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
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?
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.
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.
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 . . .
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).
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!