This is among the most useful short discussions of cancer pain I have run across. Addresses the psychological as well as the physical requirements of patients. This is a doctor who has actually observed patients in pain.
One of the founders of the legendary Chess Records has died at 95. Setting out to make a quick dollar, the Chess brothers recorded some of the most important early African-American blues & rhythm & blues records in the history of the industry. Something about unintended consequences here.
Milky coffee, english muffins, gray sky after a rainy night. It is surprising how normal I’ve been feeling for the last week. Given my disease, I’m grateful that I seem to have found a plateau of ordinary life that is characterized by weakness & mobility problems (still walking with a walker) but without sharp or debilitating pain. Current medication is mostly morphine ER at a low to medium dose, with a shorter-acting opioid for “breakthrough pain,” though I find I don’t need those as often as one would think.
I’ve begun doing some medical research online regarding pain associated with cancer. For quite a while now I’ve set my anxieties aside & just tried to get on with my days, focusing especially on writing poems; but lately I’ve had the sense that I ought to intellectually prepare myself for the progression of my kidney cancer. Perhaps it is time to start sneaking up on reality, though without becoming anxious or obsessive; in fact, I’ll probably want to go back to ignoring chronic symptoms as much as possible for a while. This sort of modulation strikes me as healthy & should allow me to work on publication projects, sending poems out, etc. (A lot of that stuff is easy to shunt aside, but has a remarkably positive physical, intellectual & even spiritual set of effects when I focus on getting such things done.)
So I’ll be listening to doctors, pharmacologists & etc. talking about pain & pain medications on YouTube & following up the very materialist parts of these discussion. (I have little or no problem dealing with the linguistic, metaphorical & spiritual sides of the problem; what I need to do for a while is look more closely at the nitty-gritty.)
Still, a lovely cool morning with mostly bare maple trees out the window, Somehow wet & dusty at the same time. The body adjusting itself to the various fields of force that act on all of us all the time. And acting on me & the qualities of my time & life in the coming months.
We are taught in Zen that even change changes, but we never really believe it. Even in the midst of change we expect to be able to extract moments of stability. Even in the midst of a disease like cancer, which is always changing, I have become lulled to the idea that I will have a period during which things remain more or less the same. I guess, depending on the scale one applies, this is more or less true; but at bottom there is no standing still.
All this was brought home to me this evening by a new pain in my pelvic bones, this time on the right center rather than the left. That is, I have been confronted by the possibility that my disease is spreading away from its site of origin. Actually, it has already done this, way up into my sternum, but there has been little or no pain associated with that spread. Without the pain, that change has seemed unreal.
But this pain has the potential to make walking even more difficult than it is now, which would amount to a major degradation of my condition. Now, a bit of rest seems to have diminished the problem, but it has caused me an evening of distress. I’m going to take it easy & chart the changers tomorrow & over the weekend then make a decision about whether or not to see the oncologist sooner than my regularly scheduled check-up in two weeks.
- Menand makes the point that for the generation that came of age in the middle of the 19th century, the Civil War was the same sort of traumatic experience as WWI & Vietnam were for later generations.
- Those experiences shook up the settled conventions that James, Peirce, & the other post-transcendentalists might have been expected to adopt had the war not come along to “tear a hole” in their lives. Menand says they were not so much alternative thinkers as men of their time who confronted a crisis of history.
- Philosophy emerges from the lives these people lived; it was not adopted as an abstract system. So much is obvious & well-known, but building a philosophy from the experience of one’s life is not a simple matter. “Visions and revisions.”
- For this group of thinkers, ideas are always contextual & are to be valued not for their immutability but for their adaptability to different situations, and for their impermanence.
This second round of chemotherapy is not uncomfortable so far, the only pronounced side-effect being a pervasive sleepiness that leaves me unable to do much more than listen to audiobooks. (Have been listening to Andrea Wulf’s magisterial The Invention of Nature: Alexander von Humboldt’s New World, which I found endlessly fascinating.) I remember the sleepiness from my first round of chemo & in comparison with that round this one has been pretty easy so far; but persistent sleepiness, while pleasant enough at first, gets pretty boring after a few days. I’ll open my laptop with the idea of writing something & ten minutes later wake up staring at the screen, mouse still gripped in my right hand. I am missing that manic phase a few weeks ago where I wrote a long poem & revised many others, wrote long blog entries, etc. etc. Now all I can manage are these little squibs. I like to think my body is putting all its energy into dealing with cancer cells & doesn’t have the reserves left over for intellectual activity–or is that just fanciful? Probably. Feeling a bit more alert this afternoon, so maybe this is a phase to be passed through. I would like to get back to doing some creative work, which is the one thing, really, that makes my situation tolerable. I’m really not interested in distractions, these days. I want to be working or sleeping, basically, with the two of them balanced in some kind of homeostasis. That & talking to friends give me a sense of well-being, the feeling, perhaps an illusion, that I have some control over my situation.
And what is my situation? I’ve used the word half-a-dozen time above & it could, I realize, begin to sound like a euphemism for having cancer–an avoidance of the harder language. Actually, it’s a term of art in Jean Paul Sartre’s philosophy that means something like “the human condition applied one case at a time”–it is always particular, never general. So my situation is having cancer, but also of being able to do a large number of things not directly involved with my diagnosis & associated disability, especially my lack of easy mobility. I won’t say that every trip to the kitchen or bathroom is a struggle, but every trip involves a walker & the inability to carry objects easily from one place to another. I use the walker because there is pain in my hip, but if it were only pain I would not use the walker; the pain is a signal of weakness & lets me know I cannot trust those particular muscles to support the weight of the left side of my body. (I’m sorry if this much description seems self-pitying–perhaps it is–but I indulge the descriptive language in an attempt to set out a phenomenological understanding of just what my situation is–to be clear about it.)1
Continuing to use Sartre’s language, one must pay attention to one’s situation in order to keep from falling into “bad faith,” or merely playing a game with one’s situation. Sartre’s humorous example of bad faith is the supercilious French waiter with his stiff yet condescending manners & neatly balanced tray falling into the game of pretending to be a supercilious French Waiter. In Zen, we often talk about acting spontaneously. Acting spontaneously, one cannot fall into bad faith; but to back up one micron from spontaneous action is to plunge headlong into bad faith. My sickness has made me acutely aware of the ease with which my situation can lead to bad faith–to being The Perfect Zen student, or the Good Patient, or any kind of exemplary role. So, I can be a Zen student, or a patient, or a grumpy old man, just so long as I am owning that identity at that moment. Aside: From the patient’s perspective, it is very, very easy to see which of the medical staff is acting in good faith & which not. So obvious as to be comical.
Enough existentialist navel-gazing for one afternoon. In some of these posts it feels as if I just keep circling the same set of irresolvables without being able to dive into the center of what becomes not much more than a semantic tangle. Well, that’s what we language-heads do! [Throws up hands in mock disgust, then laughs–ironically?]