WIFE'S BROKEN WRIST FORCES SURGERY CANCELLATION. NEW ONCOLOGIST QUESTIONS PROCEDURE

If you are a regular reader of Mind Check, then you think I have now had the surgery I’ve been talking about in this space for awhile and am now ready to report on the results. Wrong! Two days before my date in the operating room at Wake Forest University Baptist Hospital in Winston-Salem, North Carolina, my wife took a fall in one of our bedrooms on a bedspread dangling on the floor and broke a wrist.

Suddenly she was faced with having to keep appointments with orthopedic surgeons to deal with the injured wrist, and she couldn‘t drive. How could I go forward with surgery that was a diagnostic procedure and no life or death matter when she was dealing with something more urgent and needed me? I canceled the surgery.

Additional CAT Scan

I then attempted to get a new date for the surgery, but a week passed and I did not hear from the surgeon’s office. More than a little dismayed by the lack of response, I then discussed with my oncologist whether some alternate approach might be a good way to proceed while we waited for the surgeon to forgive me for missing my appointment and rescheduling me. I raised this possibility with the oncologist because I thought that it might be a good way to gain more information on just how fast growing or slow growing my “olive-size” lymph node might be. My hope , of course, was that the node might have decreased in size or might even have disappeared.

The oncologist agreed that the additional CAT Scan was a good idea, and she acknowledged that the interval between scans was of sufficient length not to jeopardize my health due to excessive radiation exposure. I then went to Baptist Hospital and had the new CAT Scan. Two days later, feeling apprehensive over what the results might be, I called the oncologist. I was told that she was not in. This surprised me and left me a little upset since I was calling on a day when I had been informed the oncologist was always in. When I hung up I was wondering if I would ever get my results and, of course, what they might be.

Unexpected Call Back

My uncomfortable feelings were not to last. Ten minutes later I received a call back, but the caller was not who I had expected it to be. The caller announced to me that she was another oncologist with the same organization, and as she talked I learned that she had a very different approach than the oncologist with whom I had been dealing. First, she told me that the other oncologist was no longer with the practice, and she asked if I knew that. “No,” I responded, “I had no idea. That subject never came up in any of our conversations.”

She then proceeded to give me the test results. The lymph node was still there, she informed me. I was not happy at that news. However, while it was still there, she was quick to add, it had changed in size. It could not be said to have gotten any smaller, but it wasn’t larger either. In fact, what had happened is that the dimensions had simply changed with one dimension larger than before and one dimension smaller.

Called Quite Stable

Having said that, she then asserted, “I consider this lymph node to be quite stable.” She also said that she felt the data from the PET Scan, cited in a previous posting, did not reveal unusually high activity, a different interpretation than I had gotten from the previous oncologist.

She then volunteered that she did not feel that surgery was very helpful in cases like mine. She said, “I prefer a wait and see approach using procedures that are non invasive. For one thing, you should have CAT Scans every two to three months.

Bone Marrow Test Preferred

“Before subjecting my patients to invasive surgery,” she added, “I’d sooner see them have the bone marrow test. I know my patients don’t like them, but I think they would all agree that they are preferable to anything invasive.”

A word about the bone marrow test, to which the doctor was referring. The bone marrow test involves drilling into the hip bone to take a blood sample from the marrow area. If that description makes the test sound unusually painful, that’s fine because it is in my opinion a test somewhat akin to torture. How would I know? I know because I’ve had 10 of the bone marrow tests. They were all awful, but I would have to agree with the doctor. They were all preferable to having surgery.

Specialist in Lymphoma and Leukemia

Finally we talked about where I go from here given the fact that the oncologist I had been seeing had departed for a new endeavor in another part of the state. The doctor told me about the remaining physicians in her oncology practice, and she let me know that of those physicians she and another were the two specialists in lymphoma and leukemia. I wouldn’t have to choose any of the physicians in the practice if I didn’t want to, she told me, but she implied that she would be happy to have me if I chose her.

Easy decision. Given her specialization in my disease and given that I liked what she had to say, anyway most of it and especially what she had to say about surgery, I felt I had an easy decision. “I’d like you to be my oncologist,” I told her.

Where do I go from here? Like the lady said, we wait and see. That means at least four CAT Scans a year and maybe an occasional bone marrow drilling (ouch!!!), that is, if I continue to be “very stable.” That’s a pretty good deal, especially given what almost happened to me.

