The clavicle is a stupid bone

In short, here's what's causing all the problems:  my clavicle.

The Radiation Oncology (RadOnc) people, God bless 'em, have a lot of checks and balances in place to make sure they don't radiate the wrong thing.  The tough part is getting the patient in the exact same position every time he gets on the table.  This is somewhat easier when you are radiating a lung or an abdomen.  This is much more difficult with me, since the main target is very close to my shoulder - a movable joint. 

One of the "checks" is those little tattoos on my body.  You line these up with certain lasers, and make sure I'm in the same general position each time.  But the RadOnc people also take x-rays to verify that the "blast zone" - for lack of a better term - is the same each time.  All of this stuff is originally worked out in the "plan."  The "plan" (their term, not mine) is constructed based on my original CT scan, my PET scans, and original x-rays.  Based on all this stuff, the doctors, techs, physicists, etc., set up a "plan" that is very precise.  But the precision allows for very targeted radiation therapy with minimal collateral damage. 

However, the precise plan means that I must be in a precise position each and every time they radiate.  The issue, apparently, is that my clavicle is in the "blast zone" on the plan, but the techs are having a difficult time getting it into the "blast zone" during treatments (without screwing up other things).  So this issue has led to "x-ray -> move Nick -> x-ray -> move Nick -> x-ray -> move Nick" over and over again, to the tune of like 13 x-rays in two days. 

So this morning, we were doing the x-ray/move Nick dance when apparently the machine got all x-rayed out and broke.  The techs were getting frustrated with the whole dance as well, so they decided, along with doctors, to essentially re-do everything - go back, do another CT scan, work out a new plan, and repeat the process.  This would have meant no treatment today, no treatment Sunday, a new plan on Monday along with no treatment, and no treatment until a new plan was worked out.  Could have added a whole week to treatment, which...just not good.  And not what I needed right now.

But the RadOnc people did a lot for me today, which was awesome.  In short, they decided to make a giant mold of my upper body:

Bad picture at the moment - I'll get a better one on Sunday - but the mold is the pink thing.  They pour some chemical goo (the technical term) into the mold, have me lay down on my back in it, and the goo forms to my body, hardens, and keeps me stable.  Then, they ran another CT scan with me in a new position in the new mold, and essentially re-did what they did before.  Which, unfortunately, included new tattoos (I'm up to 5 now.  As a bald guy with 5 tattoos, I think I should change my lifestyle.  Unfortunately, Four Loko is now banned, which is what I believe I'm supposed to drink if I'm a bald guy with 5 tattoos.  Instead, I'll have to settle for watching UFC fights and drinking King Cobras). 

This took until 12:30 or so.  But then a bit of good news:  the techs said they could treat me in the afternoon under the old plan if I could be back at 1:15.  So I ran upstairs to the Little Caesars and grabbed some lunch (side note:  If you are a hospital, and you are trying to cure people of cancer, don't put a Little Caesars inside.  That stuff has to be at least as carcinogenic as Marlboro Reds).  I made it back down to the RadOnc lair by 1:15, where they put me in the other treatment room (which is significantly better than the treatment room I was originally in), and started the process again:

See those blue things there?  Those are for the patient's arms.  In plan #1, my arms were up above my head.  This led to the clavicle problems.  In the giant mold, my arms are going to be down at my sides.  This is why I needed to be re-tattooed. 

So while I managed to make one radiation session last about as long as chemo, it was significantly less painful.  Plus, I understand why all of this stuff is being done, and I appreciate the reason.  The attending RadOnc doc, Dr. Robbins, was with me for a period of time and did a good job of explaining everything.  That's all I really ask for - just let me know what the hell is going on.  Sometimes it's about asking the right questions, sometimes it's about having the right people.  And Henry Ford has a lot of the right people. 

So the good news is that there won't be any delay in my treatment.  I'll hop into the new mold on Sunday, and we'll keep right on going.  This is much better than getting a CT scan on Monday and waiting for a new plan to be drawn up.  Everything in both plans will be the same - they're radiating the same area - it's just that the different position will change all the angles.  So that's what needs to be figured out. 

All for now.  More when I have more to say and time to say it. 

Positivity is dead

I'M NEVER SAYING ANYTHING POSITIVE ABOUT RADIATION EVER AGAIN: I started talking positive about moving to DC, and the next thing I know, my diagnosis changes, people start telling me to do different treatments, and everything goes to hell.  I didn't learn my lesson, started calling radiation a "walk in the park," and the next thing I know I'm in the RadOnc clinic for two hours and forty-seven minutes on day three to get 40 seconds of treatment.  Positivity kick is over. I have taken positivity, tied it to cinderblocks, and dumped it in the lake.  Guess I set another record though:  "Longest time spent in a Radiation Oncology Clinic to receive 40 seconds of treatment."

So this is all screwed up - like everything else with my diagnosis and treatment, basically - but I don't think the issue is serious.  I'll explain things in a longer post (with pictures!).  I'll have it up either later today or over the weekend. 

U-M RECOMMENDS THEIR PREVIOUS RECOMMENDATION: Dr. Li e-mailed me yesterday after discussing my case again with other doctors.  Their recommendation remains the same.  Interestingly, she used the article Dr. Al-Katib sent me to make her case.  Which is extra awesome. Now, doctors are looking at the same patient, the same test results, the same tissue, and the same articles and reaching completely opposite conclusions.  Please, get me back to the legal profession.  Where your entire case depends entirely on what Judge you draw.  But at least you know their tendencies in advance.

Dr. Li also said that she "would advise holding off on radiation until we get this sorted out."  Which reminded me of this scene from Dumb & Dumber.

WELL-INTENTIONED BUT SORTA INDIRECTLY MEAN:  Movember is a mustache growing charity event held during November each year that raises funds and awareness for cancers that affect men (prostate cancer, testicular cancer, etc).  Apparently, Asylum, an AOL website, declared November 18th "Have Sex With a Guy With a Mustache Day" as a way to draw attention to their cause and, presumably, entice men to participate in Movember.

I'm down with anything that raises money for cancer research.  But this seems a little misguided.  Seems to me the way to help cancer patients is not to declare a day of fun that requires a mustache to participate.  Because you know who can't grow mustaches?  CANCER PATIENTS WHO LOST ALL THEIR HAIR DURING CHEMO, THAT'S WHO! 

THE DETROIT NEWS SUDDENLY DECIDES SOURCES OF FUNDING ARE NEWSWORTHY:  On Tuesday, I commented on a Detroit News article that declared that the government's bailout of the auto industry had saved 1.4 million jobs...according to a report from the "Center for Automotive Research."  The News apparently forgot to mention that the CAR received a significant portion of their funding from the government.  Which might make a difference to readers assessing the credibility of the report.

Well on Wednesdsay, the Detroit News ran an article about Republican Representative John Mica's call to privatize airport security, and his comments calling the TSA a "bloated bureaucracy."  The result?  You better believe "follow the money" is now important!

Companies that could gain business if airports heed Mica's call have helped fill his campaign coffers. In the past 13 years, Mica has received almost $81,000 in campaign donations from political action committees and executives connected to some of the private contractors already at 16 U.S. airports.

And they're not done.  Five more paragraphs strictly on the Congressman's donors:

Companies that provide airport security are contributors to Mica's campaigns, although some donations came before those companies won government contracts. The Lockheed Martin Corp. Employees' Political Action Committee has given $36,500 to Mica since 1997. A Lockheed subsidiary won the security contract in Sioux Falls, S.D. in 2005 and the contract for San Francisco the following year.

Raytheon Company's PAC has given Mica $33,500 since 1999. A Raytheon subsidiary began providing checkpoint screenings at Key West International Airport in 2007.

Firstline Transportation Security Inc.'s PAC has donated $4,500 to the Florida congressman since 2004. FirstLine has been screening baggage and has been responsible for passenger checkpoints at the Kansas City International Airport since 2006, as well as the Gallup Municipal Airport and the Roswell Industrial Air Center in New Mexico, where it has operated at both since 2007.

Since 2006, Mica has received $2,000 from FirstLine President Keith Wolken and $1,700 from Gerald Berry, president of Covenant Aviation Security. Covenant won a contract to provide airport security at Sioux Falls in 2005 and San Francisco the following year.

A Mica spokesman did not immediately return a call seeking comment about the political contributions.

