REPORT FROM THE CHEMO WARS: HOPE PLACED IN NEW GROUP OF CHEMICALS

Imagine if someone came to you and said, “You think you are healthy. You think you are feeling just fine, but I know from tests that I have had conducted on you that you are really carrying around a disease inside you that eventually will shut down some of your major organs while causing major discomfort and considerable pain and then will kill you.

“Now in order to save you what I want to do is make you very sick and even threaten your life. You can count on it making you feel nauseous and stupid and very tired at times, and you’ll lose your hair. And, by the way, you need to know that I make no guarantees that what I am about to do will in fact save you. It might fail, and you’ll die anyway.”

“Forget it!”

Would you consent to going through the extreme, life-threatening procedure? Or would you say, “Forget it. I’ll take my chances by doing nothing. And I’ll save myself a lot of discomfort and pain in the process.” That is until the ultimate discomfort and pain, of course.

This is the kind of choice that a number of cancer experts presented me with back in 2001-2002, an option that I chose, and this is the proposition that has once again been put to me in 2007-2008 by another group of experts. That is the kind of proposition that our health care system with its advanced diagnostic procedures is now routinely able to present to us, the kind of decision that was never possible before in human history.

Complicated for the Mind

In being able to formulate decisions of this type, our medical science has fundamentally changed the very nature of the way we live our lives. Momentous decisions are now put in the hands of our health care providers and in our own hands as patients. All of which helps to provide one of a slew of reasons why life in the 21st Century becomes ever more demanding and complicated for the mind.

Okay, so that’s where I am in my latest round of medical treatments for my fatal disease. I have chosen to go down a similar road that I went down in 2002. That road brought me to Johns Hopkins University Hospital in Baltimore, Maryland, and to an autologous bone marrow transplant. That road brought me five years of remission from my MCL or Mantle Cell Lymphoma.

Wake Forest University

Now I have relapsed, and I have chosen to go down a similar but not an identical road. For one thing, I am going down this road with Wake Forest University Baptist Hospital in Winston-Salem, North Carolina. For another, my oncologist is now a bright young doctor named Denise Levitan. Then too I am being treated with a whole new group of chemicals, at least for this initial phase of my treatment. I am being treated with a suite of chemicals known by the acronym of “Cold Ice.”

What happened to Velcade? A few postings ago, I was filled with not a little optimism about a product known by the generic name of Bortezomib, trade name of Velcade, a proteasome inhibitor. As I explained back then, a proteasome inhibitor has the job of keeping biological mistakes from living, which is what those of us trying to survive cancer want to happen. We want the body’s cancer mistakes to die.

Yes, I went through eight treatments with Velcade as part of a two-drug cocktail. Specifically I received eight Velcade treatments and two Rituxan treatments over a period of six weeks. What do I have to show for it? Nothing, I’m afraid. When I had a CAT scan at the end of my treatment it showed that the lymph node in the mesentery region of my abdominal cavity that we are using as the barometer of my disease had not shrunk at all. In fact, it had grown slightly. Bad news.

Four-Drug Cocktail

And that brings me to Cold Ice. Cold Ice is a four-drug cocktail that happens to include Rituxan. “Why do you want to continue to use Rituxan even though it did not do a thing for me when used with Velcade?” I asked my oncologist. “For its complementary effects,” she responded. “We still like the way it interacts with other drugs.” Also as previously explained in this forum, Rituxan, generic name Rituximab, is a monoclonal antibody that is supposed to do its thing by targeting for destruction a specific antibody in a lymphoma mass. As we now know, it doesn’t always do what we want it to do, but I do hope it works this time. My tolerance for failures is limited.

What is Rituxan supposed to work with this time? These three: Ifosfamide, Carboplatin, and Etoposide, also known as VP-16. The three compose the ICE in the acronym while presumably the “Cold” portion is the Rituxan. All three chemicals are DNA “messer-uppers,”—if I may be forgiven a very unscientific term--either because they force the body to produce easily killed lymphoma cells with corrupt DNA or they interfere with the efforts of the cancer cells to repair damaged DNA and thus save themselves. Remember once again that the objective in our cancer wars is for cancer cells to die.

Only If Remission

Once the Cold Ice puts me into remission –and only when it puts me into remission—can I then proceed to finish the process. That process is finished this time around with an autologous bone marrow transplant. The latest studies for autologous bone marrow transplants for relapsed victims of MCL, which I am, remain somewhat encouraging. In an upcoming Mind Check, I’ll have more to say about autologous bone marrow transplants as well as their counterpart allegenic BMT.

Once again, however, we are not talking about a cure, but a prolonging of life.

