SWITCH TO STRONGER CHEMICALS GIVES HOPE THAT REMISSION WILL BE ACHIEVED SOON

A six-day hospital stay interrupted my writing schedule, and so I have a lot of catching up to do. On April 10, I made my appearance at Wake Forest University Baptist Hospital in Winston-Salem, North Carolina with wife Harriet at my side. I was there for a CAT scan to determine how well the treatment with the chemotherapy regimen called ICE had done in reducing the cancerous lymph node in my abdomen to zero, an important requirement in order to proceed with the intended bone marrow transplant.

Unfortunately, the night before I’d been hit with a stomach ache, possibly the result of indulging too much at a birthday celebration at a Winston-Salem restaurant. I’d let the staff at the Comprehensive Cancer Center know about the stomach ache when I arrived. My oncologist proceeded with the CAT scan, but she decided not to go ahead with any chemotherapy. Even though the pain had vanished at the time of the CAT scan, I was told to go home, but first she gave me the results of the CAT scan.

Lymph Node Shrinks

The lymph node was down in size by a third. ICE had been successful for me, but it wasn’t successful enough. Two-thirds of the little thing still remained. My oncologist let me know that when chemotherapy resumed she wanted to use an even stronger formulation, in fact, the strongest formulation currently available for lymphoma. And what about the stomach ache? Might the CAT scan reveal what had caused it?

It did. Anyway it gave large clues as to what might have caused it. The CAT scan revealed that the probable cause of the pain I had experienced the night before was a gallbladder flare up. I was to go home for a week and see if the gallbladder behaved itself or if the problems from it, not just pain, but also nausea or fever showed themselves. If I had any of these three, I was to come back to the hospital immediately and be admitted right away.

Gallbladder Diet

Harriet and I decided to keep the gallbladder in check with diet—a diet of substantially reduced saturated fats and also a diet rich in vegetables such as beets, celery, cucumbers, green beans and other items we found listed on very helpful websites. The gallbladder caused no trouble, and I was able to come back to the hospital pain, nausea and fever free at the newly scheduled time—that is, starting on April 17.

The session on April 17 started with an echo cardiogram to make sure my heart could take the new stronger regimen. Immediately after that, I had an ultrasound of the area of the abdomen where the gallbladder resides. A blood test came next, and then I met with Denise Levitan, my oncologist. Finally I was admitted for what would be my longest stay yet at WFU Baptist, six days of intensive chemotherapy.

Hello R-EPOCH

And what is this strongest formulation yet? It’s my old “friend” CHOP from 2002 or rather R-CHOP—“R” for Rituxan—with modifications to make it even more intensive. This latest version is known as EPOCH, but it might well be called R-EPOCH. Rituxan is still part of the mix as is Etoposide from ICE. From CHOP comes the wonderful sounding mix of Doxorubicin (also known as Adriamycin), Vincristine Sulfate (also known as Oncovin), and Cyclophosphamide (also known as Cytoxan).

Taken orally, rather than through transfusion, is the final and very important part of the group, the steroid Prednisone. It is the job of Prednisone to build you back up from the beating that the infused chemicals mete out on the body. I’m repeating myself from past postings, but remember that the chemicals of chemotherapy have the job of killing cancer rather than building up what might already be strong and healthy in the body. One problem is that they kill much more than that which needs killing.

Called An Ordeal

How did it go? These consecutive days of chemotherapy at the hospital—six in this case--can only be described as an ordeal. They are tough, and it would be inaccurate of me to gloss over them and make them sound more pleasant than they are. On the other hand, I do have to state that I have been consistently impressed with the staff of WFU Baptist. These are highly trained, dedicated and compassionate people. No blame is due to the perpetrators and administrators.

During my six days in the hospital as in my previous stays, I never felt neglected or ignored. At those rare times when the nurse and aid assigned to me were not available to answer my call, there was always a back-up person to come running. And, I have to add, the Baptist staff strikes me as committed to the concept of total care. These are warm people who constantly show concern for their patients, not bureaucrats constrained to business-like interactions.

Family Sleep-Overs Accepted

Baptist is also quite accepting about allowing a family member to stay overnight with the patient in the patient’s room. This is the situation with its cancer patients, in any case.

In the category of “ordeal” are several items. First having to get stuck so much for the drawing of blood and the establishing of IV’s. During my recent stay I underwent minor surgery to reduce the number of times I’ll have to get stuck in the future, that is, the installation of what is called a portocath or portable catheter in my chest. In addition to reducing the number of sticks, the portocath provides a central line hooked to a main artery of the body to minimize the danger of artery damage. The infusion of strong chemo like R-EPOCH can blow out small veins such as those in the arms.