In defense of the News, this article was significantly longer than the bailout article and it was penned by Associated Press writers.  Perhaps that makes all the difference.

But I don't think it does, because I think this is representative of a larger trend in journalism.  Many conservatives think the media has a liberal bias.  I don't really buy it.  Yeah, the New York Times may fall on the left side of the spectrum, but the Wall Street Journal shades right.  Sure, MSNBC went into Y2K mode on election night, but you still have Fox News.

As Radley Balko pointed out in the run up to this year's election, The media aren't liberal.  They're statist.  In the terms this blog uses regularly, the media are really, really DOOOOOOOO SOMETHING!!!!!!  It's not like the "liberal" media is spitting out articles on the plight of indigent defendants or advocating scaling back our nation's War on Drugs (TM).  They're writing hysterical articles about BAN FOUR LOKO and BAN BULLYING.  As Balko explains:

But you see the editorial pages' lust for authority on issues like campaign finance reform, where unlike left-leaning groups such as the ACLU and the Sierra Club they almost uniformly support restrictions on political speech, despite the fact that their profession is inextricably tied to the First Amendment. This deference to authority was also on display in the Kelo v. New London case, where the Washington Post and New York Times editorial boards jettisoned traditionally liberal principles such as equality and fair play in favor of a broad government power to forcibly transfer property from people of modest means to wealthy developers.

Let me be clear (I gotta pay Obama $3 every time I use that phrase) (Just kidding - I already owe him thousands of dollars of my money):  I think Congressman Mica's donors are entirely relevant to the article.  But it stuck out to me because I virtually never see an analysis like that in standard news articles.  If sources of funding are relevant to determining whether or not the message is credible, fine.  But be consistent.  It doesn't need to be six paragraphs.  A mere sentence would do.  But please, journalists, give us the whole story.  

Cancer humbles Nick, makes him write nice things about journalists and progressives

While I was on a self-imposed positivity kick because of Anonymous Friday Poster, I made a mental note to point out a pretty awesome (and simultaneously horrible) piece I read on Detroit.  Then there was another piece in Saturday's Free Press that was somewhat related and worth posting.  So here it be:

First, a "positive" example of good journalism by the always-interesting Charlie LeDuff:  What killed Aiyana Stanley-Jones?

"You might say that the homicide of Aiyana is the natural conclusion to the disease from which she suffered," Schmidt told me.

"What disease was that?" I asked.

"The psychopathology of growing up in Detroit," he said. "Some people are doomed from birth because their environment is so toxic."

Aiyana Stanley-Jones is a seven-year-old who was killed when Detroit police raided the house in which she was sleeping while looking for a murder suspect.  The police department tossed out various stories as to how the officer's gun fired, just to see what stuck.  Nothing did really, so they just went with "the gun went off" and left it at that.  Which is fine if you are a police officer (there's a law on this, I'm pretty sure, but I can't find it at the moment).  More than likely, the officers involved in the raid were just displaying the cop mentality (H/T Radley Balko). 

Anyway, LeDuff covers the particulars of the raid, but he spends more time examining the "psychopathology of growing up in Detroit."  Aiyana was killed by a police officer's bullet, yes.  But LeDuff looks at the entire story leading up to that tragic point. 

I know, I know, there's nothing particularly novel about yet another negative story about Detroit.  But this isn't "another negative story about Detroit."  It's a story about Detroit that is so detailed and honest that it has no choice but to be negative.  LeDuff excels at this type of journalism, and as a guy who spent a fair amount of time investigating murders in the City of Detroit, there were a lot of things that rang all too true in this story. 

At one point, LeDuff writes:

With large swaths of the city rewilding—empty lots are returning to prairie and woodland as the city depopulates

Which leads to my second piece from Saturday's Free Press:  Detroit's proposed urban farms face hurdles.

You might guess - based on my previous comments about farmer's markets and yoga and the like - that I would sneer at the whole concept of "urban farming" (I have no idea why.  These things just seem like they should be in the same category).  I actually think these urban farms are a fantastic idea. I know there's a lot of "community" whatnot and "local produce" thrown around when discussing these things, and that's cool, but for me, it just comes down to person X wants to use all this land that nobody else wants to use, and employ people that don't have jobs.  Which might be a good idea if you have, say, 40 square miles of vacant land and an unemployment rate between 30% and 50%.

But you all know one of the themes around here:  Government is awesome and usually does great things.  Example:

A city already filled with tiny community gardens so far has balked at allowing larger-scale commercial farming inside the city. Several such farm projects have been proposed for more than a year, but as 2010 winds down, they still await city approval.

Some of the would-be urban growers are letting their frustration show.

"There's always another layer of the onion we have to peel, and quite honestly I don't understand it," said Gary Wozniak, director of the proposed RecoveryPark project, which would initially farm about 20 acres on Detroit's east side. "Every time they overcome another hurdle, there's another hurdle."

Well that's not cool.  These people want to start some urban farms so maybe a future President can be a former community farmer instead of a community organizer (which has gotta be more useful), and you won't give them permission to use vacant land.  What's the hold up, Detroit?

Dan Lijana, a spokesman for Mayor Dave Bing, said urban agriculture is just one of many ideas the city is weighing as part of Bing's Detroit Works plan to reinvent the city.

The problem is that there are just too many ideas about how to fix Detroit.  Too many.  An abundance.  A plethora.  More detail on the holdup, please!

Some of the projects now hope to get in the ground next spring, but even that is uncertain. City of Detroit officials are struggling to understand the implications of urban agriculture within city limits. Among the concerns holding up approval are worries about noise and pollution, a lack of zoning for growing food in the city, and questions over who benefits from any economic gain.

Notes on this:  1) City of Detroit officials struggle to understand the implications of everything; 2) On a list of "Detroit's Problems," "noise" has gotta be pretty far down on the list, 3) "Pollution" is a concern in a city that has lost about a thousand factories since 1950? 4) THERE'S NO ZONING! OH THE HUMANITY! 5) "Questions over who benefits from any economic gain"?  If you know Detroit at all, you know exactly what that phrase means.

Wozniak is project director for a drug rehabilitation agency called SHAR that is undertaking RecoveryPark. The project would put recovering addicts and other distressed individuals to work growing crops and processing food.

The City of Detroit is dominated by Democrats.  How much more acceptable can this get?  Locally-grown produce?  Helping addicts and other distressed individuals?  This is like a cornucopia of progressive ideas.  And even I like it, since unlike other progressive ideas, it won't cost an assload of other people's money.

More on the holdup:

Officials also are worried that Michigan's Right to Farm law, which protects rural farmers against the encroachments of suburban sprawl, might be used by businessmen like Hantz to avoid regulation by the city after initial approval is given.

Then, too, many of Detroit's nonprofit community gardeners are urging the city to reject Hantz's proposal, viewing for-profit farming in the city as exploitation and a land grab. Critics worry that ordinary citizens won't benefit if profits go mainly to wealthy business owners.

That's awesome.  What's preventing farmers from building farms?  Michigan's Right to Farm law.  Who was the Michigan Right to Farm law designed to help?  Farmers!

The second paragraph is just disgusting.  1)  Every existing business wants to make it harder for another similar business to enter the same industry.  This is why the Detroit casinos support anything that restricts gambling in Michigan.  2)  "Critics worry that ordinary citizens won't benefit if profits go mainly to wealthy business owners" = More Detroit code language.  But Unless the "wealthy business owners" are going to be in fields picking tomatoes, they're going to have to hire people to run these things.  And those people are damn likely to come from Detroit.  So what the hell is this?

The last paragraphs are the most depressing:

Whatever the reasons, the delays are leaving Wozniak and others frustrated.

"We've asked the city for no money, no tax breaks, no resources other than access to land," he said. "And we don't care if we buy it, lease it, if it's deeded to us, if it's in a trust. Let us try something."

Well there's your problem right there, idiots!  Nobody gets what they want in Michigan without asking for goodies from the taxpayers!

Hey Detroit: these are people willing to help with your vacant land problem and employ your citizens.  This study out of Michigan State University says that urban farms could help provide residents with a major source of fresh food and vegetables - a significant issue in a city with no chain grocery stores (I would normally disregard studies from MSU, but this one is on farming.  They're the experts).  If you are worried about control, lease the land to them on a temporary basis.  But don't sit on the damn issue for years until these people go somewhere else. 