To see a sampling of the other writing of Stephen Alan Saft, also known as S.A. Saft, see the website http://www.sasaftwrites.com.

Copyright © 2008 by Stephen Alan Saft

A MODEST PROPOSAL FOR THE PERFORMANCE ENHANCING STEROID CRISIS

Whenever the subject of performance enhancing steroids and athletics takes center stage in our frenetic world of public media, it is almost always accompanied by examples of destroyed reputations and painful humiliations among our athletes and the profound sense of disappointment on the part of everyone who cares about sports and our sports heroes.

The saddest example of what I’m talking about is the story of Marion Jones, a star of track and field, who had to give back five Olympic medals earned at the 2000 Olympic Games when she admitted to having taken performance enhancing steroids. Once celebrated as the world’s most gifted female athlete, Jones also had to endure a six month prison sentence for lying to a Grand Jury.

Who’s Telling The Truth?

In the battle of ace pitcher Roger Clemens and his one-time friend and trainer Brian McNamee before the U.S. House Committee on Oversight and Government Reform, we are subjected to yet another ugly installment of the performance enhancing steroid saga. Who is telling the truth about performance enhancing drug use, pitcher Roger Clemens, definitely one of the heroes of the game, or trainer Brian McNamee? And who will be subjected to a prison term for lying to a committee of the U.S. Congress? Stay tuned to find out.

Will the unholy alliance of performance enhancing steroids and athletics never go away? Maybe not. That’s because every party to the issue including the public has different ideas about the rightness and wrongness of the issue, and too many would prefer not to think about it at all. They just want it to go away. Their anger, if they’re feeling it at all, has mostly to do with being forced to think about it because a segment of the evening news has pushed it under their noses.

Let’s Not Be Naive

And let’s not be naive. There are powerful reasons for athletes to think they need to take performance enhancing steroids and human growth hormone, not least of which is the fear that everyone else in their sport is doing it, and they’re afraid of not remaining competitive. The economic motivations are just some of the reasons. Athletes do care about breaking records in their respective sports, and they do care about longevity in their chosen sport. They love the way winning makes them feel about themselves and the accompanying adulation.

On the other hand, we can’t let our athletes take performance enhancing drugs, can we? How “real” is the game we’re watching as sports fans if we do that? How “honest” is it? Doesn’t the game simply become a case of who has the best pharmacy and the best personal pharmacologist? Is that what we want for our professional teams? Is that what we want as a role model for our young people?

The Libertarian Solution

Or do we really care? Do we really care that although a slew of laws and regulations are already on the books that they are regularly being ignored or violated? Okay here’s my proposal. We decide not to ban steroids at all. We stop all drug testing. Not just in the United States but world-wide. We say that anything goes. Let the athletes be free to take whatever they want, in whatever quantity they want, and as often as they like. Let the athletes decide whether they are willing to chance the health risks. That’s not the public’s concern. In other words we adopt the libertarian solution.

On the other hand, to ensure that public morality prevails and to help ensure public confidence in our professional sports, we will insist on this: All athletes taking performance enhancing substances or who owe their participation in their sport to having used the human growth hormone in the past must wear a prominent sign, both front and back, whenever they are performing their sport that says the following: “Steroid User.” Furthermore in the telecasts of all sporting events, a graphic must appear on screen containing the same information anytime the image of an athlete appears who is a previous or current user. “Steroid User” will flash across the screen.

Steroid User Sign

My proposal also provides a solution for the Barry Bonds and Mark McGwire dilemma. How do we handle the achievements of these baseball players in the record books? We use the asterisk approach in print media, as has been already suggested a number of times and which, as far as a I know, is already being done in some cases, but we also use the graphic approach any time their images appear, whether in print or in video. On audio, whether radio or a recording, an announcer would have the job of giving voice to some version of the “performance enhancing drugs” statement. At the same the official game program for each game would also have to include indicators as to who the steroid drug users are.

Drug Pavilion at Cooperstown

As for future record books, they should probably be published with “drugs” and “drug free” sections. The Hall of Fame in Cooperstown, New York, would include a special “performance enhancing drugs” pavilion. Barry Bonds and Mark McGwire would appear in that wing, not in the same room with Hank Aaron, Babe Ruth and Roger Maris. Pitchers would be handled in a similar manner. Depending how the current Clements McNamee hassle plays out, Roger Clements, that is, his picture and statue, could end up in the special “drugs user” pavilion at Cooperstown.

What do you think of my proposal? Let me know, and anyone interested in sending in a donation for the new “Drugs Pavilion” at Cooperstown why send it right in. Remember to mark your check for the Performance Enhancing Steroid Drug User Pavilion at the Baseball Hall of Fame. Okay, I admit that this is not a pretty proposal. It’s borne out of frustration, a lot of it.