Tied to Infusion Tree

Then there is the annoyance of being hooked up to an infusion tree. Everywhere you go—to the bathroom, for a walk in the halls—the tree with its very sophisticated electronic pumps goes with you. It is your constant companion. Fortunately, there are wheels at the bottom of the tree, but the thing is often unwieldy and you have to be very careful not to trip over it.

Another part of the ordeal is simply being in the hospital. That probably sounds like a contradiction after what I said about how good the staff at Baptist is. The good and the bad intertwined—that is so often the nature of life, right? When you are in the hospital, you are constrained. You are confined. You are forced to adhere to other people’s schedules and to do what other people think you ought to do when they think you ought to do it.

Prefer Writing, Walks

Frankly, I’d rather be sitting in front of my computer and composing a poem or a blog posting. I’d rather be listening to the birds sing as I walk with our Portuguese Water Dog Cassie Rose by a beautiful mountain stream and vicariously experience with her the pleasure she gets out of being able to dash in and out of the water at will.

Then there are all the changes that chemotherapy does to the body, which I’ve written about before—the hair loss, the nausea, the appetite changes, the fatigue, the occasional feelings of ineptness and stupidity. Not great.

What happens next? In about two weeks I’m back to Baptist for more R-EPOCH. I’ll have another CAT Scan, and then we’ll see. If I’m finally in remission, it’s full speed ahead to the bone marrow transplant. Anyway I hope that is what is in store for me. I’m anxious to get this episode in my life over and done with.

To see a sampling of the writings of this author, see the website at http://www.sasaftwrites.com.

Copyright © 2008 by Stephen Alan Saft

HOW IS MY HEALTH? NOT BAD AND OTHER GOOD NEWS

Two subjects for this posting: First a status report on my health and second an exciting announcement.

First of all, how is my health? Another and better way to phrase that question is: How am I feeling? Answer: I am feeling very well, thank you, and I am as surprised as anyone that I can say that. The reader may recall from two postings ago that with the failure of my treatment with Velcade I was about to undergo a different chemotherapy treatment regimen, this time with a four-drug cocktail known as either “Cold Ice” or “Bold Ice.” (Sorry to report that I haven’t yet solved this acronym naming dilemma, that is, what acronym to use for the combination of Ifosfamide, Carboplatin, and Etoposide, also known as VP-16, and Rituxan.)

This four drug cocktail is administered round-the-clock in the hospital and in my case took place over three days. So far I have had two separate treatment sessions. When I call this treatment regimen a “four-drug cocktail,” I am taking certain liberties. I am thinking of only the chemicals that have the job of directly attacking the cancer—Mantle Cell Lymphoma (MCL), in my case. Chemicals in addition to the big four are infused in the hospital. These chemicals have the job of protecting the kidneys and preventing nausea, among other jobs.

In Chemotherapy, Kidneys Important

Protecting the kidneys is very important in Bold Ice (or Cold Ice) infusion. In an infusion procedure, it is the kidneys that have the job of removing the saline that is a component of chemotherapy solutions and leaving the chemicals in the body, specifically in the blood stream, that have the job of working on the cancer.

When I say that I am feeling well, I am commenting on the combination of attitude, energy level, and experiences of pain and discomfort that I think of as the measure in total of that sense of being alive that I am calling “the life force.” No, I am not feeling perfect, and certainly two separate three-day chemotherapy sessions in the hospital have had negative effects, one of which is quite obvious.

The amount of hair on my body including on the top of my head is drastically reduced. In addition, my experience with food is altered. Related to a change in food interests is the intermittent battling with feelings of nausea and digestion issues, none of which has been severe so far.

Bring on Baked Beans

Chinese food, for example, now has no taste for me, and I have lost my interest in it. I do hope that my tastes for these foods will return, as they used to be part of my regular diet. On the other hand, foods that I have previously had only a mild interest in have drastically increased in appeal. At the top of this list is baked beans. I now love this product including the low-fat type. For me, baked beans have become a very soothing food and even a nausea-quelling staple.

Most gratifying for me is the fact that my energy-level has so far been only mildly impacted by the chemotherapy. Though in the midst of intensive chemotherapy, I have been able to undertake two challenging publishing ventures, which I will report on at the end of this posting. In addition, I am pleased that ideas for new writing projects have been coming to me at a fairly rapid rate.

Here’s an important aside about chemotherapy. When you are undergoing chemotherapy, you are holding two contrary wishes in your head: One is that the chemo will not make you too sick. The other is that the chemo will make you sick enough to kill the cancer inside your body. You sure don’t want what I experienced back when I was being treated with Velcade. You don’t want the treatment to be a total failure.