Metric Tools

I LIKE THIS RADIATION THING MORE THAN CHEMO:  Radiation is an absolute walk in the park compared to chemo.  I was in and out in 30 minutes this morning; subsequent treatments will require less time because I won't have to get x-rays to make sure the positioning is correct.

Positioning is the biggest part of the whole deal.  The radiation techs take about 10 minutes making sure I'm in precisely the correct position so as to minimize collateral damage.  One of the techs spent a little while searching for a tattoo on my right axilla.  I let this go for a while before I thought better of it and figured we should all agree on radiating the correct side of my body before anybody turned the machine on. 

At the very least, radiation gives much more credence to the "fighting cancer" meme, if only because you get to SHOOT FRICKIN' LASER BEAMS at the cancer until it dies.  Much more awesome than the chemical-warfare slow drip of the chemo regimen.  Although there's a certain nervousness instilled in the patient when all the techs flee the room before they turn the machine on. 

One down.  Fourteen to go.

AT LEAST THE HOT DOG BAN HAS BEEN LIFTED:  As you can guess - and as I've mentioned here before - I'm not the only one "battling" cancer.  My family has to deal with this pretty much every day as well, and sometimes, I think they have an even more difficult job because it's so hard to know exactly how I feel or what I think.  But many of you have asked how my family is doing with all this, and to tell you the truth, they're not doing so well.  But not because of the cancer.  Because of the furniture. For example:

• My grandmother is "sick to her stomach" and "hasn't been able to sleep in days" because...she was afraid that the furniture company would not be able to deliver the couch before I moved to DC.  
• My mother is concerned about Ikea furniture because they are a Swedish company and assembling their furniture will probably require "metric tools"* that apparently do not exist here in the States.  I assume this was a joke, but it was too good not to put on the internet.  Sorry mom.  Don't spit in my food. 

For what it's worth, my father is a few days away from inspiring me to pick up a camera and turn him into a YouTube sensation with a video entitled "Aging Libertarian Baby Boomer Yells at Chuck Todd and Bill O'Reilly On TV With Nobody Else In the Room." 

Really though, everyone around here is great and doing well and unless somebody is crying in their room when I'm not around, everyone has been pretty stable.  I prefer people worry about the furniture rather than me.

*(In her defense, metric tools actually exist.  I thought she made up the phrase at the time.  I think it's unlikely that Ikea has been successful by making their furniture impossible for Americans to assemble.  But probably true.  In any event, I won't be assembling it.  Thanks friends who are helping us move into our apartment in DC!!). 

SCREW LAW, I'M JUST GOING TO HELP JOURNALISTS WRITE NON-CRAPPY ARTICLES:  From the top of the front page of detnews.com all afternoon, glorious news!  Report: Auto bailout saved more than 1.4 million jobs.  The goods:

The government's bailout program for General Motors, Chrysler and other automotive firms saved more than 1.4 million jobs, according to a study by the Ann Arbor-based Center for Automotive Research.

Wow!  That's wonderful news!  It's nice to see some solid research by an independent firm...

Oh.  Protip for the Detroit News:  Critical reporting on the government does not include copying and pasting parts of their press release and lifting a quote from a czar.  Although in their defense, what I did required the use of advanced technology called "Google" and about three minutes of my time.  This is tough stuff.

Also, I fixed your lede for you, Detroit News:

The government's bailout program for the government saved more than 1.4 million jobs, according to the government.

YOU'RE WELCOME.

THIS IS REALLY, REALLY, REALLY, REALLY, REALLY GOOD:  And all of those "really's" were justified.

Truck Accident That Killed Rafters in Canyon Sparks Truck-Canyon-Rafter Reform Debate

For those of who who aren't familiar with The Onion: The Onion is a satirical news site.  So no, a gasoline tanker did not hit a rock in the Grand Canyon and then plummet onto a group of rafters down below.  

But this video perfectly captures a major component of politics and "debate" in this country.  This is the Four Loko fiasco in video form. 

Nagasaki

I wasn't even going to write anything about starting radiation today.  I briefly thought about it, but then I went to the gym.  And I had a lot of e-mails to respond to, so I did that instead.  And then I listened to some new music for a bit.  It wasn't until 1am when I was bored and still awake that I decided that maybe I would write something.  Fortunately, I had an easy time figuring out the title and picture.  If it would have been any more difficult, I probably would have just gone to sleep.  

But then I thought about the situation for a second:  I wasn't going to mention starting radiation treatment on my cancer blog because I didn't think it was that newsworthy.  How messed up is that?  How much does that say about where I was and where I am now?  How much does that say about the current state of my life?

I remember hearing the word "radiation" on the phone when I spoke with Dr. Houin back on July 30.  It was thrown in there amongst the words "surgery" and "chemotherapy."  I didn't really understand what everything meant at the time; my head was spinning too fast to really comprehend anything.  All I know is that doctors weren't sure if I had B-Cell or Burkitt's lymphoma.  I'm glad we got that straightened out.

I've mentioned before that cancer takes your entire worldview and pile-drives it into the ground.  This is an example of that.  I'm looking at radiation treatment as some minor annoyance that I have to tend to at 11am every weekday for the next couple weeks.  Sort of like going to the bank or the post office.  For anybody else, the mere mention of radiation might invoke terror.  For me, and compared to chemo, it's something I either barely think about or sort of look forward to.  Chemo is done.  There's not much that could derail my joy at that fact right now. 

***

Cancer is odd.  If you're "lucky" enough to catch things early, the only pain, misery, and irritation you will feel will be treatment-induced.  You don't feel sick at all, but then "getting better" feels like a trip through hell.  It really makes it hard to grasp just how serious the disease is.  You know it in your mind, but you're not sure you actually believe it. 

Treatment is weirder.  You get all amped up to "fight cancer"...and then you sit in a chair for six hours, lose your hair, lay around, feel tired, take pills, and just try to outlast the mutated cells in your body.  You don't fight anything.  You just buckle down and try to endure.  And at the end, you emerge from your bunker, let your eyes adjust to the light, take a look around, and hope to god nothing else survived. 

***

Sometimes, songs remind me of different periods or events in my life.  A song will remind me of "Sophomore year homecoming" or "Junior year of college" or "Spring 2009" or something like that.  If you play that particular song, your mind wanders back to the people and places you encountered at that specific time in your life.  You think about yourself, where you were, what you were dealing with at the time.  Often, you look back on those moments more favorably than they actually were in real life, since the human mind has a tendency to remember the good and overlook the bad. 

This phenomenon is very different for me now.  Normally, songs take a while to become associated with an event or time period.  Now, I can listen to a song that I associate with last month, and it seems like a different decade.  I'll listen to a song that I first heard in August, and it seems so long ago.  My time periods are all screwed up.  Chemotherapy is dead to me.  November 2nd was another century.  I hear a song from August and think, "Oh wow.  This reminds me of the time I had cancer."  I'm looking forward to more songs reminding me of that one time I had cancer. 

Somebody asked me the other day if cancer makes time fly by or drag slowly.  I answered, in lawyerly fashion, "both."  But it's true.  On one hand, everything is a blur.  You live hospital visit to hospital visit.  You are either in "treatment week" or "recovery week."  You bounce from one doctor's appointment to another.  On the other hand, you feel every moment of every day, from the time you get out of bed to the time you go to sleep.  The experience just grinds you into the ground.  Nothing happens fast enough.  If it's cycle 3, you're wondering why it isn't cycle 4.  If you get a test, the results are never processed quick enough.  And in the end, you want nothing more to be done with everything, every day drags on, you hate every moment of it...and the next thing you know, you're in remission and forgetting about radiation appointments because it's not that important.  You hate cancer with a passion.  But you think it would die with more bravado. 

***

I lifted for the first time in a long time on Tuesday night.  It was a pretty emasculating experience.  I've never been a gym rat, but I've always played enough sports to stay in pretty decent shape.  Needless to say, I haven't been doing much lately that would seem to improve my physical condition. 

And it got me thinking about my current situation in general.  I just finished six cycles of chemotherapy.  I've got dings and weird things going on all over my body.  I haven't been able to do much of anything physically for the past several months, either out of precaution or out of impossibility.  I get 3-4 minutes of constant running on a treadmill these days.  I figure I've lost 60% of my hair.  I forgot what it's like to feel my fingers.  I've heard about this alcohol substance and I think it's pretty good and I vaguely remember drinking it once, but I'm not entirely sure I remember.  Part of the reason I'm so upbeat about my condition is because I no longer remember what normal feels like.  It's pretty obvious that, all things considered, I'm in the worst shape of my adult life.  And I look at all this - I look at what this god-awful disease has done to me and my life - and I wonder how the hell I'm going to get it all back. 

