Desultory Diary Number 41: Cancer Journal, Continued

1 

How should I end it? Having achieved wisdom by an encounter with death; at last having realized that he isn't the center of the universe and never was, shall I pen him, (plume him?) into Danish kingship in the last act? America isn't even a country yet, yet I'm about to write a happy end? No, I'm writing a tragedy; gotta bump him off. How about if I have Laertes dip his sword in poison and nick the sweet prince to the other side? That's it! Methinks I got it!...

Then Shakespeare woke up. 

Who ever thought that an Elizabethan would have reached old age? The bard might be still young at heart, but inches below that heart was an almost octogenarian's hyperactive bladder. The great man might be slowing down, but the yellow bubble between his hips was about to burst. Shakespeare almost didn't make it to the toilet.

Then I woke up. Great man? Once again almost nobody, mirrored, is watching almost nobody brush his teeth. Almiosr nobody, by the way, has cancer.

2.

After the insertion of the little gold markers into my prostate, which I discussed in a previous blog, I returned to Johns Hopkins Hospital for further preparation for my impending 28 radiation sessions. This time I was scheduled for a 'simulation' session, that is, a scan to determine the exact position of my prostate relative to the surrounding tissues, in order to devise a blueprint for my treatment. According to that blueprint, very sophisticated machinery will be programmed according to the exact topography of my body.

I had been given a handout to prepare for this test. I was informed that I neededd to have a full bladder and a reasonably empty rectum so that the test would be successful. The prostate evidently has a propensity to move about; a full bladder presses against it and helps anchor it in place. The more precise the radiation beam, the more successful the treatment. Stool and gas tend to move the prostate around, so these two factors were to be kept to a minimum.

I am writing this blog not only to document my treatment, but to inform others in my condition what to expect. So I must be frank, and impart more information than innate shyness would like.

I suffer from urgency and incontinence.  When my bladder is full, I have an irresitible  urge to void. If I don't get to the toilet in time, my underwear becomes dry as swim turnks after a few laps in a pool. Not only underwear; my pants become wet as well, and I might even leave a little puddle on the floor.

This is not much of a problem at home; I usually can manage to get to the toilet in time.  You can imagine my frustation, however, if I should find the bathroom occupied. Nothing to do in those oeccasions but to 'go with the flow.' Restricting fluids helps as well.

I was in a quandary. If I drank the amount of fluid the handout recommended, I would pee on the table. If not, I would have to repeat the test at another date.

I gave up.

It turned out that nobody asked me whether I drank enough fluids. The scan was acceptable. I was told that my bladder was full! After the test, I just about made it to the bathroom.

I was reminded of questionnaires patients often need to fill out before being seen. After many visits to various specialists, I became aware that doctors never refer to the answers of the questionnaire; he or she obviously doesn't t read them. How many times do I have to get up to void at night? It wouldn't matter if I put down one or a hundred.

I couldn't manage to follow the guidelines precisely. Turns out it didn't matter.

After the scan, I was informed that my doctor had ordered an MRI of the prostate as well. I was surprised, since I hadn't been informed about this test.

Since it was an MRI, I had to remove the little gold chain I had been wearing  around mi neck for decades. Which got me to thinking...

The chain is from India. It contains a gold medaillon, which contains an engraving of the god, Subramaniyam. He is usually depicted as a non-thretening youth, holding a spear. The god is mythologically related to a Northern god of war, but he doesn't seem at all bellicose in his South Indian manifestation. Yes, Murugan, (another name for him), is holding a spear, but apparently it is used to dispel ignorance. Subramaniyam is also the subject of one of my favoirite carnatic hymns, Ka Va Va.

Nirmala had given the chain to me shortly after our marriage. Since then, I never take off the chain unless I have to. (I can only imagine what would happen if I continued to wear it during an MRI.)

On a trip to India several years ago, I decided to purchase a similar chain for Nirmala. We went to Mylapore in Chennai, where a famous ancient temple is located--and the stores of the gold merchants as well. I asked one of them for a chain with a Subramaniyam engraving. They didn't have one. The salesperson thereupon tried to pressure me into purchasing another one, with the image of a god who is 'much more powerful.' He obviously took me for one of those anemic and ignorant Westerners who hang around gurus in the hope that the pixie dust of Eastern Wisdom would fall upon them. Tried that once, long ago; turned out to be dandruff. 

"Thank you," I said to him, "but my country is full of would-be powerful gods who in actuality are no more powerful than the god you tried to sell to me. Do I look like a hippie?" With that, almost nobody exited the jewelry store.

Almost nobody is also growing blind, wizened, and wiser. Cancer smanser. Thanks to Subramaniyam's spear, as it were, ignorance now hums about like a wounded mosquito. 

3.

My next appointment is in two weeks. Time is needed to program the complex apparatus which adminsters the "image-modified radiation," the so-called IMR.  

Farewell, Eumenides! You're about to get zapped.