A friend of ours aware of how my wife’s broken wrist saved me from surgery asked us what I was going to do for her in recompense. Harriet answered, “His not having to have surgery is good enough for me, broken wrist and all.” That’s my wife!

SUBSTITUTION, HOW A RED WAGON HELPED ME TO GET TO SLEEP AT NIGHT

My current health crisis has helped me to learn more about how my mind works. I have learned, for example, that I carry in my mind at least one protection mechanism (and probably more). Some might demean this protection mechanism by calling it a form of denial. Others, however, might be kinder and see it as a legitimate even laudatory means to cope with unhappy prospects. When fears start building up, this mechanism allows me, indeed forces me, to think about something else. I call this mechanism my substitution system.

Substitution goes back to my earliest childhood. I remember learning how to use mental or thought substitution as a child of three to four years of age. As a young child I was filled with fears. Witches, demons, and ghosts populated my mind and became especially troublesome at bedtime. Some of these demons may have originated inside my young head (and may be attributable to defects in my family life), but some of them were introduced in the stories read to me and by the movies I was taken to.

The Problem of Snow White

Movies were a special problem, and nothing scared me more than “Snow White and the Seven Dwarfs.” The wicked stepmother-queen in this Walt Disney production, based on a Grimm Brothers fairy tale and completed in 1937, caused me much terror, and night after night I found myself fixating on this example of jealousy and vanity carried to the extreme. I couldn’t sleep. Something had to be done about it, but what? Well, I could force myself to think about something else.

I’d seen a kid in my neighborhood in Philadelphia with a wagon, and I thought I’d like to have one too. Did I want one just like his? No, I wanted a better one. I began to visualize the kind of wagon I wanted. I began to build it in my head. It would be bright red and shine like crystal. The wheels would be large, as large as possible, and the tires would have jet black tread. Rising up from the body for the protection of its precious cargo would be side extensions made of polished wooden slates.

The Boats Fixation

By forcing myself to think about the red wagon I pushed the wicked stepmother queen out of my head, and I was able to get to sleep. I have been practicing wagon substitution ever since except that the object visualized ceased to be a wagon decades ago. Long ago boats became my fixation. I started becoming interested in boats when I first moved to Margate, a suburb of Atlantic City, in 1953.

Like Atlantic City, Margate along with Ventnor and Longport, are parts of Absecon Island. One is never very far away from water anywhere on Absecon Island including, of course, the beach and the ocean. One is also never too far from boats.

Building a Barge in Margate

In 1953 I started building a barge-like structure on the shores of the bay that runs the length of the island about two to three blocks from my house. I was building it with a friend I’d recently made, and we were designing it as we went along. We were both fourteen at the time, I think. Barges are not exactly major challenges in naval architecture, but I suspect we would have had more of a challenge on our hands had we ever gotten to the house that was to sit on top of the barge platform.

Our barge building came to an abrupt halt when the police arrested us. My friend and I had been using house lumber taken from the house construction site of a local builder. No, we hadn’t paid for the lumber, but as part of the resolution of the case the judge decreed that we pay the builder an amount that far exceeded what we would have paid had we gone to lumber yard and purchased our wood directly.

Avoided Reform School

We had to pay through the nose, as the saying goes, and we ended up with nothing to show for our efforts. The builder sent a crew to our construction site, dismantled what we had built, and took the wood back to be used on one of his houses. Hence he profitted many times over from our misfortune. But at least my friend and I didn’t end up being sent to reform school for our misdeeds.

I recount this small episode drawn from the annals of juvenile justice not only as an example of how I learned at a young age that crime didn’t pay, but to place a date on when my efforts in mental substitution switched to the use of boats. For many years hence, designing and building boats within my head (I would frequently commit my designs to paper, but never attempted to build any of them) was a method I used to escape the everyday worries of keeping a job and supporting a family and the stresses from the political realities of the day, namely the cold war and the possibility of missiles raining down multiple nuclear warheads.

Cruising the Chesapeake

Boats were my escape, but they were not all fantasy. For a while, I lived in Maine and was paid to write and edit articles about the sea. Throughout my life, I have been privileged to own and operate boats of significant size. During the 1990s, the Chesapeake Bay became my cruising ground, and my wife and I spent many hours traveling to and getting to know its many very interesting water towns. And now my substitution object has switched to unusual varieties of aircraft and spacecraft, about which I may write in the future.