Mandatory Drug Testing

If you don’t like that idea how about that we fully enforce the laws that are already on the books including random, mandatory steroid drug testing? And, yes, cheaters, that is, people who manufacture, sell, inject, and use substances that happen for the moment not to be detectable through current testing technology are guaranteed substantial jail terms, probably even more severe terms than others.

Not pretty at all, right? but the alternate is even less pretty, and that is, to have more and more Marion Jones’s having to give back medals and having to spend time in prison. Nothing pretty about that.

To see a sampling of the other writing of Stephen Alan Saft, also known as S.A. Saft, see the website http://www.sasaftwrites.com.

Copyright © 2008 by Stephen Alan Saft

MOVING TOWARD THE MIND-CENTERED: HINDUISM AND BUDDHISM

It is time for me to revisit the subject of my religious beliefs to see what has been happening since I last took a look at the subject. As Carl Jung, the great 20th century psychologist and thinker, makes clear, the growth in the religious impulse is a natural development as we grow older, and I certainly see this development in my own life.

As the death of people we know, including loved ones, becomes commonplace and we face more and more health issues in our own lives, the reality of our own mortality comes into focus. Faced with the difficult facts of mortality we are drawn toward the answers that religion offers.

Eknath Easwaran and Meditation

When I step back and take a look at my own religious impulses, I see that I am not just getting more religious but am moving toward Hinduism and Buddhism. I cannot be surprised at this discovery, given the fact that I have remained constant in my adherence to the practices of Eknath Easwaran, founder and guiding inspiration of the Blue Mountain Center for Meditation, and specifically to the practice of meditation since joining the Floyd County (Virginia) Satsong in September 2006.

The stated practices of the Blue Mountain Center are eclectic and unlimited, that is, open to everyone including everyone of all religious faiths. The fact is, however, that while he was very knowledgeable about the religions of the West, most notably Christianity, Eknath Easwaran came out of the Hindu tradition, and he was also steeped in the beliefs and practices of Buddhism, which itself grew out of Hinduism.

(Eknath Easwaran, 1910-1999, was born in Kerala in southern India, and first came to the U.S. in 1959 as a Fulbright Scholar, then subsequently settled in the San Francisco Bay Area permanently in 1965. The developer of Passage Meditation and the Eight Point Program, Sri Easwaran was the author of 27 books on meditation and mysticism during his lifetime. http://www.easwaran.org/Nilgiri.cfm.)

Mind Centered Morality

Another reason that my interest in Hinduism and Buddhism should come as no surprise has to do with my long interest in and dedication to the idea of the individual mind as the center of the universe and the source of our morality. This was the idea that I propounded in my first book of poetry I Will Mean, first published in 1975 and revised in 2005. (See the website: http://www.iwillmean poetry.com for more on this book.) Important aspects of Hinduism, the oldest continuously practiced religion, are mind centered, and Buddhism is entirely mind centered.

Moving toward religion in general and Hinduism and Buddhism specifically, yes, but then, I must ask myself, do I accept a key tenet of these religions? Do I accept the idea of reincarnation? No, I do not. And, for that matter, do I accept the major theological tenets of Christianity and Judaism? Do I accept the idea of a transcendent all-powerful God who intervenes in the affairs of mankind? Do I accept the existence of heaven and a life of the soul outside the body? Do I believe that the ideas of good and evil are the purview of this supreme transcendent being who judges each of us and exacts penalties on the transgressor? No to all of the above.

Agnostic on Theological Issues

However, when I say “no,” let me quickly assert that these are soft no’s. Ultimately I am an agnostic on all these questions. I am a doubter. I am a skeptic. All I can say with certainty on any of these issues ultimately is that I simply don’t know. I am too much an advocate for the importance of reason and the scientific method and too much a student of history to accept these specific ideas.

I am an agnostic on the theological issues, but as for morality I believe as I first made clear in I Will Mean that it is incumbent on each of us to be his own source of moral authority. We have the right to judge the behavior of others, and we all bear individual responsibility for our actions.

The Reality of God

Let’s bring this discussion back to where it began. I claim that I am becoming more religious. In what way? The common ground I can find with Hinduism and Buddhism is the idea that the divine, that is, the reality of God, can be alive in all of us. The fact that our minds can conceive of God and all the associated powerfully positive qualities associated with God is the best argument for the existence of God. We find God and the idea of perfect goodness in ourselves. We keep God alive in ourselves.

At the same time, we stray from God when we allow corruption inside ourselves to take hold—corruption in the form of selfishness, corruption in the form of addiction or extreme preoccupation with substances including food and drugs and destructive forms of behavior.

