Cell phones get the OK

Now you can call all your friends and tell them the news: The link between cell phones and cancer is not strong. Not at all. The New York Cancer Times reports about the findings of a study in the Brit medical journal BMJ. Researchers studied almost 360,000 Danish cell phone users and according to the Times, found no increased risk of brain tumors with long-term use.

There's a caveat: The researchers said they did not record the actual amount of time that callers used their phones. There still might be a small increased risk of cancer in people who use cell phones often, and for 10 or 15 years. (Well, won't we all have used them for 15 years pretty soon?)

So don't throw away your tin cans and string yet. And keep studying that Morse Code!

Radiation is Good, says the Lancet

The New York Times just reported on an important British study showing that radiation prevented recurrences and saved lives of women who had lumpectomies.

Specifically, researchers at the University of Oxford found radiation reduced the risk of a recurrence during the first 10 years after surgery to 19.3 percent from 35 percent, and reduced the risk of death from breast cancer from 21.4 percent to 25.2 percent in the first 15 years. Radiation provided results better than chemo or hormonal therapy alone.

The Oxford doctors analyzed 17 studies of almost 11,000 women in the U.S., Canada and Europe. Women with estrogen-positive tumors who took tamoxifen (to keep their bodies from absorbing natural estrogen) and had radiation had a smaller chance of recurrence than those whose tumors did not feed on estrogen.

And where there's a plus, there's a minus. Thomas A. Bucholz reports in The Lancet: if radiation is not used, this persistent locoregional disease can metastasise and increase the chance of dying from breast cancer.

So use it or lose it.

While I was Out...

The New York Times had a good mid-October report on the pinking of America. Basically, it was about the rise of the upbeat Komen for the Cure... and its critics. Cancer Bitch has been a critic of Komen for being so large and media-glitzy but since 2008 it's been putting its funds into prevention and cure. Imagine that! Some good quotes:
The pink ribbons have become a distraction.--Karuna Jaggar, executive director, Breast Cancer Action
On Komen ads: It changes the focus of what we should be looking at to some advertising, marketing slogan. --Dr. Otis W. Brawley, chief medical officer of the American Cancer Society.
-We could prevent countless deaths if everyone got the same level of care as upper-class white women in Boston or New York.” --Dr. Eric P. Winer, director of the breast cancer program at the Dana-Farber Cancer Institute in Boston and chief scientific adviser for Komen.

And in today's (Tuesday's) Times*, there's a first-person piece by a doctor-professor who had the same stage cancer I did, 2A. Every year, she says, she checks a certain new edition of a medical textbook and consults its survival tables. There it is: Table 17-6. Average Survival of Patients With Breast Cancer by Stage.

It hasn’t changed a bit. Patients with breast cancer like mine, Stage IIA, still have a five-year survival rate of 70 percent (not great, but O.K.) and a 10-year rate of 50 percent (not good at all).

Her own doctor told her that her chances are much better than that, that the stats include those with "nasty" cancers. And I'm wondering why Feld had a lumpectomy and radiation and I had mastectomy and chemo. (Everyone's cancer is different. Of course. But I think the diff is that I had two tumors and there was no way to cut them out with clear margins and save the breast.)

We want to know. We want to know how much time we have. Which reminds me of one of the stories in Miriam Engelberg's memoir in comics, Cancer Made Me a Shallower Person. One of the things people say to someone with cancer, she wrote, is: After all, any of us could get hit by a bus tomorrow! She was, she recounts, actually hit by a bus once. Before she had cancer. She was OK. Without a scratch. I'm glad, of course, that I didn't die 15 years ago, thought it would have saved a lot of emotional anguish and nausea.
So she survived being hit by a bus. Then got breast cancer and died.

*Cancer is like catnip for the Times. Or, to put it this way: Cancer is to the Times as World War II is to the New York Review of Books.

Return of the Bitch

It has been more than a month since I've blogged and I thought it was due to laziness but it may have been lack of urgency, since this is partly an illness blog. But luckily!! a bacterium invaded and now I can write about it! Alas, breast and blood cancer are much cleaner illnesses than bacterial infection of the stomach. Luckily, this infection should be gone a week after it started, though it was not without its high points. They included a six-hour stay in the ER at Plain'n'Pious Hospital, where my doctor is affiliated, featuring a pulse rate of 125, one IV and several immodium, or I suppose the plural would be immodia.
As she was very nicely driving me to PPH, G gave me heart-attack advice, which seems worth repeating: If you think you're having a heart attack, take aspirin and call and ambulance, because the ambulance-driven customers get more respect.
I saw my doctor today and she almost sent me in for another IV, but I told her I wasn't willing to spend hours in the ER again. She said she would call ahead and order it, but I doubted I would get quick service. She sent me downstairs to get the collection container for a sample (because PPH's sample showed nothing, and she dismissed it as a crude test anyway; if I trusted in PPH I would say that it probably checks for dire illnesses with large molecules). I walked in and the clerk said to sign the board. Did we need to have our names so publicly and largely displayed? I looked around. There was no board, black or white. She pointed. Oh, there was a list on a clipboard. But really, have you ever heard such a list called "a board"? I know, we call a table a table even when there's a cloth over it. Anyway, she asked if I wanted a hat. She had in hand a large plastic object that would make a perfect hat if you were standing on your head while balancing on the sides of the toilet seat. Also it can be used to catch your waste before putting it in the sample cup. She told me, It's disposable.
That's a relief.
Later I took a bus about two blocks to the Landmark and saw The Hedgehog, or Le Herrison, which has many and even mostly wonderful parts but isn't a great movie. As I discussed it with myself afterwards, I thought the rich Japanese man of the film was too democratic in his friendships and everyone knows the Japanese are xenophobic. Then I responded to myself saying, That's a stereotype, and must every depiction of someone reflect the stereotypical view of people from that country/religion/profession? And I responded to that by affirming, What a good point, and the movie is also showing that only the marginal--foreigners and children--can see beyond rigid lines of class. So, Hegelianly, I concluded I was right.

Announces or reveals?

