Surly

So it's colonoscopy time again next week, and I'm surly about it. I don't mind the procedure. I even enjoyed the first one -- or was interested by it, anyway -- because they didn't put me under and I could watch my insides on the monitor. The procedure is fine. What makes me grumpy is a) it's a hideously expensive and elaborate test without a large likelihood of return on investment, and b) it disrupts my painfully-arrived at diet for a whole week, forcing me to choose less healthy foods. No seeds, no nuts, no whole grains. So my breakfast oatmeal, with chopped nuts, is out of bounds. Replaced it with home fries this morning. The quarter cup of peanuts I eat in the afternoon I guess gets replaced by a couple tablespoons of creamy peanut butter: I'll need to go buy some today. And the flax seeds I chew in the evening are of course out. For a week. To reduce the chances of an early exit by colon cancer by half a percent, or whatever it is, while taking the small but severe risks of bowel perforation, bad anesthesia outcomes, and hospital-sourced infections.

The only real reason I'm going ahead and doing it is to convince my doctor that, although I won't take steroids, I'm really a good little patient who usually does what he's told. And the only real reason I want to stay on good terms with my doctor is that if I'm dying in pain I'll want opiates, and the physicians' guild holds the monopoly on them. Simple as that.

Among the many ironies of my life is that politically I'm dedicated to universal health care that, in my own person, I don't particularly want. I would far rather go without health insurance. Much of modern American health care, and especially the expensive parts of it, I would gladly forgo. I want the vaccines; I want the emergency trauma care. I want the check-ups. But I don't want a heart transplant. I'm not excited about dragging out my potential cancer death or cardiac failure, and I have no interest whatever in spending much time in the sleepless disease-vector boxes that are modern hospitals. God. TVs on all the time, lights never more than half-off, and never a let-up in the goddamned noise; I'd rather sleep on the street than in a hospital. Drug me if I'm in pain and let me die already.

I love medical science. I love being able to look things up and nose around in research articles. Medical science is wonderful. I'm not one of those people who bitch about "Western Medicine" per se, or who thinks alternative medicine is fabulous. But our peculiar three-player medical delivery system, in which all the money extracted has to flow through an insurance company before it reaches any caregiver, and runs through multiple curtains of obfuscation and profit-taking before it gets there, does not thrill me. And it would be lovely if I had somehow had back some of the $500 to $800 per month I've been paying, decade after decade, for medical services probably worth $5,000 in total. Seriously: it's hundreds of thousands of dollars I've paid into this system. I could find a use for a few hundred thousand extra dollars.

I probably won't post this: there's not really any point, and it sounds too like a certain sort of right-wing yapping that I don't want to encourage. I'm not thinking clearly enough, perhaps, about all the unknown unknowns. The number of ills that can befall a person is truly astonishing, and I might well wake up grateful in a hospital bed tomorrow morning.

But I am still surly. Even if the scrambled eggs and home fries this morning made really a nice change from boiled eggs and oatmeal. I just want everything to hold still long enough to lose that goddamn inch or two from my waist. I don't want to spend my time chasing rather remote chances of colon disease when I'm staring down the barrel of quite likely cardiovascular disease. Living long enough to get colon cancer would really be something of a feat, given my history and my family history. Something I could be proud of.

Welding Torches

“Bones like fairy dust,” they said.

Stress fractures in the vertebrae; a fibula

that took two years to heal; two

bone marrow transplants.
The angel of death

hovers, beats his hummingbird wings,

darts in for little sips of nectar

with his hypodermic bill.

The wind comes off the snow

at four in the morning: the dog

shrugs in her sleep. Stars are swung up

by invisible hands, like toddlers

shrieking for – joy? – fear? – and the morning

builds slowly underground.

When I tell her she looks good,

she shrugs. “If you still have your hair,

people figure you're not sick.”

Her eyes glance at me for a moment

before they turn aside.

I cradle her feet while you

speak softly to her, five feet away,

a thousand miles away, where the stars

burn like tiny welding torches; where

they are building something in the night sky –

something sightless, infinitely complex.

I look up to see the tears come in your eyes:

all of our stories

are converging. The stars

run down your cheeks: this

is what flickers on the dark steel

rising in her nights.

