cancer a possibility

My neurologist called yesterday to say that he ordered the CAT scan because my fifth vertebra “didn’t look right” on the MRI. It looked no better on the CAT scan, and he thinks I could have cancer. Since cancer rarely originates in that location, it would probably have metastasized from someplace else—my prostate, he speculated. He said he had spoken with my internist, and that I should expect a call from him. This is my second cancer scare this year--I had a lymph node biopsy in February.

Peggy got in late yesterday and left early today (she works three, ten hour shifts each week), so I didn’t give her the news because she wouldn’t have slept. She had called me from work to ask if I had heard from the neurologist, and I could truthfully tell her at that time that I had not. My thought is still that I could accept such news for my sake, but I don’t know how I could accept it for hers.

timing the market versus loyalty to Bogle

I told Peggy in May that I was so pessimistic about stocks that it was all I could do to stay in the market. She said that maybe I shouldn’t, but my market philosophy came from John Bogle (the father of indexing), and I felt that I would be disloyal to him if I sold. So it is that I’ve received yet another lesson in the fact that, when I get screwed because I trusted an expert, the expert seldom if ever gets screwed with me.

So what did Bogle say that caused me to stay astride a horse that was running pell-mell toward a cliff? He demonstrated to my satisfaction that no market guru has ever demonstrated anything close to a consistent ability to time the market, and that effective market timing requires getting it right twice—once when you sell and again when you buy back (bull markets typically post their highest gains early on). I know he’s right, yet I don’t recall a single instance in which my own hunches were wrong. I have regretfully avoided buys because they seemed risky only to see them soar while my less volatile buys dropped. Now I’ve lost a third of our savings because I trusted John Bogle more than I did myself.

The trouble is that I don’t know if my hunches were a matter of intelligence or luck. Since I didn’t record them, I can’t even prove to myself that I was right as often as I think I was. It could be that I simply remember the times I lost money because I didn’t listen to my hunches while forgetting the times I made money because I listened to John Bogle. After all, no one remembers the thousands of times he drove to the supermarket safely; he only remembers the one time he had a wreck.

Having ignored my correct hunch to sell, let’s see how right I am over the coming months about my belief that now is the time to buy. Sure, the market looks risky, but if you wait until things have quieted down, you’ll miss out on its biggest gains.

Lullaby--by William Blake (1757-1827)

O for a voice like thunder, and a tongue
To drown the throat of war! - When the senses
Are shaken, and the soul is driven to madness,
Who can stand? When the souls of the oppressed
Fight in the troubled air that rages, who can stand?
When the whirlwind of fury comes from the
Throne of God, when the frowns of his countenance
Drive the nations together, who can stand?
When Sin claps his broad wings over the battle,
And sails rejoicing in the flood of Death;
When souls are torn to everlasting fire,
And fiends of Hell rejoice upon the slain,
O who can stand? O who hath caused this?
O who can answer at the throne of God?
The Kings and Nobles of the Land have done it!
Hear it not, Heaven, thy Ministers have done it!

the neurologist calls for another test, thoughts about dying

I had my MRI night before last. The neurologist’s office called at 8:00 this morning to say that he had ordered a CAT scan, and that the CAT scan people would call me. The CAT scan people called at 9:00, and said to get there ASAP, that they would work me in. This made me wonder what the dickens the MRI showed—or else didn’t show.

Based upon her terror of cancer (as opposed to her experience as a nurse) and her subsequent tendency to diagnose it at the drop of a hat, Peggy thinks I have bone cancer. She would not have shared this particular bit of information if we hadn’t been fighting at the time. Fortunately, Peggy’s fears are seldom my fears, so they don’t affect me except to make me sad that she has them.

Even if her direst prediction is right, death scares me mostly because she would have to carry on without me. Maybe I would be scared for me too if I really believed I was dying, but I think I would mostly worry about her and feel guilty that I was abandoning her. This is not because she couldn’t make it on her own (and even find satisfactions that she would not otherwise have known), but because it would be hard for her to do so. Our marriage has been through a lot during these 37 years, but it has generally gotten better since I stopped having affairs, and I would even go so far as to say that it’s pretty good now. This means that another thing that would make it hard to die would be knowing that I didn’t try as hard as I should have to deserve Peggy.