Evil of Hatred Obsession

Our ideas can also be a corruption, that is, can be in opposition to the possibility of God within us. We can become obsessed with hatreds for this group or that group. Instead of practicing the supreme manifestation of the God within, which is love, we indulge in the hatred of people. We become trapped in the tightening mental prison in which we hate the individual because he is the member of the hated group, and we hate the group because it is composed of hated individuals. The total unreasonableness of people trapped in such hate preoccupations does not dawn on them, or more accurately they will not let it dawn on them.

Meditation, which I do every day for at least one half hour in keeping with the practices of the Blue Mountain Center, is my way of finding and centering in consciousness the God within. My meditation now consists of seven memorized prayers from the Jewish, Christian, and Hindu traditions, which I recite to myself at least once and sometimes twice a day. These prayers are all found in the book God Makes The Rivers to Flow, a compilation of prayers selected by Eknath Easwaran and published by Nilgiri Press, the publishing wing of the Blue Mountain Center (website: www.nilgiri.org).

Let Nothing Upset You

The latest addition to my meditation repertoire is the shortest and comes from the Christian tradition. Entitled “Let Nothing Upset You” (page 206), it is by St. Teresa of Avila and is just seven lines long. I quote it here:

Let nothing upset you;
Let nothing frighten you.
Everything is changing;
God alone is changeless.
Patience attains the goal.
Who has God lacks nothing;
God alone fills every need.

I added this prayer to my meditation because of what it says to me as I proceed through multiple chemotherapy treatments and because it helps me address a central obsession in my life: what I perceive as the insufficient recognition of my creative work. For both of these issues, the word “patience” in the prayer is very meaningful as is every word of the piece, for that matter. But how can I, an agnostic who claims that he doubts the existence of a separate transcendent God, say such a thing? “God” is mentioned three times in a piece that is only 29 words in all.

Because God is the best in us. Let me end with a recent poem of mine that summarizes my thoughts on this crucial subject:

THE BEST IN US

No king of the good.
no emperor of ideas,
no president of order.
So how do we, all the single I’s,
make sense of the possible,
fill time with the semblance of a plan?

On radio Guillermo Dell Toro said
when confronted with atrocity
he learned no supreme separateness
offered any answers,
that if that is what he had to have
he’d have to make his own.

Struck with his profundity
you were suddenly in trouble.
Why all the study of the mystics?
Why say words from long past seers?

Then it dawned on you:
There is no contradiction.
The struggle toward enlightenment
coexists among the constancies.
As we seek a path for ourselves
our quest is tempered by the best in us,
a best as utmost as the mountains,
a best as always as the sea.

See my comprehensive website at http://www.sasaftwrites.com, also http://www.iwillmeanpoetry.com.

Copyright © 2008 by Stephen Alan Saft

HOW AM I DOING, A CHEMOTHERAPY STATUS REPORT

I have now had two treatments, and I am pleased to report that I am not feeling too bad. That’s two treatments down and another 22 to go. The routine is as follows: I go twice a week for two weeks in a row. I am off the third week, and then a new cycle begins.

There will be a total of six such cycles, meaning that the total amount of time involved is 18 weeks. Since I took my first treatment on January 7, I’ll finish up the first full week of May, that is, assuming that there are no interruptions for illness.

Pneumonia, A Concern

How likely is an interruption because of illness? Hardly out of the question. In 2002 when I did two separate rounds of chemotherapy—the second one at Johns Hopkins University Hospital as part of a bone marrow transplant—I got a nasty case of pneumonia. The disease was a side effect from the first round of chemicals, and it kept me from proceeding with the bone marrow transplant for several months.

Diseases like pneumonia take hold in the body because one of the results of chemotherapy is an assault on the body’s blood chemistry, for example on the white cell count. It is our white cells that protect us from disease. The fewer white cells we have, the more likely that diseases can infect us.

Watch the White Cell Count

In my case, as a victim of a form of blood cancer called lymphoma and specifically of what is now referred to by the acronym MCL or Mantle Cell Lymphoma, I have a defect in the way my body makes white cells, at least one kind of white cells, the B cells. The chemicals I take then have the job of killing white cells. For me then, close scrutiny of my white cell count is critical.

What chemicals am I taking? I’ve talked about one of them already in a previous posting. It’s called Velcade, trade name for Bortezomib, a product of Millennium Pharmaceuticals. Inc., and Johnson & Johnson Pharmaceutical Research and Development, L.L.C. I also mentioned the fact that during my treatments of 2002 I took a product called Rituxan, a lot of it. Surprise, surprise, I’m taking Rituxan again.