As I indicated at the beginning of this essay, some members of the psychiatric community might look at my use of substitution and accuse me of living too much in a state of denial. At the age of three, had I analyzed what it was that scared me about the wicked stepmother queen of “Snow White and the Seven Dwarfs” and then somehow risen above it instead of spending mental time with imaginary red wagons, perhaps I would be better off today.

Developing the Imagination

Possibly, but then something has to be said on behalf of exercising the imagination, especially if one is a creative person. My red wagon was one way I discovered and developed the power of the imagination as a means to overcome fear.

I am now actively involved with the program of the Blue Mountain School of Meditation, as I have previously indicated. Some of the reasons I am pursing this practice are to get control of my mind and keep it focused as much as possible on the positive, to enhance the moral center of my life, and to minimize the role of fear in my outlook. In addition to daily meditation itself, this practice calls for the daily use of a mantram, that is, the use of a saying of a religious nature repeated over and over again to oneself to substitute for the negative thoughts during times of anxiety.

Not So Benign Substitution

Yes, another form of substitution. Let us acknowledge the value of substitution then, despite what some mental health care professionals might say, but let us quickly bring the importance of good judgment into the discussion. There is benign substitution and not so benign. When we use addictive substances and fall prey to risky attitudes and behaviors to substitute for the fears that plague us, we are doing ourselves and those around us no good. We cannot eat our way to a sound mind, for example.

At the same time, we must assert the principle of moderation even with benign substitutes. If we are spending a preponderant amount of our time in our head designing red wagons or boats or whatever and not accomplishing other things that need to be done in our lives, that may be our clue that a rigorous re-examination of what is going on in our lives and the need for intervention are necessary.

Yes, but no one should have to spend his every waking moment thinking about health problems. We all need a break from that kind of fixation, as steeped in reality as it may be.

ABOUT MIND CHECK

Thank you for tuning into Mind Check, a biweekly effort to prove that we are what we think and that clear thinking leads to effective action and to a better world. Mind Check is intended to serve as a bridge between the realm of the human spirit, that center of our energy, mental and physical, and our rationality or reason, of which the scientific method is an excellent example. Mind Check is also intended to prove that the ideas of right and wrong are innate, not exclusively inherent in the situation or the whim of the moment.

To communicate with the author of Mind Check, please write to stephen.saft@gmail.com. For examples of the writer’s other writings, see the website http://www.iwillmeanpoetry.com. The author is also preparing to launch a site of podcasts consisting of spoken poetry, essays and short stories. Be on the look out for it.

Copyright © 2007 by Stephen Alan Saft

FINDING THE OLIVE IN THE HAY STACK

So what’s happening? I would love to launch into a brand new subject in Mind Check, but I have unfinished business to attend to, and I feel I owe you, the visitor-reader-viewer, an explanation of what’s been happening since my last posting.

My big news is that since that posting I met with the surgeon and his assistant. This visit was strictly a consultation, not the procedure itself, as I originally expected it to be. The visit also included a disappointment. According to the surgeon, the laparoscopic approach may not be able to do the job, that is, it may not be able to find the very small object it is supposed to remove—an object measuring 2.4 cm by 1.4 cm.

Searching Less Familiar Territory

Performing such a task is a challenge just a little less daunting than finding a needle in a haystack—for several reasons. First, the surgeon and his team are looking for an object that is very small. In our meeting, the surgeon described it as “the size of an olive.” Second, the surgeon and his team are dealing with less familiar territory than what they are normally used to as a laparoscopic team where known parts of the anatomy such as the gall bladder or appendix or spleen are the usual targets of a laparoscopic search. What they have to go on are the images from the CAT and PET scans. And that’s all!

Finally, even if found relatively easily, this “olive,” which is an enlarged lymph node, may turn out to be behind something important like a blood vessel that can’t be moved aside too easily, anyway not by something as small as a laparoscope.

Conventional Surgery An Option

If the surgical team cannot find or reach the object, then right on the spot they will enlarge the initial incision and perform a conventional surgical procedure. First, however, they will be using the laparoscope.

Laparoscopic surgery, what is it? Laparoscopic surgery is usually what people in medicine mean when they talk about “minimally invasive surgery.” Because it is minimally invasive, recovery time is normally much quicker than with conventional surgery. Hence my disappointment when the surgeon told me that he might not be able to complete my procedure laparoscopically.

