At this very instant, as I peck out my initial words one-handed (because I have a Vitamin C IV dripping into the other arm), I await my doctor’s appearance to discuss some “concerns” about my latest blood work. It’s never an easy wait for a patient who has had cancer. Every time more blood is drawn, a clock starts ticking. A couple of weeks for results, more or less: that’s what you expect in the US. (At Dr. Carlos Bautista’s Immunity Therapy Center in Tijuana, I never waited more than 48 hours.) So how will it go this round? Will you roll another seven… or has Destiny decided to send you Snake Eyes? Will the hammer click harmlessly on an empty chamber again… or has your spin of the pistol’s cylinder found the bullet today?
Meanwhile, Burl Ives is crooning, “Have a Holly, Jolly Christmas” somewhere down the hall. And out in the parking lot, sitting alone in a cold car, my wife awaits the return of her awaiting husband, the quiet caboose in a train of tension and misery.
Can you understand why it pisses me off so much that my fellow citizens readily surrendered our republic and our personal freedom over their fear of a damn flu virus? They’re so very afraid that they might die—that if they were among the millions to be infected, they might also fall among the .3 percent of the known infected to perish. (About 40 percent of the infected never know bout it, since they have no symptoms.) Meanwhile, as these panic-moths hurl themselves into the flame to escape a disease indetectible almost half the time, I play Russian Roulette every few weeks with a blood test. They can’t crawl out from under their beds in their terror of a bad cold, but every day of my life is lived in the shadow of a tombstone.
One thing I know to be amiss with my blood (though I dare not take anything for granted: must keep myself prepared for the worst) is the effects of overdosing on Firmagon for six months. Almost unique among the drugs I was administered in Mexico to be accepted by mainstream American medicine, Firmagon dries up testosterone—and testosterone is the favorite food of prostate cancer. This is, indeed, a major ground of optimism about the “mystery concern”: I’ve been shooting myself so full of the drug that cancer would have to overhaul its menu to make a comeback. Interesting, isn’t it, that ITC so grudgingly supplied me with additional boxes of the stuff while, as it appears, having reached some international compromise to permit the shipping of substances disliked by the FDA. Could it be that American distributors want exclusive dibs on Firmagon—that the FDA is far less alarmed at the prospect of a witch’s brew entering my system than it is at that of US doctors and drug companies not carving maximal profits out of big-ticket items?
All I can say is, Firmagon is one hell of a torment even to some who consume it in recommended doses. Chills, dizziness, soreness at the site of injection, joint and muscle pain… I came to know all of these thanks to overdosing; and the last, it occurs to me, is probably routine in anyone who leads an active life. You need testosterone to stimulate muscle repair and recovery after a vigorous workout. I wrote of this weeks ago. I’ve been aware for some time that I couldn’t tax my body as I used to on a regime of hormone-suppressants and plant-based proteins. I learned my lesson as a result of a couple of hard take-downs and their aftermath. As I would try to ease my incidental tears and pulls back into shape using a tried-and-true pattern of stretching and “nudge” exercises (the kind that refuse to let the sore spot flee all pain and go slack), I would find myself merely re-aggravating old problems—maybe making them worse. I couldn’t demand anything of my muscles at all, it seemed.
It’s not like the last six months have given American constitutionalists no other cause for distress… but I began to grow downright depressed. Finally, last week, as I prepared my monthly Firmagon injection, a chain of thoughts began to close its links which was to pull down my vast wall of error. I was dissolving the powder in distilled water from the ampule. (I won’t give you a step-by-step account: every Firmagon kit has over half a dozen components, and the procedure for using each in proper position and sequence is tortuous.) I knew that the box containing two kits was marked dosis inicial, and I knew that each hypodermic of the two contributed 120 milligrams to the 240 total. (A single shot of that magnitude in one spot would make the first-time user’s tummy swell up like a watermelon.) I knew that each booster, of which this was my fifth, should be 80 mg. Therefore… therefore, I would need to squeeze out approximately 33 percent of my preparation before injecting the remnant. I say “approximately” because the ampule had no calibration. The only way that I could reduce 120 mg. of Firmagon to 80 mg. was to “eyeball” it.
