I Am Not Eternal

24 March 2020

I spoke to the latest oncologist assigned to mollify me yesterday about life expectancy now that the stage 4 lung cancer has entered my brain. We talked about further radiotherapy — I’ve just had a round that went by swimmingly until the last day and then threw me into a personal apocalypse for over a week — a return to chemotherapy and the new third generation targeted therapy drug I’ve just started. She knew I’d read the literature on the latter and it’ll keep me going, on average, around 10 months before the other options are all that’s left. But maybe I’ll be lucky and get another year or two. She told me about clinical trials and the rapid rate of change in drug availability. But we both knew I understood precisely what ‘terminal’ meant: around a year and a half +/- whatever bonus I might get.

Out of curiosity I asked her why she chose to specialise in oncology. It is, after all, a field in which almost all patients die, and despite the glowing headlines cancer research isn’t delivering much more than the occasional few extra days of life for patients with the 200-odd complex diseases we so flippantly brush together and label the singular ‘cancerter’. Not a happy scenario at all.

Unlike almost every other oncologist I’ve spoken to — around 10 in a system that assigns doctors randomly for each patient visit — she admitted that she could do nothing for patients except give them drugs and talk to them. The talking, she said, was the most important part, and what attracted her to the field. People need to communicate their greatest fears, their hopes forlorn or otherwise and be told first that someone is there for them and then what they might not have relished they could still do.

I was so unwell and had already had her explain 18 of my current symptoms that I didn’t ask her name or look for her ID, and she was as masked as I was in these virus plagued days. But it struck me that she was the most personable doctor I had ever spoken to, and there have been very many. I am not eternal and for far more mundane reasons, neither is she. But her belief in the power of communication is. At least I hope so. It’s inspired me to start writing again. Maybe about cancer, but as Dr House once said, “cancer’s boring”. Well, too much of it is. And I’ve only got a short time to write.

Cancer, communication, writing, oncology

The Stones Cannot Speak

4 September 2016

But They Whisper Still

2016-08-16 10.59.15.jpgAt a distance the temples are just old, decaying buildings – shells of something that for someone else used to be. This is Angkor, and tourists rush headlong towards heritage, that abstract noun which covers all things we don’t really understand about other cultures, and often about our own.

Pick one structure or another and the impression lingers. Walk through the tumbledown doorways, along the narrow halls, beneath the arches with block piled upon perilous block. What does it mean? What did it mean, and for who? There’s a sense that all we can see is just the core of something else. Perhaps it was always that way – a framework of convenience layered with stucco and gems and other fancy things, but held together by an idea of grandeur, and the persistence of that idea.

The bas-reliefs whisper this insistently, hurrying the mythic past ever forward into our many presents. See the Hindu epics reshaped by Khmer hands, worn by time and many tribulations but emphatic in their portrayal of order at its origins. Look elsewhere in the sandstone for how life must have been when the temples were the city, and the city was the most magnificent the world had ever seen.

So there is decay, and the scars of many thefts, conquests and savage wars remain. Yet that accentuates the story in the stones. Angkorian civilisation was not pleasant – it was built by force and slavery. But it was without parallel, and it persists as a magnificent idea, murmured across time.


No Cathedral, This Time

1 April 2013

Truisms leap out of the most unexpected places. Earlier today I was learning how to program in the Processing language and read one of the more profound subheadings I’ve encountered in a while:

Don’t start by trying to build a cathedral

Some people would take that to mean ‘know your limits’. I prefer to consider it a reminder to nurture my ambition – to bring it along slowly, wrapped up in learning. The goal is the cathedral, but the first step is a shovel to test the soil. It’s all about patience, and couldn’t we all use a little more of that?

Shine on You Crazy Doubter

26 March 2013

The English language is a peculiar beast. How often do we say things we don’t mean or things we don’t understand? A classic is the ‘I could care less’ line, which has so twisted ‘I couldn’t care less’ that now the meaning has changed to actually suggest that someone really could care less, but perhaps not much. Such is the way language evolves, purists be damned.

Yesterday I read an exchange that highlights this plasticity. One person wrote that a lack of evidence would “shine doubt on” a particular study. My immediate reaction was to think, no! And no again! Doubt is dull and certainty is  . . . bright. Doubt clouds our vision, right?

Well, maybe not so much. It’s all a matter of perspective. Doubt isolates weak hypotheses. It identifies flaws and reveals implications. Doubt, we could say, is the torch of knowledge, without which we couldn’t see beyond our presumptions. So, yes, shine doubt on everything, so we can see more clearly. Purists be damned.   