Not Terminal

In summary, I do not feel in any respect that I am close to death, in other words that I am terminal. I feel very much alive and hopeful. That said, I need to comment on the fact that I am moving ever closer to the next big stage in my medical treatment, which is the bone marrow transplant.

The idea behind the bone marrow transplant is that the patient has his blood chemistry redone. The hope is that through this extreme life-risking process the impurities in the blood that allow the generation of cancerous lymphocytes, a disease known as lymphoma, will be eliminated. Back six years ago, that is, in 2002, I had my first bone marrow transplant.

Called Autologous

Back then I was my own donor, that is, the basic stem cells that were used to rebuild my blood system came from me. The technical term for this kind of bone marrow transplant is “autologous.” The stem cells taken from me were purified to the maximum extent possible and then cryogenically frozen for later infusion in me.

In an allegenic bone marrow transplant, the stem cells come from a donor other than yourself. In this type of bone marrow transplant, the patient has an even greater chance of receiving a completely clean infusion. On the other hand, the risks from an allegenic bone marrow transplant are far higher, especially for anyone over 60. (I am approaching 69.)

Hoped for a Cure

Back in 2002 I hoped that the bone marrow transplant would cure me of lymphoma. What it did was give me five years of remission from the disease, but alas it was not a cure.

If and only if I am in remission from my latest chemotherapy—and that can only be determined in a CAT scan—I will go through a round of injections to build up the stem cells in my blood. My blood will be drawn so that the technicians can get at my stem cells, which will then be purified and preserved through a deep freezing or cryogenic process. What is left of the blood chemistry generation system that remains in me, most of which is centered in the hip bone, by the way, will then be killed.

Tense Time: Blood Chemistry Regeneration

The process of growing a new blood chemistry generation system in me will begin with the thawing of my purified stem cells and their infusion back into my body. Then comes the tense time when I and the medical staff wait for the reinfused stem cells to take up home in my hip bone and to regrow a new blood chemistry generation system. The whole process will take no less than seven weeks, and then there is the recuperation and recovery time, an indeterminate period.

I will be coming back to this subject of the bone marrow in subsequent postings, and so let me now switch to my big news, my “exciting announcement.” I have now signed a contract with Xlibris, an on-demand publishing service, for two books. My hope is that the first of these books will be available in about a month. The Xlibris bookstore is at the following address: http://www2.xlibris.com/bookstore.

Announcing: Murdoch McLoon

The first book is a sea adventure called “Murdoch McLoon And His Windmill Boat, An Epic For Our Time.” The second book is called “City Above The Sea.” Both books are poetry. “Murdoch McLoon is a story poem, and both are illustrated featuring the work of talented illustrator Lisa Marie Brennan. Look for more information on both books in these pages and on my general website: http://www.sasaftwrites.com. It is anticipated that both books will have their own websites and will be offered through the Xlibris bookstore as well as Amazon.com, Barnes and Noble, Borders and other online outlets.

I will be providing more information on these two books in subsequent postings. Thanks for tuning in to Mind Check. Look for another posting in about two weeks.

Copyright © 2008 by Stephen Alan Saft

AN EARLY ENCOUNTER WITH AN AGGRESSIVE MEMBER OF THE OPPOSITE SEX

Last night I watched a fine documentary film called “Tony Bennett, The Music Never Ends.” This enjoyable piece of work, made by the director and actor Clint Eastwood, is a good overview of the life of Tony Bennett, born Anthony Dominick Benedetto, who also is a very accomplished painter.

Tony Bennett will be 82 years old this year, and he still keeps up a very demanding performance schedule. To say that I am envious of Tony Bennett’s continuing success as an artist in two different forms and his apparent good health at an advanced age is indisputable. One of the things Bennett says in the film, which really touched me, is—and I am reconstructing this quote from memory— “I am very happy with the way my life has turned out.” Tony Bennett, a man also very involved with the civil rights movements in this country; Tony Bennett, a very impressive human being.

Reviewing One’s Life

How many of us can say that we are very happy with the way our lives have turned out? I find that I spend a lot of time reviewing my life these days and thinking of the ways my life could have turned out differently—and yes, in some respects, better. It’s an exercise that my mind forces me into, in part because of my age, my circumstances, that is, health, and the fact that I am very analytical and very curious, traits that I think go along with my being a writer.

One of the conclusions I have come to is that the decisions that we make during our early years have everything to do with the person we are during our later years. A related conclusion is that even the slightest change in a decision, especially during the early years, will result in a major change in the outcome of a life. When I look, for example, at decisions I made as regards women, these conclusions become vivid in my mind.

