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April 20, 2004

The Big C

Today is the big meeting with the oncologist out in Santa Monica. Moms, of course, is brave and confident in the way that women of faith are. Although it sometimes feels like diffidence to me, the bottom line is that her head is straight and she's ready to go under the knife.

We've gone through the legalese of Advance Directives and decided who is going to decide what. There are significant details with regard to the timing and milestones in the grey areas and percentages of recovery progress on the respirator. It comes as a small surprise that there was nothing at all in the California form which suggested that same sex couples could not designate their partners as having medical power of attorney. This may be new, at may be not, but I've seen it and I know. It's an admittedly odd way to come to a political discovery, but there is always something to learn when you walk through life with your eyes open. Ours are open and watery, but the vision isn't blurry. Our mother is 67 and about to lose a kidney.

Everyone's best guess through the lenses of the MRI scans that the cancer has originated in the right kidney and is pressing up against the liver. So while the kidney has got to go, there will be a good deal of residual cancerous growth on the liver itself which the surgeons will have to scrape like so much carbon on toast. Liver tissue regenerates rather quickly, so we are hopeful that as the surgeons do their scraping they don't get too happy about it. So we have requested that RFA be available during the surgery to zap any spots of cancerous tissue that appears to be left.

The complication in all of this is a recently discovered spot of something ugly in the vena cava, the main vein to the heart. Nobody knows exactly what it is. I suspect that it might be part of the missing yellowcake from Niger, but I could be wrong. The smart money is it being some bit of cancer which broke loose from the homeland and established a colony in the new world, in which case the news is not so good. But there is a significant minority report which indicates it might be a simple blood clot, which can be deftly handled in a 15 minute procedure. The difficulty in this is you can't know until you've cracked the ribcage and opened the damned thing up. I'm sure we all look very forward to nanotechnology. Until then we do it the old fashioned way. At worse they will have to bypass and pull some veins out of her leg and make a graft of some sort. I will ask specific questions about the diameter of these pipes today.

As you might imagine, such thought takes a bit out of one. I hope at my turn to be a lucid subject.

It reminds me of my late uncle Salif, who remained a man of mystery until his bitter end. His decision, that old African, was to keep quiet about the reality of his cancer. He became a consumate asshole to the people who loved him most. He drove them away in a calculation of love, selfish to be sure, but effective. By the time he died, his wife and kids were practically to the point at which they were wishing him dead. That may be the way they do it in Mali, but things are different here. And yet it makes us think about our willingness to submit to death and in what ways we prepare ourselves and others for it.

I'll have time to be philosophical beyond that point another day. This day, it's down to Santa Monica for the Big Meeting.

Posted by mbowen at April 20, 2004 10:14 AM

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