A truly beautiful book about what is certainly a terrible and often terrifying collection of illnesses. Our family, like almost all families, has wrestled with cancer and wrestled with the scary and frequently devastating treatments that hope to kill the cancer before they kill the patient. This book provides a rich and illuminating context for those struggles, giving a palpable sense of the diseases and how our understanding and approaches have changed and how they’ve stayed the same. Mukherjee’s story telling is deft and compelling, sharing a complex and often very technical history in a way that remains personal, compelling, and accessible. It at times borders on the poetic, but without ever becoming sentimental or maudlin.

While this is technically about cancer, the book provides valuable insight into the complexities of medical research, whether scientific, mathematical, political, or social. We’ve made huge strides in so many areas of medicine in the last two centuries, but we rarely appreciate the oft tortured, surprising, and complex channels wended along the way. Yet to understand cancer and cancer treatment, and important challenges such as antibiotic resistance, and drug R&D, funding, testing and approval, it’s critical that we have this sort of context.

So most highly recommend; absolutely one of the best books I’ve read.

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Really.

Nothing.

Take Northwest Airlines (or Delta or whatever the hell they are at the moment) as a shining non-example.

Last Tuesday I flew to Montréal for GECCO (one of the really big conferences in my research area). I was supposed to fly to DC yesterday for an NSF review panel today and tomorrow. I would then fly back to MSP on Wednesday.

Unfortunately I became quite ill yesterday morning, starting with diarrhea, and then adding vomiting just in case I hadn’t gotten everything out of my system. As a result I took what I thought was the fairly wise decision of not flying to DC for the panel. The one relevant study I found indicated that after surveying 1,000s of people, they only found one would actually wanted to sit for several hours in a small tin can thousands of feet in the air next to someone who was busily ejecting all their gastro-intestinal contents. And that one lucky customer thought they were Napoleon.

So, you might think that I was doing the airline industry a favor by not bravely struggling to the airport, puking at the ticket counter, and racing to the toilet the moment I boarded their flight.

They apparently see it differently.

The folks at the NSF have kindly told me to skip the whole panel thing and go home and recuperate. Most of the panel’s work is being done today, so there’s not much point showing up tomorrow, etc., etc. My insides are behaving today, but I’m still quite weak and run down, so I’m planning to stay here the rest of the day and head home tomorrow.

I called Northwest Airlines to see what we could work out. Twice. Same stupid answer both times.

They insist on flying me back to MSP via DC “because that’s how my original ticket was set up”. I’m sick. I just want to get the hell home. They have a direct flight to MSP from Montréal. Put me on it. Please?

No.

“Can I put you on hold to see what we can work out with ticketing?”

“Sure.”

<Polite language that translates to “You’re screwed.”>

And they wanted $200 in penalties for the privilege of six hours of travel instead of two. Oh, and the chance to see the inside of DC National again for a bit. Thanks. Really. Thanks.

200 frickin dollars to put a sick person on the slow boat to Minnesota. This is the finest customer service money can buy, apparently.

I did this twice, with identical results.

I was so pissed the first time that I announced that I was going to buy a one way ticket from some other airline (any other airline) and hung up. I’m generally extremely polite with these people, because they’re powerless drones passing along bad news they have no control over. I suspect on their scale of asshole-ness, I was still really polite, but I did feel a little bit bad about it after I hung up.

A phone call was placed to the center of all wisdom and common sense (aka WeatherGirl), and we discussed the situation. It would in fact cost me over $500 to fly back on another airline, and that had a stop in Philidelphia; the best non-stop was over $800.

Ugh.

Crow was therefore eaten, and I called Northwest back and said I’d take the $200 “deal” (hence the second call).

Ugh again. And to DC I go.

Because of the DC leg, there’s no plausible routing that gets me to MSP for the last (3 hour) shuttle ride back to Morris. The current plan is for my remarkably generous family to drive out to pick me up (7 or 8 hours of their life I don’t get to bill to anyone). Otherwise I’ll start shopping around contacts in the Cities and see if someone will let a sick puppy sleep on a couch tomorrow night and take the shuttle Wednesday.

I’m sure there are a thousand reasons by their bureaucracy “needs” me to go through DC, but none of them make a damn bit of sense. I’ve heard this sort of “logic” before, and it’s the same stuff lazy software developers use to justify why something “can’t be done”, which what they really mean is “We can’t be bothered”.

I suspect the big issue may be that the middle leg (Montréal to DC) is on United, and United is gonna want a pound of flesh from Northwest regardless. So instead of working with me, or trying to work with United, Northwest insists on making United fly me to DC so the corporate accounting plays out in the end.

Damn.

At least I have a good health care plan. Watching this amazing Bill Moyers interview with Wendell Potter makes one despair for the capitalism that is running rampant across the globe, and all the misfortunates being trodden under foot in the process. In that perspective I’m damn privileged.

I think I’m going to eat some more of the fruit from this morning’s breakfast and take a nap. I’ve got a long day tomorrow and need my rest.

photo credit: Unhindered by Talent

• Democracies are very unlikely to attack other democracies. So more democracies for the win?
• Countries that educate girls and women tend to greatly reduce the risk of conflict.

On a vaguely related point, a SciAm 60 Second Science podcast from way back in late May looks (briefly) at some of the significant problems that researchers are having getting women, especially older women, involved in medical trials.