Cavity Inflated

Here is how the online encyclopedia Wikipedia defines laparoscopic surgery (www.wikipedia.org/wiki/laparoscopic_surgery): “The key element in laparoscopic surgery is the use of a laparoscope: telescopic rod lens system that is usually connected to a video camera… Also attached is a fiber optic cable system connected to a cold light source …to illuminate the operative field, inserted through a 5mm or 10mm cannula [hollow tube] to view the operative field. The abdomen is usually insufflated with carbon dioxide gas to create a working and viewing space.”

The target of this tiny gizmo is, as the surgeon described it to me, “a thing the size of an olive.” Not only must this olive be found, but it must be cut away from the surrounding mass and then extracted. Once out of me, it will then be sliced and put under a microscope by a pathologist (an expert in the causes of disease) and a report prepared.

Lymphatic System Defined

The olive is an enlarged lymph node, a part of the body’s lymphatic system. What is the lymphatic system? Every cell in the body needs to be fed to stay alive. Every cell in the body also needs to be cleaned to remove the byproducts of metabolism or feeding. The feeding is accomplished by the body’s tissue fluid, which is part of the body’s blood system. The cleaning is the role of the lymphatic system, which is also responsible for defending the body against disease. Tissue fluid and lymphatic systems are linked.

On the web site http://www.lymphnotes.com, one of many that deals with lymphatic issues, tissue fluid and lymph are compared and contrasted. “The role of tissue fluid is to deliver the groceries to the cell. The role of lymph is to take out the trash [the byproducts of metabolism] that is left behind and to dispose of it.”

Known As Lymphoma

Lymph nodes play a central role in the production of antibodies, which the body produces to fight disease including cancer. Sometimes the nodes are cancerous themselves. That may be the case with “the olive” inside of me, found by both CAT and PET scans and shown to exhibit higher than normal metabolic activity by the PET scan. Cancer originating in the lymph nodes is known as lymphoma.

If the “olive” is found to be evidence of lymphoma, then my oncologist (cancer specialist) is likely to recommend chemotherapy as the treatment. Chemotherapy primarily involves the transfusion of chemicals into the blood stream. Sometimes chemicals are also taken by mouth.

Chemicals Are Killers

Most of these chemicals are killers. That in fact is why they are taken. Their job is to attack and kill fast growing parts of the body such as cancer cells. Unfortunately, there is no way to stop them from also killing other fast growing cells in the body such as hair follicles and parts of the stomach lining. Hence the sudden baldness we see in cancer patients. Hence the bouts of nausea they frequently experience.

By talking about chemotherapy at this stage, I am getting ahead of myself, and that is not a very good idea when dealing with anything as momentous as the possibility of a cancer reoccurrence. In fact, it is not a very good idea in any case. I am learning from my meditation practice to live in the present, and never has such a skill been more important.

It is the now that is important. It is learning to make the most of the present that is essential. That is the best path to getting the most out of every moment of life.

ABOUT MIND CHECK

Thank you for tuning into Mind Check, a biweekly effort to prove that we are what we think and that clear thinking leads to effective action and to a better world. Mind Check is intended to serve as a bridge between the realm of the human spirit, that center of our energy, mental and physical, and our rationality or reason, of which the scientific method is an excellent example. Mind Check is also intended to prove that the ideas of right and wrong are innate, not exclusively inherent in the situation or the whim of the moment.

To communicate with the author of Mind Check, please write to stephen.saft@gmail.com. For examples of the writer’s other writings, see the website http://www.iwillmeanpoetry.com. The author is also preparing to launch a site of podcasts consisting of spoken poetry, essays and short stories. Be on the look out for it.

Copyright © 2007 by Stephen Alan Saft

BRAVERY NEEDED WHEN FACED WITH MEDICAL TEST FINDINGS

One of the characteristics of modern life is the enormous amount of information we all have access to and specifically the great volume of information we have access to about ourselves and our health. In medicine, for example, sophisticated scanning devices exist that look inside the body and provide complex information on how our insides look and how all our many parts and regions are functioning.

I am referring specifically to medical scanning technology, the offspring of the original non-invasive method to look inside the body, which is still with us today, known as the X-Ray. These offspring techniques have names like MRI for magnetic resonance imaging, CAT or CAT scan for computer-aided tomography, and PET or PET scan for positron emission tomography.

Scans May Scare Us

Miracle techniques, right? Without them the early detection of most forms of cancer would be almost impossible, as would an effective method of tracking the patient after treatments like surgery or chemotherapy. Yes, great techniques, but they are also great sources of worry. The information from medical scanning technology gives us a great deal more to think about in this information-loaded anxiety-ridden world.

