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The January sun can also be harsh, almost cruel. Later this morning I was doing the "get out the vitamin pills" ritual, and I accidentally counted out four. Lian has returned to Seattle, to her own life. Soon I will be counting out only two pills. Oh I miss my daughter! I will so much miss my son! But I am so thrilled at their happiness, their vitality. The brightness of January also can remind me that the Spring season isn't all that far away, the cycle returns, this time laced with another year of memories.
Last night I was reading Haruki Murakami's new novel 1Q84 and ran across this passage:
"Humans see time as a straight line. It's like putting notches on a long straight stick. The notch here is the future, the one on this side is the past, and the present is this point right here. Do you understand?" "I think so." "But actually time isn't a straight line. It doesn't have a shape. In all senses of the term, it doesn't have any form. But since we can't picture something without form in our minds, for the sake of convenience we understand it as a straight line."Writing like that is why I've been a fan of Murakami's for several decades. I think, though: is it memory that imparts the notches onto the 'something without form'? The older I get, the more valuable the memories of life become. When I inadvertently count out four vitamin pills, the extra pill triggers those memories, and it suggests that deeper and richer ones are yet to come. That helps me face the stark January sun.
I had also scheduled a regular physical that day with Dr. Richter. Even though I'm seeing plenty of doctors on an almost weekly basis now, I hadn't had an overall physical exam for awhile. All was fine. Except for the myeloma, of course.
One x-ray, two doctors down, and then meetings at Columbia on Tuesday in anticipation of the coming academic term. I felt pretty out-of-sorts from the Velcade, a bit more so than normal for some reason, but managed to spend an enjoyable dinner with great old friends Rick Bassett (who is back in New York after the past three or four years in Africa), Akira Takaoka, and my iRTcmix collaborator Damon Holzborn.
Wednesday with Dr. Pearse, and the big news is that they've moved the Hematology-Oncology group at Weill-Cornell into a new location. It's about 4 blocks from the main hospital area in one of the surrounding buildings. Roger said "you'll appreciate this, Brad" and outlined some of the academic/political/budget reasons for the move (Hem-Onc apparently is doing well). Oh us silly humans. The visit was fine, the 'gang' was all there (Faiza, Patty, etc.), and although it was a bit more cramped space-wise than the prior location, it was only the Hem-Onc group patients. I was able to get in and out quickly. Two things I missed, though: the little canteen on the way out of the hospital where I would stop to get a small carton of grapefruit juice, and the little meditation chapel where I would enter, pretend I was medieval, think about time, all that. Maybe I'll walk the few blocks back now and then. Roger wasn't totally thrilled by the new location; his lab remains back in the hospital building.
The rest of the week went well. I was feeling better Thursday and Friday, so I was able to get a little swimming done. I see Dr. Yi on Monday and will find out what more needs to be done after the x-rays. Possibly an MRI, maybe nothing. Both Dr. Yi and Dr. Pearse don't think the pain is myeloma-related. My stats have been low, and it all seems so slight. Roger said that if it does appear to be caused by cancer activity he would like to do a PET scan to see if there are other active areas that need to be addressed.
This happened to me this morning. A friend of ours, renowned chef Dan Orr, is starting a new venture in my home town of Columbus, Indiana. Called FARMbrew, the new brew-pub will build on Dan's successful FARMbloomington restaurant. Dan's mom and (now-deceased) dad are/were among my parents' best friends. Dan was closer to my sister's age, but I knew his older brother Tom -- a tremendously talented artist and energetic friend -- before a tragic electrocution accident claimed his life in high school.
Anyhow, I had put on a piece titled ...and the rain embraced our closing words by the group Language of Landscape (click here to hear it) and I noticed that Dan had included a number of digitized photos on his FARMbrew web site. In addition to being a master chef, Dan is also an accomplished photographer. I decided to click through a few of them.
With the beautifully measured piano chords in the background, I soon encountered pictures like these:
The one that really got me, though, the one that pushed my emotional buttons all the way in, was this one:
One thing that has cycled back around that I don't welcome is the stupid myeloma. The results from my x-ray showed that there were some new 'lytic lesions', the clinical hallmark of myeloma activity. The minor pain I had been feeling in my shoulder unfortunately has a basis in reality. The odd thing is that my stats have been so low. But they haven't been totally in remission, so perhaps these lesions have simply occurred over a long time-span. In any case, I'm fairly certain that Dr. Pearse will want me to undergo a PET scan to see the extent of any activity. After that we'll have a few decisions to make.
