Watchful Waiting

When my father was diagnosed with prostate cancer, late in his life, his doctor told him that most men who live to be eighty will develop prostate cancer but that it grows very slowly at that age and they will generally die of causes other than prostate cancer.  His doctor recommended “watchful waiting”, keeping an eye on the slow, inexorable advance of this common cancer in older men.  Sure enough, something else killed my father, undiagnosed liver cancer, though saying it that way is a bit unfair to the several highly regarded specialists he saw regularly in the last two years of his life, it actually was diagnosed, in the ER, six days before he died.   

A few decades later, I myself watchfully waiting, in this case for the results of an MRI on my prostate, an MRI done because my prostate specific antigen levels were quite high.   The test results were quickly emailed to me, along with a bill for $162 (thank you, Medicare… the US Gold Standard…) for the short visit with my urologist to set up the MRI (bill for that to follow).  I have learned that reading medical test results without knowledge can be needlessly stressful, so I am watchfully waiting for the call from my doctor to tell me what the MRI results mean for my immediate futire.

In this waiting mode you can invent stories, more or less likely, that may or may not explain the delay in hearing from the doctor — though we have no idea about any of these theories.   If it was good news, the MRI showed everything nice and benign on the old prostate, the doctor would have immediately called to tell me, no?   Since it’s not good news, next step biopsy to confirm cancer suspicion from MRI, he’s waiting to have a few minutes to talk to me since the discussion is longer than “good news, it was benign”.   If it was bad news, another theory goes, he’d have called right away.   No, wait, he’d give me a day or two in my preferred fool’s paradise before dropping the bad news that I need to have a long needle repeatedly inserted up my ass and jammed into my prostate, likely followed by cancer treatment of some kind.  Or any other story I can imagine, including a list of stories involving complications in the doctor’s own life that have caused him to fall behind in updating anxious patients.   Since each theory is equally plausible, and equally implausible, I put the whole theorizing out of mind now that I’ve emailed my doctor telling him I have my fingers crossed until he tells me what the MRI results mean.  Figure of speech, “fingers crossed”, since I am clearly typing with uncrossed fingers.

I think, philosophically, that everybody has to die of something.   I also recall the foamy urine I was seeing five years ago, foam that got so thick it looked like the head on a well-pulled pint of Guinness, foam you could piss deep holes in as you went.  Ending with a smiley face in the foam was always fun.   That foamy urine, with the swelling of the legs, turned out to be symptoms of a rare kidney disease that taught me a new word — “idiopathic”.   What does idiopathic mean?   It means we don’t know what causes it, as to the pathology of this disease we are, as they say, idiots.  As to the cure?  33% of the time a short course of chemotherapy (at around $25,000 a bag) knocks it out, and I was in that lucky 33%, and lucky too that Obamacare hadn’t been repealed.

That constant itch on the inside of my left scapula?   A dermatologist told me the name several years ago but I never retained it.  It’s neurological, not topical, I recall that — put what you like on the skin, the itch is caused by a signal sent from a nerve, so nothing will really help with the itch, outside of a good scratch, which I was advised only makes it worse.  In the Age of Surveillance Capitalism we live in, I was discussing this itch with Sekhnet, as she scratched it, and soon had videos about Notalgia Paresthetica sent to me, for my edification, or shopping pleasure.

Fucked though so much of this world is, designed by the greediest for the benefit of the greediest, with applause and hero worship for the most successfully greedy, the mass of humanity not only viciously screwed but driven mad by deliberate lies that benefit the worst people alive at any given time, spread with increasingly ridiculous ease by those paid to do it, for the enormous profits of selected far-sighted tech billionaires … we don’t want to leave it.  This miraculous world is not the problem, the problem is that we must all leave it one day.  The only consistently useful practice available to most of us is taking care of ourselves and our loved ones as well as we can, and watchful waiting.

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