-biological components may be factors to consider. Or maybe the only human part that would be off limits would be the brain—the organ considered by most people to be the driver of humans’ humanity? I think the degree to which an artificial body part replicates—exactly—the original may be a factor; the more similar to the “real thing,” the more acceptable…ethically. Artificial intelligence (AI) probably will accelerate the need to make decisions about what is acceptable and what is not…if, indeed, anything is not acceptable. Issues unrelated to the core function of a replacement part probably will come into play at some point. For example, if replacement parts were to effectively assure “human” immortality, how would humankind deal with growing numbers of living, breathing people? Available space might become the deciding factor, versus the degree to which a person remains a person after having more than fifty percent of his body replaced with artificial parts. This probably is not something that will need action within the next two years, but it may not be long thereafter before it requires serious consideration.

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Sleep has never been fully understood; and it probably will never be completely revealed for what it is. It is just as mysterious as life in the deepest parts of the deepest oceans. We still do not know all the insects that inhabit Earth. Our appreciation of non-human life forms is shaped by our tendency to compare other beings’ lives with our own, even though we have little reason to believe the comparisons are legitimate. I read a headline the other day that claims a scientist…somewhere…has successfully transformed light into a flexible solid. We have only skimmed the surface of reality. I would like to see a snapshot of what more humans will know in a thousand years. Perhaps I can. Just not yet.

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.

The results from my PET-scan were available to me on the cancer center’s portal within an hour or two of the procedure yesterday (Wednesday) morning. As usual, the findings in the report were laced with medical terminology and, therefore, not completely clear to me. But I understood the radiologist’s summary well enough to know the scan was not what I had hoped for. Among several concerning statements from the report’s “Impression” section was this one: “Development of hypermetabolic nodularity in the posterior and medial right pleural space compatible with pleural metastasis.” A quick online review of the prognosis associated with pleural metastasis suggested I might have a relatively brief, rather bleak., future.

Later in the day, when I met with the oncology nurse and the oncologist and told them what I had found, I was advised not to rely on Google for medical opinions. Yes, I was told, the results were not good, but they were not nearly as bad as they might have been. I was presented with various treatment options to consider, going forward, among them: switching out some of the chemo drugs that have been used so far to fight the cancer; additional radiology treatments; and exploring clinical trials conducted by M.D. Anderson Cancer Center in Houston that might be a fit for my situation. In addition, I learned that it is possible that my recent bout of COVID-19 might have had the effect of accentuating some of the physical manifestations of cancer…so the results could conceivably have been overstated; they will explore that possibility.

After a fairly lengthy consultation, we collectively reached some decisions: 1) my oncologist will present information about my case to M.D. Anderson, requesting consideration of my inclusion in one or more clinical trials [one of my brothers had suggested that more than a year ago]; 2) in about four weeks, I will have a CT-scan to enable the oncologist to determine the extent of changes to the disease; 3) after the next chemotherapy treatment, the drugs used will be replaced by others that may hold promise; and 4) I will consult with the oncological radiologist about further treatments. The realities of my circumstances are pretty stark, though. I have Stage 4 lung cancer, which is generally considered incurable, so the medical response to the disease tends to focus on limiting the cancer’s growth, improving the quality of life by minimizing symptoms, and extending life expectancy.

I mentioned to the oncology nurse (who I like very much and who shares our sense of humor), after I read the results of the PET-scan yesterday, I coincidentally received a piece of promotional mail from the Neptune Society, gently suggesting I consider pre-paid cremation. We got a good laugh out of that. The nurse responded that I should not to plan to go into hospice care just yet. And mi novia replied that she would just have to unpack the hospice care “go-bag” she had prepared for me. Gallows humor.

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Dealing with the idea of death through humor seems both powerful and absurd. Death is inescapable; there’s no point in denying it. And there’s no point in insisting on treating the concept of death with unshakable solemnity. But to laugh at something so utterly final—something that alters the world left behind—suggests more than a hint of madness. “We cannot conceive of our own death.” I’ve read that many times and I suppose I agree with it, yet even in facing that impossibility I still insist on trying. Thinking about death leads to all sorts of questions. How long does death last? Does one’s consciousness simply disappear at the moment of death…and, whether it does or not, what happens to it? Does the death of another person manifest physically in survivors in some way? Is death equivalent to flipping a light switch? Of course, there are many people who believe death is simply the next stage of some kind of magical or spiritual existence…how do they square two (or more) different dimensions? Far more questions than answers.

