Friday, July 19, 2013

Insert title here

I called the Polk Country (Des Moines) Recorder's office yesterday, just to confirm that the marriage license is ready.  It is.  The call indicates a change in my personality over the last two years: I used to be completely blasé about this sort of thing, just assuming that everything would go as scheduled.  Now, with so little to do during the day, I have too much time to worry that something will go wrong.  The wedding bands also arrived.  They fit and look great--a white brushed gold center band with polished beveled edges.  The wedding party has increased to a grand total of four, as two friends from the area are driving up together for the ceremony and the dinner afterwards and then driving back that same evening.

I've wanted to blog about the George Zimmerman verdict, but there are so many things to say that I'm afraid I can't create a cohesive (or even coherent) essay.  Bête noire number one is Angela Corey, the Florida state attorney, a Tea Party sort, who had no interest in prosecuting Zimmerman and passed the task to her subordinates.  She had no such problem with Marissa Alexander, the African-American woman who fired a warning shot into the air to try to scare off her abusive husband.  No one was injured, and Alexander should never have been charged, but Corey was aggressive and prosecuted the case.  If it went to trial, under Florida's draconian minimum sentencing laws, the punishment would be a twenty-year sentence.  So Corey offered a plea deal: plead guilty to a lesser offense and get "only" three years in jail.  Confident that there was no viable case, Alexander refused the deal.  She was convicted after a jury deliberated for all of twelve minutes and sentenced to the full twenty years.  (Thirty years ago, about 20% of cases went to trial; now less than 5% do, mainly because the risk of what might happen given the severity of minimum sentencing laws and three strikes, you're out, as Alexander found out, is so frightening that, whether the accused is guilty or not, a plea bargain seems the safer alternative.)  After the trial, which the prosecutors of Zimmerman (i.e., what should have been Corey's side) had lost, Corey gave an almost celebratory press conference, now willing to be front and center.  She was dressed and made-up to the nines (the Katherine Harris of the 2010s) with a giant cross around her neck, reinforcing my prejudice that the larger and/or gaudier the cross someone wears, the less I trust him or her.

Then there were the peculiarities of the Florida judicial system, most notably having six-person juries in non-capital cases.  Seminole county, where the trial took place, is 80% white, so statistics might suggest that there would be a black juror, but there was none.  Studies have shown that the presence of even one black juror on a panel reduces convictions of black defendants by at least 10%.   With a twelve-person jury, there would have been a greater chance that the jury panel would have been more diverse.  Equally unsettling was Judge Nelson's decision at the beginning of the case that arguments from "racial profiling" could not be introduced.  I have no idea what her rationale was, since race was clearly at the heart of this case.  (Zimmerman's defense team refused to admit this during the trial, and then as soon as it was over and they were giving a press conference, Mark O'Mara introduced it with no qualms about the hypocrisy.) 

Zimmerman's defense team was high-powered because of 100s of 1000s of dollars that poured in from outside conservative sources.  My own choice for outrageous moment was when O'Mara brought in a huge chunk of cement, announced theatrically that he wasn't going to drop it on the floor, and then make great show of wiping his hands and suit, as if they'd been contaminated by what he contended was Trayvon Martin's lethal weapon.  No matter that the fatal shot took place on grass 25-30' feet from the sidewalk.  No matter that by the sidewalk-as-weapon argument, we're all in possession of deadly weapons any time we walk on a road or street. 

And then there was juror B-37, who could hardly wait to speak out and announce a book deal (since abandoned).  She said that she thought George Zimmerman's heart was in the right place.  Clearly, Trayvon Martin's was not, since it was at the wrong end of Zimmerman's gun.