On Being British . . . Or Not

22 March 2013

What’s in an accent? A way of twisting words, a slight inflection, a gargle in the right spot? Much of it has to do with that, mediated by locality and culture. We usually speak our surrounds – often physical location, but also our social circumstances. I grew up around building sites, and heard the rough, low drawl in one ear and the much fainter, mellower tones of the middle class off in the distance in the other. Yet there was something that linked the two ways of speaking – a kind broadening never heard in the big cities to the south, a twang that I never quite managed to tweak myself. And neither did my brother, perhaps because our grandparents influenced us heavily in our earlier years and led us to a way of speaking that was a little less circumspect, but a little more suspect to some.

I once took a phone call from a close relative who told me I sounded like a poof. Her words, not mine.

When I arrived in Hong Kong people started to comment on my British accent. I’ve been dealing with people in a corporation in the US lately who have said much the same. It’s odd how people’s expectations guide them. Take a voice a little out of the ordinary (and I mean a very little, really), a lot more out of context, and push it towards a comfortable category.   

I’m Australian, by the way. Northern. You can’t get an accent a terrible lot less British than that. 

Pass Me Off

22 March 2013

You would think that those most attuned to the profound arcana of the interwebs might just be a little sophisticated with their password policies. Well, I would anyway, and it gives me a little rush of pleasure every time I log on to a website in the know. Imagine if you will a cabal of website admins huddled over a boiling pot, the wind blowing across the moor as their screechy high voices cackle new and clever ways of forcing users to Damn Well Use Unique and Secure Passwords. Oh, the sheer malevolence of their ways. There’s got to be a touch of dark but delightful art in there somewhere. Surely.

But, alas, their voices are never heard in some surrounds. Tonight – a little blustery, a little cold, just the right atmosphere I thought – I registered with a website that would only accept alphanumeric characters, dashes and underscores in my password. So, let’s consider the psychology of this. It just has to encourage people to use common nouns separated by dashes, or their own names, perhaps all three or four, wedged open with underscores. Bet the password guru didn’t think about that.

And on the subject of the unthunk (which is, I suspect, a common habit in this case), my bank’s password policy not only restricts me to alphanumeric characters (none of those shifty dashes, no siree) but it also only allows 8 of them. Way to go, Bank of Insecurity.

What’s a guy gotta do to get a bit of respect from the minions of Moloch? This is really starting to pass me off . . . 

Coach You, Coach Me

19 March 2013

What is a coach? Or, more specifically, what does a coach do? I’m fascinated by rugby league – a brutal game if there ever was one. Coaches really matter because discipline keeps the whole collision thing from running out of control. But what does a league coach do? Instruct, inform, guide and cajole? Well, not really. Or at least not entirely. The league coach creates a framework in which his team can excel. Sometimes it does that against the coach’s instructions. That must be frustrating with set moves rehearsed day in and day out, but you can’t argue with results. Learning by rote only works so far, and brilliant moments are often spontaneous and individual, which is why the game is a joy to watch. No spectators, no coach.    

This interplay of discipline and spontaneity is sport’s gift to the world. It’s so obvious there, played out on the grand stage. We take it elsewhere, shape it, change it. Bringing up kids is much the same. Parents say ‘here’s your structure, but you’re not a robot. Let’s see what you can do.’ Yes, even here in Hong Kong (though to actually see that you’ll need to look a little harder). We coach: even when saying ‘no!’ or ‘never!’ there’s always the unspoken alternative – ‘surprise me’ (but in a good way).

In business too.

A supervisor who coaches doesn’t say ‘you’re wrong’ with each error. Sometimes that’s important, but everyone needs to learn. The coach picks the time to say ‘this isn’t optimal, let’s look at an alternative. What’s the process you see? Let’s think it through and see what the outcome will be for us and the customer.’ Hard? No, not really. You just need patience. Not everyone can learn, but those who can and do will push you on too. To ask the right questions you need to know the right answers, or at least versions of them. Returning to sport, that’s why the very best coaches win multiple championships. They shape their teams, and the teams shape them.

So, Stephanie, thanks (to end a little cryptically – it’s the team that counts, after all).

It’s All About Process, Really

17 March 2013

I just put Minecraft on the computer in the loungeroom. Its an interesting enough game in itself but watching the kids work out the new possibilities of the full version (they’ve been playing on their iPads for a couple of weeks) it strikes me that their love of process is nearly as developed as mine. Working out where to place blocks, why to do certain things and how to build structures isn’t just about creation – its also about understanding systems and owing the processes you use. It’s about imagining that things could be otherwise, and making them so. Great work kids!

