Rainbow over the minicipality

Rainbow over the minicipality

Tuesday 8 September 2015

New Dawn, remember this date, 8th September, 2015

Hot the much mail-delayed letter from my Oncologist.  Most amasing, he treats me like someone who will understand, and I do understand.  I think this is what makes me feel better, not just his detailed prognosis which suggests a good chance of success.
They know the probabilities of success but nor clearly the causes.  Perhaps it is a matter of probability like quantum effects.  Perhaps it is the result of genuine quantum effects at a human scale.

Here is my reply:  Which I shall now edit, so it might be different.  Whom am I telling with this blog? No one at present, but if I do live another couple of decades, who knows?



1225 High Street, Armadale Vic 3143                                               8th September 2015

Dear Professor Millar,

Thank you for your very re-assuring letter dated 24th August that arrived today.  Rather pathetically I confess, that you are the first person ever who has taken a letter of complaint of mine seriously and responded in a way I can understand and that actually addresses my concerns and does not patronise me – and I have written hundreds of such letters for many reasons I was distressed, not just medical.  Thank you.

You probably wonder why I have not searched the InterNet myself and found these studies.  Especially considering I have done tertiary studies that were totally On Line, so I am not only proficient but accomplished having gained a High Distinction with Open University.  But I have digressed into a rare moment of personal pride and optimism, brought on no doubt, by the very positive prognosis implied by the many studies you quote.  I could draw a ‘tree’ (I forget the name) that allocates percentages to the quotas from previous percentages, especially if it included margins of errors or standard deviations and so forth.  Again, I digress, but my point is that I am liable to ‘self harm’ as Alexandra (the last Counsellor to quit on me, who promised she never would, though it was arguably a problem of bureaucracy not hers personally,) identified it in my behaviour.  I used to wonder if I was cursed!  This was brought on by child-hood trauma that went un-treated for decades and made worse by me being very introverted.  I think I avoid doing things that I can do and which would benefit myself, like presently avoiding getting a plumber, as I need to every year or two, to clear the street-tree roots from the sewer.  Anyhow, reading your concise digest of the pertinent research provides me in a page what many hours of research might give me, once I had worked out how to filter the relevant from all the other studies that get reported, with or without peer-review.  No wonder Hospital and Medical Departments do not regularly try to impart this sort of information, but I wonder how other people cope.  Oh!  I just remembered, most people are more optimistic than I am.  I think it is a sort of skewed, normal distribution, with people being born optimistic with most people tending towards optimism with the mean far above the mode, and increasing levels of pessimism with no actual upper limit.  I exist in a stratified region in this and many other demographic distributions.  Excuse me for telling you all this, but you can understand me and perhaps will find it interesting. 

All I wanted to do was thank you for your letter.  When the first of the post-operative PSA results came in, I had an appointment on the Friday with Dr Langdon before my scheduled appointment on the following Tuesday with Mr Hanegbi.  The result was tiny.  Point zero Zero three, if I remember correctly or three thousandths of one percent, if my arithmetic is correct.  Dr Langdon seemed very pleased with this infinitesimally tiny result and congratulated me on the success of the operation, which confirmed Mr Hanegbi’s post-operative comment that he had removed more tissue than the minimal and was sure everything had been cleaned.  I felt wonderful, especially as I had been having great success with the Counselling from the other, chronic problem.  I cannot tell you how excellent I felt.  Suddenly I noticed that all sorts of other things, both physical and psycho-social were cleared up.  Then on Tuesday, Mr Hanegby gave me the expert opinion: the result was small but was not zero.  Had I not read in the literature to hope for zero?  Yes I had.  I understand the mathematical difference between something that approaches zero and zero, and that is the greatest ontological difference two entities, states of being or members of a set can have.  Someone later told me that the degree of accuracy of these tests is improving rapidly.  The test a while back might have show zero, but that would have been a false (positive or negative, I am dyslexic and confuse them?) I forget who told me, not yourself, I think, but it does not matter.  The dramatic, earth shattering news was that I was not free and needed more treatment. 

Why does all this treatment take so long to start?  Why wasn’t I given or offered the hormones when I was first diagnosed with even a tiny amount of Cancer?  Then I was told to wait as few men have it progress in their lifetimes.  Why wasn’t I it started as soon as the need for the operation was diagnosed, for the treatments to run together.  There were three weeks between the ghastly, fatal biopsy and the operation itself.  Three weeks of turning my mind off and not thinking about anything except the preparation exercises and work and other important duties.  I did go to the theatre as a kind of last treat, just in case, and luckily they were two of the best and amongst the few memorable theatrical experiences.  Then I waited another three months for another PSA test, which would have been zero in two circumstances: I had been on the hormone androgen deprivation which I was not, or the operation had removed every trace of the cancerous prostate cells. My PSA had risen three-fold, as I recall and I was referred to you.

You are aware of the next blow to my self-esteem when I gained the knowledge that it might have been possible to avoid the operation, and its side-effects, and go straight to the treatment you were offering.  I still do have concerns about that choice having been made for me.  I accept that it may have been the best choice in the circumstances.  I am still not sure why a man such as myself is not put immediately onto the androgen deprivation.  It would seem that the cancer is put on hold for the duration and may be wiped out.  For those men who come off the treatment, surely an operation is then still possible.

On Friday, I am attending your clinic for the scan in preparation for the Ray Treatment (I don’t want to think about it)  but I do not anticipate seeing you, which is why I am writing this letter.   Thank you for reading it if you have gone this far.  If it did nothing more but amuse you with my pretentions of cleverness, then I am still happy, because writing it has given me a chance to work through the delight and existential optimism your mail-delayed letter has given me.  It has tunnelled through my layers of pessimistic introversion to give me hope for the future.  On that point I should add that death in itself holds no fears for me as to me it seem obvious that beyond each end of our temporal existence the same non-existence exists, if “zero” can be said to actually have real, ontological existence, apart from a point on a made-up, heuristic number line.  However, I do enjoy being alive and have today resubscribed to the MTC, surely the act of someone who anticipates survival.  Thank you.

Yours sincerely,

Norman F Pollack                                                                   Copy: Mr Hanegbi, Dr Langdon

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