Tuesday, July 16, 2013

this and that

My birthday passed quietly.  As I start year #69, that was a fine way to begin--or as I celebrated my 44th birthday if I continue to use the hexadecimal system of counting that is so much more forgiving than the decimal system.  We went out to dinner.  Mohamed ordered well; I didn't.  It's probably too early to draw any conclusions about the reduced dosage of the chemo (down from 600 mg a day to 400 mg) and a similarly reduced amount of one of the blood pressure medicines, but the last week has seemed better than the two or three rather miserable weeks that came before.  My stomach seems more settled (despite my bad birthday dinner choice), and although I still crash at least twice a day, the periods of sleep have been somewhat shorter. 

As I talked about the cancerous body in the last blog and its mysterious workings, I should also add how one's circadian rhythms are totally disrupted.  Some of us are morning people; some night owls.  Some wake up full of energy and ready to start talking; others want silence until after coffee and half an hour of becoming themselves.  Many people flag at some point in the afternoon.  Some settle for more coffee or Red Bull; others want a power nap--or a long siesta.  But everyone has a basic rhythm (and one that partners had better adapt to).  And then suddenly, after six decades of the same pattern, I lost control of how my body reacts.  I wake up at 4 one morning; at 8 the next.  It doesn't make any difference, though, because after three hours, my body is going to shut down.  I can't get to the shower because the bed intervenes.  I sleep for an hour and then gradually pull myself awake, I who have always been instantly fully alert and ready to chatter.  I know that after about three good hours, I'm going to crash again--not the twenty-minute "power naps" that I used to love, but two full hours of deep sleep.  The evenings are less regular.  On my birthday, by late afternoon I was feeling nauseated and had no desire to get off the couch.  We went out anyway, and though dinner wasn't very good, in the middle of my dried-out steak, I suddenly felt a burst of energy, which lasted for another three hours.  As with so many effects of the cancer and of the chemo, what my body does is out of my control.  How I've lived and coped for all these years is no longer relevant.  And my whole self-image has changed in unpredictable and unexpected ways--unpredictable not in just the long run but from one minute to the next.

Despite our stereotypes of Lebanese or Egyptian men covered in gold chains, in the part of the Arab world where Mohamed comes from, men do not wear jewelry and never gold.  We had decided not to exchange wedding rings, but a couple of days ago we broke down and decided that an "outward and visible sign" of our new "inward and invisible state" would be good.  So we ordered brushed white gold rings.

I've written before about my home town, Story City, which is about 40 miles north of Des Moines.  If my energy level is good next Wednesday, after we pick up the marriage licenses, we'll make the drive north for a "tour" of Story City (it had a population of fewer than 2,000 when I was growing up, so it isn't going to take long to visit the town).  My parents and maternal grandparents are buried there, so we can visit their graves.  The other day I got a nice note from one of my classmates.  We graduated from high school 50 years ago, and we haven't seen each other since, though we've exchanged holiday cards and notes.  I told her that I was going to be in Story City on the 24th, so we're going to get together for lunch.  I don't want to romanticize my childhood too much, but I think it is indicative that she's meeting a gay man with his Muslim fiancé as they prepare to marry that evening--and her only reaction was pleasure.

Saturday, July 13, 2013

Deadlines

My friend and former colleague Linda Hughes recently sent me an article from last Sunday's New York Times by the poet Meghan O'Rourke called "Deadlines."  O'Rourke contemplates the fact that while death has always been one of the great subjects of literature, we are living in an age of a sub-genre: the literature of dying: "Writers are recording their own deaths as they happen."  She cites work by Updike, Hitchens, Broyard, Ebert, and Marjorie Williams, as well as her "favorite," James Merrill's last book of poetry, A Scattering of Salts.  Of course, no book has been more important in de-mythologizing death/dying in literature than Susan Sontag's seminal Illness as Metaphor, in which she brings down the curtain on the use of illness as anything but what it is--no more romanticization (as with tuberculosis) or demonization (as with cancer and later AIDS), no more "wars" on cancer. 

