9.02.06, The Long Arm After Sunset

[during daylight]

When the sun goes down you will find me at my keyboard.

You will not find me today, since I slowly skirt from book to book,
and from here to somewhere else.

Occupy a small piece of park grass not far from water spray, a piece no one
else wants. It's supposed to be this way. No conflict, no mine, no retroactive nostalgia, just reading and time's passage. All the innocent voyeurism.

Remember, avoid prolonged exposure to the sun while taking chemotherapy drugs.

Franky Scale: 6. Again, getting drug times, food times, sleep times all right. Somewhat trickier than it sounds.

[after sunset: (This added a few hours after this post, I guess I don't want to apologize for it, I take what you said, DP, to heart, and thanks to the both of the commentors so far. But since out of genuine caring some of you might feel this kind of "talk" is too grim, just remember it's good for me to express it. It has to come out sometimes, on occasion it just needs to make its way out. Already there is enough inside me, in all the various states of matter and emotion, to try to cap it all. I only want to stem any over reacting, just in case. This kind of pain and fore-trauma needs to be experienced for it to dissipate. I do want comments though, as I always do, since they help keep this whole thing moving and alive, they keep us in some sort of dialog I imagine. I just wanted to prevent any over reaction in them. In mutual understanding then.)]

A few comments, including some off-blog through email, have come in about my last doctor's appointment and the issue of pain. Thank you all and let's do assign a special Pile of Shit Award as was suggested. Slarry, you mentioned or asked about the procedure itself. Well, if you're going to do research you might first want to see four abstracts/articles I have on it — it actually seems quite good, low risk, and is very standard procedure for pancreatic cancer pain — and if you do look it up notice that it's officially called the NCPB, or neurolytic celiac plexus block. The celiac plexus contains the primary nerves going out from behind the pancreas, so you kill deaden the nerves and you usually end up eliminating a good deal of pain (74% of the time). One study even shows a slightly lower mortality among patients who underwent the procedure (perhaps because of increased quality of life?) but I don't believe that's an entirely reliable conclusion since the study wasn't specifically designed around that information. Overall, it looks good and has a zero percent mortality, from what I've read.

Discussing the NCPB forms a good transition into the next topic, which might fall under the category of morbid thinking. For the past couple of days I've been more preoccupied — not unhealthily — with death time. Reading the abstracts for those articles is part of the reason. Information about those who undergo the procedure inevitably leads to specifics about how many people undergo a re-do after about three months, and how many don't live that long.

Couple that with dreams. Where supposedly the unconscious, which itself is structured like a language, speaks. A wish fulfilled, though usually several steps removed through displacement, symbolism, overdetermination, etc. Two dreams this week remind in part why sleep might be necessary but not always desirable for me. One, I totally lost the content of, but the feeling I awoke with is better left unsaid. True to the dream structure, it's what cannot be said. In the other, however, I do remember some of it and it involved spending some time with someone I know, who's dead. Someone I knew. You don't have to be Freud to makes some sense of it.

The Wednesday meeting with those two doctors, which in terms of being put off and realizing how (un)important you are to The System truly resonates with David's story about his mother, and the dreams, and a little catch up on my own management schedule all conspire against high Franky Scale numbers. Then there is simple the passage of time. There is Camus telling how only for the condemned is there liberation, only for those last days does the indifference to draining minutiae reveal itself. There is also at times a feeling not of proactive choosing the absurd, more Camus (an active daily confrontation of a meaningless life, rather than a living death chosen by others), but of just being tired. Only problem is that I can't always distinguish the cause — from chemotherapy, from missing sleep due to pain or due to anxiety, from — here comes a term I don't like to even say or think — cachexia. The wasting away process.

Your cancer grows while the rest of you wastes away. It just gets "healthier" while you pay the price. Quite a lot of people die specifically from cachexia. People with pancreatic cancer that is. Now, do I apologize for being so heavy here? Well, it has to happen somewhere and I expect if you're reading, then to some extent, you're already along for the ride. I read the words "advanced" and "terminal" and "late stage" and that too is tiring. It creates an unproductive cycle where learning about the disease might "save your life" and yet the more you read the more you're battered over the head with these terms. With the reminder.

The book What Dying People Want is so benign and sensitive compared to a medical article. Yet that too, I can only stand to read it for so many pages at a time. . . . Where is all this going? How did it get started? I thought of writing about little everyday routines, about the park, the sunset, normalcy, about sitting outside editing poems for a friend and making notes for projects in the future.

But today the reminder has been serious, the words "terminal" and "advanced." Sharp awareness of what time a pill must go down. So in the end, the sun, park, poems, etc., I still feel like much of these is being held a certain distance out in front of me, held by some anonymous hand at the end of a very long arm. I don't know whose arm, but it's sinewy, strong, looks possessed of endurance. I stand and stare, it waits extended. A game of chicken where no movement wins. A game with no winning — so like one dear friend recently reminded, I have to keep standing, face up, taking all the absurd fucking time that hangs in between.