Medical authorship, Part II

To continue my exploration of medical authors' personalities:

For the many men suffering from prostate cancer throughout the world, we must continue our efforts to improve diagnosis, treatment, and basic understanding of this fatal disease. —Walsh and Brooks

The author of this chapter most senior in age (JES, 67 at that time) had a complete physical examination by Dr. William M. McClatchey in March, 1987, which was reported as negative. Because of pain in his left knee, he had another partial examination in October, 1987.
WMcC:     I want to do a rectal.
JES:     But I had a rectal by you 6 months ago.
WMcC:     My professor told me that not one patient will leave my office without a recent rectal examination.
JES:     (Unwillingly) O.K.

Rectal exam revealed a prostatic nodule. Prostate specific antigen (PSA) from the earlier exam had been 0.3 ng/ml; the current report was 0.4 ng/ml. Both were within normal limits. But biopsy revealed adenocarcinoma. Radical prostatectomy by Dr. Sam Ambrose 2 weeks later revealed that the prostate (including its capsule) was full of cancer. Five years later an LHRH (luteinizing hormone-releasing hormone) agonist (Lupron) was started because the PSA had risen to 5.3 ng/ml. At present, Dr. Skandalakis is asymptomatic and the PSA is under 0.

PSA is a marker of prostate disease. In the clinical context, it is probably most useful for monitoring cancer recurrence.

Good with words

I love listening. I used to think that listening was more important than talking, that I talked to get people in a position so I could listen to them. With a certain kind of arrogance, I used to think that being good with words is knowing when silence, when listening, is more important than what you have to say. Being good with words, is looking through the unique turns of phrase or accents that each person has, and being able to understand what they are saying, and empathise with what they actually mean.

With time, I realised that the obvious was true: being good with language wasn't just about listening, but about talking. I wished I had a more engaging charisma, a more appealing timbre and accent - to be the kind of person who actually could engage people with my insightful words of comfort, or witty repartee, or dramatic tales, or effortless small talk. Instead, I'm the kind of awkward that can't even finish the punchline to my own joke before cracking up.

I realise now that being good with language just isn't about having the widest vocabulary or the most lyrical turn of phrase. It isn't about having an appealing vocal timbre, or enunciating all your ending consonants. Being good with words is knowing what to say in love, just as the good book says (1 Cor 13:1). Being good with words is knowing what to say to make someone else understanding you, to get on board with you. You might not have to use big words or fancy high-falutin' phrases, and in fact you most probably won't have to. What you do need to do is know the other person well enough. You need to know what words to say to so they understand, not your words, but your meaning.

With time, and as it turns out, with almost with no bearing on language at all, I realise that in the best relationships, being understood is just as valuable, and important as understanding. Yet with sadness, I realise that may never exist.

Heart

What is this strange thing that our human hearts are capable of? That we can feel it plummet to the depths of our shoes, beat faster with anticipation, flush us red with the heat of the moment, beating every beat for that which exists outside of us - another beat, another rhythm, another person. That we can feel the synchrony of our lives as it speeds up and slow down, and races after - another beating heart.

When closing your eyes brings you no rest

Sometimes I cannot help but wonder whether gay (or bisexual) poets exist precisely to echo - no, to iterate - the inexpressible sentiments of tenderhearted women. This particular one, by Walt Whitman, seems to capture the frail uncertainty of our human convictions and our understanding of the world, and contrast that to the unthinking certainty of flesh and of the senses. 

the undergraduate

a poem for two

for memories' sake inhale

sweet quince and milk chocolate 

roughly, stubbled cheek on mine

the nighttime effervesces 

an aged, brittle me-ss morphs into you-ngness

a fearful asymmetry
burning bright 

it heats the night

a fine balance

to enwrap ourselves as one

only with one eye on the door

one ear on the driveway 

adrenalin pumping 

surreptitiousness 

into pleasure - 

making
half-smiles

and muffled noises

redouble 

inward esctasy.

I was young once

you are young now 

is what my hands tell me

they go places long forgotten 

have I never loved before?

they never knew my hands before

they just needed feather dustin'

faded jeans and young hands

loosen old knots and loosed love

while time ticks on

embers die off

leaving the unbearable cold deadweight of duty

a whiff of quince and 

the scent of Cacharel

has a hot headiness of its own

to be enjoyed
only with another eye on the door

another ear on the driveway

adrenalin pumping 

blood rushing

into pleasure - 

making
half-smiles

and muffled noises

redouble

unforgotten

Dialectical: Hide/Seek

Is face value too skin deep?

Or do I need to psychoanalyse?

Should I trust my instincts?

Just dive in?

Drowning babies won't survive

while doubting Thomas dithers five.

Doctors hide behind diagnostic labels

and paternalistic care disguise.
Patients hide behind false confidence:
Doctor, doctor, yes, I'm fine -
but when the truth gets out,
instead of empathy,
the doctors try to hide

And there's 

nothing I can do
but learn from other doctors,
learn how to hide

behind paperwork,
and behind-the-scenes condescension,

We avoid lawsuits,

and avert blame.