One good thing about the holiday break: I accomplished almost everything I wanted to get done. I have updates to two of my software language 'objects' completed, a fair amount of documentation finished, and I'm almost done with a small suite of three new pieces. And we had a wonderful family times -- great memories!
The first week of classes went well, including an interesting dissertation proposal defense on Friday about "Princeton Theory". One of our music theory graduate students is taking a look at the growth and transformation of music-theoretic discourse at Princeton from the 1950's up through the present. I had forgotten (or perhaps didn't explicitly realize) how my musical thinking had been shaped by being immersed in that environment. The discussion of the proposal also reminded me that I was at least a small part of that scene. That realization made me strangely happy.
I had a near-embarrassing moment in my "Music Hum" class on Thursday. One of the exercises I like to do to kick off the class is to ask students to bring in examples of what they consider a musical 'masterpiece' (it's a great way to discover new bands!). I wind up by playing a few things for fun, Jimi Hendrix' Purple Haze (both original and the string-quartet version performed by the Kronos Quartet), some Captain Beefheart, etc. Then I play the piece Fratres by the composer Arvo Pärt. I tell a story about it. A lot of my Music Hum teaching is telling stories. I explain to the class that music has an unparalleled power to connect personally with you, hence my tales of personal engagement. I believe that the roots of a 'masterpiece' lie in that connection.
Here is the piece:
Listen to this music, now. Here I am, with my new-born daughter. The difficulty and struggle you hear in Kremer's virtuosic violin-playing, the steady chords of Jarrett's piano, the purity of the melody played using violin harmonics and the (to my ears at least) "timeless" quality of the harmonies; this music embodies the pain and joy of life, the fierce awareness -- back then with new life held in my arms -- that this is it.
The power of the music, the way it can reach in and grab my soul and take me simultaneously deep inside and way outside the act of living, I tell the class "this is why I am a musician". But the danger in playing this piece and uncovering it in front of twenty-some undergraduates is that I relive that initial experience when I hear it. Look at them, they're all about Lian and Daniel's age. I almost broke down right right then and there.
Fortunately I was able to recover enough of myself to finish
up the class. What a way to start the term.
Dr. Yi was also puzzled by the apparent myeloma activity. He showed me the results of my latest blood work -- Monday -- and most of my 'stats' are in the normal range now! I wonder what the heck is going on?
Classes are going on, of course, and they seem to be going well. I do enjoy teaching the Music Hum class, and my TA (Elliott Cairns) is good. My computer music seminar is pretty intense, but everyone seems very engaged. Dense stuff, but the pay-off in terms of sound-producing capabilities is high. Here's the description, plus links to the syllabus:
Again, my blood stats were really low, almost 'non-detectable'. The PET scan is scheduled for Friday, and coupled with the bone-marrow information, we'll see what's happening. It will be several weeks before all the test results come back. Dr. Pearse doesn't think there's actually much cancerous activity taking place. I hope his instincts continue to be correct!
Weird, I write this now, and I think that in a couple of weeks I can read it from a totally different perspective. Hello, Brad-of-the-future. Isn't time strange?
So not a 'deep' blog-post here, just reportage of the stuff of life. This is how it goes, we string these episodes together, and there we are. Another episode looms: tomorrow morning we're doing an "ambient pancake breakfast" as a fundraised for the Roosevelt Arts Project here in town. Jill's doing the hard work, making the pancakes, and I'm doing the "ambient" music. I think Terry Pender will be down to join me, so watch for some new PG tunes in the next day or two.
First of all, about a week-and-a-half ago, the "ambient pancakes" were served. The event went really well, thanks in large part to Jill slogging away in the Borough Hall Kitchen and helping to transform the Hall into a festive place. Terry drove all the way down from his home in Hopewell Junction, NY to wail away on his guitar. Many friends and neighbors pitched in, and the whole morning was about as successful as it could probably be. Here are photos and sounds:
I've had strange dreams, the material we're doing in various classes and projects at Columbia is very exciting right now, approvals have been given for our new "Sound/Arts" MFA program, more and more and more. But I wonder how much of this could be termed "borrowed time" (as if any of it wasn't!). If I was Catholic/traditional-Christian, today -- Ash Wednesday -- would be the beginning of Lent (get it? "lent", borrowed... ha ha ha). The reason I wonder about this borrowing is that I'm sitting in one of the exam rooms waiting for Roger Pearse. The results of my tests over the past few weeks are now in, and he wanted to see me. So, here I am. More later.