But I'm also as happy as I've been in a long time.  Because the worst is over.  Because as much as cancer might not want to surrender, it isn't going to survive one more blast of radiation.  Because cancer so alters your way of thinking and your view of life that you can stand amongst the rubble and smile, because you know that while so much around you didn't make it, you did.  And that's the most important thing.  Because you can rebuild.  The rest of the stuff...well that's just stuff.  You can deal with that. 

***

Kipling:

Or watch the things you gave your life to broken,
And stoop and build 'em up with wornout tools;

And lose, and start again at your beginnings
And never breath a word about your loss;

It's hard to describe cancer.  I'm up to about 115 posts on here, 80-90 of which are about cancer, and I still don't think I even come close to adequately describing the experience.  It's an absolute bundle of paradoxes.  It's simultaneously far-and-away the worst thing that's happened to me and something that I've been able to handle like every other obstacle in my life, as you've witnessed here.

But there's no doubt that this damn thing comes along and stomps on the sandcastle that you've spent 25 years or so building.  It's brutal.  Unforgiving.  Indiscriminate.  It doesn't care who you are, where you're from, what you've done in life, how much money you have, who you know, what you had planned.  It doesn't care in the slightest.  It comes along and completely messes up everything for no particular reason.  And it gives you two options:  go through hell to live, or die.  No in between.  That decision wasn't difficult. 

But damn, does it make you grateful.  When I hear those songs that remind me of some random night in the past ten years, I think, "Oh my God, that was the greatest time ever!"  It probably wasn't, but it was a time when cancer wasn't even a thought, let alone a possibility, let alone a fear, let alone a reality.  And that elevates it to "greatest time ever" status by my new life standard. 

And it also elevates my current state - not dead but bald, battered, with bloodshot eyes, probably cancer-free, and waiting to deliver the death blow to deadly disease - to "pretty damn good."  And each day, as I piece things back together, as I get healthier, things get a little bit better.  Until I get to a point where I work an 80 hour week and say, "Wow, that was the greatest week ever!"  Because I know how horrible things can be.  And I know how quickly things can get that horrible.  So every day things are not horrible...well that day is a blessing.  This is my new standard, standing amongst the rubble.

Stockpile the Four Lokos! I'm not back on the sauce until next week!

Ever since Phusion Projects mixed Al-Qaeda with AIDS, sprinkled in some Hugo Chavez, infused it with rape and murder, liquefied it and put it in a colorful can that your kids will just love, the writing has been on the wall.

Today, the writing is in a Chuck Schumer press release:

FOR IMMEDIATE RELEASE:                                           CONTACT:

November 16, 2010                                                        Brian Fallon

SCHUMER: FDA TO EFFECTIVELY BAN CAFFEINATED ALCOHOLIC DRINKS; FTC WILL NOTIFY MANUFACTURERS THAT THEY MAY BE ENGAGED IN ILLEGAL MARKETING OF UNSAFE BEVERAGES

After Months of Pressure by Schumer, FDA to Send Notice to Manufacturers of Caffeinated Alcoholic Beverages that Product is Not Considered Safe; Move Will Effectively Ban Products from the Market

FTC to Send Notices to Manufacturers That They Are Engaged in the Marketing of Unsafe Alcoholic Drinks

Schumer: Let This Serve as a Warning to Anyone Who Tries to Peddle Dangerous Beverages to Our Kids—‘Do it, And We Will Shut You Down’

Yes, those are the original fonts.  I bet Brian Fallon is an effing blast at parties.  He probably talks about Chuck Schumer a lot. 

Question:  Does a Chuck Schumer press release include the word "Schumer" more than an Alan Iverson press conference includes the word "practice"?

***

My dad was watching some coverage of the new TSA molest-a-thon procedures last night, and a TSA talking-bot came on and made some sort of absurd statement.  My dad responded, to nobody in particular, "You know, this stuff almost seems like things coming out of the Soviet Union during the Cold War."

The phrase was uttered with a sort of acknowledged hyperbole.  If anything, it reminded me of a scene from American Beauty:

Ricky Fitts:  What's new in the world, Dad?

Colonel Frank Fitts: This country is going straight to hell!

Ricky Fitts:  So...nothing's changed.

But I don't know anymore.  Reading through this press release - and some of the articles I've come across in the past few days - I just don't know anymore.  Some excerpts from Chuck Schumer's love letter to himself (which I am not reproducing in its entirety because Chuck Schumer press releases are more toxic than R-CHOP):

These announcements come after months of intense pressure by Senator Schumer to have the drinks banned because of serious risks to consumer health and safety.

If by "months of intense pressure" you mean "something Schumer did not know existed before October."

“Let these rulings serve as a warning to anyone who tried to peddle dangerous and toxic brews to our children. Do it and we will shut you down,” said Schumer. “This ruling should be the nail in the coffin of these dangerous and toxic drinks. Parents should be able to rest a little easier knowing that soon their children won’t have access to this deadly brew.” 

Parents will definitely be able to rest easier knowing that little Timmy is probably out chugging a bottle of Everclear.  And what the hell is with the "brew" thing?  You'll see more of that in a second.

In addition to New York’s efforts, Oklahoma, Utah, Michigan, and Washington acted to ban the drinks as did a number of colleges, including Ramapo College, Worcester State University, the University of Rhode Island and the Wentworth Institute of Technology.

Well if the Wentworth Institute of Technology says it's a bad idea, I'm on board.  I trust those cats.  And Ramapo Colege...well it just sounds like bad things happen there regardless of Four Loko involvement.

Compounded with its health risks, beverages like Four Loko pose a unique danger because they target young people.

As opposed to Chuck Schumer, who poses a general danger because he targets everybody.

The style of the beverages – with a vibrantly colored aluminum can colors and funky designs –appeal to younger consumers, increasing the likelihood that the beverages will be consumed by young adults and creating a problem for parents and business owners who might be misled by the branding.

Here's this odd argument again.  Authorities seem to be taking the color preferences of 7-year-olds and projecting them onto 19-year-olds.  I don't get it.  I'm not sure about this, but I think I was pretty clear of the "OMG bright colorzzzzz!" phase more than ten years ago.

And shouldn't using the word "funky" disqualify anybody from holding a position of power?

Four Loko is also stocked next to other energy drinks, creating further confusion.

"I was getting a little tired working on that brief this afternoon, so I went to the store for an energy drink.  Six hours later, I regain consciousness on the floor of my office, completely nude, with blood and vomit everywhere and a dead prostitute stuffed under the desk.  Now, thanks to Chuck Schumer, this will never happen again!"

Last week, Schumer was joined in his efforts to ban the drink by Jacqueline Celestino, grandmother of...

SOB STORY ALERT! SKIP!

I'm done with Chuck for now, because there is so much more awesome stuff.  For example, apparently there was a conference in which all the members of the Senate agreed that they would refer to Four Loko as some variation of a brew:

"Alcoholic energy beverages are a witch's brew of stimulants and alcohol, creating wide-awake, energized drunks who pose a serious threat to themselves and others," [Senator-elect Richard Blumenthal] writes.

Four Loko just before processing.

And this piece, from Reason's outstanding Hit & Run blog, gives us a rundown of Four Loko's apparent ability to cause a "hallucinogenic frenzy" and make people "lose their minds."  Seriously:

Baltimore Sun writer Erik Maza notes that Four Loko, like LSD, has the power to cause insanity in people who have never consumed it. People like Mike Hellgren of the Baltimore CBS affiliate WJZ, who reports that "a Maryland woman is dead after the drink made her lose her mind."

And the crack reporters at the New York Times conclude that it's The Facebook that is causing all the trouble:

Young people appear to be drinking Four Loko at an astounding rate, based on testaments posted daily on Facebook pages that pay tribute to the beverage.

You know, because it's definitely not the MILLIONS OF ARTICLES AND CONSTANT PRESS COVERAGE AND CHUCK SCHUMER'S FACE THAT MAKES EVERYBODY TO WANT TO BLACKOUT.