There’s Something in Absentia

14 July 2009

On Absence and Return

Ozone Playground, by Pulpolux !!! with Creative Commons Attribution-Noncommercial 2.0 Generic licenceAbsence is often considered an intentional void, a failure to be rather than the result of a distraction or restriction. There is often a condemnation involved, at least implicitly. A list of absentees, absenting oneself from a vote, being absent without leave – none of these measure or define behaviour deemed appropriate. Yet an absence is simply the lack of an expected presence, a disappointment only because it defies what we want rather than determines what is probable, or perhaps even possible. Absence speaks to our suspicion, whispers that someone else has erred.

How, then, do we rein in our expectations, or the presumption that a regular presence is necessarily and alone a good presence? One way would be to appreciate the aggregate rather than the individual. What do we achieve together more meaningfully than alone? Teams tend to outperform the combined capacity of their individual members, and societies – by and large – maintain the trajectory of their change despite emigration and remigration. It would be difficult to define either of these examples as a form of stability, yet they both indicate that a certain type of continuity has greater value than even the most identifiable absence. Sure, any sports fan could cite a team that failed after one member left (Michael Jordan’s first retirement, anyone?) but on a social scale, even with an increase of absences, the dilution is barely measurable.

Of course, this all goes to prove that my recent lengthy absence from the blogosphere is a small nothing in a vast ocean of somethings. But it’s so often difficult to escape self-censure, which is ultimately the whisper of the ego against the roar logic. No wonder I have ringing in my ears.

No @$#*% Way!

13 July 2009

A Word or Two about Swearing

Broken, by Aeioux, with Creative Commons Attribution-Noncommercial 2.0 Generic licenceAge, a family and a sneaking suspicion that things can be better said are often what push people to swear less often than they might. There is always a sort of opprobrium to cursing, or what my grandmother (and yours, no doubt) calls ‘foul language’. Cue images of stench and decay, of wrongness of language that must indicate the decomposition of thought. Perhaps there’s a point to the moralising, but it often seems a convenience, a judgment of what’s proper and prudent without any indication of how that position has been attained. There are undoubtedly situations in which swearing is unnecessary – variations of the word ‘fuck’ used an adjectives can range from the emphatic (as in “I really fucked up”) to the needlessly vulgar (as in “oh my fucking God”). Yet, as it happens, swearing does have at least one purpose – to mitigate physical pain.

In the current issue of NeuroReport, Richard Stephens, John Atkins and Andrew Kingston describe the results of an experiment in which subjects were asked to immerse a hand in icy cold water and “repeat a swear word”, and then asked to undergo the process again while repeating a “neutral” word. The result? When the subjects swore, they tended to keep their hands immersed longer. Stephens and his associates explain it this way: “swearing increased pain tolerance, increased heart rate and decreased perceived pain compared to not swearing”.

As an interesting aside, in an interview with the London Telegraph, Dr Stephens mentioned that he first thought about the link between swearing and pain when his wife was in labour; it would be difficult not to imagine why. His findings could well have verified what delivery ward nurses already know, and there’s a fitting counterpoint. It turns out that “swearing did not increase pain tolerance in males with a tendency to catastrophise”. Drama queens, in other @$#*% words.

What is Inspiration?

4 April 2009

Notes on an Unassuming Man

Fire walk with me, by by chaosinjune, with Creative Commons licence (Attribution 2.0 Generic)I have often wondered what it means to be inspired, pondered the mechanisms by which a state of subdued awe can be generated, and in turn generate action in me. Inspiration seems to be ethereal, the purely subjective identification of a best case scenario according to which we might live, or at least aspire to live. The word actually comes from the Latin inspirare, to breathe in, and in that time-worn connection we should be able to grasp its significance. Something or someone who inspires us makes us breathe in new ways of understanding, or at least ways of understanding the common place anew.

Yesterday I had the great pleasure of interviewing a man who did just that for me, a professor at one of Hong Kong’s universities. He’s a chemist, which might not sound inspiring in itself, but it is when seen in its proper context. As a child he wanted to be a doctor, to help and to heal, but it soon became obvious that the blood and associated gore doctors have to deal with would make him squeamish, to say the least. So, in his youthful enthusiasm, he decided to become a chemist, to research the means by which diseases might be cured.