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I wonder if anyone will ever read the thousands of pages of blog posts, etc. that I have written? Much of my writing today gets an occasional view by a very small number of people, but the vast majority of what I’ve written in the past decade or two has never been seen by eyes other than mine. I certainly understand why the output of my fingers is not lapped up by eager readers. There’s too damn much of it to cope with and the number of idea “gems” buried in it is far too small to warrant the time and effort to read through the rest of it. But, still, without someone to read it, all those hours at the keyboard seems completely wasted. Except that those hours probably rescued me from my own madness.

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My weight seems to have stabilized, more or less, but yesterday’s weigh-in at the doctor’s office surprised me. I had lost a bit more weight, tipping the scales at 169 pounds. A few years ago, at the peak of my corpulence, I was 82 pounds heavier. I am pretty sure most of my recent weight loss (in the last year or so) has been the result of losing muscle. My skin and flab hangs off of me like clothes that are several sizes too big. Had I been smart and disciplined, I would have worked to at least maintain my musculature, rather than let it weaken and shrivel. “Should have…” Ach!

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For some reason, I feel incredibly weak at the moment, as if I haven’t eaten in days. But I have. I’ve eaten as if I have been trying to gain back all the weight I lost. Perhaps a cookie is what I need. And maybe an Ensure. And a nap.

Online news this morning is deeply depressing, so I will not subject myself to any more of it for a while. I made the mistake of glancing at the AP and NPR websites when I sat down; the headlines were more than enough for me. The unrelentingly monstrous news coverage of the President’s address to a joint session of Congress dashed my secret desire to learn that the Designated Survivor procedure had been implemented.

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Sustained winds of only 15-20 miles per hour were—until just moments ago—making the doors, walls, and windows of the house creak as if the howling winds roaring against them were much more powerful. For a few moments, though, the winds’ ferocity seemed to have diminished, only to be replaced by even longer and louder shrieks. I can only imagine the power of the gusts as door and window frames groan against them. Though I doubt the winds will be strong enough to do any direct damage to the house, I have no such confidence in the ability of nearby trees to withstand them. Recent storms have knocked large, time-weakened limbs and branches to the ground, cluttering the streets. The roadsides close to us have lately been littered with shattered pieces of old-growth trees, torn from their trunks. Perhaps Mother Nature is cleansing the forest in preparation for a frenzy of sprigs and shoots and assorted other greenery.

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Interference with my usual morning ritual disturbs me. No coffee, nothing to eat…only water to drink this morning. Five hours will pass before I can return to some semblance of early-day normalcy which, by then, will no longer be a match for the time of day. At least the PET-scan is scheduled for relatively early today (8:30-10:30); otherwise, I would feel the pangs of hunger and the chaos of shattered custom until late in the afternoon. By the time I visit my oncologist for the scan results, I may have been able to consume a light lunch. I am ravenously hungry. I will be hungrier as the hours pass. Not a complaint; just an observation.

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Last night, we deliberately avoided the atrocity that would take over broadcast television. Instead, we finished watching a BritBox 2-season Australian serial (Scrublands) about a journalist’s investigation into a small community’s young priest who commits a mass killing in his congregation. I was impressed with the plot, the writing, and the acting (for the most part). One of the characters looked very familiar to me; mi novia investigated why I might know him and discovered that he (Robert Taylor) played Longmire on the long-running American TV series. I had no idea he is Australian.

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The wind. Again. The sounds could be recorded and used as part of a sound-track for a film set in a lighthouse during a vicious storm. Why a lighthouse? I am not sure; it just seems right. It could be set in a decrepit old mansion on a deserted coastline.

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I awoke too early this morning. I can barely keep my eyes open. Time to set my alarm for 7:30, rest on the loveseat in the TV room, and forget about my powerful urge to eat breakfast. Later, I’ll make my way to town…hopefully bright-eyed and bushy-tailed.

A quick scan of today’s Life Kit feature on the NPR website this morning led me to another NPR story from last September.  The second piece changed my approach to this drab-looking day just enough to make me want to delve more deeply into into eight so-called skills the article claims can help boost one’s mood and manage stress. The skills, taught in an online course developed by a team led by Judith Moskovitz, a research psychologist at Northwestern’s Feinberg School of Medicine, are these:

• • positive events;
  • savoring;
  • gratitude;
  • daily mindfulness;
  • positive reappraisal;
  • self-compassion;
  • personal strengths; and
  • attainable goals.