Facts

I have discovered in myself a new response to novels, when I glance at rows of them in the library. It's ridiculously naïve: but this is not real. This is all made up. I used not to mind that; I used to prefer it. Now there seems something dangerous about it. We are already prone enough to make it all up: why encourage each other? I am hungry these days for fact. I read mostly nonfiction. The more facts the better. How many people died of diphtheria in Cairo in 1908? That's the sort of thing I want now. Maybe it's because I am aware now of how hard facts are to come by. When I was a boy it seemed that facts were all over the place. My father was an inexhaustible fund of them. How far away was the moon? How much more likely were smokers to get cancer? What was the real, indisputable, Latin name for St John's Wort? My father knew all those things, and made sure that I did too. My world teemed with authoritative facts.

He meant no harm by this, of course, and in the long run I think it was good for me. I inherited, anyway, his respect for facts, and I learned early that much of “what everybody knows” is dead wrong. But it left me with the impression (which was easy to get anyway, growing up in the sixties) that the fact collection was all under control and proceding splendidly. My help would not be needed.

And what I could see, but it seemed that my father could not, was that all these facts were curiously helpless. My father steered by them, his own idiosyncratic course, but nobody else I knew did. Everyone else steered by stories. Even if they were obviously false stories: the stories in Genesis that my father found so ridiculous, or the New Testament miracles of walking on water, of loaves and fishes – my father, it sometimes seemed, was the only man in the world to whom it mattered that these stories were manifestly false. And I very gradually learned – for I was a voracious and indiscriminate reader – that most of the bedrock stories, the founding of America, the high nobility of the Civil War, and even my father's favorite stories of the religious persecution of science, were mostly false, or at least tendentious. My father, I decided, much as I admired him, had missed the point. What mattered was not whether stories were true: it was whether people wanted them to be true. Or rather needed them to be true. Many people did not at all want a fearsome avenging God: they knew they'd sinned, and that God was going to smite them. But somehow they needed him anyway. And so I wandered away into stories, as the things of real power, the things that really caught people by the throat and made them change their lives.

And I turned – partly I suppose out of sheer rebelliousness against the dominion of fact – to fantasy. It seemed more honest, somehow, to say right up front that you were talking about places that never were just because your heart yearned for them, or about imaginary phantoms just because you dreaded them. Others might mistake the Shire for the kindly England of Tolkien's childhood, but I knew better. Tolkien grew up like any American child, rootless and homeless, a fatherless, Catholic, South African colonial come home to precarious suburbs and a new school every year, a permanent alien and outsider. Tolkien could describe home with such overwhelming feeling, so convincingly, precisely because he had never had one and didn't know anything about what homes were really like. All he knew was what he longed for. I wasn't looking for the Shire to be real. I just wanted to know that someone else missed it, too.

Now that I'm sidling back into science, because I'm on the outskirts of medicine and I really need to know things – such as, does massage assist the metastasis of cancers? – I'm finding that facts are not so easy to come by after all. Good science no longer seems like the juggernaut driving all before it: it seems more like a delicate, fragile lighter-than-air craft, as threatened by its duller-witted partisans as by its enemies. I want to go back to school, or at least get some textbooks, and get a good scientific education. I didn't pay proper attention in the statistics class for my computer science degree: and the fact that I got an A makes me very uneasy about the general state of research. How many people actually know what they're doing out there? I haven't done a lab, nor written a science paper, since the the 8th grade. I read abstracts of papers and get only the vaguest sense of how important their results are: for my own field of massage research I've been relying heavily recently on Paul Ingraham, of SaveYourself.ca, but I have only his word for it that he knows how to evaluate these things. I ought to be able to evaluate them myself.

It used to be thought that massage was not appropriate for cancer patients, because it would push the lymph around, and that might spread the cancer. There was never any evidence that this happened: it was just a plausible hypothesis, and one that nobody wanted to test. (For good reason: “Hey, let's take a group of sixty cancer patients, do massage on thirty of them, and see if their cancer progresses more rapidly!” is a study that's hard to get enthusiastic about.) I read a book about it a couple years ago that emphatically denied massage could do this, and it seemed to be the standard modern book on massage and cancer, but I don't recollect what research it rested on, if any. Even back then my common-sense response to the idea that massage might help metastasis was that if you were relying on your lymph standing still to save your life you were a dead man anyway: but common sense isn't always a very good guide in medical matters.

But you see? An untested hypothesis became a standard medical protocol (“no massage for cancer patients!”) And the scientific basis for my present conviction that massage is fine for cancer per se (though radiation or chemo may contraindicate it) rests on information I no longer remember, derived from research which (if it exists) I couldn't reliably evaluate even if I did read it. And I'm one of the science-minded massage therapists. Oy.