Newsperson Andrea Mitchell has reported that she has breast cancer. You've probably already heard that. Odd that NBC http://www.nbcchicago.com/entertainment/television/Veteran-Reporter-Andrea-Mitchell-Reveals-She-Has-Breast-Cancer-129396688.html
uses the term reveals. Is it because it's cancer? Because is a sexy-type part of the body? Earliest stage. Terrific prognosis. She's aware of how lucky she is she found it early. She also says, This disease can be completely curable if you find it at the right time. I suppose it can be. But it isn't always.
It sounds like she dealt with the cancer within the last week, so it seems like it was small surgery, likely a lumpectomy. So she could have easily gotten away with not even mentioning it. It's to her credit that she does.
She urges women to get scanned. I can't fault her for not going on to talk about disparities in health care or potential environmental causes of breast cancer. She's the chief foreign affairs correspondent, a news person, and so can't go on the bandwagon. Though she does mention her long support of Susan G. Komen for the Cure.
She also noted that one in eight women in the U.S. are diagnosed with the disease. Which will be news to some people.
I have been remiss. A few weeks ago, the Feinberg School of Medicine at Northwestern released its study A Profile of Health and Health Resources within Chicago’s 77 Communities. One of its five foci was racial/ethnic disparities in breast cancer mortality. It found that poor women and women without insurance are less likely to get mammograms, and also that these women were less likely to be told to get a mammogram. (Well, we all knew this, but here's the evidence.) It uses information from the Sinai Urban Institute, so that part of the report is old news. I also found out that Komen has funded the Chicago Breast Cancer Quality Consortium, which aims to identify deficiencies in quality and make improvements. I think that's good, and try as I might, I can't think of anything wrong with that. Which is a disappointment to me. See the report at http://chicagohealth77.org/uploads/Chicago-Health-Resources-Report-2011-0811.pdf
It's odd that the illustration of the section on breast cancer disparities is a photograph of five attractive young women in pink shirts with ribbons pinned on them and jeans. Their hands are held out, one on top of the other. They are, in order: black, white, brown, white, white. They look pretty happy despite the disparities. I suppose you could use a picture of a down-and-out woman in chemo as an illustration. Or a funeral. The photo that goes with the childhood obesity section is of mostly-white kids and adults--thin, all of them--walking in the Crown Fountain in Millennium Park. The question is, to raggedly paraphrase Bobby Kennedy: Do you show the problem as it is or do you show what the problem would look like fixed?
This is actually a serious question, because deep down, it's about motivating people to change, either themselves or the community. What inspires? (The answer is not the hang in there kitty cat pictured above.)

When the brand means the brand

Let's consider brands, not as in corporate branding or even personal branding, both kinds ubiquitous in this Age of Labeling. (A student once asked me if he published in a low-level magazine, would that damage his brand?)
Let's talk about Effexor, the brand. There's a debate about whether there's a difference between generics and brands. They're supposed to be the same, right? But there are always some differences. If you want to read some patient testimonies, you can go here. The FDA says there's no important difference between brands and generic.
All I can say is that one kind of generic Atarax helps control my itching and one does not, and one brand of generic Buspar (with the rounded corners) helps with my anxiety and one (sharp corners) does not. I'm a sensitive sort. The FDA says that people might have a relapse (of depression, of seizures, of ulcers) that just so happens to occur at the same time that a switch to the generic occurs, and they'll blame it on the generic. But I swear that a recent switch to generic Effexor led to "breakthrough" weeping twice. In cases where the drug has an effect on emotions, it is impossible, I think, to prove that there's a difference. There's no way that you can compare yourself to yourself, except if you're living in Groundhog Day, and even then the outside factors shift each day.
This is why I paid nearly $100 today to Osco Drugs so that I could get a week's supply of brand-name Effexor so that I could compare myself to myself on and off the brand.
What happens if I find there's a big difference between the generic and the brand? Then I have to appeal to the insurance company, and last time I did this, headquarters misplaced my paperwork and then refused to allow me to buy the brand name for the generic price. Eventually I got off the drug because of news that it interfered with Tamoxifen.
Tonight I was riding my bike back from the Y and thinking how much I felt like myself. Which is a slippery slope in the creative nonfiction biz, because the Weltanschauung in academic/professional circles is that everyone has personae and you can't "be yourself" in your writing because there is no consistent self. I do remember reading an advice book or essay when I was young that attacked the hoary notion that you should "be yourself," asking in so many words, Who is this vaunted self? and arguing that our selves are not yet formed in teen-age-hood and that we should conform and be tactful. I've tried to find the quote in How to Get a Teen-Age Boy and What To Do With Him When You Get Him, but all I found is that the author died of cancer in 1995.
I remember reading Peter Kramer's Listening to Prozac where he talks about a patient who says she feels more herself on Prozac. Commentator Sherry Turkle had this to say about the notion in Life on the Screen: Identity in the Age of the Internet, published 16 years ago:
If a patient on the antidepressant medication Prozac tells his therapist he feels more like himself with the drug than without it, what does this do to our standard notions of a real self? Where does a medication end and a person begin? Where does real life end and a game begin? Is the real self always the naturally occurring one? Is the real self always the one in the physical world? As more and more real business gets done in cyberspace, could the real self be the one who functions best in that realm?
All I know is that I haven't wept since Tuesday--this "I" being the self that moves in the world and the self that stays at home.

(Illustration: I Am Half-Sick of Shadows," Said the Lady of Shalott by Sidney Harold Meteyard. 1913. Oil on canvas 30 x 45 inches. Private Collection, Europe [as of 1985].)

the doom of it

B reminded me that when her physical pain was so great years ago, she had told me she thought of suicide, and then later, maybe months or years later, I'd said, Aren't you glad you didn't do it? I didn't remember the conversations at all. I think of Spalding Gray every time I have the attack of itching/stinging. I know why he did it. I can feel a parallel to what caused him to go over. I know what pain or discomfort (discomfort: such a plush, seemingly innocuous word) can lead you to do. Just to stop it. All you want is to stop it. I cannot stop weeping. I wept Friday because a medical resident smiled her way into the exam room, and I told her, I didn't think residents bothered me any more, and I was embarrassed that they still did. I feel attacked. I feel stripped apart. I feel taken, taken brutally, by surprise. I cannot believe my hyperbole. Many many years ago in an interview for an internship, I was shocked to be told that the length of the internship was not what I thought. To be told differently than what I'd assumed--I was shocked, embarrassed, into gaping silence. Because the world was not the steady thing that I thought it was. Or rather, not the steady thing I knew it wasn't, but needed it to be. Then again, all this, this being deeply felt despair, deeply felt sorrow, could be caused by a switch from the brand Effexor to the generic capsule. And last time I filed for a switch back from generic to another brand name medicine, the insurance would not allow. Not allow. To be boxed in. To have no choice. My father would say, Only a fool is happy all the time. He had no idea. No idea of daily despair. Of the depths. How bad it could get. There was only unhappy or total happiness. I didn't even hope for total happiness. I wouldn't have bothered to hope for it. Total happiness wasn't necessary. I agreed with him on that, I didn't demand such luxury. All I wanted was to be delivered from the darkness. To live in the world the way I imagined a normal person would. I knew that I might not receive this award or that one, or be accepted into the ivy league university I thought I deserved. I did not demand or crave a life that consisted of always winning. All I wanted to was to be released from the invisible choke at my neck. To start out looking the morning straight in the eye. On a level playing field, you could say. As if there were some guarantee from our alleged Creator that we would not feel each day as if life were against us.