Why this new kind of literature?  One reason is our current penchant for and ease of documenting ourselves (think of 'selfies' and 'photo bombs'). I didn't have to search for a publisher; I spent maybe ten minutes choosing a blog platform, registered for free, and chose a background; voilà I had an immediate forum.  More important are the changing nature of the illnesses from which people die, the medical advances that prolong life, and our attitude toward fatal illnesses.  It wasn't until the 1970s, as O'Rourke points out, that patients with terminal diseases were told that they were dying.  O'Rourke calls ours the age of "protracted death."

For the first half of the essay, I nodded along in agreement with the various ideas and quotations.  I was particularly struck by Christopher Hitchens's realization: "I don't have a body.  I am a body."  And I would add that it's almost as if I have two bodies: externally I'm aware of what's going on, of the diminishment, a word that I have often used as did Updike.  How far is it back to the car?  Will I have any appetite for dinner?  Will I make it from the car to the bathroom (the details that Nora Ephron didn't want to burden her friends with, yet that determined the rhythm of her days)?  And then there's my internal body and the inability to know what's really going on.  Yes, once every three months, I lie on my back, my clothes still on, but my pants pulled down, on a moving table that slides me into a whirring machine for a series of CT scans.  I know the routine by now.  I stare at the slot that says "laser beam  do not stare."  I know the mechanical voice that says, "Breathe in.  Do not breathe.  Exhale" while an orange icon with puffed out cheeks gets ready to change to a green one with its mouth open."  I know the needles and the different styles of injecting them, and I know what size port I need put in.  I glance at the blood work report with its red exclamation points by those numbers that are problematic.  But I don't know what the abbreviations in the left hand column mean or what the numbers are supposed to be.  What's happening internally is a mystery to me, and I suspect often to the oncologist as well.  I make the leap of faith to trust what he tells me to do next; what he can't tell me is what will happen next.

The second half of O'Rourke's essay speculates on the authors' motives, and there begins the divergence between her interpretation and what I think I'm doing in writing the blog.  I don't think our "realism" is a form of denial, nor do I see it as a final "act of control."  The process of diminishment is a galvanizing subject, but not, I think, a terrifying one.  Frustrating, irritating, and sometimes discouraging, yes.  But terrifying, no.  And what we know we can't control as writers is giving the narrative an end.  Life and art have a shape: from Aristotle on we've talked about beginnings, middles, and ends.  But what the narratives of dying, unlike the dying itself, can't by necessity have is an ending, except perhaps as a postscript added by an editor.  That will always be out of control, and I think writers are well aware of that limitation.

Tomorrow is my 68th birthday.  It's always marked by ambivalent feelings--especially positive when I've spent le quatorze juillet in France with parades, flyovers, and a giant fireworks display at the Eiffel Tower.  Everyone is in a celebratory mood that day.  On the other hand, my father died on my birthday thirty-one years ago.  He was 68.  Neither of my grandfathers lived past 68 either.  I used to think that this year would be a worrisome one, even if the worry was irrational.  After the diagnosis and prognosis, I thought, "well, that's one worry I won't have to face."  But here I still am.  And here comes year 69.  My goal is to break the pattern of my paternal relatives--and to be true to my own skepticism by putting away any nagging thoughts that the year is jinxed.  It's going to begin with a very different kind of landmark event, one I never thought I'd live to see, let alone participate in: our marriage.  So here's to year #69.














Wednesday, July 10, 2013

test results

Monday it was time for the once-every-three months full battery of tests at the KU Cancer Center.  First always comes blood work, and unfortunately, for the third time I got Marci, one of the world's least competent phlebotomists.  As always, she first tried to put a port (because I would later need it for the CT scans) in my right arm; as always, after many attempts, she gave up on that arm as the three vials of blood were only half full.  She had better luck with the left arm.  She never gets it right the first time.  She puts in the wrong sized ports so that they have to do it all over again when I go for scans.  She often draws too little blood, so the CT people have to do that again.  All the while, she mutters, "This just isn't my day."  Marci is not a young woman.  Has she been doing this for many years?  Trying to be friendly, I asked her whether she ever got tired of drawing blood.  "Oh, no," she said, "there are always challenges and things that go wrong."  I doubt that was an overstatement.