This I did, though deliberately underestimating the ejectum. (The stuff is expensive!) For some reason, I still needed a few more mental links to close. I think it literally occurred to me between sleeping spurts that night (the muscle pain doesn’t allow steady sleep) that I’d never squeezed out any “extra” from the previous shots. Not only that… but the first supposed booster, administered on my last day at ITC by a couple of novice nurses—it was a Saturday, and the duty roster was pretty thin—didn’t feature any expulsion of excess in its preparation, either. None. I would have noticed, for I knew I’d have to imitate the procedure. Every booster of Firmagon I’d ever received was a 50-percent overdose, except the one I’d just completed. That one was probably just a 10-percent overdose.
The doctor came, and we had our talk. He’s a sweet guy. I haven’t seen that degree of caring among very many Americans in this profession.
My PSA is up from nearly dead zero three months ago to 42. A huge leap over an incredibly short period. We’ll retest it next week, we’ll schedule a bone scan, we’ll plan for contingencies… maybe I’ll go back to Tijuana. I would, in a flash. I’d stay there, if I could.
So… Death and I are chained at the ankle once again. We always were, of course… but now I get to see his leer whenever I take a careless peek. Everyone is saying, “Oh, this is just a setback! We’ll figure it out! Everything will be fine!” Actually, I—the lowly patient—am the only one who seems to have a coherent theory of events. Firmagon caused my muscles to bleed without mending; inflammation (as an independent professional confirmed for me just now) can severely elevate PSA scores; thus my tests are going to show high numbers as long as the poison in my system continues to keep my triceps and gluts and thighs from sealing up.
And, just to add a personal speculation… why wouldn’t genuine cancer cells rally and multiply when the body is over-strained in the simple matter of repairing leg muscles after a walk?
Firmagon was the most “American” of my treatments, and I never really liked its m.o. Annihilate your adversary by annihilating one of your own battalions… how very like the American medical establishment! I guess this present challenge, as my son calls it, is an opportunity to form a better battle plan. Everything seemed day-to-day before. Now we can go long-range.
All the same, the ultimate in long-range thinking is recognition that one’s body cannot function beyond a certain point. It’s understanding that life in this world doesn’t have a ticket for infinite trips up and down the track. My own destination cannot be so very far up the line.
As my wife drove me home through the maze of backroads where the GPS led us, I studied the mowed green farm lawns, the fields now stripped of their cotton, the horses blanketed for one of our first sub-freezing days… and the small new subdivisions of young professionals fleeing Atlanta taxes, above-ground swimming pools for toddlers dryly weathering the winter, Christmas lights making candy-canes of columns here and there, mansards and bay windows and railed porches or broad decks proposing scenes for private domestic celebrations…. It was beautiful. It was all beautiful, including the “bourgeois domesticity” (words inevitably sneered by the mortal enemies of families).
And yet, if I was supposed to mourn silently, “Please, God! I’m not ready to leave all this! Please let me live a while longer!”… well, I thought no such thing. I thought of my own special places where I was a child, and how much more beautiful they were to me than these, and how I could walk right into them and see all my lost people, never to be parted from them again, on the day when I broke through the barrier. I’ll stay for now, all right… or I’ll try. I’ll tolerate Death’s cold breath down my neck as I gaze at the sun’s afternoon scythe harvesting a tawny field. But when I finally pass through, the chain that bonds my clammy companion to me will break forever, and he will be left behind.
I began writing this page last Tuesday. On the calendar day when I post these words, December 4, I have reached my sixty-eight birthday. Will I see another? If I do, it is well… and if I don’t, that is well, also. I don’t like to mar my plateau of peace by adding that the cowardly traitors sure to make this world so much more challenging for my son will be a pleasure to leave behind, but… well, so it is. I tell you, I pity grown human beings who so fear my dark, mute companion that they will sell their souls for a pair of blinders.