To read about how Prozac changed my life, click here.


This morning my hematologist Dr. Z called the Quick Dermatologist and got him to agree to increase my light therapy to three times a week. She said that I needed to see him quickly next time I was in Phancy for phototherapy. Then Dr. B himself called me and said he would increase the frequency and duration of the light therapy. He said that his office gets 200 calls a day, that he's short dermatologists, that in 10 years 35 dermatologists have left the practice, that there's a nationwide medical dermatology shortage because everyone wants to do Botox, that no one wants to live in Chicago because it's too expensive. So, hear ye hear ye, skin doctors of the world: Come to Chicago. It's cheaper than New York. He was going to prescribe doxepin, then I asked what it interacted with, and, alas, it interacts with parts of the Cancer Bitch cocktail.

So wherever you are, raise a glass to Dr. Z, hematologist extraordinaire, human being, researcher and newlywed.


Here's a recent article on the shortage, which doesn't mention cosmetic dermatology.

A 2005 article in non-scholarly magazine for dermatologists shows that the number of dermatology residents is increasing, but that the specialists are not evenly distributed around the country; there aren't enough dermatologists in, say, rural Mississippi. It doesn't mention the fancy part of Chicago.

The Suspense Builds...

This is the fax I sent to the Fancy Dermatology Dept. today. I succeeded in getting an appt. Sept. 1 with another derma on the staff. But that's a long way away, counting in itch-minutes. This afternoon my hematologist said she'd call the dermatologist and see if she could get help for me. There is nothing stronger than Atarax, she said, except Interferon injections, which I don't want to start. She also told me I could take two Ataraxi at a time, assuming these are 10 mg. tablets. I looked and I have 25 mg. tablets.
Oh well.

To: Dr. B, Nurse R

page __1_______ of _____2_____, including cover page

Hello—I’ve left messages yesterday and today because I’m been suffering from severe itching and I believe that you can help me. It is frustrating not to be able to make an appointment or to talk to the doctor.

I have severe itching caused by my polycythemia vera. It had been under control w/ 24-hour antihistamine and hydroxyzine, and two sessions of phototherapy a week, up to 6 minutes at a time. Before, it was 3X week. The last dermatologist I met w/ was Dr. A, because it was too difficult to get an appt with Dr. B.

I had a fellowship in Western Mass from mid-June to mid-July, and found a dermatology office there where I had phototherapy 2X week, building up from 3 minutes to 5.

Mid-July traveled to New Hampshire and Maine, where it was hot and humid. Two horse flies bit me, which triggered severe itching all over. Despite antihistamines, the itching continued, probably exacerbated by severe heat, humidity, and high mold counts. (I'm very allergic to mold, but never had a skin reaction from it before.) I returned to W. Mass. for more light therapy, which helped some.

When I returned to Chicago in late July I was somewhat better, and then worse.I had to begin my phototherapy at square one, starting with 37 seconds/session, twice a week. This Saturday I had terrible itching after riding my bike about 30 minutes, and hydroxyzine helped for only a little while (on top of 24-hour Allegra). Sunday I stayed inside all day and as soon as I walked outside, I would feel itchy. I've called Dr. Brieva a few times yesterday and today, leaving detailed messages that were not relayed in their entirety. I unfortunately missed a return call from Dr. B's nurse, R. The problems:

1. Phototherapy protocol is that after a gap in treatment at Northwestern, the patient starts from square one--getting phototherapy for only 37 seconds at a time. The five-minute sessions in Mass. are not taken into account because every machine is different and they can't be compared. Are there any exceptions to this? Can I get a higher amount of light because I’m suffering?
2.I can’t get an appointment w/ Dr. B until Sept. 24. Because it is hard to get an appt with B, I saw an associate of his, A, last time. She's gone now, on a fellowship, and I suppose she has no prescribing power at Northwestern at this time. Or does she? Or is there another doctor I can meet with immediately?
3.I left two messages for B yesterday (Monday). I asked for an appointment, to talk to him, for a prescription for 3X week, and whether there was anything stronger than Atarax. The nurse called back today, for a few moments when I was away from the phone, telling me he would have to see me before changing the phototherapy frequency. I would be happy to see him but he can't see me until Sept. 24.

I would like, at least, to talk to Dr. B on the phone about having longer phototherapy sessions and more often. I’d also like to know if there is an Rx that is stronger than Atarax.

If this is not possible, I’d like a recommendation for a dermatologist in the Northwestern system who is easier to get in touch with.


Will it never stop? the annals of bureaucracy

When we were in southern Maine in July we walked along the beach, got our legs wet, rinsed off, then started back up the road to our motel. This was during a nation-wide heat wave, and thus the cool temperatures that we had been seeking on the coast had eluded us. They were not within reach. The cool temperatures taunted us. From a large distance. So large that we did not know where these increasingly mythical cool breezes were. In Canada, maybe? Iceland? Greenland? Maybe. Or some place on the other side of the equator where it was already (or still) winter. But not in Ogunquit, where we had stationed ourselves, about a mile from the beach.

On the way back from said beach, two examples of what they call the official state l bird of Maine--the horsefly--bit my legs, one fly per leg, one bite per fly.
Both legs started itching and I started rubbing them against one another while I was walking so that I could scratch while going forward. And so for a few days I was itching all over.

This is not an unknown state for Cancer B(itch), whose polycythemia vera and accompanying itch have been documented on these cyber-visible-non-dimensional non-pages. The aforementioned blood cancer causes the itch. It was first manifested as itchiness after showering. One woman, Cancer B(itch)'s temporary dermatologist in Massachusetts, told her this summer, had apres-bain itching before she could be diagnosed with polycythemia. Which gives one pause. To have a symptom of a disease before your body registers that you have the disease. If that wouldn't make a person crazy, I don't know what would.

