June 10, 2009
For the last couple of months I’ve been receiving post-surgical, i.e. adjuvant, chemotherapy. After several treatment delays due to low white and red cell counts, my oncologist started giving me a biweekly shot of Neulasta to stimulate the bone marrow and produce white cells. This has been working and I’ve had only minimal levels of bone pain, the worst known side effect of the drug. Another new garnish to my diet is Emend, an anti-nausea drug that has helped me survive the most difficult days in my treatment cycle. I’ve also started taking the antibiotic doxycycline and it has helped control the rash I get from Erbitux.
On Tuesday, June 16 – Bloomsday – I meet with my oncologist to determine how much more chemo I am going to have. It will probably be either 2 or 4 more cycles, making for a total of 12 or 14 Folfox cum Erbitux. I am not going to lobby for any particular result because there is too little applicable research. Rumor has it that “length of regimen” studies are ongoing, but nothing has appeared yet that could guide this treatment decision. Besides, at this point I am more than willing to trust my oncologist; over the last year he has proven many times that he knows exactly what he is doing.
After my last encounter with Socrates and Glaucon, I thought I had reached a philosophical peace with my current condition: I would do everything possible to survive the chemo treatments and then try to delay or prevent recurrence through diet, exercise, and stress reduction. I would concentrate less on the high risk of relapse and more on the quality of the oyster mushrooms and the red sauce. Down with seething, smoldering, and anguish. Up with planting hibiscuses, picking asparagus, writing articles, and learning Chinese characters with the kids.
Then I ran into Friedrich Nietzsche at the Oberlin bowling alley. As usual he was on lane 4, which, despite its proximity to the jukebox, nobody uses because the lights flicker and lead to searing headaches and very low scores. “One longs for a condition in which one no longer suffers,” he said when he saw me, “but that is wrongheaded. In fact our pains are personally necessary for us and all life is experienced as the ground of anguish.”
He squinted at me as Steely Dan’s “Glamour Profession” began to purr its polished sound:
Brut and charisma
Poured from the shadow where he stood
— But isn’t it natural to try to reduce one’s suffering?
— Natural for insects, sheep, and philosophers like Socrates. The fact is that the path to one’s personal heaven always leads through the voluptuousness of one’s own personal hell. As I was explaining to that idiot Glaucon who lost his dollar and was pounding the jukebox a few minutes ago, all of us need terrors, deprivations, impoverishments, midnights, adventures, risks, and blunders just as much as we need their opposites. The sparks fly upward! You should let your suffering lie upon you, Jed, and experience it not as evil, hateful, and worthy of annihilation. It is no defect of existence except in the sad eyes of those who wallow in pity and worship at the religion of comfortableness.
One on one
He’s schoolyard superman
— Friedrich, you’re really saying that I should cherish my vomiting, neuropathy, neutropenia, nosebleeds, gastrointestinal disorder, all-body rash, weight and hair loss, psychological stress, short life expectancy, and cracked and bleeding skin?
— Obviously. Each of those little pains is as necessary as rhubarb in pie. And remember also that they are yours alone, that there is no use discussing them publicly like a frog in a bog. You should stop your blog.
I drove the Chrysler
Watched from the darkness while they danced
I’m the one
— But the responses to the blog have strengthened and consoled me.
— They may have distracted you, but as I said in The Gay Science all personal and profound suffering is incomprehensible and inaccessible to others. Whenever people notice that we suffer, they necessarily interpret our suffering superficially. It is the very essence of the emotion of pity that it strips everything distinctively personal away from the suffering of others. In fact your “benefactors” are, more than your enemies, the very people who diminish your worth and your will. They try to help but their intellectual frivolity is outrageous: they know nothing of the whole inner sequence and intricacies that are your real distress. And as I said, they never understand that you need every last bit of your anguish, alone and unaccompanied, whole and uncut (269-70).
Living hard will take its toll
— You know, you have a reputation as a nihilist but now you’re outdoing yourself — I love these people and their messages! What do you think people can do for each other?
— I would make those who wish to help – and I count myself among them – bolder, more persevering, simpler, and gayer. I would teach them what is understood by so few, least of all by those preachers of pity: to share not suffering but joy.
Under the sun