Choices

On Saturday afternoon, I did something quite extraordinary: sat in bed and listened, really listened, to the entire Metropolitan Opera broadcast of John Adams's amazing "Dr. Atomic." This is his telling of the first atomic test, and of J. Robert Oppenheimer's role, and anguish, about his role in the development of the A-bomb.

I wasn't at all sure that I could listen. I don't like Adams's earlier opera, "Nixon in China," and (like most people, I imagine), I've never sat down and listened to an entire opera broadcast. But "Dr. Atomic" is wonderful, and this was also a trial for something I plan to do a lot of in the months ahead--really listen to music. In fact, as I type, Nate is assembling my new Bose Wave radio/CD changer.

And it also seemed important that I think about the people--from Marie Curie to the citizens of Hiroshima and Nagasaki to, yes, me, who have or will succumb to various kinds of radiation. And to think about choice. Because even though Oppenheimer questioned whether he had a choice about working on the bomb, of course he did. We all do.

Tomorrow I will choose between the only alternatives I have left, as far as the cancer is concerned: begin a course of irinotecan, the only chemo for stomach cancer that I haven't tried, or do nothing. There are many problems with the drug: it's the one that's very likely to cause diahrrea; they could only give me a 50% dose; it has a 15-20% chance of working; even if it worked, it would give me only a few months.... Of course, the alternative--do nothing--likely means dying in very few months.

Tomorrow I will see Dr. Holen nd once again talk about this choice. (We, with Nate, also discussed this last Thursday.) Because I know a lot of you will not want to wait a week to hear my decision, I'll post an update tomorrow afternoon.

As Oppenheimer knew, choice is difficult. But it's also important, and good.

Ironically, my appointment with Dr. Holen is scheduled at the exact time of Barack Obama's inauguration. We all made a very good choice!

Chicago? - and more

For you Madison blog-followers: I will be at A Room of One's Own, 307 W. Johnson Street, at 2 PM Sunday, November 23, reading from and talking about Facing Fear. I plan to reflect on lessons from the recent election and to offer tips on how to cope with anxiety in the face of the current financial crisis. I'll also talk about life as a cancer survivor.

And on that subject, here's the latest from the world of what's next. I saw Dr. Holen last Thursday and learned that 1) the CT scan last Wednesday showed the tumors still growing very slowly (1-3 mm in two months); 2) genetic study shows that I have not one, but two mutations on the genes that express the crucial enzyme that allows people to metabolize irinotecan, the only (I think) drug I haven't had that is FDA approved for stomach cancer. The mutations mean that I don't produce enough enzyme and a full dose of the drug would generate life-threatening diarrhea.

Which leaves us with another possible option. The University of Chicago has a Phase 1 clinic and a lot of trials, overseen by a doctor Holen knows. So the next step is to go to Chicago to be seen by this guy, who will have in his hot little hands a full listing of every treatment I've had for both Hodgkin's and the current cancer, and who can determine whether I'm eligible for any of their studies. CancerConnect, the office here that researches available studies for various cancers, will set up the appointment and call me. I haven't heard anything yet, but I imagine that I will this week. (Because if I don't hear anything in the next day or two, I'll call them.)

Meanwhile, my energy comes and goes. I think it depends on whether the sun is out (right now, it is, which is great), how much rest I've gotten, the phase of the moon, and how successful I am in putting into practice what I know about allaying anxiety. Not as easy as you might think.

Speaking of energy--Saturday night my friend Janet and I went to see the tap dancer Savion Glover. He is unbelievably great. Go see him, if you ever get a chance. In addition to being a fabulous dancer and stage presence, he is one of the most aerobically fit human beings I've ever seen. Some time during the first part of the show I realized I was holding my breath, watching him. But of course, he had to breathe--and it turned out that he could not only breathe while dancing, but also sing.

Friday night we'd seen Sarah Chang, the violinist, play Brahms with the Madison Symphony Orchestra. Another virtuoso performance (Chang, not the MSO). It's truly amazing what humans can do. Individually, and also--as we learned last Tuesday--in community.