A Personal History of the Itch until Now:
The itch is as mean as a horse fly. It causes all-over itching, even after benadryl, 24-hour antihistamine, gabapentin and aspirin. In the emergency room, she discovers Atarax, and swoons.
The Friendly Hematologist said we will have to try Interferon if we can't control the itch.
But then she tells Cancer B(itch) of a dermatologist at Fancy Faculty Foundation who specializes in skin conditions caused by non-skin-related conditions.
The Quick-speaking, Quick-moving Dermatologist prescribes phototherapy three times a week, which means that three times a week Cancer B(itch) stands naked in a tank that emits purple light, UVB rays, that are successful in calming the itch. She still must keep taking antihistamines.
After a year, another dermatologist in the practice prescribes the phototherapy just twice a week, because it is doing its job. Cancer B(itch) has built up her tolerance and practice so that she stands for six minutes each time in the tank.
Cancer Bitch goes to western Mass. on a fellowship, and locates a dermatologist who provides phototherapy in a little folding tank upstairs from his little cottage of an office. He believes in patient-directed care, and so Cancer B(itch) continues her phototherapy for five to six minutes at a pop (Fancy Foundation has failed to send her medical records, but the dermatologist trusts her), twice a week. Her itch is under control, with the light and the antihistamines.
After the fellowship, she and L become cool-seeking devices on their way to New Hampshire and Maine beaches.
Enter the horse fly.

Cancer B(itch)'s itching is uncontrollable, except when she's inside in the air conditioning. L originates a plan to return to western Mass. for phototherapy. They cross three state lines in one day.
She is light-therapied.
She is less itchy.
The dermatologist opines that there are new allergens in New England that are causing the strong reaction.
It is better back in Chicago. For a bit.

This Saturday she and L ride their bikes about three miles to a union picnic. Her legs are itching, though she's taken a 24-hour antihistamine. At the picnic, it's worse. There is no air conditioning available. She takes a generic Atarax and after about an hour, the itching stops. But gets worse later that day, despite Atarax, and throughout the weekend when she goes outside.
There are theories:
1. It's the heat.
2. It's the humidity.
3. It's both. Cancer B(itch)'s theory is that it is heat, as well as the humidity, which is a sign of, well, general wetness, which indicates lots of mold spores floating around, mold to which she is allergic. The allergy usually causes a reaction in her lungs but for some reason the reaction is going straight to her legs (unlike food, which goes straight to the hips--you knew that was coming) because her skin is now the weakest point. It is compromised.
She is afraid to leave the house. This is not agoraphobia. This is φαγούρα-phobia. She and L start to walk to the card store about five blocks away and they have to go back and get in the car. It is that bad.
And what makes this all worse is that at Fancy, the nurses have made her start her treatments from scratch, beginning at 37 seconds in the tank, instead of six minutes, because that's the policy, which is based on the theory that all light tanks are different, so you never know the strength of the one you used elsewhere. You'd think by now there would be ways to measure that.
And--she can't up her frequency in the tanks to three times a week, because the dermatologist prescribed twice a week. And they can't call that dermatologist because she's on leave. The end. You'll be back up to six minutes soon, the nurse says, though that isn't true.
The Original Dermatologist is very busy (though he is quick) and Cancer B(itch) gets an appointment with him in late September.

Finally today she takes bureaucracy into her hands and calls the Quick Dermatologist's office at Fancy, and talks to an overworked, indifferent worker who puts her on hold about seven times in the middle of conversation. Success is achieved in the form of getting the worker to agree to take a message for the Quick Dermatologist. This is so very different from the way things worked with the Massachusetts Dermatologist, who was casual about appointments and writes a health blog and majored in Comp Lit in college.

I know this account is tedious, so tedious that maybe no one will ever get to this line that acknowledges the tedium. My friend S is recovering from a hysterectomy and waiting to hear whether the nodes that were removed are cancerous. I apologize for telling her about my itch. She says no no it's fine it makes her feel more balanced in the world to hear other people's problems, makes her feel less that she's only thinking of her own ills. As Steve Goodman sang,

And it ain't too hard it to get along with somebody else's troubles,
They don't make you lose any sleep at night.
As long as fate is out there burstin' somebody else's bubbles
Everything is gonna be alright.
And everything is gonna alright.

Steve Goodman photo--he died of leukemia

Photo of black horse fly from here.

Ozone action

San Francisco Photos

So tomorrow is to be an ozone action day in the Chicago area, meaning that those in "sensitive groups" who have sensitive lungs should limit their outdoor activity. And those who pollute (most of us) should try not to. As a sensitive grouper because of my asthma, I therefore should stay indoors in the air conditioning, which filters out many allergens and pollutants, but uses up much energy. And I shouldn't ride my bike, but if I drive instead, that's no good, either. I plan to row on the polluted Chicago River, which is filled with untreated sewage, though the EPA says it needs to be swimable. I like what BART does in the Bay Area: lets people ride the train free on when the ozone is high, on Spare the Air days. Free is always a good incentive. I think all public transit should be free. Which is a dangerous thing to say in these Government is Bad times. It used to be that the anarchists were the ones saying There's no government like no government. Now it's the guys in suits holding tea bags that they could steep safely if they wanted to because the manufacturer had to follow guidelines set by the FDA and OSHA and so on.

{photo courtesy of Tripadvisor}


So I get a robo-call from Rite Aid Pharmacy, where I got one prescription when I was in Massachusetts this summer. The computer voice asked me to input my date of birth, and then asked if I wanted to refill my prescription. It said that the call might be recorded for training purposes.

So another robot will listen to it and thus learn how to improve its customer service skills?

{Image from Metropolis}

Brain and Body

The New York Times reports that moderate exercise, including light weight-lifting twice a week, can help keep your brain from deteriorating, at least at a fast clip. We are always worrying about our brains at Cancer Bitch HQ, and we are determined to use our left hand (when we remember) and to learn something new (chess) so that we can make new grooves in our brains--at least that's the way we imagine it. For various technical reasons, I have to put the New York Times' article URL here: http://tinyurl.com/3lhgptm
instead of hiding it under a highlighted word. But you can figure out how to find it, right?

On Vacation

Haymarket Cafe, North "don't aspirate the H" ampton, MA:

Cancer Bitch has been studying African-American history in New England, and now she's on vacation in central and western Massachusetts. Please forgive her lack of posts.

"The Big C" returns

I saw the cable cancer show, just once, last year, when it was launched. It was the only episode I could watch for free, since we don't have cable. If you so desire, you can read what I said here. It struck me as weird that she didn't tell anybody about her diagnosis. She just used it as an excuse to break away from her very very constrained life. (Watch for the new video, "Mets" patients go wild!!")The show is continuing, and a real-life melanoma survivor wrote a critique today in Salon. Mary Elizabeth Williams says, among other things: Much of the most interesting stuff surrounding a devastating disease is what it does to the people around you. And in that regard, "The Big C" shows improvement over last season. I'll have to take her word for it. Those of you who've seen The Big C--What do you think of it?

The new fountain of youth

[This is how I would look having coffee in London in 1740 if I were male. I'm the one in the powdered wig and breeches.]