Women were also more likely than men to say that they’re too old or not healthy enough [to participate in a trial] … But women over 65 are one of the fasted growing segments of the population. … our ability to improve care, develop new treatments and find cures depends on research and educating aging women about their role in medical breakthroughs.

Damn – women are apparently important! Treating half the population like dirt is not only ethically dodgy – it has negative practical consequences as well!

Who’d’a’thunk?

The mother of a good friend was just diagnosed with pancreatic cancer (Wikipedia, National Cancer Institute). They don’t know much about her situation yet (she’s down at the Mayo Clinic undergoing tests), but pancreatic cancer generally has a very poor prognosis, so this is likely to be a tough time for them all.

Our thoughts are with you.

Victory!!!, originally uploaded by Unhindered by Talent.

Or at least damn good news!

My dad IM’ed me in the office this morning to say that he’d just gotten back from his first major doctor’s visit since radiation treatment ended last month, and he got a clean bill of health. They didn’t see any signs of the cancer in his throat, so now it’s all about regaining his strength after the nasty rigors of the treatment.

They say that if this type of cancer is going to come back, it will almost certainly do so within two years. So now we wait. Today’s report, though, means that however it turns out, going through all that bought him something significant, and that really helps.

Whew…

Those wild and crazy people at WalkingTimeBomb.com have a whole host of ads aimed at college students who blithely assume (despite all the evidence to the contrary) that they’ll quit smoking after they graduate. Some of them are pretty strange and don’t make a lot of sense, but some are real winners:

Hitting yourself in the face with a hammer is not harmful as long as you only do it socially.

When I’m at the bar I like to smack myself in the face a few times with a good claw hammer. So what? Who am I hurting? Or the other day I was walking along with Joe and he pulled out a shiny ball-peen model. Man, we just went to town with that baby. But what of it? I don’t plan on being one of those life-long hammerers. I’ll just quit after I graduate by tapering off with some of those small rubber mallets.

Generally I’m a pretty libertarian kind of guy, and I rarely give students grief about their smoking even though they bloody well ought to know better. Going through this cancer fight with Dad, though, makes it tough not to run around shouting at students that I see smoking.

The problem is that the claim that smoking (or not wearing a seatbelt or a bicycle helmet or whatever) only hurts the fool is based on a sad and ultimately unacceptable assumption that there is and will be no love in that person’s world when the odds come for their due. To watch my mother hold Dad while he’s vomiting again in the middle of the night, to hear her voice break on the phone after spending another all-nighter with him at the hospital, all this shatters any arguments that the impact of these choices is limited.

We are people, and that has implications.

When my father started smoking in the early 40’s, there was no broad understanding of the horrible risks involved, and as that data became clearer the tobacco industry spent millions to confuse and obfuscate the issues. At some point when I was a kid (late 60’s, early 70’s) Dad became convinced and stopped cold, an action I have always admired.

Today’s students can’t claim ignorance, and I sure as hell hope they don’t plan on lonely, loveless lives. I know that I have higher aspirations for them…

Some of it is just not very pleasant. Chemo makes him throw up (as it does many people). I’ve watched a fair bit of that while we’ve been here, although nothing close to what Mom’s helped him through, and these moments definitely fall in the “I wish I could pretend I hadn’t seen that” category. There are probably powerful images that could be made of this distress, and one could argue that going through this is a key part of the fight against the cancer and therefore worthy of documentation. But some other photographer will have to do that. It’s my dad, and I need to be giving him a hug and helping him wipe his face, not taking his picture.

Some of it is the sounds that still photography just doesn’t capture. Extreme discomfort can be a very noisesome beast, and there’s been plenty of that, with more to come. Harry Smith would probably tape the whole thing, but I’m passing on that as well.

Some of it I would love to capture, but just haven’t, and probably won’t, because it’s not easy and I’m only willing to go so far to record the moment. Mom stroking his forehead in the near dark, helping him calm down after a bad spell and encouraging him to go back to sleep. Her hand on his back; his hand in mine. Little glances; fleeting expressions; moments. In the end, the little signs of why we’re fighting this thing.

Sometimes you have to live, wading through the experience instead of recording it from the shore. I keep reminding myself that now is a good time to live.

“My father is fighting cancer.” Nope. Sounds too much like a back alley brawl, and this is a much bigger deal than that.

“My father is battling cancer.” Closer. Given the great chunks of medical machinery being brought to bear on his illness, “battle” seems more descriptive than “fight”. But battles are (usually) parts of wars, and I’m inclined to be more explicit about that. So…

“My father has become a foot soldier in humanity’s on-going war with cancer.”

This seems pretty apt. We (mostly my Mom) are the support staff, providing love and support and matériel, eagerly and nervously awaiting news from the front. But he’s the one in the trenches, dealing with the foot rot and the deafening machines of war and the crap rations.

The key diagnoses were last week, and luckily my wonderful sister was able to fly down from New York and be with them for several days of intense and difficult information gathering. A huge thanks to her for being there for all of us!

Dad’s got cancer of the throat. The doctors place the odds at 50/50, but the system is pretty complex and there are a whole host of things that could slip or crack. He’s got several weeks of radiation and chemo ahead, so it’s going to be a long slog (and probably a rough Christmas), but Dad and Mom and the doctors are all prepared for the fight. Saturday morning was the first skirmish; happily he came through that in excellent shape.

Everyone here in Morris has been really supportive and wonderful, for which we are extremely grateful. We’re going to take off the week of Thanksgiving and will drive down to be with my parents for that week. Until then, it’s fingers crossed and a lot of time on the phone.