That might sound like all too much idealism but the professor is in his 50s now, still searching, still working on molecules that might yet attack and kill cancer cells. Like all good scientists he doesn’t have a timetable for achievement, just a desire to search, try and fail, and then try again. Despite decreases in funding each year over the last 12 he continues because he has never forgotten that he set out to make a difference.

And recently he made a breakthrough in another disease. His university wants him to patent his efforts, to show that the institution is leading the advancement of knowledge no doubt, but he has quietly deflected the requests. When I asked him why he said it was simply because research wouldn’t progress if anyone had to pay him royalties before a form of medicine could be developed from his work. As always, his object was to help, to play a role in healing one day, somehow. As I left his office I realised what really inspired me the most – selflessness.

Cosmic Flight School, by nflorence2012, with Creative Commons licence (Attribution-Noncommercial 2.0 Generic)It’s somewhat ironic that the most inspiring people sometimes have to remain anonymous, cloaked because they need to dance a delicate little jig in doing what it is they do that inspires others. Inspiration is about the shifting of perceptions, the act of influence by deed and not necessarily by name. But, of course, I know who the professor is and each time I read his name I’ll be cheering him on. It’s kind of personal now – having spoken to him, my life has changed.

Not All Sugar Tastes So Sweet

8 March 2009

Two Perspectives on Cane Growing in the Philippines

SUGARCANE, by who.log.why, with Creative Commons licence (Attribution 2.0 Generic)Difference need not end all conversation. Allow me to offer a rather personal example. My wife and I were raised in difference countries, subjected to different environments and shaped by very different experiences, but there is one thing we each know something about. Sugar. My understanding, such that it is, comes from a proximity to the industry in northern Australia, knowing people who worked in the mills during the season, tramping through the fields as a kid and watching the fires and the harvesters as an adult after I moved away. My wife, in important contrast, was born into the sugar-growing areas of Negros Occidental in the Philippines, saw the suffering of the tenant farmers and their labourers, and joined the revolution against Ferdinand Macros as a teenager to right those wrongs. Worlds apart, you might think, but sometimes different perspectives on a common theme draw minds together.

I’ve long thought that mechanisation could break the vicious poverty associated with sugarcane growing in my wife’s home province. Most landholders keep tenant farmers in a kind of feudal grip, paying very little for the crop they produce six months of the year and extending loans with high interest rates for the other six months, tying whole families to indenture. If these families, spread out across five or six haciendas, could hire cane harvesters they could massively decrease the time it takes to get sticks to the mill and likewise decrease the delay between planting and payment for their crops. This obviously wouldn’t solve the problem of six months’ employment in every twelve but it would reduce labour costs and thus the size of loans, and the associated favouritism, handed out by the hacienda owners.

There are numerous flaws to this argument, as my wife is quick to point out, even though the premise of mechanisation is sound. I mentioned a reduction in labour costs, but the cane cutters, known as Sakadas, are also very poor people relying on seasonal work. Mechanisation would be the death of their meagre hope, pure and simple. The provincial economy couldn’t absorb them in other roles – step off a plane at the provincial airport in Bacolod and you’ll immediately see the prevalence of unemployment. The city has a permanent air of Depression about it, as though better days never really managed to come. There’s certainly no future there for out-of-work Sakadas.

Perhaps more significantly, if the hacidenda owners didn’t try to sabotage mechanisation – and their political clout relies on the control of people, not machinery – they could very well take up the idea themselves, doing away with tenant farmers and Sakadas in one fell swoop. As my wife argues in equal measures from experience and conviction, the situation is delicately poised, with small changes likely to have large repercussions. The only certainty is that the levels of poverty induced by these feudal relations are not sustainable; as the sugar land shrinks and gives was to urban subdivisions, as the remaining land yields less each year and the soil becomes increasingly salted, something will have to change.

When nature speaks, by My DrEaM SHOTZz, with Creative Commons Licence (Attribution-Noncommercial 2.0 Generic)We agree that mechanised harvesting is the only humane way to get a sugar cane crop to the mill, and the sort of collective action that it would entail is the great hope that pushed my wife into action against Marcos and his cane-growing cronies all those years ago. But the ensuing dislocations would be horrendous. Greater minds than ours, and more committed political actors, have tried and failed to break the grip of the hacienda owners – people, not incidentally, who rarely hold all of their estates legally, and who bankroll their own militias. Opposition often means death.

But maybe mechanisation is somehow the key, perhaps combined with diversification into other crops. For now, it’s certainly something to think about.