Why? First because scanning technology provides data including images that must be interpreted by human beings with titles like radiologist or oncologist. These specialists may not interpret the data correctly. Even when the interpretation is dead on perfect, it is almost always more about suspicions rather than certainties. Scans are rarely ends in themselves. A slew of follow-up procedures are required.

CAT and PET Findings

An example, please! In an earlier posting to Mind Check, I revealed my personal history with cancer and specifically with mantel cell B lymphoma and with thyroid cancer. As I noted then, a diagnosis of mantel cell B lymphoma is not a particularly good one, but the fact that I have gone well over six years since my initial detection and over five years since my bone marrow transplant at Johns Hopkins Hospital is grounds for considerable celebration and grounds for encouragement.

Because of my medical history, I now submit to twice yearly CAT scans. Unfortunately, my last scan revealed something suspicious, specifically a lymph node measuring a little more than 2 centimeters by a little more than 1 centimeter, and I am now in the midst of trying to find out what this little thing is. In fact, as of this writing, I have not just had a CAT scan but also a PET scan, the latter a technique relying on nuclear technology, specifically an infusion of radioactive sugar, to measure metabolism or glucose intake in specific regions of the body.

Good News and Not So Good

The second scan led to the news that no other area in my body showed anything suspicious including no vital organs. Good news, yes? Nonetheless what is to be done about the suspicious lymph node, albeit quite a small one? It should be noted that between the initial CAT scan and the PET scan, a small increase in the size of the node was detected, and the PET scan revealed higher than normal activity in the node, a possible indication of cancer.

Now what do I do? Should I ignore the little thing until it gets a lot bigger? The oncologist I’m seeing wants me to consult with a surgeon about having the lymph node removed using a laparoscope and to do it now. Laparoscopic surgery is minimally invasive and entails the shortest possible recovery time. The removed node would then be put under the microscope for positive identification. Should it prove lymphomic, I’ll confront a new set of options.

Realism and Bravery Needed

A lot to think about and a lot of potential for worry. The thought that I have been down this road before and survived is helpful, but I also know that I must be realistic and I must be brave. We do not live forever. That is a given for all of us. Something has got to kill each one of us.

The fact is that I love life, and that encourages me to keep on fighting. At the same time, as I wrote in a previous posting, I see no benefit in dwelling on my mortality. I see no benefit in allowing worry to take over my life. The meditation practice I am engaged in and which I discussed in still another posting is very helpful at times like these, for it helps me to attain mind control and to experience some peace of mind. Specifically I have been a practitioner for several months of the methods taught by Eknath Easwaran and his Blue Mountain School of Meditation.

One of my blessings as a human being is that I have a lot of interests and a fundamental interest in what is going on inside my head at any given moment. These interests help to sustain me during difficult times. The concern of my wife and family and friends also sustain me, and I am also very grateful for that.

ABOUT MIND CHECK

Thank you for tuning into Mind Check, a biweekly effort to prove that we are what we think and that clear thinking leads to effective action and to a better world. Mind Check is intended to serve as a bridge between the realm of the human spirit, that center of our energy, mental and physical, and our rationality or reason, of which the scientific method is an excellent example. Mind Check is also intended to prove that the ideas of right and wrong are innate, not exclusively inherent in the situation or the whim of the moment.

To communicate with the author of Mind Check, please write to stephen.saft@gmail.com. For examples of the writer’s other writings, see the website http://www.iwillmeanpoetry.com. The author is also preparing to launch a site of podcasts consisting of spoken poetry, essays and short stories. Be on the look out for it.

Copyright © 2007 by Stephen Alan Saft

UNUSUAL ACTION IS THE ATTRACTION

It is human nature to be fascinated with action especially when that action is not ordinary or commonplace. Unusual action attracts us. Passivity or inaction does not. When, for example, someone takes extreme action and kills 32 people with an automatic pistol and then kills himself we want to know everything we can about him. Why did he do it? How was he brought up? What was he going through that led him to commit such a horrific act? Where did all this intense hatred of others come from?

We may even say that we feel sorry for him that he could contain so much hatred within himself. We may go even further and try to find in this perpetrator of so much mayhem, pain and misery an excuse to see him as some kind of victim himself—a victim of supposed persecution of the mental or physical kind. Meanwhile we may find it harder to think about the victims, all these innocent people whose lives were taken from them and all the grieving families and friends.