All of us are terrified about losing our memories. About getting Alzheimer's. About forgetting just enough to realize how much we have lost. About becoming piteous burdens. Coffee can help! It seems so simple, so American, so gung-ho we can do it--didja know that the cure was right in our cupboards? Well, it seems to be true. Mice who were given coffee or a coffee-ish substance could remember better how to run through their mazes or open the drawer that housed the cheddar, or whatever the scientists were having them do, better than mice who didn't get a cappuccino.

Specifically: Researchers at the University of South Florida found that the caffeine in drip coffee, as well as an ingredient in coffee that they couldn't isolate, can stave off Alzheimer's. And, there's more! The USF web site sez: An increasing body of scientific literature indicates that moderate consumption of coffee decreases the risk of several diseases of aging, including Parkinson’s disease, Type II diabetes and stroke. Just within the last few months, new studies have reported that drinking coffee in moderation may also significantly reduce the risk of breast and prostate cancers. This will be reported in the June 28 issue of the Journal of Alzheimer’s Disease, 25(2). More here: http://hscweb3.hsc.usf.edu/health/now/?p=19816

A cure for lymphedema?

A French doctor has pioneered the transfer of lymph nodes from the groin or other body area to the underarm in order to put a stop to lymphedema, which is the painful swelling of the arm after breast-cancer surgery. It's caused by the removal of lymph nodes, which, according to some research, isn't even necessary. Doctors are performing the surgery experimentally here. You can read more about autologous vascularized lymph node transfer here: http://www.nytimes.com/2011/06/21/health/21lymph.html?ref=health

Note: This is not lymphoma we're talking about, which is cancer. This is "dema," as in swelling.

[Photos from mysassysleeve.com, which sells these covers to put over medically-necessary compression sleeves.]

News to me: estrogen is not the enemy

Two gynecologists have told my friend S she needs a hysterectomy, which she is scheduled to have in August. She told me that the docs told her that hormone-replacement-therapy would be fine for her afterward. I was shocked, and told her that the reason that breast cancer numbers are lower is that women have cut back on HRT. She countered that the second doctor told her au contraire. I looked around the 'net and found that this news was broken six months ago. At the big pow-wow for breast cancer oncologists in December in San Antonio (a smart place to go in December) last year, researchers presented evidence that women who take estrogen and have no family history of breast cancer are not at risk for developing it. The American Association for Cancer Research reported on the findings: While endogenous estrogen (i.e., estrogen produced by ovaries and by other tissues) does have a well-known carcinogenic impact, hormone replacement therapy (HRT) utilizing estrogen alone (the exogenous estrogen) provides a protective effect in reducing breast cancer risk, according to study results presented at the 33rd Annual CTRC-AACR San Antonio Breast Cancer Symposium, held Dec. 8-12. So now it makes more sense that a gynecologist at Fancy Hospital (who is tuned into non-traditional, or as they call it, integrated medicine, which is really traditional, in that it emphasizes nutrition) told me a couple of months ago that I could have soy products, that they were phyto-estrogenic, but safe for me to take despite having had estrogen-eating tumors. But only soy products that were in a natural form--edamame, soy milk, tofu and the like, not texturized vegetable protein. I asked her later if she would be my gyne, but alas, she said that she worked only on the study I am taking part in--a screening to prevent ovarian cancer. She also said that I should have 40-60 grams of protein in the morning to help with my memory/chemo brain. Do you know how hard it is to get that, if you don't eat mammals? That's a heap of a lot of soybean. Not a horrendous amount of fish, or turkey bacon, though.

So what did they expect?

Researchers in Portland, Oregon, found out that when people lost Medicaid dental benefits...they went to the dentist less, their dental health suffered, and they used the emergency room more often. On the one hand, I want to say, Well, wasn't this obvious? Why did you bother? On the other hand, I'm assuming this was done so that health-care activists would have some data to use in their arguments. In the meantime, the cavities yawn wider.

Test problems

Ah, it can make life difficult from time to time when your basic fear is of annihilation. I'm afraid of my personality being squelched, of my person being killed, of my being being obliterated, not to mention my soul. I went to a Psychic Healer (neuropsych consultant at Plain University) because I'm concerned about my memory loss. I told him and his minions that when I was 16 I had some tests, and I became hostile toward the tester. Later I said I realized why: It was the individual's response to the notion and action of the testing experience, where the tester is trying to capture you in the confines of the test. So of course what happened was, after giving me tests that made sense (repeat this list of words, repeat this list of numbers, recall this image, add these numbers and these numbers, recall the animals in the first list but not the second list, etc., etc.), though were also annoying because they showed a cultural bias, the minion gave me the Minnesota Multiphasic Personality Profile to fill out at lunch. I was hoping to eat lunch at lunch and read about Reconstruction (of the South, not the breasts). Instead I answered True and False to statements like, I believe that working hard mostly leads to success. (In this economy? Among *all* people in this unequal world?) And: I fear earthquakes. I fear snakes. I fear spiders. I'm afraid of flying. I get upset before short trips. (Separate statements.)What is a short trip? I was anxious before driving to Valparaiso because I don't drive on highways much and I had to get myself organized to talk to a class and do a reading and an interview. Is 90 miles a short trip? Is going to Trader Joe's several blocks down? How about going half a mile to B and S's?

I was annoyed at the cultural bias (The world is generally a fair place.) and also at the lack of subtlety. Either true or false. Nothing in between. It was also decidedly archaic: I don't read all the editorials in the newspaper. If I were a journalist I'd like to cover sporting news. I remember that phrase exactly: sporting news. There were several statements about being a journalist. There was none, strangely enough, that said, If I were a journalist I would be depressed to be in a dying profession, and I'd probably be out of work and freelancing for my former employer at one-tenth the pay and without health insurance besides. Another statement was like this: I'm as happy as most people. What does that mean, in this land of foreclosures, in a world of war and suffering? As happy as most people? Even Freud famously and modestly attempted to restore people to ordinary unhappiness. Other statements: I have many brilliant ideas. I could be famous. I know more than some experts. People think my ideas are strange or peculiar. I could be a comedian. I'm assuming that a True would indicate mania and unrealistic ego inflation. But I have had brilliant ideas. Ten percent of the people I went to grad school with are famous. I know three MacArthur-certified geniuses. I was paid as a comedian in grad school. People do think my ideas are strange, and I think that's a positive. I've been analyzing culture through, as they say, feminist and Marxist lenses, for 25 years. I do know more than some experts. (But, Cancer Bitch, what if the statements have more to do simply with self-esteem and in the case of the comedy career, with optimism and sense of humor?)
L and my friend G the therapist say I shouldn't try to out-psych the test. Wanting to do so is probably a sign of a controlling personality and inflated ego. But I could have told you that.
And, said my other friend G: What if Maureen Dowd or Steve Martin took the test? What if a Nobel-Prize winner with truly brilliant ideas?
I decided not to turn in my answers. The Psychic Healer was annoyed. He said that the test helped him in his diagnosis. (Do you want to know what I fear? What I tell myself? What my faults are? If I'm anxious? For $20 I'll sell you any of my books and you can find out in any five pages. Or read this blog for free.) Yes, Cancer Bitch is hostile. Just like when she was 16 years old. Which disappoints her, she who wants to change into a better person. He gave me a test that he didn't like as much, but which I liked better, because there were gradations: False, Somewhat True, Mostly True, Very True.
But the main thing is, probably (and I could have told you this not much after 16), that I am afraid of being pigeon-holed. I'm afraid of a world going on without me. Of that old demon, Thanatos. Who isn't?