It goes without saying that this nationwide spaz attack has been the greatest thing that could ever happen to Four Loko.  Sales are through the roof.  There's a cute absurdity to politicians and journalists who won't shut up about how the beverage gets you really drunk, keeps you awake, and makes you hallucinate and lose your mind, and in the next sentence, scream about the colorful can.  Because that's what makes it appealing to teenagers.

But hold on, I'm not even at the best part!  You wanna know the best part?  Do you have your awesome hat on?  Go put it on.  I'll wait.

Ok good.  Now here's the awesome part:  Do you want to know who's at least partly responsible for putting this stuff on the market?  YOU ARE!  And me.  And Chuck Schumer.  And the parents of the kids who apparently killed themselves by drinking this stuff.  And so on.  Because:

Phusion was formed in 2005 by three former college students from [University name redacted] with the help of a loan from the Small Business Administration. It now distributes alcoholic beverages, including Four MaXed and Earthquake, in more than 45 states.

Actually, it appears to be three separate loans.  For a total of $200,000.  But who's counting when it's not your money.

***

You know what, I have a solution to all of society's ills.  Ban everything.

Wanna have a cupcake on your birthday, kid?  TOO BAD! BANNED!

Think you're helping the environment by carrying a reusable bag to the store?  YOU'RE NOT! BAN THEM!

Don't like choosing an increased risk of cancer or sexual assault as a prerequisite to going somewhere else in the country?  SCREW YOU! MANDATORY!

Cupcakes?  Too dangerous.  Bags?  Too dangerous.  Alcoholic drink?  Too dangerous.  Machine that shoots radiation into your body and takes a nude picture of you?  You better get in that machine, citizen, or we're going to grab your boobs.  Or fine you $10,000 if you don't let us.  I love my government!

Here's my serious question for people:  At what point after government officials snatch a cupcake from your 8-year-old on his birthday, take a drink out of your hand because it's "too dangerous," tax plastic bags to try to get you to buy reusable ones and then ban those, and then, if you want to visit grandma in Phoenix, give you three options:  Accept a blast of radiation while we take nude pictures of you, submit to a sexual assault, or pay $10,000, will people start to believe that the problem is not that Republicans are in power, or that Democrats are in power, or that idiots are in power, but that these people have inherently too much power.

I mean, maybe you think Four Loko is way too dangerous and shouldn't be sold.  Or that childhood obesity is a serious issue and we need to do everything possible to combat it.  Or that terrorism is such a serious problem that we need to take nudie pics and molest people to stop it.  Or so on.  Fine. 

But what happens when, inevitably, the ban hammer gets aimed at you?  When there are new - or more likely, just "more" people in charge who have to keep themselves busy and employed by making decisions about what's "best" for you?  Or what if you happen to irritate the wrong person in a position of power?  Actually, I sort of know what happens:  The people who spent the better part of this decade screaming give way to a new group of people who will take their turn screaming for 4-8 years.  And then we repeat.  All apparently without noticing that the same shit happens no matter who is in power.  You can't sit there and advocate one Chuck Schumer program after the next and then cry when he takes away your drink like the Bartender General.  I mean, you can, but you'll look pretty silly.  Because it's all part of the same monster.  The way to not get screwed over here is not to elect people who talk nice and hope they don't kick you in the eye.  It's to never give these people so much power over your life in the first place.

Does any of this relate to cancer?  Not really.  But sort of.  Because I'm worried that, one day, the same bumbling idiots that banned a beverage because Chuck Schumer thought it was too dangerous will some day be the ones making decisions about whether cancer patients get life-saving or extending cancer drugs.  Oh shit.

It's not that it's the right decision.  It's not that it's the wrong decision.  It's that it's not your effing decision.

Updates! On things!

MADE PEACE WITH SLOAN-KETTERING.  After a couple phone calls, I think I have things settled with the people at Sloan-Kettering.  They recommended radiation (which was actually useful, since U-M was on the fence for some reason), so I'm going to go through radiation, get a third scan, and then probably head out to New York sometime between Christmas and the New Year. 

I *hope*, based on the fact that the people over there seemed very interested in me getting another PET scan, that the results of that PET scan will have some bearing on their recommendation (the PET scan is expected to be very dark/good).  But we'll see. 

FOR NOW, A PLAN OF SORTS.  I think I know exactly what I'm doing from now until the end of the year.  Cancer-wise at least.  I start radiation this week.  I need to get 15 doses in (max of 5 days a week) which I'm hoping to do by December 10th.  Radiation has latent effects even after you're done being microwaved, so I'm going to wait about two weeks and then get PET scan #3.  I'll meet with Dr. Anderson a few days after that and then head out to New York.

Then, hopefully, I'm done.  If not, it's more treatment after the first of the year.  I'm hoping for the first, planning for the latter. 

YOU WIN, MARYLAND.  The fact that I only needed 15 days of radiation treatment was outrageously awesome.  At least, as awesome as radiation therapy can be.  But it certainly made my December a hell of a lot easier.

Or more difficult.  Because I don't have to get in 20 or 30 days of treatment, I have the entire week of December 13th open.  And that is swearing-in week in Maryland.  And because I can make it to swearing in, I decided to try to make it out to Maryland to make it to the MOST IMPORTANT AND CRITICAL INTERVIEW OF MY ENTIRE LIFE THAT IS VERY IMPORTANT SO IMPORTANT THAT EVERYBODY - EVEN CANCER PATIENTS - MUST COMPLETE IT IN PERSON BECAUSE IT IS VERY IMPORTANT AND CRITICAL. I'm also going to make it to the "PROFESSIONALISM COURSE" on December 4th, and I'm going to try very hard to not write a blog post on it.  I guarantee I will fail at that. 

When I called the various hospitals to see if they could review my case, I also asked them if they could review the contents of that envelope Maryland sent me the other week.  Unfortunately, the best experts in the country couldn't make sense of all the documents.  There's one document in there that says that my interview MUST be completed by December 3rd, but after exchanging e-mails with friends, that deadline also appears to be completely fake.  So who knows.

Also awesome:  This trip will require me to take an airplane.  Which will require a trip through security.  Dr. Anderson said I should, sometime in the near future, check to see if my sperm survived the nuclear winter inside my body, so I think I might just have the TSA agents check that while they're down there.  Kill two birds with one stone. 

TO THE DISTRICT!  In happier news, the light radiation schedule and clear week of December 13th means Emily and I will be able to move into our apartment in DC on Saturday, December 18th.  I'll probably head down to DC early that week and possibly become a lawyer or something, but I don't know.  I don't consider the swearing-in thing a big deal because 1) it's just the natural culmination of me not spectacularly screwing up since 2007 and 2) still got the cancer deal going on.  Don't want to celebrate things until that is over. 

Also, I want cancer to be done.dead.gone before I move to DC.  I don't want shit to be up in the air.  I don't want to receive any additional treatment in DC.  Anything more I have to do, I will do in the Detroit area.  I don't want to associate anything in DC with cancer.  I want to associate that with my post-cancer - and cancer-free - life.

What's the beef?

A commenter from Friday writes, in part:

The Mitch Albom rants are getting depressing...aren't there some positive things about people you feel are worth the time writing about?

I responded in characteristically snarky fashion.  But I also said that I really enjoyed the comment. Because I did. It raised an interesting point. 

Contrary to popular belief, I don't particularly like picking on Albom.  I honestly do try to avoid writing like him, and I disagree with pretty much everything he writes.  But after the first couple times, it's not entirely fun for me to keep hitting the same target over and over.  I only wrote the Four Loko piece because I had previously posted on the Four Loko controversy, and Mitch Albom is a fan favorite around here.  I couldn't pass up an opportunity to comment on the Albom Loko column.  But I'll let his stuff go from now on unless something particularly preposterous comes up. 

But before I put him to rest, I think I should clarify my real beef with Mitch Albom:

First, I despise his writing.  I think it's tired, lazy, formulaic, boring, and simple.  And I think this leads to 1) the oversimplification of complex subjects about which he, as a journalist, is supposed to educate/inform his readers, and 2) sweeping, bombastic, bold statements that often belie the complexity of the issues he covers.  As evidence, I give you a Microsoft Word analysis of his latest column:

Foolproof, I know.

Yes, that is a column in a major American newspaper that is written at a fifth grade level with under 9 words per sentence.  I get that newspapers have to be dumbed-down for the average reader.  Albom dumbs-down the dumbed-down. 

