On Being Ill: Taking Responsibility for One’s Own Decisions

When you have cancer you wind up taking a lot of medicines & how to take them & being given advice about food, almost all of them offered on good medical authority & with the best of will. When you start out on these processes you try to follow them to the letter–which pills go with food, which without & how long before, how many times a day & all the rest. If you follow all the instructions to the letter one would do almost nothing all day but organize one’s pharmacopeia.

Having now had some experience as a consumer–in both the biological & economic senses–of cancer medications, I’ve arrived at a couple of basic conclusions, to wit: 1) Follow basic dosage instructions especially for number of times a day & spacing between doses; 2) cluster doses by time of day into groups of medications & organize them into a pill holder; 3) try to take the ones supposed to go on an empty stomach at the same time even if it means fudging the times a bit–one really should not have to be worrying about what to take & when more than four times a day. Even cancer patients have things to do other than being sick. 4) Start pain medications at the lower range of the recommended dose, but once you get used to their effects don’t be afraid to adjust them upward, though without exceeding maximums, at least by very much. You can also “stack” pain meds a bit toward higher concentrations during parts of the day you need them most.

But the take-away here is that you don’t have to be neurotic about scheduling your medications. Some goes for eating, both what & how much. I find I eat mostly snacks & eat more sweets than I “should,” but it’s my body & how I feel today is at least as important as how I might feel in a week or a month or a year. Ultimately, this all applies to whether to take some medication at all, up to & including the miracle drugs designed to dissolve tumors or whatever; it applies, too, to how aggressively you decide to oppose your own illness & how much to understand the illness as a part of the life process. (This latter goes beyond the original intention of this post & perhaps I’ll return to it another time.) Finally, all this is about deciding that–following the advice of your doctors & family members & friends–you must decide makes you feel best right now.

It is easy, of course, to use the above as an excuse for being perverse, neurotic & self-destructive. That obviously is also a choice, but not one I would encourage anyone to follow, no matter how shitty & hopeless some mornings feel when the rest of the world is getting up & going about its usual business. Take care of yourself; don’t be intimidated by authority; don’t be passive.

Note: It’s a mark of how spaced out some of the new meds I’ve been taking this month that spelling errors & typos persist on the blog longer than they should. Sometimes no doubt forever.


Pain & the Absence of Pain, Or: “There is a Crack in Everything . . .”

After cracking (an apparently not vital for locomotion) part of my pelvis late last week & living though a weekend of increasing pain, I’ve been astonished at how quickly the pain has resolved & my psychological orientation turned around. My bones have been weakened near the site of the tumor around my lower spine because of radiation & chemotherapy, so putting a little extra strain on it by bending to pick something up apparently caused a crack. It began like a bad muscle ache on Friday & got worse until Tuesday when I got in to see my oncologist. (Could have gone to the Emergency Room but wouldn’t have been numbed & told to see my oncologist. Figured I’d just wait.) And I have to say that once I arrived my team swung into action with X-Rays, an IV for morphine, steroids . . . so that by the time I left I was already beginning to feel better. And at this point, about a week after the incident, I feel better that I had before I injured myself. The added attention to the pelvic pain has spilled over & is alleviating some of the more general pain associated with the cancer. It’s not as if I’m dancing–I still walk with a walker–but I feel almost well.

Which is a little unsettling. When I feel this well, it can be hard to recognize that I am still sick with kidney cancer. Most of this is no doubt a bounce-back effect from last week’s misery. When severe pain is reduced the body goes into a kind of celebration & pulls the mind along with it. I’m not complaining. I’ll take it. One result has been a spurt of writing–several short poems (not usually my best mode) with which I am quite happy. I’ve secretly sent a couple to friends for whom I thought they would have special resonance, but amn otherwise holding them close to my chest until I’m more sure of the language I’ve written in, which is much more Harmonium than Spring & All. More lush than I have been accustomed to working in.

Process Philosophy at SEP

I have been reading the Stanford Encyclopedia of Philosophy‘s article on Process Philosophy & am finding it quite useful, especially in terms of vocabulary & context. That is, the article provides a vocabulary & a context for using that vocabulary as it applies to Whitehead & those thinkers who have been touched by his work.

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Problems & Adventures

Stengers writes that an adventure can only begin in response to a problem. Thus the old father’s perverse decision to set his sons a problem by disposing of his property 1/2, 1/4 & 1/6. The problem being that when you feed three sons, eleven camels & those particular fractions into your problem-solving machine you do not get a solution, but rather an “adventure.” Presumably, one is supposed, when confronted with a problem in this way, to go along with the adventure, as opposed to giving the machine a whack with a hammer. To do this requires a certain kind of humility that is shown admirably by the boys in the parable. Instead of escalating from giving the machine a whack to whacking each other, they seek ot the village elder. In seeking out the elder they recognize the fundamentally social nature of their problem. It cannot be solved alone, or even within the family; instead the sons must resort to the wisdom of their community (embodied in the figure of the elder) in order to sustain their adventure long enough to solve their problem. Of course, this is not a one-off proposition, but an ongoing prescription for leading an adventurous life. Still, the boys were lucky, too. They had a community to whose wisdom they could appeal; they had a problem to which the “necessary fiction” of the twelfth camel could be applied; & they were themselves humble enough to seek the community’s help in the first place. At no point along the way is the hearer of the parable asked to take anything on faith; instead, he/she is merely asked to look at the “cash value” of various possible solutions, such as killing & eating one of the camels. Not very many of these alternatives are addressed in the parable, but they are implied. It is further implied that none of them would have the value of the elder’s fiction–they would not have been adventures. Looked at in this way, an adventurous solution to a problem may be preferable to a non-adventurous one even if it lies, i.e., tells a lie by creating a necessary fiction such as the boys owning a twelfth camel, or the existence of God. (Spinoza’s god rather than Descartes’.) The elder is a pragmatist.