Taking Rituxan Again

According to the website http://wwww.lymphomaininfo.net, Rituxan (generic name Rituximab) is “a monoclonal antibody” that works by taking advantage of the fact that cancerous B cells “have a site on them called the CD20 antigen. This is like a puzzle piece, waiting for a molecular linkup with another substance. IDEC Pharmaceuticals developed the anti CD20 antibody IDEC-C2B8 which links up to the antigen site on the B-cell. This allows Rituxan to target B lymphocytes [for destruction] and not other cells in the body which do not have the CD20 antigen site.”

Sounds like a miracle drug, doesn’t it? Yes, but here it is five to six years later, and I’m being treated for a relapse of MCL. I have to hope that whatever the Rituxan doesn’t get rid of this time around will be knocked out by Velcade, which I pointed out in a posting two months ago is a “proteasome inhibitor,” a type of biochemical whose job it is to promote the natural process in the body of “apoptosis,” that is, the process of eliminating anything made incorrectly. Translation: the elimination of cancer.

Seconds for Velcade Infusion

Another surprise for me as a chemotherapy veteran has been the frequency and the amount of time I am getting the two drugs. For every one time that Rituxan is administered, Velcade is administered four times. The infusion of Velcade takes seconds. The infusion of Rituxan is much slower.

On my first day of infusion, that is, January 7, I was in “the chair” from 11:00am until 3:30pm or a total of four and a half hours. Of that time, Velcade infusion lasted less than a minute. About 20 minutes was taken up with the infusion of drugs to prevent side effects such as respiratory attacks and nausea. The rest of the time or about four hours was all Rituxan. All future infusions of Rituxan, I’ve been told, should last about half the time or about two hours. The first use of Rituxan must be handled especially slowly to guard against an allergic reaction.

Put Directly in a Vein

Lest there be any doubt about it let me make clear that all these drugs or chemicals are put in the body intravenously, that is, they are dripped directly into a vein. None of them can be taken by mouth.

Once I have completed the ordeal, can I expect to be cured? No! My oncologist, on the staff of Wake Forest University Baptist Hospital, made that clear during a preliminary meeting during which the forthcoming procedure was explained to me. “I’m afraid that we do not have a very good record of success when it comes to curing lymphoma,” she stated.

I Love Life

So why am I doing this if I can't expect a cure? Why am I going through the whole not exactly pleasant procedure? For a prolonging of the good years, such as the five good years I experienced after my two rounds of chemotherapy and my bone marrow transplant of 2002. I love life. My mind still works, and I still have a lot of work to do. My wife, family and friends continue to convey the fact that they want me around. Any other reasons for wanting to stay alive pale by comparison to these.

Bring on the Rituxan and the Velcade. Let’s get on with this war.

For a look at the variety of writing that I do, see the website http://www.sasaftwrites.com.

Copyright (c) 2008 by Stephen Alan Saft

POETRY, THE BEST MEANS TO EXPRESS CONVICTIONS AND BELIEF

Poetry is verbal expression in which a limit is imposed on the number of words used and the words are selected for their emotional and intellectual impact and for their musicality and rhythm. That’s an initial attempt at defining this art form that I have spent a lifetime engaging in. I define it because the theme of why I write continues to be my subject, only this time I am narrowing my scope to a specific writing type.

I need to add a whole other kind of consideration. If poetry were only an art form marked by restraint, musicality and rhythm I might not have bothered with it, but I was also attracted by characteristics I venerated in the works of greats like William Shakespeare, John Milton, William Wordsworth, John Keats, Walt Whitman, Emily Dickinson, Robert Frost and many others.

I Will Mean

I write poetry because I believe that poetry is the best means to express convictions and belief. In this respect, I see poetry and religion as not wholly separate activities. It is what I meant when I elected to use the title “I Will Mean” for my first book of poetry. As a writer of poetry, I want my work to be significant for you and for me. By significant I mean that I am striving for a premonition of permanence, a feeling of concreteness, a sense of truth. Another way to look at it is that poetry is a means to use words to achieve a feeling of comfort with oneself and with one’s place in the stream of experience that is our totality.

The words “striving” and “arrive” are very telling in this case. I like to write poems that involve discovery, that involve bringing the reader/listener on a metaphorical voyage in which I and my reader/listener end up wiser than when we started out.

Too Quick With The Rules

When I was younger, I admit that I was capable of erring on the side of dogmatism. I was a bit too quick to impose rules in order to define what I meant by good and bad poetry. Now I would like what I am saying to be thought of as a personal aesthetic. This is what I am about when I write poetry, but I do not insist that anyone else adopt my principles. And, yes, as a reader of poetry I have found pleasure in works that I would not have written myself, works that adhere to a set of apparent principles that are not my own.