Second, Albom is a nationally-known, local figure who is relevant to three issues of great interest to me: writing, journalism, and politics.  Everybody knows him.  Most everybody is familiar with his writing.  He's a prime example to use.

Third, I wouldn't have so much of a problem with the guy if it wasn't for the tone he takes in every single column.  And I know I'm not the only one who notices this.  I think one commenter hit the nail on his head when he described Albom's columns as "sanctimonious screed."  Another commenter mentions that "There is a condescension to Mitch...that is palpable."  He says things like, "And always, always, be mindful of who you are serving – not your ego, but your reader," when virtually every Mitch Albom characterization I have ever heard from anybody that has ever known/met/worked with him has included the term "massive ego."  If there's anything worse than being pious, it's being fake.

Fourth, stop doing this:

Once, missing Thanksgiving was unthinkable. But "once" was a long time ago.

At least it used to be that way.

In recent years, the holiday has been shaved

Once, Thanksgiving couldn't come fast enough.

Today, we shy away from obligation.

In the old days, if you weren't at Thanksgiving, the silence would haunt you.

Today, you can be online, on Facebook, checking e-mail, downloading movies.

The older relatives, who always knew this, have sadly passed away.

In a single column.  Just stop.  Every time you do this, Mitch, a 7-year-old shotguns a Four Loko.  Just stop it.  Right now.

Finally, and most importantly, Mitch Albom is the antithesis of everything I believe about writing, journalism and politics.  I know that's a bold statement.  But it's entirely true.  As a writer, you have to be interesting, informative, and honest.  As a journalist, you have a special duty to put in the effort to inform your audience about a particular subject or subjects.  And if you want to be taken seriously when you write about politics, you have to have a political philosophy that goes beyond "Things I like" and "Things I hate." 

Albom fails in every regard.  His writing is boring, simple, and worst of all, feigned.  As a journalist, I can't remember the last piece he wrote that required actual work to produce - getting on the ground, talking to sources, digging beneath the surface.  (Wait, actually I can:  It was this piece from Sports Illustrated published on January 7, 2009...which looks remarkably like this piece written by Matt Labash of the Weekly Standard, published on December, 25 2008).  Nor are his columns informative or interesting:  He takes predictable stances on predictable issues.  And I'm not sure the guy has a political philosophy beyond "subsidize that which I like (like the entertainment industry) and ban that which I dislike (like Four Loko)."  He's a "renowned" journalist and writer and an undeserving recipient of numerous awards who produces half-assed pieces for public consumption that aren't interesting and do nothing to inform or educate people.  He does the exact opposite of what I try to do around here and what I would do as a writer with particular interests in journalism and politics if I kept this blog going.

That is my beef with Mitch Albom.  It - unlike Albom - is not feigned. 

***

So how does this work in practice?  Fortunately, the Free Press provides us with an excellent opportunity to compare two views on the same subject.  Unfortunately, that subject is one I did not want to go near on this blog.  But for the sake of making a good comparison, I'll get on with it. 

The backstory:  A 14-year-old Freshman at a local high school had sex with an 18-year-old Senior.  That's illegal in Michigan - the age of consent is 16.  The 14-year-old and her mother went to police with the girl's story. Then they went to the media.  Surprisingly, adding everybody in metro Detroit to the list of people who were involved in this fiasco did not help relieve tensions.  The girl faced increasing bullying and humiliation at school, and she eventually hanged herself.  A truly horrible story all the way around.  Either way, lives were going to be destroyed over a high school relationship.  Everything about the entire episode was awful.

So it's a big, tragic, local story, perfect for local columnists.  Albom punted and wrote about Turkeys, so Brian Dickerson picked up the slack: 

Samantha Kelly's grieving mother, June Justice, says her daughter's Nov. 8 suicide was precipitated by peers enraged at Sam's decision to press charges against 18-year-old Joseph Tarnopolski. Justice's description of the abuse her daughter endured in her final weeks is stomach-turning, and I'm horrified that it has continued in the wake of Samantha's death.

There's no excuse for such posthumous defamation. But after watching the legislators, courts and prosecutors grapple clumsily with the conundrum of teenage sex for more than a decade, I think I understand the fear and rage behind the backlash.

"Precipitated."  "Posthumous defamation."  "Conundrum."  Those are big words.  And those are complex sentences.  And that is...nuance and ambivalence.  And an interesting take on a complex and tragic situation. 

Managing teen sexuality has never been easy -- not for policymakers or parents, and certainly not for teenagers themselves.

Hey what's that?  It's an acknowledgment of the seriousness of the problem and the difficulty in managing it.  More difficult than, say, BAN EVERYTHING!!!11!!

The reaction 18-year-old Joseph Tarnopolski tweeted upon learning that he would likely face felony prosecution for an awkward but seemingly consensual sexual encounter with Sam Kelly two days earlier -- All girls are, are liars and backstabbers! he railed in a Sept. 28 post to his then-handful of Twitter followers. Way to ruin my life -- was callous and devoid of remorse for his own bad judgment.

But it was an accurate forecast of the life-altering consequences certain to arise from any conviction for uncoerced sex with an underage partner.

That's balance.  There's fault, but it's not absolute.  Sometimes, a party in a conflict is not absolutely evil or absolutley good.  As much as columnists want to make that the case, it doesn't match reality. 

Once prosecutors had established Samantha's age and the fact of their sexual encounter -- an encounter Joseph had already admitted in a handwritten statement to police that matched Samantha's own handwritten account in virtually every detail -- he faced an indeterminate prison term and 25 years on Michigan's public Sex Offender Registry, where colleges, would-be employers, prospective landlords and new acquaintances would find his name and photograph listed among rapists and child predators until he was in his 40s. That was disproportionate on its face -- harsher and more enduring than the penalty Joseph would face for assaulting a stranger with a tire iron.

There's more thought and information in that paragraph than you see in 90% of the drivel produced by Albom or columnists of his ilk.  It contains little known facts (the fact that both parties agreed that the sex was consensual; the penalties the 18-year-old could have faced).  It contains an analysis of those facts (the consequences of such a penalty).  It contains a helpful analogy.  It's the type of stuff you should write if you were, say, a professional writer hired by a major newspaper to pontificate on the pressing local issues of the day.

Anyone who has been around teenagers readily understands how arbitrary this boundary between perpetrator and victim is. Some 14-year-old girls are sexually savvy; others are shockingly naïve. Some 18-year-old boys are predatory; and some lack the maturity, or at least the superficial sophistication, of the younger women competing for their attention.

Most teens, like Samantha Kelly and Joe Tarnopolski, fall somewhere on the continuum between these extremes -- neither wholly innocent nor terribly corrupt, vacillating at any given moment between curiosity and anxiety, caution and recklessness.

But Michigan law admits no such distinctions, and allows no reasoned allocation of culpability for a shared moment of sexual impulsivity. In the eyes of police and prosecutors, the partner 15 or younger is 100% victim, the partner 16 or older 100% felon.

Rationality and reason in an emotionally-charged situation.  And Dickerson takes a very tough position on a landmine-plagued issue...and comes off as completely unobjectionable.  I mean, what about those three paragraphs is objectionable?  It captures the emotional component of the story.  It captures the personal component of the story.  It captures the legal component.  All while providing a pretty rational opinion - which after all, is the job of a columnist. 

Even better, the Free Press provides us with a terrible version of the same column.  What would that look like?  From the always-terrible Rochelle Riley:  Teen failed by system that should have protected her.  That's right.  This 14-year-old teen was failed by the system that should have protected her by prosecuting the 18-year-old.  Which it did.  And now she's dead.  So...um...yeah.  Go on, Ms. Riley:

No, the reason she killed herself is because an 18-year-old neighbor who goes to the same high school broke the law.

He...committed murder?  I'm confused. 

In Michigan, it is illegal to have sex with a 14-year-old girl. There are no extenuating circumstances. There are no ways for a minor to consent. It is illegal — for a reason. Fourteen-year-olds cannot make decisions about sex. They are too damn young.

Lot of nuance there.  Probably comes as a surprise to the thousands of American 14-year-olds who make decisions about sex every day.  Nothing to encourage, of course.  But isn't there a least a cognizable argument to be made that it is an issue best handled by a parent, not a Judge. 

So why did Joseph Tarnopolski, who is legally a man, walk out of a courtroom, charges dismissed? Because the prosecutors were cowards who refused to enforce the law.