Time to parler that Frainch

The New York Times says that we're better organized and more focused if we speak two languages. There’s a system in your brain, the executive control system. It’s a general manager. Its job is to keep you focused on what is relevant, while ignoring distractions. It’s what makes it possible for you to hold two different things in your mind at one time and switch between them, cognitive neuroscientist Ellen Bialystok told the Times.

--illustration from here

The catch is you must be truly bilingual--and not just put in a mot here and there. Bilinguals staved off Alzheimer's for four or five years, and they were better able to multi-task. You can argue that multi-tasking is our problem, that we need to breathe, slow down and do one thing at a time, rather than two things a la fois. I am so happy when I'm speaking French. Should I strive to become truly bilingual? And in French rather than Spanish, which more of my fellow Americans speak? But for those of you who are thinking of speaking another language more often or studying another language--vas-y!

I had trouble finding a good bilingual image. Let me know if you have some better ones.

The wonders of jagua

Jagua is a fruit-based temporary dye. It is not black henna, which is henna mixed with black hair dye, and can cause all sorts of nasty blistering and infection. No, jagua is no such animal. With a tube of jagua gel (and without using the little pointer tip until the end, because I was too lazy to go upstairs and look for it), I created a medusa on the top of N's new chemo-head. N is getting chemo, then surgery, then radiation. Then more surgery. I mention the lack of pointer tip, because without it, the gel came out too quickly and I think I wasted some jagua. In any case, it took a whole tube to form the medusa and snakes. This is how it looked when I finished:
I was copying freehand from a design and I think I made the medusa too friendly-looking. Here is how N looks from the front:

The pictures were taken when the ink was still wet. When the jagua dries, you peel it off and underneath it's like dark gray paint. It can last up to two weeks. When N sends me a photo of it after it's peeled off, I'll post it here.

Pregnant and diagnosed with cancer--not the end of the world?

reported this morning about women who survived chemo while pregnant and gave birth to healthy babies. Usually, it's simply a terrible accident of timing: The pregnancy has nothing to do with the cancer's emergence.

You might be thinking that higher hormone levels are causing cancer at this time, but CNN reports that studies show that pregnant women are more likely to have hormone-receptor negative tumors than hormone-receptor positive tumors--meaning they are not fed by pregnancy's higher levels of estrogen and progesterone.

If You Recall the Past in Detail, You'll be Less Depressed than if You Recall it Only Generally

Australian firefighters who experienced trauma were more likely to have PTSD if they couldn't recall the events specifically.
That is what the New York Times is telling us.

The Times reports: “People with P.T.S.D. tend to ruminate at a very categorical, general level about how unsafe life is, or how weak I am, or how guilty I am,” said the lead author [of the firefighter study], Richard Bryant. “If I do that habitually and then I walk into a trauma, probably I’m going to be resorting to that way of thinking and it’s going to set me up for developing P.T.S.D.”

Overgeneral memory can protect people from traumatic memories and such people have it easier than those who think back to the trauma specifically--in the short term.

Without detailed memories to draw upon, dispelling a black mood can seem impossible. Patients may remember once having felt happy, but cannot recall specific things that contributed to their happiness, like visiting friends or a favorite restaurant, according to the Times.

“If you’re unhappy and you want to be happy, it’s helpful to have memories that you can navigate through to come up with specific solutions,” Dr. Williams said. “It’s like a safety net.”

Mindfulness meditation can help people accept their negative memories and not ignore them, according to Dr. Williams. “I always tried to forget the past, the very bad past that made me depressed when my husband died,” said Carol Cattley, 76, who attended a mindfulness course here [Oxford, England] taught by Dr. Williams. “I’m much more interested in it now.”

[Image: Meditation by Alphonse Mucha]

The MAAMies

The votes are in, and Cancer Bitch did not win a MAAMie this year, but CB congratulates the winners of Mammogramatically Challenged And/Or Also Metsters [meaning those with metastasis] blogging awards nonoring those who disrupt the cancer culture status quo.
Click here to read more.

Image: © Chnutz vom Hopfen
From an issue of Romaunt de la Rose, 15th century

Statute of Limitations on Chemo Brain is Extended or: Where Did That Noun Go? Check Back in Five Years.

The New York Times Well blog reports that chemo brain doesn't necessarily fade away after a year. It can last up to five years. Or more. Researchers measured the cognition of 92 surviving patients who had blood cancer treated by chemo as well as bone marrow or stem cell transplants. According to the Times, the results should be the same with people treated for breast and other cancers. Read the abstract here in the Journal of Clinical Oncology.
Judging by the abstract (which I'm sure isn't fair) this study seems pretty loose. Are the same chemotherapy drugs used to treat various kinds of cancer? Were certain chemo potions more likely to render their recipients word-less? I looked for the complete article via Smart University's online library, but could not find it. I'll keep trying.
[Illustration: women hunting for nouns that escaped from the tips of their tongues. Also deer.]

Another temporary bald head

Nicole Xylouri Osborne is going through chemo with attitude. Here she is with her new "do" by Sheba of Sparrow.

I have been remiss

Please excuse Cancer Bitch's absence from her blog for the past week. Wait--it's been longer than that. She's been, uh, observing Passover. Obsessing about her failing dental implant? Overwhelmed by the New York Times Magazine articles on cancer last week and wondering how to summarize them and then as more time passed, figuring that it was too late and time to write about the next new cancer thing which is what?
The bad thing about hanging out with people w/ cancer is that they can die on you.
Friday was the funeral of Cindy Gerstner, whom I knew from ROW. Just below is a picture of Cindy with her daughter at a ROW open house last year. When I met her, her cancer was already Stage 4, but she was rowing with the rest of us. She was one of the few if not the only one of us who'd rowed in college. She spoke at our fundraiser in September and came to our regatta in Wisconsin that fall, even though she didn't row.
Our coach J wrote about Cindy in her blog. Cindy was a professor of biology and ecology and she was so very matter-of-fact about her disease. There are other women in ROW who are Stage 4--for some reason they are the trimmest and strongest-looking of our bunch. They remind us that cancer is more than fun and games.