The Supreme Narcissist

The perpetrator acted out in such an extreme attention-getting manner because he felt he deserved such attention. He saw himself as more valuable and more important than all his would-be victims. He was in this respect the supreme narcissist, a personality that we described in previous installments of Mind Check and classified as evil.

The painful reality is that this evil young man was right. He used extreme action to gain attention for himself, and he got it.

Challenge for the Moralist

The attraction of extreme action is part of the challenge for the moralist. The moralist is forced to classify actions into three large categories, those that are good, those for which moral judgment is not relevant, and those that are bad. Justice through a nation’s legal system is not possible when the doer of such evil as happened at Virginia Tech also kills himself.

Our only recourse as responsible citizens of the world is our relentless condemnation of such acts because they are evil, but also in the hope that through such condemnation we may prevent another act of this type from happening ever again.

Remembering the Victims

Yes, as humans, we may be fascinated by and curious about an evil doer in our midst, but we must not fail to speak out about what he has done. And we must never fail to remember the victims. One of the messages in all of this is that there is much in human nature that may be understandable—“natural,” so to speak—but just because certain acts are part of the natural condition and as students of life—scientists, for example—we can study them, they are never acceptable or pardonable. And we must condemn them.

For example, at this time of grief for the innocent victims of the Virginia Tech massacre, it is not enough to remind ourselves of the Columbine tragedy in Colorado with weak words betraying a flabby mind set. It is not enough to remember all the other examples of gun violence in this country instigated by people judged to be insane. The recent murder of school girls in Amish country in Pennsylvania also comes to mind. We must speak out.

Mental Energy and Charisma

The topic of mental energy has been on the Mind Check agenda as something to write about for some time. The attraction of mental energy and the attraction of people of action are similar phenomena. Mental energy is what we mean when we use the word charisma. As we know from recent history, the charismatic leader may also be a force for unmitigated evil.

Saying that someone is too judgmental is often used as a pejorative in human affairs. Yes, people can be judgmental to a fault, but the fact is that the ability to make judgments is an inherent capability of mind. When this capability is not exercised, we lose our ability to lead independent responsible lives.

Morality, which is the application of judgment based on a reasonable, compassionate code of conduct, needs always to be acknowledged as the mind functioning at its highest level.

ABOUT MIND CHECK

Thank you for tuning into Mind Check, a biweekly effort to prove that we are what we think and that clear thinking leads to effective action and to a better world. Mind Check is intended to serve as a bridge between the realm of the human spirit, that center of our energy, mental and physical, and our rationality or reason, of which the scientific method is an excellent example. Mind Check is also intended to prove that the ideas of right and wrong are innate, not exclusively inherent in the situation or the whim of the moment.

To communicate with the author of Mind Check, please write to stephen.saft@gmail.com. For examples of the writer’s other writings, see the website http://www.iwillmeanpoetry.com. The author is also preparing to launch a site of podcasts consisting of spoken poetry, essays and short stories. Be on the look out for it.

Copyright © 2007 by Stephen Alan Saft

LESSONS FROM VIRGINIA TECH: PAY CLOSER ATTENTION TO OUR POETS

As we begin our recovery from the horror of what occurred at Virginia Tech just a week ago, we look at the lessons learned from this tragedy for all humanity. Mental health professions both at the university and at a major hospital near by judged this future killer of 32 people to be merely depressed and no threat to others, but one person thought otherwise and that was poet and university professor Yolanda Cornelia “Nikki” Giovanni.

Not only did Nikki Giovanni ask that the future mass murder be removed from her class, but she sought protection from the police to ensure her personal safety. Giovanni saw in this severely disturbed person who happened to be her student far more than the depression and suicidal tendencies that was all the so-called professionals saw. She saw the would-be mass murderer. She saw the evil.

Professionals Need Retraining

Lesson one from this tragedy then is that our mental health professionals need to be more alert to psychopathology. Lesson one is that most of our mental health professionals need retraining. Only a small number of people who exhibit mental disorders are any more than threats to themselves, but the fact is that that one exception can do an enormous amount of harm in a society in which weapons, including automatic weapons, are so freely available.

For one thing, mental health professionals need to learn that one of their major jobs is the protection of the public, and they need better diagnostic tools to ferret out the psychopath from those who are just depressed and suicidal. The fact is that one highly intelligent and sensitive person, namely the poet Nikki Giovanni, saw far worse than simply depression and suicidal tendencies in this student who sat before her and shared some of his inmost thoughts with her through his writing.