Had I been writing the articles, I might have referred to the “skills” as “habits” or “practices,” but the names attached to them probably are not particularly important. I think developing habits that can redirect one’s thought processes is what can lead to positive changes in one’s moods and sense of optimism. And, of course, reduce anxiety and stress to more manageable and more tolerable levels. In many respects, the skills described as taught in the online course (which I have yet to find operating online) remind me of the elements of meditation practices. Perhaps my interest in this morning’s readings will prompt me to invest more real, measurable efforts toward developing the skills/habits…rather than just investing more time in mulling them over.

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A wall of windows in the oncology center’s treatment room looks out on a small private courtyard. On the other side of the private space, across from the windows, is a two-story artificial waterfall. Yesterday, while I spent 5+ hours receiving my chemical infusions, I stared at the waterfall. The water pouring over a flat stone at its top fell in a smooth, almost solid, sheet to the pool below. Rough stones on both sides of the waterfall lent an air of authenticity to the scene, but the smooth sheet of water did not look natural. It was too consistent, too precise, too predictable. Aside from its location—inside the courtyard of a building—its controlled flow over that flat stone betrayed the fact that it was counterfeit. Had the stone over which it flowed been interrupted with rocks too heavy for the water to move, the water might have been disturbed into “rapids” that would have seemed, to me, to be more realistic. But as I pondered these unimportant perspectives, it occurred to me that my sense that the design was imperfect overlooked the purpose of the feature: it was meant to be soothing and mesmerizing. The water feature was designed and created and built by people who likely understood and appreciated its purpose. People for whom easing the anxieties of cancer patients was and is important. That, I think, is an example of my own positive reappraisal.

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For the next 24-26 hours, I am to minimize my intake of (or refrain from) carbohydrates, sugar, caffeine, alcohol, and various other substances that could interfere with the validity of the results of tomorrow morning’s PET-scan. I sneaked in a banana and a cup of espresso before the fast began; if I hurry, I could have a little more before the clock strikes the hour of abstinence. Last night, as I thought about what I can eat during my hours of denial, it occurred to me that medical centers and offices could do a service for their patients (and make some money on the side, as if they need it). The service would be selling pre-packaged meal kits designed to ensure proper diets before medical procedures. Ideally, these kits would require no refrigeration and would have long shelf-lives. And they w0uld be reasonably-priced. I had a similar idea (that I thought about pursuing on my own) several years ago when I was mistakenly diagnosed as being in kidney failure and, later, with pancreatitis. I tried to interest members of one of my client associations (dietitians) at the time in joining forces with me, but did not know how to attract both the right expertise and the necessary capital to launch the idea. The scope and breadth of “do not eat” foods for people facing various diseases is stunning. I really believe such a service would take a great deal of pressure and anxiety off of people who face medical demands to radically change their diets. Fortunately for me, for now anyway, I am on only very short-term restrictions. I can last 26 hours. I’ve proven that over the past few months, when I’ve sometimes gone 4-5 days without eating more than a cracker or a bowl of soup.

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Today’s scheduled post-chemo injection is delayed until tomorrow, after my PET-scan. Apparently, having the shot today would require another wait of several days (or a week) before the scan. So, after my scan tomorrow, I will get the shot and meet with my oncologist to go over the results of the scan…assuming the results reach her by the time of my afternoon appointment with her. Crossing my fingers and toes that the results are good.

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If a full-blown dictatorship is in the offing or a global thermonuclear war is just around the corner, I hope their horrors will be quickly extinguished. Utter and complete nuclear annihilation (if it’s instantaneous), of the entire planet’s population might not be such a bad thing. But a dictatorship, which could ruin otherwise tolerable life experiences for a lot of people who don’t deserve crushing authoritarianism, is not acceptable. Whatever it takes to avoid it—socially acceptable or legal or deadly dangerous or not—must be undertaken when the signs are unmistakable.

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On a more positive note, Springtime is just a few weeks away. Soon, flowers will begin blooming, leaves will start to sprout, the air will warm (and, unfortunately, fill with pollen), and the grey days of Winter may be behind us for a few months. By the way, I believe the creators of the television series, Designated Survivor, were engaged in wishful thinking.