Still Focused on Myself

I made an appointment to see the periodontist (pere) on Wednesday because I am still in dental pain. His son did the implant but has been out of the office. I realized today that I have:
a dentist a periodontist
well two periodontists
a podiatrist
an internist
an oncology gynecologist
a plain gynecologist
a therapist
a psychiatrist
an oncologist
a hematologist
a surgeon and accompanying rotating radiologist
and I think that's it. If I were Tom Lehrer I would have already written a song about it.

[Image: one of the elements in Lehrer's song]

Just one sentence about me

The antibiotic I'm taking to get rid of the infection from my dental implant precludes me from getting my twice-weekly phototherapy that is necessary because it helps with the intolerable itching caused by my blood cancer.

[Image: Victorian Blood Book, from the library of Evelyn Waugh, now at U of Texas, http://www.hrc.utexas.edu/enews/2009/february/bloodbook.html]

Does "support" include treatment?

Komen just received a $1 million grant to tell poor ladies in the Rust Belt about breast cancer. Over the next four years, the program will train nearly 500 lay health advisors [first in Ohio, then east and west] to provide education and outreach on breast cancer in 17 communities served by Key Bank and Komen Affiliates nationwide. Lay health advisors will provide information, referrals to health care resources, one-on-one consultations, assistance with scheduling, support during health care visits and more.

Komen founder and CEO, Ambassador Nancy G. Brinker, said the grant will help Komen reach women who otherwise might not be helped. “These women may be unaware of their risk for breast cancer, unable to access the health care system for answers, or unsupported if they do need treatment. Our mission is to ensure that all women have the information and support they need to confront this disease. This commitment from KeyBank Foundation will help make that possible.”

Are these women going to be treated for their cancer? Is Komen going to get them mammograms and biopsies and MRIs and surgery and chemo and radiation? Will these disadvantaged women be trained to find out what they need, and then discover on their own that they can't get it it? I'm all for helping people who need help, but there's help and then there's help. The adviser can make an appointment for you, but who's going to foot the bill?? I can't find any more info about this on the web, and we bloggers are known as parasites of mainstream media, feeding on what's already out there, ready to quick-draw our opinions. Oh no, does this mean I'll have to do some original reporting? Stay tuned.

I Love Prednisone & I ain't foolin'

I love prednisone in the summer, I love prednisone in the fall, I love prednisone in the winter, and I got my hands on some today because I am very very lucky and this doesn't have to rhyme.

I've had two itis-es since Saturday: laryng- and bronch-, and finally went to the doctor today. I was already on the mend. That's how it always works. She told me to use my inhaler every four hours but the albuterol wasn't doin' nothin. So she gave me 10 20-mg tablets of prednisone--co-pay only $2.40. What can beat that?

I love prednisone because it's the one thing that always cures my very bad asthma or bronchitis. I try to avoid it because it's not good for you--I treat it as the last resort. In fact, I wrote a long poem about it as last resort many many years ago, when I was at a resort of sorts, an artists colony in the middle of allergens. The poem was almost accepted in a feminist magazine's special issue on invisible disabilities, but the editor objected to a line about breaking the back of something, maybe capitalism. It was ableist to be seeing a broken back as negative, that was the argument, though the back that was being broken was sheerly metaphorical. Maybe that made it worse. Anyway, it's probably one of the better poems in English about prednisone.

Stanley Elkin wrote a wonderful essay, Out of One's Tree: My Bout With Temporary Insanity, about craziness caused by high doses of prednisone he was taking to treat breathing problems caused by his MS. He might also have been taking it for the MS itself. I sent a copy of the Elkin essay to my cousin D, after our family dinner was briefly interrupted by a call from one of his patients. D is a psychiatrist, a psychoanalyst yet, and I think he had to admit his patient to a hospital because she was suffering from prednisone side effects. But I never take it long enough to be so affected. I don't think.

Scar project

I just came across this. This is one of a number of pictures of young women 18-35 who had breast cancer. The photographer is David Jay and you can find info about his book and project here.

I don't particularly love this picture with its S&M overtones (Hang 'er on the rack! It's not enough that we've sliced off her breasts!) but at least she's pretty and sexy in a Hollywood noir kind of way, and more importantly, it was the only photo from the web site that I was technically able to copy and paste.

Hill of Beans

The Huffington Post reports that scientists at Stanford have figured out a way to turn anxiety off and on in mice. About one-fifth of Americans are anxious in any given year, says the Huff Post, allegedly quoting the NIH, but the link didn't lead me to the source.

The scientists found ways of stimulating cell projections in the amygdala section of the brain, causing mice to be less anxious, and seem emboldened, spending more time exploring open spaces than control mice.

They sound like the mice I had in my old place. They would run around the kitchen with impunity, and stand there in the middle of the floor with the lights on, looking around. I don't know what emboldened them. Maybe their drinking water was contaminated with Prozac.

So here are many questions: What does it mean that one-fifth of us are anxious at any given time? Have humans always been anxious and are we only now finding a way to keep track of the numbers? Are we more anxious now because of our fast-paced life? Or eating food additives, or living with the minute hand so close to midnight, or with constant reminders of war and terror and uneven distribution of wealth?

Maybe we should be anxious. Since the invention of the telegraph, we humans have been able to transmit news of death and destruction immediately all over the world. Our species has grown cognizant that the earth is fragile. At the same time, we've been assaulting the earth with toxins, pollution, strip mines, cement and so on and so forth. Nature (tsunami, earthquake) combines with culture (nuclear reactors) to extend disaster.

Does anxiety to lead to working for social change? That's the real question. If we weren't all medicated, would we be up in arms more? Are we sedated and inert? Probably not. When I was at my deepest level of anxiety, I wouldn't answer the phone because I would start weeping. I was not in the mood to go to a rally or knock on doors. On the other hand, does political action lead to feelings of connectedness and mastery and increased self-worth? Yes, it can. So as the song says, Don't mourn, organize (while it's still legal).

... it doesn't take much to see that the problems of three little people don't amount to a hill of beans in this crazy world. Someday you'll understand that. Now, now... Here's looking at you kid.