Art in general needs to be open, welcoming, accepting of diversity of points of view and methods. I believe that, and I am not comfortable setting myself up as some kind of czar of the right way to write.

Value “Reachingness”

Having said that, I do need to reaffirm at least one of my older principles. All that I ask of another poet is that you place a premium on what I call the “reachingness” of your work. If I am going to invest the time in reading and attempting to understand and appreciate your poetry, I need to have the sense that you meet me half way, that you care whether you reach me. If after reading your poem several times, nothing sticks, that is, I come away as confused as at the first reading, then I have to conclude that you failed, that it is not my problem as reader. It’s your problem as writer, that I wasted my time with your work.

Even our most prestigious literary publications have not always done a good job with their poetry. A case in point is The New Yorker. I have been a full time reader of this magazine for the last several years. During that time, I have been a dedicated reader of The New Yorker poetry and have usually felt that my time with these poems was very well spent. In recent years I think the poetry has been especially good—noticeably better than in the years before, no doubt owing to the ascendancy of a new editor-in-chief, David Remnick. That said, however, there are still exceptions.

Spy’s Clandestine Code

The exception in the latest issue is entitled “The Onion Poem” (The New Yorker, Dec. 24 & 31, 2007, p. 106). Nice title, yes? The title is the only good thing about this 18-line conglomeration arranged in nine sets of couplets. If there is anything to be derived from this mess, it will have to be explained in a prose paraphrase because the poem itself is a jumble of images that might work as provider of a spy’s clandestine code, but for nothing else.

I have to quickly add that this same issue includes two very fine poems by Grace Paley—“One Day” (page 84) and “Suddenly There’s Poughkeepsie” (page 116). I especially enjoyed the latter.

Time to put up or shut up. What contribution am I prepared to make to the fine art of poetry writing? Here’s a poem I recently completed entitled “The Great Unity.”

THE GREAT UNITY

Tick Tock, Tick Tock.
The clock marks the tightening of constraints.
Divided by the labels that organize.
Thoughts confined, stratified,
Day by day talking less to him and her.
Walls rise. The gulf adding to its size.

Tick Tock, Tick Tock.
Thoughts completed by their gaps.
And we become a Babel
of believers too committed for understanding,
partisans of the one true truth
that also excludes, ignores, denies.

Tick Tock, Tick Tock.
Life as the egg divider.
Everything in its compartment.
Everything has its place—
until lacking any superior vision
there is no chance for peace.

Tick Tock, Tick Tock.
Too much definition.
Too much separation. Too much wall.
And soon there is blood on those walls —
hatred, torture, slaughter of innocents,
anguish, the death of the young.

Tick Tock, Tick Tock.
Time to work for a reordering inside the head,
a relearning how to see and how to hear,
learning the sanctification of clarity,
learning comfort with the totality,
learning real love and the great unity,
the becoming one with the everyone, the all.

STEPHEN ALAN SAFT

For more on my writing including poetry, see these web sites: http://www.sasaftwrites.com
http://www.iwillmeanpoetry.com

Copyright © 2007 by Stephen Alan Saft

WHY I WRITE, THE PURPOSE OF MIND CHECK REVISITED

I am pleased to announce that I have launched a new website using the following address: http://www.sasaftwrites.com. The purpose of sasaftwrites is to serve as a comprehensive reference for all of my writing and to make it easier for the Internet user to find me. For example, sasaftwrites will contain the first few paragraphs of each of my Mind Check postings at the time each is posted.

At sasaftwrites, the website visitor will also find one of my poems, a synopsis of one of my novels, and an excerpt of one of my plays. In addition, I hope to be adding an index of the many topics that I have covered in Mind Check since starting the blog in early 2007.

The Moral Imperative

As the current year draws to a close and a new one looms ahead, this is a good opportunity to revisit the subject of why I am doing the Mind Check blog and in fact why I am motivated to write period. When I first started Mind Check, I said I had a purpose and that that purpose contained within it a moral imperative, namely to make myself better and in so doing to do my small part in making the world a better place.

Specifically I was dealing with the intersection of mind and that external to the mind which I will call “the other”—the other as linked to “I” by that metaphorical bridge we call writing. At the center of this process are the groupings of words with their rules that we call language. The concept that explains words and language is known as communication. Communication is also another way of explaining this intersection of self and other.

Informing Myself What I Think

Okay, so getting down to basics, why am I writing? I write to bring out what I believe for my own benefit and for that of others because I believe that I have something to say that has value to me and to others. And I write because I must, because the need to write is very strong inside me.

