Tuesday, June 19, 2007

The tongue,

said the endodontist this morning, is a very curious animal.

This is true. It has its own obsessions and compulsions. The tooth (number 13, third from the left, on top, next to the molars), had broken off after phase one of his root canal. Part of the remaining tooth had formed a point, which my tongue kept touching and feeling until I had a sore on it. The mild endodontist shaved off the point and will finish with the root canal next week. Then I'll get a crown from the dentist. I don't know why he didn't do the rooting out of the canal and the filling of it in one fell swoop. I should ask. I also don't know why he works downtown only on Tuesdays.

He told me his brother is an oncologist in Washington State who had cancer in his tonsils and directed his own treatment.

The cancer cell has its compulsions and obsessions. We are told: "Normal" cells stop dividing when they come into contact with like cells, a mechanism known as contact inhibition. Cancerous cells lose this ability. The cancer cell does not get the social cues. It cannot read the faces of the other cells. It does not know when to stop reproducing iteself, when to stop telling that story one more time about its cross-country trip in a beat-up station wagon. Because of this we need to ingest poison to stop the cancer cell, and in so doing, the toxin stops other harmless and helpful cells in their tracks. The faster the cells are dividing, the more likely it is that chemotherapy will kill the cells, causing the tumor to shrink. They also induce cell suicide (self-death or apoptosis).

Cancer cells are uninhibited. They put our lampshades on their heads and run through public fountains. But these same frolicking, out-of-control cancer cells are trying to kill us. In defense, we try to induce suicide. Can you blame us?

Today was chemo Round 5, the first dose of Taxol, which is derived from the Pacific yew. We have some kind of yew bushes out front, which we prune. I don't know what kind they are. Taxol is preserved with a chemical called cremo-something, which a few people are allergic to. The nurses told me that a reaction is rare, but they laid out epinephrine and benadryl on the table nearby just in case. They'd already given me some benadryl in the drip. Reactions include feeling very hot or having constricted breathing. It happens in the first few minutes.

After a few minutes on the drip I felt blood rush to my head and ears and they were hot hot hot, and there was a heavy foot on my chest and it was hard to breathe. I reported this calmly because they’d said they were prepared. They took me off the Taxol and gave me more benadryl and put oxygen cannula in my nostrils. I felt better. Then a few minutes later I had what felt like menstrual cramps, and a nurse gave me a heat pack. The cramps went away in about ten minutes.

Was this anaphylactic shock? I asked. No, said the nurse, it was anaphylaxis. Which, from what I read, is serious and life-threatening. But not shock.

So it may not end with a whimper, or a bang, but with a closing up.

*****

Waiting for the L (train, not husband) today to go to Fancy Hospital I saw a guy in a very dark suit, white shirt, red tie with diagonal red and white stripes. Something odd about his outfit--so very severe, formal and self-conscious. He had opened a black leather folder to reveal a list, handwritten on yellow legal paper. Tell about... Tell about your… I presumed they were interview questions he was going over. His outfit was too perfect and plain. He did not seem proud of his suit. It was not ill-fitting but didn't seem tailor-made, either. Who wears white shirts any more, and who wears a black suit when it’s 80 degrees? I don’t see many people in suits on the L, but that’s because I don’t ride much during rush hour, especially in the morning. Tom Wolfe says he wears a white suit because he’s not trying to fit in. He used to try to dress like his interview subjects but he couldn’t look authentic. So he decided to look out of place. If you use that line of reasoning, then a person interviewing for a job shouldn’t look like an employee because he’s an outsider. Perhaps it is right and proper that he should dress differently from them as a sign of respect and a nod to the artificiality of the interview process. At the same time, he wants to communicate the message that he’d fit in. He wants the interviewers to imagine him working with them. When they offer him the job they should grab his jacket and fling it across the room and tell him to loosen his tie, roll up his sleeves and tear up his practice questions.

If he is smart, he will keep the list of questions.

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