Yep.  Bingo.  Because if prosecutors are anything, they're cowards.   Definitely the only possible conclusion here, Rochelle.

The intent at the time the law was passed was so strong that it’s a felony punishable by up to 15 years in prison and 25 years on Michigan’s public sex offender list. That’s serious.

Act is serious because law say it serious!  I have an idea: Let's make jaywalking a felony punishable by quartering and then write hysterical columns saying, "That's serious!"  No.  It's either serious or not serious on it's own.  Things don't suddenly become "serious" because do-something legislators, in their infinite wisdom, declare it serious.

Perhaps we should look at the statutory language for third degree criminal sexual conduct, Rochelle?  Oh, nevermind.  You're already screaming about something else:

Oh, and there is one more crime that happened in this case, besides a law being ignored. It is a crime that has gotten an increasing amount of attention in recent months, particularly involving gay teens.

Bullying.

Bullying is a hate crime.

That would be true, except for the fact that it's not.  At least not yet.  Don't worry.  We're getting there.  Because the obvious response to a situation that saw a high school dispute dragged into court and ended with a teen ending her life is...to drag more high school disputes into court?

There ought to be a law against bullying. Oh, wait. There is.

A year ago, President Barack Obama signed a law making it a federal crime to assault an individual because of his or her sexual orientation or gender identity. That doesn’t go far enough. The law should be amended to make it a crime to assault individuals because they are human.

Wait...I thought bullying was a hate crime?  Now there should be a law against it.  Oh good, there is. But it doesn't go far enough.  So there isn't a law against it?  Confuse readers much, oh newspaper columnist, whose job it is to...I don't know...not confuse the hell out of readers.  Also, I think Riley is contractually obligated to mention President Barack Obama in every one of her columns. 

And there is a law against assaulting individuals because they are human.  It's called assault. 

I haven’t recounted details in the case of the Huron Township 14-year-old who hanged herself after finding life too hard to bear. I am not using her name. There are already too many lurid details and wrong conversations that teens are having about something as serious as sex.

Thank you, Ms. Riley, for respecting this girl's privacy.  By writing a column about her and then posting it on the front page of your newspaper's website two millimeteres away from a news article that gives her name in the first paragraph.

Our kids are mating like rabbits and we think there’s nothing to be done because it’s the times, it’s uncool to complain or because abortions are a dime a dozen.

Uh...

That's all I got.

I don't know what I'm supposed to get from that, Ms. Riley.  I don't really get any facts.  I don't get much of an opinion, besides horribly tragic event is horribly tragic.  I get rage at a pretty easy target, which isn't very interesting, and spillover rage at a few other parties.  We get the requisite amount of three-word sentences and one-sentence paragraphs for a crappy column, so that's nice.  But the final paragraph ends with a missive to prosecutors to enforce the law, which is exactly what they were doing in this case when it kinda sorta led to the individual the law was supposed to "protect" killing herself.  And your response to that situation was to...call prosecutors "cowards" because they didn't continue to enforce the law.  Which 1) ignores the actual reason they didn't go forward with the prosecution and 2) would result in the successful destruction of two lives, not one.  Which, ok fine, I can see an argument there.  But the way in which you present it just makes it seem like you are out for blood.

The thing is, an argument that an 18-year-old should be legally prohibited from having sex with a 14-year-old is entirely reasonable.  I would tend to lean more toward Brian Dickerson's more nuanced and flexible approach, particularly when you are dealing with intra-school affairs, but I would never, ever call somebody who held Ms. Riley's position an idiot (the way she seems to characterize anybody who would disagree with her position). 

These people are paid professional writers.  They are journalists.  Their job is to do exactly what I do here on a daily basis:  To inform.  To educate.  To provide commentary.  If I rip on Mike Bouchard, it's from the perspective of a cancer patient watching other cancer patients get thrown on the ground by Bouchard's storm troopers.  If I rip on a columnist, you get my commentary, plus direct quotes, plus a link to their piece.  You get both sides of the argument by the very nature of my writing.  I ranted about the Four Loko thing and posted actual excerpts from the police report that started the whole mess - something I've seen nowhere else on the internet.  As a guy who really likes writing and politics and previously dabbled in journalism, I don't have much sympathy for professional journalists who are consistently terrible at their jobs and do far more to dumb-down and obscure than to enlighten and inform. 

Sometimes, this crap irritates me and I feel like writing about it.  So I do.  If you don't want to read it, you don't have to.  But the Four Loko/Mitch Albom pieces have received a pretty good response, so I figure somebody's gotta be getting a kick out of this stuff.  And maybe, somebody will think about one of these issues in a way they haven't before reading one of my posts.  And I think that's a good thing.   Besides, what the else are you going to do?  Work?  Didn't think so. 

Das Klusterfukken: The Q&A

This whole recent debacle with my diagnosis/course of treatment has become quite messy.  I don't fully understand the situation, so I understand if a lot of my peeps around here don't get it.  So I came up with this helpful Q & A - with myself - to (hopefully) clear things up.  

Briefly, tell me what the hell is going on:

Everything was going swimmingly until I went up to U-M for a third opinion on October 12.  After reviewing my case, U-M doctors indicated that they believed that my current treatment regimen (R-CHOP) was "inadequate" and that I would need two additional cycles of a more intense chemotherapy regimen.  The entire issue now is whether I should get additional treatment or whether my current plan (R-CHOP & radiation) is adequate.

So what type of cancer do you really have?

Uh...lymphoma.  Beyond that, it depends on who you ask.  Henry Ford decided I had high grade Diffuse Large B-Cell Lymphoma with a C-MYC rearrangement (I'll explain that in a moment) and a high proliferation index (100%).  U-M concluded that my tissue had features of B-Cell and Burkitt's lymphoma, but decided that it was best characterized as high grade Diffuse Large B-Cell as well.  Dr. Elaine Jaffe of the National Institute of Health - one of the most renowned lymphoma pathologists in the country - concluded that I had a "special subtype of Burkitt's lymphoma."  So...there's like a really good chance that one of these three groups is correct.  The interesting thing is that everybody is seeing basically the exact same things under the microscope, but everybody seems to reach a slightly different conclusion.

What are those funny terms you discussed above?

The "funny terms" are causing all this confusion.  I'll try to explain:

• "High grade" - this means the cancer is "aggressive," and generally refers to how quickly the cells divide and reproduce
• "C-MYC" is a genetic mutation present in my cells.  Dr. Al-Katib says that this stuff makes the cells "crazy."  It is most closely associated with Burkitt's lymphoma.
• "Proliferation index" refers to the percentage of cancer cells that are actively reproducing.  Mine was 100%.  

What is the difference between Burkitt's and B-Cell lymphoma?

I'm not entirely sure, but here's what I gather:  Burkitt's lymphoma is a crazy aggressive form of lymphoma associated with the C-MYC thing and a high proliferation index.  The fact that I have these things tend to favor a diagnosis of Burkitt's lymphoma, but pathologists report that the actual cells of my tumor look like B-Cell lymphoma under the microscope.  Because Burkitt's is more aggressive and crazy, it requires a more aggressive treatment.  Burkitt's is also much, much less common than B-Cell (here in the US).  Those are the major differences.  

Does an exact diagnosis really matter?

Not entirely.  It certainly helps.  But everyone agrees that my lymphoma is crazy (C-MYC) and aggressive (high-grade and high proliferation index), and that matters more than the exact name of the diagnosis.  R-CHOP is the standard treatment for B-Cell lymphoma, while Burkitt's tends to be treated with more aggressive regimens.  But both cancers will respond to all the treatments to some degree.  It's just a matter of finding the right one.

So why did U-M come to a different conclusion than Henry Ford?

I'm still trying to figure that out, and really, until that question is answered, I'm not seriously considering additional treatment.  When I asked Dr. Li from U-M this exact question, here was her response:

Your lymphoma cells have the genetic mutation (C-MYC) and high proliferation features (KI67 100%) as Burkitt's.

Which is fine.  Except...everybody already knew that.  U-M didn't do any additional testing on my tissue; they figured those things out by reading the Henry Ford pathology report.  Dr. Anderson and Dr. Al-Katib both explicitly considered this stuff in August, and decided to go with R-CHOP.  I'm still not sure why U-M came to a different conclusion. 