Doctor-Go-Round, Prescription Cornucopia, Chronic Pain, the Cause of Depression

My week. Monday: surgeon. Tuesday: neurologist, acupuncturist, and hand rehabilitation therapist. Wednesday: MRI. Thursday: acupuncturist and dentist.

My daily prescription regimen: Lexapro (for depression), Elavil (for sleep), Ambien (for sleep), Requip (for sleep), Vicodin (for pain), Feldene (for inflammation).

Yesterday, the surgeon declined to operate on either shoulder because he thinks I have a vertebral problem that will require surgery first. This is why I saw the neurologist today. The neurologist ordered an MRI and a nerve conduction study. I will have the first done tomorrow night and the second next Wednesday.

The hand rehab therapist blamed the failure of my wrist to heal from carpel tunnel surgery (last April) on the impingement in my right shoulder and the unnatural way I hold my body in order to avoid pain.

My acupuncturist suggested that I sleep with several pillows under my head and my chest so as to suspend my shoulders above the mattress, and that advice represents the most I got for my $550. That very night, I slept ten hours. The trouble was that the chest pillows hurt my ribs more with each passing night. I substituted various combinations of blankets, foam wedges, and air mattresses, and I even tried compromising so that some weight remained on my shoulders, but to no avail. Since my back long ago became too painful to sleep on—even in a recliner—I am in an unenviable situation.

I can no longer bike, and I can only walk without shoulder pain if I keep my hands in my pockets. When that doesn’t control the pain, I fold my arms. When that fails, I cross them atop my shoulders. Housework is a nightmare, and I don’t know how I’m going to rake the leaves, yet inactivity and feeling like I am not pulling my share of the load is even more difficult.

Yet, I cannot say that living with pain has been a total loss. I haven’t gained in compassion—as one might expect—but I have gained in a more immediate understanding of how flimsy and temporal our lives are. Only the very young are without wounds or ailments, and oftentimes not even them. Yet, despite this—and even because of it—beauty and meaning are possible. As I write, I am listening to Loreena McKennitt. How sweet her voice is, and how such grandeur as my race can achieve sustains me through the long nights. Pain reduces a person to elementals.

The Lexapro has been such a boon that I can almost imagine it being worth the thousand dollar a year price tag. Without it, I don’t know how I would get through this….

Few people presume to tell those with cancer or a bad heart that their problem will go away if they count their blessings or stop taking life so seriously; but I have received much such advice over the years, and I would compare it to telling a person who is drowning that he needs to swim.

Years ago, I was in an informal support group, and was surprised to learn that a great many of my fellows actually did believe that all manner of mental and physical ailments were entirely a matter of troubled thinking, so that all a paraplegic, for example, needed to do to walk was to envision himself as being able to walk. Such a belief is like religious faith in that it is impossible to argue against it because its holders—who tend to be young and healthy—see it as coming from a higher plane than mere evidence or logic and therefore unassailable by mere evidence or logic. It is also like much religious faith—and much advice to the depressed—in that it is smug and insulting. If I can think like a “normal” person simply by taking a pill that alters my brain chemistry (while a “normal” person would not be affected by the same pill), this surely implies that my brain chemistry might have been the cause of my depression.

I’m aware that everyone from the excessively timid to the grossest overeaters wants to be thought of as having a disease, partly because it takes away the moral stigma and the onus of personal responsibility. But what if they’re right? I know I couldn’t be a drunk if I tried just as I couldn’t weigh 400 pounds if I tried. Besides, the fact that such problems might not be entirely a matter of choice doesn’t diminish the responsibility of the person who is suffering from them anymore than the fact that my shoulder problems were not a matter of choice diminishes my responsibility for dealing with them. Even if a person should deny his own responsibility all the way to the grave, he would be no less dead.