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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