Did They Talk to Nikki Giovanni?

Did any of the mental health professionals who were charged with evaluating this student ever talk to Nikki Giovanni, and if they did why didn’t they take her concerns and her fears more seriously? Let us remember that this future mass murderer was also accused of stalking two female students. Stalking is an act perpetrated against another. It is an insight into psychopathology whether the two female students pressed charges or not.

As regular readers of Mind Check know, I have spent considerable effort in this blog on the subject of evil. In this respect, I have been aided by my readings of the writings of the great psychiatrist M. Scott Peck, who we lost in 2005. Our contemporary psychiatrists and other mental health workers need to start by reading or perhaps rereading M. Scott Peck, and they need to take his work very seriously. Yes, the evil do walk among us, and they are capable of immense destruction.

Liviu Librescue Remembered

Before closing this installment of Mind Check, I want to call attention to the loss of Liviu Librescue, age 76, as part of this tragedy and thus pay my respects to this survivor of the holocaust and engineering and mathematics lecturer at Virginia Tech. Among the 32 innocent victims of this horrific act of evil, Librescue died blocking the door to his classroom and thus protecting his students from the madman outside. Monday, April 16, the day of the massacre at Virginia Tech, was Holocaust Remembrance, and it was on such a day as that that Liviu Librescue gave his life so that others might live. I stand in awe before such an act of self sacrifice and heroism.

ABOUT MIND CHECK

Thank you for tuning into Mind Check, a biweekly effort to prove that we are what we think and that clear thinking leads to effective action and to a better world. Mind Check is intended to serve as a bridge between the realm of the human spirit, that center of our energy, mental and physical, and our rationality or reason, of which the scientific method is an excellent example. Mind Check is also intended to prove that the ideas of right and wrong are innate, not exclusively inherent in the situation or the whim of the moment.

To communicate with the author of Mind Check, please write to stephen.saft@gmail.com. For examples of the writer’s other writings, see the website http://www.iwillmeanpoetry.com. The author is also preparing to launch a site of podcasts consisting of spoken poetry, essays and short stories. Be on the look out for it.

Copyright © 2007 by Stephen Alan Saft

TO SURVIVE CANCER, FIGHT THE DEATH OBSESSION

The revelations about the reoccurrence of cancer in Elizabeth Edwards, wife of John Edwards, candidate for president, and the spread of the disease in Tony Snow, George Bush’s press secretary, has brought the disease front and center to public attention once again. This attention has forced me to think once again about my own battles with the disease.

One of the many excellent articles on the subject appears in the latest issue of Newsweek Magazine (April 9, 2007, page 30ff). This first person account by Newsweek writer Jonathan Alter contains many echoes from my own life. Like Jonathan Alter I was diagnosed with lymphoma, a cancer of the blood system, in fact with the same variety of the disease, called mantel cell B. In my case, the diagnosis came at the very beginning of 2002, and by the end of that year I had undergone a bone marrow transplant at Johns Hopkins Hospital, Baltimore, Maryland.

Initial Chemotherapy, Then Transplant

Like Alter, whose diagnosis came over two years after mine, I was found to have a tumor growing in my stomach region. Like Alter, my course of treatment consisted of an initial assault with a transfused chemotherapy called CHOP, an acronym for a witch’s brew of chemicals used to treat a number of cancers. And like Alter, I was then transfused with Rituxan, considered a pharmaceutical wonder at the time.

Unlike Alter, however, I did not need surgery to remove the tumor; chemo did the whole job for me, but while I did not have to put up with surgery, anyway for tumor removal, I did have to put up with pneumonia and a prolonged recovery from it, a byproduct of the CHOP. My bone marrow transplant, designated as autologous, the same procedure that Alter went through, was followed by transfusions of a whole lot more Rituxan in hopes of knocking out the agent or agents that caused my illness in the first place. (In an autologous transplant, the patient is his own donor. The alternative, an allogenic transplant, requires a separate donor.)

No Evidence of Reoccurrence

Now five years and several checkups later, the medical community is still not able to find evidence of the disease in my system, but like Alter I will not use the term “cure” and not even the term “remission” in describing my situation. I am cancer free at the moment, and that is all I will say on that subject.