Midnight in the Garden of Mammos

[still from CBS]

Today's Trib had a story about mammogram parties at local hospitals. Apparently this has been going on for quite a while. CBS reported in 2007 on midnight mammogram parties as well as mammogram parties earlier in the day. The idea is that women get together to make a party out of their annual checkups, employing chocolate, wine, cheese, flowers, manicures, camaraderie, massage to help them bear the painful pressing of the mammograpy machine. The funny thing is that the Trib had a story on this in 2010, as well as 10 days ago, by a different reporter, in the Des Plaines local. Today's (3/16/11) story says that the parties are for women who have not had cancer. Oh well. I had a farewell party for my breast. (You can see photos of it on the right.) Apparently that's old hat. And not above reproach: Writing in Jewish Woman magazine in 2010, Elicia Brown quotes Barbara Brenner, executive director of advocacy organization Breast Cancer Action:“People respond to crisis in whatever ways they need to cope. That’s what’s positive about this,” [Brenner] says. “But selling T-shirts, throwing Bye Bye Boobie parties—how does that get us closer to ending this epidemic? How does it get us closer to better treatment options that increase the quality of people’s lives? Too bad we can’t throw a Bye Bye Breast Cancer party!”
Too bad, but in the meantime, why not have fun while looking death and disease in the eye? Isn't that the basis of most rituals and festivals?

[Skull by Thaneeya McArdle]

In Qatar

It used to be that people wouldn't talk about cancer, especially breast cancer, and that women who noticed lumps would wait months and months and maybe years to get treatment. That's how it is in Qatar, according to a short video. Watch the film in a quiet place, because the volume is pretty low, at least it was on my computer.

Two million of us

There were 2,591,855 survivors of breast cancer in the US on January 1, 2007. That's according to a new study released by the Centers for Disease Control and Prevention and the National Cancer Institute. That's quite impressive. It comes to 22 percent more survivors since 2001 for breast cancer alone, and 20 percent for cancer overall. More and more are living with the disease, though there's living with and living with. Living with, for example, could actually mean dying. As the report states: Finally, the data do not permit specifying whether a cancer survivor is cured, in active therapy, living with a chronic cancer-related illness or disability, or dying from cancer.

Oh well. If you read the comments after the New York Times article about this, you get more food for thought. The commenters say that doctors over-test and over-diagnose, that survival isn't the be-all and end-all if you're out of work and the bank has foreclosed on your house, that toxins are still swirling about around and inside us.

I don't know what statistics would be more meaningful. You could see who has Stage 4, and count those people as soon-to-be-non-survivors, but then again some people are living with Stage 4 of various cancers. I suppose everyone is a survivor until they croak.

News flash: Hot flashes are good! Or at least not bad for you!

Is it hot in here?

A new study of menopausal women shows that hot flashes aren't all bad. We found that women who experienced symptoms when they began menopause had fewer cardiovascular events than those who experienced hot flashes late in menopause or not at all, says endocrinologist Emily Szmuilowicz, lead author of a study that will be published in the June issue of Menopause magazine. (For some reason, unlike AARP, Menopause magazine doesn't automatically find you when you're at that age.) You can read an abstract of the paper, titled “Vasomotor symptoms and cardiovascular events in postmenopausal women” here. Or the Northwestern Memorial Hospital press release, which is easier to absorb, here.

[painting: Hell by Bosch]

Man speaks for woman

O O O this should not bother me, but after all I'm the Bitch, and so many things can bother me that wouldn't bother a non-bitchy person. There's a woman who was diagnosed with breast cancer at Sloan-Kettering, just one of 200,000 women who will hear that the test was positive this year, and the noteworthy thing about her is that she's the Wife of a Doctor. A Doctor at Sloan-Kettering, and ain't that ironic or crazy or what-have-you, and since this is the age of irony, her husband gets to write about the experience in the New York Times. Am I jealous? Yes. Is that what's fueling my ire? Yes. No. Am I annoyed that he writes in an ungainly fashion and strains when he makes comparisons and isn't very interesting? Yes. Am I jealous? O, we covered that. Sort of. It's in the New York Times blog, not print, and since cyberspace is everywhere and nowhere, in a way you could say that it is not in the New York Times, or you could say it is there and everyplace else in the known world. But even at the blog, aren't there editors? Must not be, otherwise we wouldn't have such sentences as: The late nights along the Seine were as dark and dreary as the sunshine was bright that Wednesday morning on the Upper East Side of Manhattan.

The author is a doctor at Sloan-Kettering. What kind of cancer doctor? No one says. He admits that the white coat has been his protection against involvement and emotion. But anyone who's ever visited a hospital could tell you that. He also has pull, not surprisingly. He tells us that they got an appointment with a friend who's a breast surgeon: When I told him Ruth had felt a lump, he had made room to see us right away.

Which is nice. And I'm sure they have insurance, which is good because I doubt that professional courtesy would pay for all her subsequent treatments. Which is good for them, especially since they seem pretty young and it appears from this first installment that the cancer has spread to her lymph nodes. (Though you've read here that removing cancerous lymph nodes may not be required, after all.)

Of course, a more erudite decision on the part of the Times would have been to tap (virtually) the shoulder of the Cancer Bitch and offer her the blog spot. She could write: When the Cancer Bitch has Blood Cancer, a comedy of manners that has not yet ended. But the tap was not received, no messages were left. And a more relevant and important and serious decision would have been to get an uninsured woman to write about her breast cancer. Or, second best, the husband of said woman. Or daughter. Finding such a person would be easy--it is said in these parts that a scoffing full professor (the kind who hires adjuncts) once said he could spit outside the window of his office downtown and spray any number of PhDs, the point being that those with doctorates in English should be grateful, o so grateful, hat in hand and bowing and scraping, if and when they were offered a couple thousand dollars for teaching a course as an adjunct. So too, unapocryphally, you could walk to to the county hospital here, named for a politician, John Stroger, who spent his last days, comatose, in a private hospital (Fancy Hospital, in fact), and find hosts and hosts of people without health insurance. Interestingly, ABC News told us: Stroger lost a brother who was turned away from a segregated hospital in the South, and the availability of quality healthcare became his pet issue. He struggled for decades -- sometimes alone -- to make sure the Cook County Hospital remained open. There was a libertarian Republican named Tony Peraica who ran against Todd Stroger, son of John, for Cook County Board president, and I didn't like Peraica's politics at all, but I had to appreciate one commercial in which he said he would improve Cook County Hospital so that it would be good enough for John Stroger to go to. Peraica lost and Stroger died and Ariel Sharon remains cocooned in his own coma, and I think no one in Israel has the chutzpah to pull the plug on him. The photo above right is of a sculpture of Sharon by artist Noam Berlavsky.

The transformation implied in the blog, I think, is that a doctor regains his vulnerability and dare we say humanity, not to mention humility, when he is the spouse of a patient, and not a Doctor draped in sanitary whites. This is a tricky concept, because we writers would tell him that the story is his--but if he makes the story too much his own, he will seem like a cad because it's his wife who was stricken. The best thing for him, in order to remain a sympathetic narrator, is to contract a serious disease himself. But such things take time.