The CT scans were scheduled for 11.  It was after noon before they even began.  Luckily, they went quickly and smoothly, though I had been shivering for an hour.  Usually they give me a heated blanket, but there didn't seem to be anyone around.  Finally, I got my expensive bone-strengthening shot, and this time I got my favorite nurse.  The shots burn, and most of the nurses put it into my arm slowly, operating on the mistaken theory that it will hurt less if the medicine goes in slowly.  This nurse just jams the needle in, plunges the medicine in in one fast injection, and it's over.  Her method is much less painful.

Our friend Scott had been waiting patiently for over an hour (I had told him I'd be done at noon) at a nearby restaurant.  We finally showed up, and since I hadn't eaten for 24 hours, I was ready for food.  My appetite hasn't been good lately, and my turkey sandwich was delicious, but enough food for the rest of the day.

Our appointment with Dr. Van, the oncologist, was at 2:20.  He's always late, but he set a new record by arriving at 4:10.  In the meantime, we're in a small, windowless cubicle.  One of the characteristics of a teaching hospital is that there is always an intern or a resident who comes in and asks questions that I've already answered dozens of times and that are clearly there on the computer monitor.  I sometimes get impatient with this, but Monday's student was pleasant enough and provided a break in the monotony of waiting.  All of the tests results, however, were very good.  The hemoglobin count had actually risen, and most important there was no growth in the kidney tumor.  So exhausted as I was, at least all the news was very good.

Still, the last few weeks haven't been very pleasant: I've felt the need for even more naps than usual, my appetite has been minimal, and what I do eat doesn't stick around very long.  So we're going to make a couple of changes in the routine, including the amount of Votrient, the chemo, that I take.  In the protocols, people start at 800 mg, but almost no one is able to support that (for one thing, the Votrient raises the blood pressure dramatically; I take three different anti-hypertensive medications).  Most of the people in the tests had the dosage cut immediately to 400 mg.  I've been on 600 mg for the last two years, but we're now going to lower the amount to 400.  In the clinical trials, the average time that patients took Votrient was 7-8 months.  Only one subject made it to 24 months.  I don't know whether the trial ended then or whether s/he couldn't support it any longer.  I've taken the chemo for slightly over 24 months now, so it's probably time to reduce the amount I take.  We're also going to cut in half the dosage for one of the blood pressure medicines.  The hope is that with less medication I'll have more energy.

As always, I slept the entire way back to Topeka and then crawled immediately into bed.  I have spurts of energy--two or three hours at a time--when I feel almost normal.  But they're interspersed with crashes when both my mind and body shut down completely. 

On a different note, yesterday we gathered up my friend Virginia as the "disinterested party," went to the nearest bank where there was a notary, and the three of us signed the Iowa marriage license application, had our signatures notarized, and put the documents in the mail.  I also mailed a check to the "officiant," so everything is proceeding apace with our marriage plans.

Sunday, July 7, 2013

politics, etc.

A couple of days ago as I watched my umpteenth show about politics, Mohamed asked me when I first became interested in (I think he meant obsessed with) politics.  One of my first memories comes from 1960 when I was fifteen.  The recent census had reduced the number of U.S. Representatives for Iowa by one, so the state had to redistrict.  There were two Democrats among the Congressmen (they were all men in those days), and the Republican goal was to put the two into the same district in order to eliminate one of them.  I decided to create an alternative plan that would put the two in separate districts.  I can remember sitting on the floor of my bedroom, a map of Iowa's 99 counties in front of me, along with a list of the new census data for each county.  There were obviously not only no computers in those days, but no calculators either.  I did have a very primitive adding machine, which had been designed as a children's toy, not for use in business or other serious matters.  That meant I had to double check everything by hand.  I'm not sure how long it took, but I finally came up with a plan, which I sent to a Democratic state representative.  He introduced it in the House, and it became the Democrats' official bill.  Of all the bills introduced, it had the least population variance between the new districts, it had the most contiguity among the counties, and it kept the two Democrats in separate districts.  Of course, the Republican legislature defeated it on a straight party-line vote, and Iowa lost one of its two Democrats in Congress.