One reason that I feel I need to temper my optimism is because mantel cell B lymphoma is not the only major cancer I have suffered in my life. And when I say that, I am not counting skin cancer, specifically basal cell carcinoma, for which I have also been treated. Basal cell carcinoma is usually classified as “minor.” No, I’m talking about thyroid cancer.

Lumps Seen in a Mirror

About 40 years ago, I was shaving at the bathroom mirror of my fourth-floor Brooklyn walkup, when I noticed two golf ball size lumps projecting from either side of my neck. The cause of these strange lumps was determined only after one of them was surgically removed and a section of it put under the microscope. The lumps were evidence of thyroid cancer. In subsequent surgery, my thyroid gland, which sits in front of the throat, was removed along with the second lump and all the lymph nodes the surgeon could find in my neck.

Being diagnosed with thyroid cancer at the age of 26 was a total shock, in fact even more of a shock than being diagnosed with mantel cell B lymphoma at the age of 62. The first shock was a total coming to terms experience, that is, a total coming to terms with the denial most of us feel about death, especially when we’re young. I was 26 years old. I was newly married, my wife was expecting our child, and I was going to live forever, right? Wrong!

Facing Cancer as Young Person

I was mortal, and I was capable of coming down with cancer. That I could suffer such a gross disease meant that I was going to die. Maybe not from the thyroid cancer. Maybe not right away, but someday, and that was that. Hence when I heard the diagnosis of mantel cell B lymphoma for the latest health crisis, my dominant initial emotion was “not again.” But that thought was followed by a surge of strength. “You beat thyroid cancer, and you will beat mantel cell B lymphoma,” I told myself.

Yes, I read all I could find about this variant of the disease on the Internet, and, just as Alter found in his own research, what I read did not sound good, but I refused to take the bleak accounts as an automatic and immediate death sentence. I would fight this thing. I would do what the doctors told me to do, and I would see what happened.

I had gotten through the thyroid cancer, I told myself, and I knew that it would be better for me if I took the attitude that somehow I would get through this latest crisis as well. That I was going to die someday was already accepted. I had dealt with that reality 40 years before at an age when it was much less customary to think about life and death issues. And now faced with the new diagnosis I knew I had to work against allowing myself to feel that my death was imminent.

Five Years Out

So now I am five years out from my bone marrow transplant, and I am still here.

Because I was trying to keep my mind focused away from the notion that my death was just around the corner, I kept reminding myself to make sure that I was living my life not as a dying man, but like someone with many more years of active life ahead of him. First I began planning with my wife a move coincident with our retirements from jobs in the ever more congested Washington area and to the mountains of southwestern Virginia. The idea that I would be moving to a more healthy environment had a lot to do with our decision.

Moving to the Mountains

As residents of the mountain, we decided to lead as healthy a life style as possible including a regular program of exercise and being more mindful of what we were eating. We decided that we needed to be more aware of what was going on inside our heads as well. That, for example, is why I joined a meditation program, and it had a lot to do with why I started this blog. Then some months later, we decided to make room in our lives for a puppy.

Yes, the thought would dawn on me occasionally that this very intelligent, energetic and mischievous little dog might outlive me and my wife, but I made myself put that thought aside. No, I had to restrict the amount of time I spent thinking about my death and allowing thoughts of death to influence any of my decisions. Death is a given, as it is a given for all living things, but I was going to live my life as fully as possible. Meanwhile, care of a young dog has forced me to be even less focused on myself, and that is a good thing.

My efforts at putting thoughts of death aside is not perfect, of course. Like Alter I still go through a lot of anxiety whenever a periodic medical check up is in the offing, but most of the time I am happy and optimistic and excited about the work I want to accomplish in my life.

ABOUT MIND CHECK

Thank you for tuning into Mind Check, a biweekly effort to prove that we are what we think and that clear thinking leads to effective action and to a better world. Mind Check is intended to serve as a bridge between the realm of the human spirit, that center of our energy, mental and physical, and our rationality or reason, of which the scientific method is an excellent example. Mind Check is also intended to prove that the ideas of right and wrong are innate, not exclusively inherent in the situation or the whim of the moment.

To communicate with the author of Mind Check, please write to stephen.saft@gmail.com. For examples of the writer’s other writings, see the website http://www.iwillmeanpoetry.com. The author is also preparing to launch a site of podcasts consisting of spoken poetry, essays and short stories. Be on the look out for it.

Copyright (c) 2007 by Stephen Alan Saft