Madness

Doing the same thing over and over again and expecting a different outcome is a sure sign of madness.  Repeating almost the same chemotherapy on a cancer that has shown refractory to it seems to me to fall into the same category.  Still, what can I do?  Doing nothing is not an option.  It won’t give better results – which might now need to be measured in months or years and not survivorship or not.  Jumping off a bridge is not an option either.  I would be throwing away too much.

The clinical study that adds methadone to chemotherapy to see whether it improves the outcome is close to enrolling patients.  The hospital is in Ulm, just a few hours from here.  There’s a handy questionnaire on the website to check whether one qualifies.  I don’t.  I have apparently not exhausted all the options of chemotherapy yet.

This is bad, but it could also be a reason for hope.  In my upcoming (though as of yet still unconfirmed) second chemotherapy program one of the drugs (oxaliplatin) will be replaced by another (irinotecan).  To both deserve a box in the questionnaire, they must be sufficiently different from one another to maybe make a difference in the therapy.  Maybe I’m not about to repeat what I’ve already done.  The bad news is that the study works with the mix containing oxaliplatin, against which I had an allergic reaction such that it was withheld during the last session.  Any positive outcome might not apply to me.

Another compound on the list is trifluridin, a nucleoside analog that I haven’t encountered yet.  It was never mentioned as a possibility, but I see that it’s available in Switzerland and prescribed in cases where chemotherapies with oxaliplatin and irinotecan have failed. It seems that there are even bleaker cases than mine, and that I have quite a way to go before giving up becomes the only way out.

This should lift me up, but it’s heavy lifting.  Since the devastating news from the oncologist yesterday, I haven’t exactly been bouncing around with joy.  With the futile mental acrobatics of an empty head, I’ve almost managed to persuade myself of the utter despair of the situation.  I spent a fortune on a new stereo that arrived this morning, but what’s the point?  Who’s going to appreciate it?

Everyone knows they’re mortal, but the certainty is a distant one, and it’s easy, almost instinctive, to ignore it.  If the inevitability of death becomes imminent, it has a different effect.  It colors all thoughts, blunts sensations and subdues energy and enthusiasm.  Why bother becomes a logical reply to almost anything.  Once you’re in this hole, it’s probably very difficult to get out.

I was standing at the edge of the hole a few times today.  It was hard to focus on work, and during the bike ride in the morning (as if I were a graduate student again), the road was struggling to hold my attention.  Questions that one shouldn’t have to ask kept popping up in my head.  Are the children going to be ok?  They're so little – and so good.  It’s my duty to send them off into their own lives.  This is difficult when they’re only 3 and 5.  How will Flucha cope?  Why am I being deprived of forty years of my life?  All good questions and all utterly pointless.  Even if anyone had good answers, it wouldn’t do me any good to know them.

In the end, I cut the nonsense.  There’s more to life than thinking about its end.  I finished my work for the day and went down to connect the stereo.  An hour later, with the amplifier warmed up, I enjoyed Saint-Saëns almost as if I were sitting in a concert hall.  At least that’s what I’m trying to convince myself of.  It helps justifying the expense.  I sit on the sofa, the children run around and scream, Flucha cooks burgers, and I imagine the next steps.  It would be madness to stop fighting.