The story is especially relevant today after the Supreme Court struck down section four of the Voting Rights Act.  Within days--actually hours--after the decision, Texas, Alabama, Mississippi, and Virginia began to implement laws changing voting requirements, laws that had been on hold as the states had had to wait for preclearance from the Justice Department.  One of the strategies, of course, is to discourage minority voting by requiring photo IDs, by eliminating Sunday voting (always a time Black voters have gone to the polls after church: "first the soul, then the poll"), and by reducing the number of days for early voting.  But a second strategy, perhaps even more effective, has been gerrymandering, packing minority voters into a few heavily Black or Latino districts to make sure that in the rest of the state, their voices carry little weight.  In 2012, for example, Democrats won a majority of the votes in North Carolina for U.S. representatives, but because of the gerrymandered districts, Republicans won 9 seats with only 4 going to the Democrats.  It's estimated that of the 435 Congressional districts, about 400 have been drawn to make them safe for one party or the other with only 30 or so being truly competitive--hence one cause of the polarization of American politics as candidates have to appeal to their "base," since the true contest is the primary, not the general election. 

Republicans have also been shameless in their attacks on reproductive rights.  To use North Carolina again, in a last-minute move, legislators sneaked new, more restrictive abortion regulations into a bill prohibiting the use of Sharia law in the state (surely one of the burning issues of our times).  Texas, Virginia, Wisconsin--all have passed or are in the process of passing laws restricting abortions and closing clinics where they are performed.  At least, these states get national publicity.  In a small state like Kansas with its Republican legislature (all but one "moderate" Republican senator having been purged by the party in the last election) and Republican governor, the voting restrictions and the anti-abortion legislation pass with little or no attention.

Tomorrow, Mohamed and I return to the Cancer Center for the three-month battery of tests.  I can't eat for four hours before the CT scan, though finally I've been told it's all right to have some black coffee.  First comes the blood work; I want to see what my hemoglobin numbers are, since they've been low and dropping for some time now.  I've had so little energy lately that I want to know whether I have to wait for them to hit some magic number before I'm eligible for a transfusion or whether one would help now.  The CT scan will reveal whether the primary tumor continues to grow slowly, the last word being the important one.  Perhaps between the tests and the consultation, we can have lunch with some KC friends.  I'm always hungry, but tired, after 16 hours or so of not eating.

Thursday, July 4, 2013

Happy 4th!

Happy  4th of July, a holiday I'd appreciate more if we didn't have a 75# german shepherd who is traumatized by fireworks (and our oven).  The neighborhood fireworks began Sunday afternoon, and Kimber promptly found a way to flee the backyard.  Luckily, he adopted two women who were walking around the lake we live on and followed them home.  They called, and we found the three of them sitting happily on their front porch.  They had her on a leash, a smart move since the last time she escaped and adopted another family, after they called and we arrived to pick her up, they opened the door, thinking she'd run joyously to see us again.  She ran joyously all right--just not in our direction, and the search resumed.  Every night since Sunday, Kimber refuses to leave the house after about 7:30 p.m.  Booms seem to be constant, and she's not taking any chances.  At least, we've learned what a strong bladder she has.  Today there will be a big fireworks display over the lake, so we'll give her a tranquilizer.  She'll look like Droopy or Deputy Dawg, but she'll be calm for the night.