Is one of the things I am saying that I do not know my own mind without resorting to the process of writing to bring out the ideas inside my head? That’s exactly what I am saying. My thoughts exist inside my head as fragments, as the incomplete parts of a whole. I need the writing process to objectify those fragments, that is to put them outside of myself to improve my ability to see them or understand them and thereby to aid my mind in filling in the gaps in logic or reasoning and imposing on them a structure.

Pursuit of Fame and Glory

When I was younger I also had another motive for writing, and that was to win myself what I perceived as fame and glory. I believe that such a motive is common among younger writers, and I am pleased that it is not nearly as strong in me as it once was. The pursuit of fame and glory is a good way to add to one’s unhappiness.

Let’s look at the concept of morality and see how it fits in with the topic at hand. The issue of morality must be brought into this discussion because earlier I used the value judgment concept of using writing to make myself better and the world a better place. The key words are “value,” “judgment,” and “better.” All three words raise the probability that a morality is at work in what I am saying.

Code to Measure Against

Morality is a code of behavior or a standard of behavior against which attitudes and behaviors can be measured and having to do with judgments or values, underlying which are the concept of good and evil. That said I have to quickly play devil’s advocate and admit that if writing were inherently a moral act, then what we call hate literature would not exist. As a subset of communication employing language, writing is a way for the self to reach the other. However, we may choose to use writing to exhort the other to hate.

On the other hand, I still believe that by aiding the process of objectification referred to earlier, writing facilitates our being able to see what is moral and what is immoral, what is right and what is wrong more easily. This is why all of the literature acknowledged to be great (admittedly another value judgment) is moral. The fact is morality and aesthetic judgments are inextricably bound together.

Stilted Morals in Literature

The last two statements urgently need clarification. Do I mean that all literature acknowledged to be great has a moral, that is, that it contains a statement of precepts having to do with right and wrong? I do not. In fact, such literature is often quite stilted and is often anything but great.

Do I mean that great literature always presents its subject in a morally positive manner in order to convey its supposed message? If that were the case we would have a very difficult time coming up with a fair assessment of the tragedies of the ancient Greeks—Oedipus Rex and Medea, for example—or the tragedies of Shakespeare such as Hamlet, to cite a small number of examples.

Example of Medea

No, I mean that great literature even when the subject is powerfully negative--a mother who murders her children, as in Medea, for example--derives its power from the presupposition and the foreshadowing of a moral universe in which such behavior is a gross violation.

An exposition of the underpinnings of mortality—the concepts of right and wrong—can only take us so far. Ultimately we must acknowledge the need for a leap beyond reason into a realm where what we know we know before reason or we know before experience, a concept encompassed in the word “apriori.” Whether we are deeply religious or consider ourselves not religious at all, even an atheist, we cannot free ourselves from value systems. They are hard wired into our brains and have everything to do with how we look at the world and how we communicate with others.

Twisting of Values

Yes, but values can be twisted as in the example of hate literature cited earlier. Correct. If this twisting takes place (alert, value system again at work!), the mind is capable of knowing that some defect in reasoning has taken place, although it may not do so. Hence we have people, too many of them, who are steadfast in their hatreds.

The logic behind behaviors and actions deemed to be good is quite compelling, and it is good to remind ourselves of it frequently. However, ultimately the mind has to make a leap and accept the proposition that correct action is good action because it is good because it is the right thing to do. For religious people this is what faith is all about. For them it is a basis, perhaps the most important one for some, for a belief in God.

A very happy new year to you all.

To reach the author of Mind Check, write Stephen.saft@gmail.com. Comprehensive website at http://www.sasaftwrites.com.

Copyright © 2007 by Stephen Alan Saft

FIGHTING THE CANCER WARS WITH A NEW DRUG CALLED VELCADE

And so we begin a new chapter in this saga called surviving with cancer. I’m subtitling this chapter or posting Velcade. What is that? Velcade is the trade name for a new product developed by Millennium Pharmaceuticals to fight a nasty blood cancer called multiple myeloma. Recently the uses of Velcade expanded when the U.S. Food and Drug Administration approved its use for fighting a version of NHL or non-Hodgkins lymphoma known as Mantle Cell B Lymphoma.

Readers of Mind Check may recall that Mantle Cell B Lymphoma is the disease that I was diagnosed as having back in late 2001 and for which I was treated first with a mixture of chemicals known by the acronym CHOP and later, that is, in October 2002, with a bone marrow transplant at Johns Hopkins Hospital. During both episodes I also received several infusions of a product called Rituxan.

Bad News, Right?

Readers of my previous posting to Mind Check will recall that I have just recently undergone a biopsy at Wake Forest University Baptist Hospital. That posting did not include the all-important pathology report of the two specimens removed from me laparoscopically because at the time I had not yet received it.