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I hear the voices of reason, but only in my dreams. Noise that pretends to be Silence drapes over me like a shroud. Absolute silence is just a fantasy, except in death. Even then, its echoes reverberate off walls, limitless in their thickness. Darkness, darker even than before there was Light, envelopes everything, even Time. Truth has yet to be created, so it cannot be told. But without Truth, there can be no Lies. Proof of the impossibility of Everything, laden with Doubt, signals that Nothing is strewn all around us, discarded like the rest of all the knowledge we never had.

Yesterday afternoon, after the outside temperatures had climbed into the low 50s, I went for a short walk. Walking into the brisk breeze, in the dappled shadows of leafless trees, I felt uncomfortably cool, despite wearing a down vest. When I turned around to face the sun with my back to the wind, warming comfort washed over me, instantly erasing that feeling of unpleasant coolness. The sensation was exaggerated, almost like walking into a house heated by a wood-burning fireplace and leaving brutal winter conditions behind.  Had the outdoor temperatures been much colder, the adjustment might have seemed too much. Basking in the sunlight and protecting my face from the wind was enough to give me a giddy sense of appreciation for what, in hindsight, was so minor that it makes that sense of elation seem almost absurd. But that is how startled one can feel to experience even brief flashes of unexpected, almost overwhelming, awe.

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My appetite has grown enormously—exponentially might not be too strong a word—since last week, when I began taking my doctor’s prescription for prednisone in response to my COVID-19 diagnosis. Based on the limited research I’ve done on the correlation between appetite and the drug, surging hunger seems a common side-effect of taking prednisone. Fortunately, the decreasing-dosage prednisone regimen (4/day for 3 days, then 3/day for 3 days, then 2/day for 3 days) lasts only nine days. According to several assertions made on health-related websites, I can expect my hunger to return to normal levels soon after I stop taking the pills. I am relatively sure that the pills are largely responsible, too, for a significant boost in my energy over the same period. Breaking a many-months-long routine, I have been napping only rarely and briefly over these several days, too. I wish I could count on a continuation of that increase in energy, but I doubt I can. Today I will have another chemo treatment (number 17?) which, if it is like the others, will sap my energy, my appetite, and my ability for a week or two to tolerate only 7-8 hours of sleep per day.

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Three large scars on my body offer evidence that I have escaped death at least three times. There may have been other occasions when I was spared that personal conclusion, but the scars are visible and obvious reminders. The first one, an almost fully-healed slice about six inches long, is on my lower-right abdomen, where a long piece of my intestines (and my appendix) were removed in 1990, allowing me to survive a severe effect of Crohn’s disease. The second one, from 2004, is easily recognizable as evidence of coronary artery bypass graft surgery, or CABG. A surgeon split my sternum to get access to my heart and arteries, where he bypassed two significantly clogged coronary arteries with living materials harvested from my inner chest wall. The third scar, produced in 2018, curves around the upper right side of my torso, where a thoracic surgeon gained access to my right lung, surgically excising the lower right lung lobe, which had been invaded by a malignant tumor.  I suppose the two scars—one on each side of my upper chest—where two jugular Infuse-a-Ports were installed (one in 2019 and one in 2024) might count, as evidence of potentially life-saving surgeries. They were implanted to facilitate access for infusions of chemotherapy drugs to fight lung cancer. All of this is to suggest that my body has been attempting to take its own life for quite a number of years. I believe I was 18 years old when first diagnosed with Crohn’s; 53 years since my body’s first obvious effort to kill me. Had my Selective Service System lottery number been lower, my death might have occurred long, long ago, courtesy of the United States military and/or the Viet Cong. Fortunately for me, my lottery number (which I do not remember) was too high for me to be drafted. I was in my final months of my high school senior year when the drawing for men born in 1953 was held in February 1972; I went to college, instead of Vietnam, where 58,220 of my fellow Americans died in an unnecessary war.