Better question then:  Why did Henry Ford choose to go with R-CHOP?  

Because of the worst phrase I can possibly hear right now: Clinical judgment.  In my initial visit with Dr. Anderson, he explained the difference between regular chemo (R-CHOP) and what he called "premium" chemo (more intense regimens).  At the time, they were ready to go with the premium stuff because that's what the initial path report indicated.   Dr. Anderson also expected that, given the fact that I had some crazy ass form of aggressive lymphoma, my PET Scan would show crazy ass aggressive lymphoma all over the place (organs, multiple quadrants, multiple extranodal sites, etc).  When the PET Scan came back and showed a glowing ball of hot damn but only a single, tiny extranodal site in the same quadrant, Dr. Anderson was stunned but pleasantly surprised.  The bone marrow biopsy also came back negative.  So, given the fact that my cancer seems to have been caught very early, the Henry Ford tumor board decided to go with R-CHOP.  Also, this allowed me to avoid more intense chemo that would increase the risk of a) problems during chemotherapy due to an even more busted-up immune system and b) long-term toxicity issues.

If it's Burkitt's, or at least has features of Burkitt's, why wouldn't you just treat it as Burkitt's?

Great question.  I ask myself (and my doctors) this question all the time.  Here's the best answer I can come up with:

You know those posters they put up in your elementary school classroom (for the peeps my age - they didn't put those things up until the feel-good 1980s and 1990s) that said "You are special" and "You are unique."  Yeah...those are pretty much bullshit.  But not for me.  I am VERY special and unique.

Remember:  My cancer has those crazy features - the C-MYC thing - and all of the cells (prolifeation index 100%) were reproducing very quickly (high-grade).  Moreover, Burkitt's lymphoma tends to show up in other places on the body, not the particular lymph node that mine chose, and does not produce what is called a "granulomatous reaction," which is a reaction produced when your immune cells try to wall off a foreign presence in your body (which mine did).

So here's what Burkitt's lymphoma usually does:  Shows up in a hidden part of the body, doesn't explode out of your body in an easily visible lump, and acts all crazy and grows like a mothertrucka.  Ergo, it is usually not caught very early, and when it is, it is usually all over the place.

Now back to me:  Not only did this thing explode out of my arm in a "oh my god what is that thing" sort of lump, I got to a clinic the next day, got it biopsied two days later, had the tumor removed 12 days later, and was in treatment within a month. 

So the argument is that because I am young, healthy, and the cancer was early stage with no bone marrow involvement and hadn't spread very far, R-CHOP was the best treatment because it allowed me to avoid the excess toxicity of a more intense regiment.  Moreover, there is a strong argument that the usual statistics about Burkitt's lymphoma - its high relapse rate, its tendency to get in the central nervous system - don't apply to me, at least not as they appear in the usual literature, because they are mostly stage 3 and 4 cases with bone marrow involvement, multiple extranodal sites, and so on.  In short, the people in the medical literature who relapse are not like me because I am special and unique and this thing came flying out of my armpit and was all like "Ima getcha" and I got it first.

The other major reason for not treating more aggressively:  toxicity.  This stuff isn't Juicy Juice.  It is poison.  And introducing even more intense stuff into my body increases the chance of causing other problems down the line.  It doesn't make sense to blast the hell out of the cancer to the point where I give myself a heart attack in 20 years.  So there is a fine line to walk here.  

What if you're wrong?

Ask myself this every day, and that is why I am begging for somebody to make a comprehensive case for more aggressive treatment.  A one-sentence recommendation ain't gonna do it.  Dr. Li has been great, but the best I have from her is the concern about central nervous system relapse, and her belief that the cancer will act more like Burkitt's.  I haven't heard her directly address my unique characteristics that led Henry Ford and Dr. Al-Katib to conclude that R-CHOP was the way to go.  I know she has spoken with both Dr. Anderson and Dr. Al-Katib.  I hope she will do that again. 

Is there any good news in this? 

Plenty actually.  As I've mentioned, my cancer was aggressive both in terms of the rate or cell division (grade) and in the number of cells that were actively dividing (proliferation).  The awesome thing about this is that the chemo drugs target fast dividing cells (which is why stuff like my hair, my digestive track, and my spermzzzzz are all taken out in the process.  But the bottom line is that if 100% of the cancer cells are dividing very quickly, then you're projected to have a pretty good response to treatment.  And I have.  Burkitt's lymphoma is actually characterized as more curable for this exact reason. 

Also awesome is the location of my tumor, which is away from other vital organs and will allow doctors to radiate with minimal collateral damage. 

So what are your current thoughts on whether you will undergo more treatment?

At the moment, I would say there is very little chance that I will undergo more treatment.  But I am absolutley open to doing so if it seems like the best option.

The main reason I'm against more treatment at this point is that the doctors who say my current regimen is fine have fully, passionately, and comprehensively stated their case.  Those aren't just randomly selected adjectives.  I mean Dr. Al-Katib, Dr. Anderson, and even Dr. Kim have 1) explained why they chose R-CHOP, 2) explained why they didn't choose a more intense regimen (and why they wouldn't now), and 3) seem to really take my unique characteristics into consideration.  Dr. Anderson took the U-M recommendation back to the Henry Ford tumor board, discussed my case individually with other doctors, and reviewed my case with the pathologists after getting the report back from Dr. Jaffe at the NIH.  Everybody he spoke with concurred with my course of treatment.  Dr. Al Katib showed up to our meeting with books, pictures, and journal articles and told us that he would treat his own son the exact same way.  Dr. Kim is the one who explained how my case differs from most of the Burkitt's cases he has seen.  Most importantly, these guys have openly acknowledged the weaknesses in their case - they admit that more aggressive treatment gives me the lowest chance of relapse.  But it also increases the chances of complications and increases toxicity along with the chance of long-term issues.  And they think the benefit (lower chance of relapse) is not worth the risk because my chances of relapse are already low.

I'm fully open to being convinced.  But in my mind, the case has not been made for more treatment.  Not even close.  What I really need is for a doctor who recommends additional treatment to address the Henry Ford case for less aggressive treatment.  To say that my particular characteristics don't matter.  To admit and explain the risk of additional toxicity.  To address the arguments of the other side.

I'm keeping potential biases in mind, too:  Dr. Anderson and Dr. Al-Katib came up with and concurred with the R-CHOP regimen, and it could be argued that this makes them less likely to tacitly admit that the original plan wasn't perfect.  But second opinion docs have biases too:  To prove the value of their opinion by contradicting the first one; to issue "just to be safe" recommendations; to issue recommendations that put the cancer first, not the patient (that's probably a little harsh, but there is a difference). 

Do you ever kick yourself for getting yourself into this mess?

Kinda sorta all the time, actually.  I'm really upset that I didn't go to U-M in August, because all of this stuff could have been settled back then.  But Dr. Anderson was on the fence back in August, and that might have led him to favor a more intense regimen, which means I would have had a more intense regimen, and we've already seen a great response with a less intense treatment...so I don't know.  Maybe that would have led to overtreatment.

On the other hand, I don't really kick myself for going to U-M and starting this fight in October.  I do in the sense that I know this entire terribly frustrating mess is of my own doing.  But I don't really believe that I would be better off if we never had this entire discussion.

I'm mostly irritated at the pace at which this is all progressing, which is currently "John Navarre attempting to scramble."  And also the depth of information I'm getting from people who think its a fine idea for me to go hang out in a hospital for a while and get more poison pumped through my body.  If you recommend that, you better bring the wood as to why you think it's a good idea.  And that hasn't happened so far.

How will you make your final decision?

It will be 100% medical.  And by that I mean I will not let my own non-medical preferences get in the way:  my desire to get to DC, my desire to be done with this, my desire (need) to start working, and so on.

Don't get me wrong:  If I have to go hang out in a hospital for a good chunk of the beginning of 2011, I'll be crushed.  It will be so god-awful in so many different ways, I don't even want to discuss it.  I want nothing more than to finish this thing off and get on with my life.  I don't like being 500 miles away from Emily.  I don't like the idea of not being able to start my job on time.  I don't like the idea of going through chemo again.  I don't like the idea of putting more poison in my body.  And so on.

But I hate cancer even more.  And I know the people around me do too.  So if I reach a point where I am convinced that my best chance to beat this for good is to undergo more treatment, I will do that.  Period.

But I have a long way to go before I'm there.