When all I want to do 

is hold you,

tell you I'm sorry,

you're wanted,

please don't hurt yourself,

please don't try to die.

Bite the dust

The ghosts of him haunt every corner -
her wistful longing hunger
knawing through,
attempting to ignore this still -
they drift past, they pass through
she feels the icy chill; she trudges
on as the frost sets in on branches while
higher still, the infernal sun drenches
the world with vibrant ultraviolet oncogenic colours,
its tearing heat
welling up
torrid and torrential raining sun
sweltering down,
it does not warm
her beading brow,
or light her shaded eyes. Still
she cracks her pained face into a painted smile,
a paragon of politesse,
she remarks on the weather, and continues
her marathon through ice and fire,
as the ghosts of him around her loiter.

It's been a while

I was randomly clicking through iTunes today while packing and came across this beautiful piece by Evan Rachel Wood. It makes me want to watch Across the Universe again and revel in the beautiful artistic cinematography.

Ideals versus People

Despite what has been said about no man being an island, we aren't quite the Pangaea that one might think. Rather we seem to be connected by the currents of activity which happen to thrust us together - a rapid version of continental drift that pulls us apart, and brings us in close apposition. We never quite touch, although at times it seems we come close to it. Perhaps it is our fallen nature that prevents of from ever fully sharing in each others' world.

In interacting with others, it pays to realise that ideals are weak things, and that ideas are only as strong as their impetus to realise, or actualise them. People build up so many ideas about what they want in relationships, about what they are looking for, that they are invariably disappointed. There is nothing wrong with developing these ideas of the sake of conversation, but the double-edge to ideas is that they very often stick around. They influence day-to-day decision-making subtly and pervasively such that the expectations you have of someone, the way you relate to them, and the impression you form, are all coloured by your preconceived notions.

When it comes to ideals, is it not more exciting to hold off thinking about them until you find yourself actually in a relationship with someone? Then, you can build on each others' perspectives and craft ideals and worldviews together, rather than endlessly turning these over and over in your mind before you start, building them up as barricades and hindrances that fortify a lonely island. Some think otherwise. Some think that by doing so, by preempting future troubles and concerns, and by firmly establishing their conceptions, they can avoid later strife or error. The problem is that there is a disjunct between theory and real life, and that ideas can never comprehensively address people and the intricacy that is life.

Colleague, boss, housemate, coursemate, brother or sister, prayer buddy, brother- or sister-in-Christ, bible study member, non-Christian friend, mother, father. Each seems to have its own set of predefined relational contexts and social norms. Whatever happened to just loving someone? Christians in particular seem to spend their time forging ideals and trying to get people in church to conform in the name of obedience, yet I fear an indviduals' path tends to take a narrative ethic rather than an absolute one. I have found that every person's moral dilemma is different, and there is no exact similarity between one person's choice and another's - that one action might be made in virtue according to one person's decision, but the same action might be made in vice in someone else's.

Yet there are so many meaningless church sessions trying to standardise the way we think about an idea, and attempting a reductionist's approach to moral decision-making. Ideas about sex, marriage, and gender roles, particularly, come to the forefront in the church where I am at. And I don't know how comfortable I am in the pews listening to what is said sometimes, as I see model become uniform reality, and a failure to recognise sinfulness within the paradigm, while readily recognising the sinfulness outside of it. Oh, we are such a sinful, fallen world. But when we do this, this is godly. But how very untrue this is! Within that very system of action it is possible to see where sinfulness can seep in, in the form of pride, selfishness, and all a manner of insidious ways, and this makes us no less prone to sin than the next person.

The strange thing is that I realise there is a role for this type of thinking in certain contexts. There are some things about morality, and about God, which are irrevocable. It is good to know what these are, and to be clear in them, and to be reminded of them, and to let these govern life decisions. Broad strokes paint a picture that I agree with, but the devil is in the details, and perhaps it is in these that I find real life prevails over human hermeneutic preaching.

Over the past year or so, I'm coming to appreciate more and more the simple reality that relationships in true reality, in God's kingdom, are best thought of in the context of being brothers- and sisters-in-Christ, and being accordingly loving. My experiences have led me to see that supporting someone with love means intimacy and empathy. It means rooting for them when they are struggling in the absence of judgement. This holds true whether you are relating as a colleague, boss, housemate, coursemate, brother or sister, or significant other. We can support each other by showing our care in the ways that we can, and realise we can never be perfect for someone, even so. Even more importantly, loving someone means forgiving them, or making the choice to forgive them preemptively. How much of blame and unforgiveness in a  relationship comes from someone not being able to address our own personal flaws, our own inadequacies, rather than their intentionality to hurt you.

Perhaps loving someone is not about doing what is right, doing what one ought to, because the underlying emotional truth is that in thinking in this way, in doing so, you are only stroking your own egotism and self-righteousness. Instead, what is right is defined by the process of loving others.