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How much of the “news” we read or hear or see is based on propaganda? How confident should we be that the “enemies” of the U.S. are truly as despicable as we are led to believe? And how certain are we…or should we be…that people who share our political and social philosophies truly understand and have thought critically about the “facts” and how they interpret them? If they are wrong…or lying…or terminally biased…are we just as misguided? When we wonder whether Russian citizens or Chinese citizens or Iranian citizens really and reasonably believe the U.S. is the enemy, should we not wonder whether they wonder the same about us? I have grown increasingly skeptical over the years of politicians of all stripes. Not just politicians, either; the average Joe or Jane must convince me of their honesty before I assume them to be believable. I think all the political philosophies in operation worldwide are, at present, simply expressions of manipulative power-mongering. What we need is not democracy or communism or socialism or authoritarianism or dictatorship, but a new form of governance and citizen participation composed of elements of various political foundations…with healthy doses of anarchism thrown in to keep them all in check. What that new form of governance might take is anyone’s guess; I just think we have been lucky so far that we have not been collectively obliterated by allowing any of the existing forms to become overwhelmingly powerful. But people in general, who often tend to be stupid and arrogant, tend to believe what their minds tell them; we all need to insist of ourselves that we be far more humble, while maintaining high degrees of doubt and curiosity. At least that’s how I feel this morning.

Immutable facts—certainty cast in bronze—often take on different appearances when viewed through a temporal lens. Like people, as they age, they can become encrusted with patina left by the passage of time. Though facts may remain unchanged, their importance—or their insignificance—evolves to reflect the circumstances surrounding them. Sacrosanct facts and truth are illusions created at the sometimes-chaotic intersection between understanding and interpretation; both of which reflect the influence of perspective. The angle of one’s point of view and the presence or absence of obstructions to that viewpoint determine what a person’s mind processes. There is no inarguable reality. “Nobody’s right if everybody’s wrong.”

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Bias can cause us to interpret ideas and experiences in ways that confirm our opinions and beliefs. We can, for example, decide that every word from the mouths of progressive politicians is a liberal lie or, conversely, that when far-right conservatives speak, it is only to mislead. Statements or actions made by people with whom we usually disagree may be ascribed negative motives which do not actually exist. But people “friendly” to our biases may be assumed always to have only the best intentions. Either way, bias is the enemy of understanding and an obstacle to knowledge. We tend to find it difficult to admit our biases, especially when they contrast with evidence that does not support them—we disbelieve the evidence in favor of our biased opinions. I think the root of that difficulty is that we feel deeply wounded when proven wrong. Rather than admit our strongly-held (but unsupportable) opinions are wrong, we fight to hold on to our self-respect by refusing to admit our faults. By doing so, we dig the grave for our own integrity.

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I keep coming back to an old idea of mine for a book or a short-story set in a fictional town suffering decay brought about by “progress.” Though I regularly think about it, I have been unable to force myself to do much more than that. Actually thinking through the story and the characters—and the ways in which the circumstances and the people affect one another—would take much more time than heretofore I have been willing to force myself to give. If I am to have even a remote chance of brining the story to life, and to conclusion, I have to insist on spending many uninterrupted hours writing every day. Even then, I do not know whether the product would be worth the effort. And maybe it’s just wishful thinking; maybe it’s more work than I’m willing or able to devote to something for which there is no assurance of “success.” Who knows? I’ve had so many now long-dead ideas for stories that I’ve lost count. Ach! And here I sit, procrastinating by complaining to myself about procrastinating.

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We’ve begun watching an Acorn TV (British) police detective drama series entitled “Ellis.”  The show, starring Sharon D. Clarke, has thus far been riveting. I need to admit that I’m better at consuming entertainment than creating it.

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Even though we both feel considerably better than we felt during the peak of our fairly minor battle with COVID, we’re still spending our time at home. Had it not been for the damn COVID, we would have gone to the World Tour of Wines dinner a few days ago (Thursday); it would have been nice to visit with our regular wine dinner group and to taste good wine and good food. But, to the extent possible, we’re avoiding contact with others, just in case…we do not want to get, nor to give, unwelcome illnesses. Tomorrow, though, and through Thursday, I will make the rounds with medical folks again. A long chemo session tomorrow, a post-chemo injection on Tuesday, a PET-scan on Wednesday, and (still to be confirmed) a follow-up review of the PET-scan results on Thursday.

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It’s almost 6:30 and I’ve been up for 2½ hours. I’m getting a little sleepy, though, so I might just nap a bit. I’ve already had my breakfast of a peach-flavored Ensure and a banana, but I may have room for something a little more substantial. I shall see.