From the way I began today’s posting, you’ve concluded that the report was not what I was hoping to hear, that the pathologist saw evidence of the return of Mantle Cell B Lymphoma on the two slides that the surgeons made of what they took out of my abdominal area. Bad news, right? Yes, bad news, but I’m not ready to give up.

Problem with Procedure Repetition

As a relapsed victim of Mantle Cell B Lymphoma, I could repeat the procedures I went through in 2002—that is, the witches brew called CHOP followed by another bone marrow transplant and the extensive use of the agent called Rituxan, which is taken by infusion and which works by binding to a particular protein (the CD-20 antigen) on the surface of normal and malignant B-cells and thus triggering their elimination.

Back then, however, I was warned by an oncologist and expert on lymphoma that I should be prepared for the fact that each repetition of this blood cancer fighting combination could be expected to be less effective than the one before. How much better then to be taking a brand new agent, one that my body has not been exposed to before.

Learning Biochemistry of Cancer

Okay so that brings me back to Velcade and the reasons that I remain extremely hopeful despite a disappointing pathology report. Velcade did not exist as a viable option for fighting Mantle Cell B Lymphoma in 2002, but it’s available today. Trying to figure out how Velcade works has pushed me even deeper into trying to understand the causes of cancer and specifically blood cancer. It has pushed me to make my aging brain absorb complex biochemical concepts having to do with cell development including mistakes in cell development and cell death.

Velcade, generic name bortezomib, is a proteasome inhibitor. It is the first proteasome inhibitor to be approved for use in humans, but in reviewing some of the information on proteasome inhibitors on the Internet I see that it is not the only one and I am sure we will soon be hearing about the use of other such agents in the blood cancer battle.

Proteasome Inhibitor, What Is It?

What is a proteasome inhibitor? Sometimes when the body puts together groups of proteins to make cells it makes a mistake. What is supposed to happen is that these mistakes die, a process known as apoptosis, and are eliminated from the body. But what if they won ‘t die? What if they insist on growing? We call that process cancer.

“Proteasomes are responsible for the selective degradation of proteins when cells no longer need them,” says the Peptides International website. “Inhibiting proteasomes in cancer cells can disrupt protein regulation, which ultimately can lead to apoptosis or programmed death.” (http://www.pepnet.com/proteasome.html) This death is a good thing. We want errors in cell development to die and be eliminated, not to be perpetuated as cancer.

Helpful Publication

The best description of mantle cell lymphoma for the lay person that I have seen including causes, diagnosis and treatment options is published by the Leukemia & Lymphoma Society and is available by calling the society at 800-955-4572. (Ask for the document entitled “Mantle Cell Lymphoma” Number 4 in a series.) It is also available as a downloadable document in PDF format on the Internet. (http:// www.leukemia-lymphoma.org)

In reading this document one learns that the cancer causing error in Mantle Cell B Lymphoma has to do with a protein called cyclin D1. “MCL [Mantle Cell Lymphoma] is distinguished by over expression of cyclin D1 (a protein that stimulates cell growth) in almost all cases. The over expression of cyclin D1 is usually caused by a translocation between chromosomes 11 and 14.” Chromosomes carry the genes that convey our hereditary characteristics.

Transformation of a B Lymphocyte

Later the document tells us how this error gets turned into a full fledged disease. “Mantle cell lymphoma (MCL) is the result of a malignant transformation of a B lymphocyte in the outer edge of a lymph node follicle, called the mantle zone. The transformed B lymphocyte (lymphoma cell) grows in an uncontrolled way and the accumulated lymphoma cells form tumors in lymph nodes leading to their enlargement. The lymphoma cells can enter the lymphatic channels and the blood and spread to other lymph nodes or tissues such as the marrow, liver and gastrointestinal tract.”

Thus the war resumes for me using a new weapon called Velcade. What is at stake is something very dear to me, namely my life. I got through the first battles of this war in 2001 and 2002, and my hope is I will do at least as well in 2008. One of the things I have going for me is that I am still feeling strong and vigorous. I am no beaten warrior forcing his weakened carcass back into battle. No, I am beginning to see myself more like the biblical hero Samson once again doing battle with the Philistines.

I was reminded of the Samson image in a recent discussion of my medical situation with my friend Brooks Townes. After hearing of the latest twist in the saga of my battles with blood cancer, Brooks said, “I think of you as someone in a huge building that is about to collapse on him. Then the building does collapse. Huge pillars and huge ceiling pieces are falling all around you, but somehow nothing touches you, and you come out unscathed.” Let us hope that Brooks’s vision applies in this case as well.

To reach the author of Mind Check write Stephen.saft@gmail.com.

Copyright © 2007 by Stephen Alan Saft