Decision Means Turning Point

A clarification is very important before I go much further with this discussion. I am using the word “decision” to mean turning points in my life resulting from choices that I made. Seen from the distance of time these decisions or choices look really large, but at the time the decisions were made, many of them did not appear so monumental.

Part of this clarification has to deal with the nature of the word “decision” itself. Many times the decisions we make appear to be made for us and are the result of pressures coming from our families and others important in our lives. Many times the decisions are coming from very deep seated sources fundamental to our psychological makeup, and we can‘t be certain of their origins.


A Steel Pier Adventure

Let me take the case of a young woman I will call Alice who I met while working on Steel Pier in Atlantic City. It was the summer of 1955, and I was 16 years old, as was she, I think. Starting in the summer of 1953 and for the following four summers I worked for the refreshment stands of Steel Pier, an entertainment complex started by George Hamid and extending half mile out into the ocean at the Boardwalk and Virginia Avenue. For most of my four summers on the pier I was a stock boy doing jobs like emptying trash cans, sweeping the floor and keeping the counters supplied with orange and grape drink, which I and the other stock boys mixed in hidden ice houses on the pier, and with hot dogs, hamburgers, and ice cream.

Working behind the counters and attending to the customers were young women, also teenagers. Some of these young women attended the local public high school, as did I, but a number of them attended the local catholic high school and some of them commuted from the mainland and attended mainland high schools. It was thus an opportunity for teenagers who might not otherwise meet to get to know each other. Alice lived on the mainland. She was a pretty and intelligent young woman, and I enjoyed talking to her. She was also well endowed and as it turned out much more aggressive physically than I was used to.

Encounter in a Stock Room

I enjoyed talking to Alice, but it soon became apparent that she had another kind of relationship in mind. First she arranged for me to see her changing from her street clothes into her uniform with another of the counter girls in an area that doubled as an additional stock room. By simply opening a door when I knocked—which is the procedure that we stock boys were supposed to follow— Alice surprised me by letting me in and thus allowing me to see her in her bra, and she allowed me a long enough look that I had no doubt how well endowed she was. Second, a day later she came after me in one of one of the areas where we stock boys kept the ice and where we mixed orange and grape drinks.

That a girl could be that aggressive was entirely alien to me, and I rejected her. Not only did I reject her, but I lectured her on her behavior. A day later I carried the lecture even further. Accosting her on an outer deck that was used by some of the Steel Pier performers for periods of off stage relaxation, I said to her in an angry voice, as best I can remember, “We’re not the same religion, and I don’t see how any relationship between us could ever work out.” The poor girl was so chagrined by these multiple verbal onslaughts from me that she quit her job that day, and I never saw her again.

Such a Prig

Over the years I have frequently thought about the Alice episode in my life and with a variety of conflicted emotions. “How could I have been such a prig?” I have frequently asked myself. “How could I have been so cruel to her?” Given how my life turned out, my lecture on the differences in religion is especially absurd. Then I think about the squandered sexual opportunity. I was obviously not blind to her considerable physical appeal. Why then did I spurn her?

Was this then a case of her being the aggressor and my inability to deal with any situation in which I was not in control? I do have to admit that it would be a long time before I could be comfortable with any situation with a woman in which I did not feel I was in control. As a result I passed up many another opportunity for sexual experience after Alice during my early years. Then too there are the issues of class, issues I hate to admit but I’m afraid they were there. Despite her intelligence, I saw her as a poor girl, as an underprivileged girl; I saw myself as better than her economically. When it came to Alice, was I a snob? I’m afraid so.

Fear of Entrapment

Related is the fear of entrapment, even at the age of 16. I saw myself as college-bound. I saw pretty, well-endowed Alice as a possible trap, as someone who could get pregnant and keep me from realizing my college dreams. Yes, that fear was at work as well. And finally there was just plain fear of the opposite sex. I was a heterosexual male all right, but that didn’t stop me from being afraid of women. This fear took the form of being afraid of women’s bodies.

In a future posting I may face head on this fear of the opposite sex, but I am not ready to do that now. The reader will have to accept as a given this fact about me.

Complexity of Sex Drive

Where am I going with this discussion other than to reveal a fact about my early life and how my mind worked when I was younger? One important fact is how important sex was and is, as both a positive and negative force, but how complex our feelings about the subject are. Is the sex drive ever a pure emotion disconnected from other considerations? Probably not.

I do hope life turned out okay for Alice. I do hope she didn’t waste too much mental energy dwelling on the mean stock boy who spurned her advances on Steel Pier the summer of 1955.

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

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