There is good news on the marriage front.  The websites I'd found that included copies of the Iowa marriage license application form all said that applicants had to appear in person to file.  That meant that the trip to Iowa would be at least four days, given the three-day waiting period to pick up the license.  A four-day, 250 mile trip may not sound that difficult, but given that I crash every three or four hours and never know when or how often I'm going to need a bathroom, it sounded rather formidable.  But an old-fashioned call to the Polk County recorder's office revealed that the form (three pages, not the one page which I had found on other sites) could be submitted by mail.  I downloaded the form, and the next friend who visits us is going to be shanghaied to the nearest notary public, since we need the signature of a "disinterested party," and that signature, like ours, must be notarized.  Once the form is duly signed and notarized, I'll mail it, and then after three days the license will be ready and valid for the next six months.

I think we'll drive up on a Tuesday later this month.  On Wednesday we can pick up the license and perhaps take the hour trip to my hometown.  A tour of important places there from my childhood should take about thirty minutes (it's not a big town), and we can visit the graves of my parents and my maternal grandparents who are buried there.  Maybe we can find some good Norwegian food (that's an oxymoron) or least some authentic kumla.  And then on Thursday we can have the actual ceremony and drive back to Topeka.  All this sounds much more manageable--a shorter trip and just one thing to do each day. 

For some reason, BlogSpot will no longer allow me to publish an entry without a title for the post.  I'm not sure why, after over 170 posts, there's the new policy, but without a title, I can hit 'publish' as often as I want with no results.

Monday, July 1, 2013

marriage


Last week President Obama gave his most detailed and significant speech on climate change, certainly the most important issue of our time and one that rarely gets effective discussion.  Among other things, he outlined a plan to reduce U.S. carbon emissions by 17% by 2020.  And again, the speech got almost no coverage on the news.  Hours were devoted to Paula Deen; almost nothing to Obama's speech and proposal.

 Last week the Senate passed 68-32 a "comprehensive'' immigration bill, the first in nearly three decades.  Although it presents many obstacles and is incredibly expensive for the border "surge," the Democrats were content because the bill provides a "pathway to citizenship" (even though the pathway is 13 years long); Republicans were moderately content because of all the provisions making the pathway difficult and because of the surge.  The bill goes to the House where Speaker Boehner has promised to ignore it.  The House will start over with its own bill <shudder> or, more likely, try to pass a number of  smaller, individual bills.  The future of immigration reform is in serious doubt.  Sen. Patrick Leahy of Vermont threatened or promised, depending on your point of view, to introduce an amendment to the Senate bill that would have explicitly included same-sex couples in the marriage provisions.  Democrats tied themselves into knots, knowing that even if they supported that provision in their hearts, which almost all of them did, it would keep any Republicans from voting for it, causing the bill to fail.  Fortunately, the Supreme Court decision rendered Leahy's proposed amendment unnecessary.

 At least, we hope that's how the decision will be implemented.  Last summer, Mohamed and I discussed going to my home state of Iowa to get married, but there weren't any practical implications of a marriage.  This summer, however, the stakes are different.  If the federal government granted the benefits from an Iowa marriage, it could affect Mohamed's visa status, my federal income taxes, social security benefits, etc.  So once more, we're contemplating the trip north.  It's a four-hour drive from here to Des Moines, so if we left on a Monday morning, we could file the marriage application on Monday afternoon.  Then there is a three-day waiting period, so we couldn't actually get married till Thursday.  But we could lounge around the hotel, explore whatever there is in Des Moines, and drive 45 minutes north to my home town.  I could show Mohamed my childhood home, my school, the old stomping grounds, and I could visit the graves of my parents, who are buried there.

 Everyone is urging us on, and a long-time friend has said she will drive down from northern Minnesota to be our flower girl.  Some days it all seems feasible and something we need to do.  The last few days haven't been great, and I've needed to sleep even more often than usual, so right now the trip sounds awfully complicated.  Still, we haven't been out of Topeka, except to the cancer/med center, for two years, so it's probably about time we're a little more adventurous.