Anyhow, here is the info from my appointment with Dr. Pearse yesterday:
Hey everyone -- I wanted to let you know how my meeting with Dr. Pearse went this afternoon. The results from all my tests & scans came back, and they basically confirmed what my blood-tests have been showing: I have a low-level of cancer activity going on. One example: the bone-marrow biopsy showed 10% plasma cells (the bad guys). Sounds not-good, but to put it in context I was at 80% plasma when I was first diagnosed. This means that the drugs are working to keep the cancer at bay, but they aren't completely eliminating it. Dr. Pearse thinks that possibly adding the steroids to the mix again (aaugh!) could lower the activity further, but he doesn't like to over-use the steroids because of the long-term negative effects. He's also worried about one other thing, the fact that I've been experiencing occasional pain from some of the active lesions. What is disconcerting is what the PET scan showed: I have these micro-lesions all over the place. This was true in my initial diagnosis, too. I've only experienced problems in my arms and shoulder-blades, but I also have sites in my skull, my hips, my ribs. my spinal column. Dr. Pearse is worried that if I developed an active fracture in one of my vertebra it could be extremely unpleasant (and downright dangerous). There's been an on-going debate in the myeloma research community about the use of chemo vs. immediate transplant as an 'induction therapy', and Dr. Pearse has typically gone with chemo (it worked well for me!). Studies don't really show an advantage of one over the other at present. But he thinks that now may be the time for me to do the transplant. He believes that my cytogenetics indicate that I could have several years -- possibly more -- of remission. He also knows of a number of new drugs now under trial, so I'll have a few more options if and when the transplant starts showing myeloma activity again. Yes, even with a transplant there is no cure at present for this happy disease. I'm very much inclined to follow his advice. He said this isn't necessarily an emergency situation (unless something dramatically changes), so we can probably schedule it sometime in the summer, or whenever is convenient. But it may be a prudent decision to get it done sooner rather than later. I have more questions I need to discuss with Roger; there was a lot to absorb this afternoon. I feel like I'm involved in some weird card-game, what is the best strategy for playing my 'hand'? Jill and I are talking about it, and after I check with Dr. Pearse again we will set something up. Most likely this will be early in the summer, but possibly even sooner if it seems the best decision. The transplant means a three week hospital stay, and Dr. Pearse said I'll feel really awful for about five days during the stay. After that, life starts again, slowly but surely.Perhaps our time is 'borrowed', and now I need to pay back the loan. This is just one big whopping adventure, isn't it?
It isn't, though. How quickly we forget about change. I thought I had reached a point of stasis, life was going well, I could handle the myeloma with new drugs (and my side-effects weren't too terrible). I read back in this blog, though, and it's like another person at times, from another life. How did the steroids feel? How was it to first face mortal-realization? Why did I complain about this/that/the-other? What was I thinking?
As I lay in bed waiting for Lian to arrive -- Jill went to pick her up at Newark, being a much better 'morning person' than I am -- the weather turned windy. I was worried her flight would be delayed, but she arrived with no problem, even a few minutes early. I watched the sky brighten outside. This is what I saw:
Then I looked out the window at our strangely spring-like weather. This is like April. And when April comes, will it be like this? I'll probably be in the hospital, trying hard to recover from a total decimation of my immune system. I wish "leap day" allowed you to leap around in time. This is all part of the adventure, I guess. One thing I still don't know, when will the stem-cell transplant happen? I won't know until a week from Friday. I have an appointment to see the transplant specialist at Weill-Cornell. He'll tell me my future.
At first I thought he was going to recommend not getting a stem-cell transplant. He was asking a lot about my general health, which is actually pretty good. After this line of questioning, I was almost expecting him to say something like: "well, given that you're not doing all that badly on the drugs -- your cancer activity is relatively low [etc.] -- perhaps it's not such a good idea to undergo a transplant right now." But it turns out that one of the better times to do the transplant is when you ARE in decent shape, because the procedure does knock you down pretty dramatically. In fact, I have to undergo a battery of tests (pulmonary function, heart EKG, dentist certification that I don't have any dental disease, etc.) to verify that I'm able to handle the transplant. My schedule the next few weeks will be totally insane.
The good news is that he expects that my hospital stay will only be two weeks, maybe a little more. The even better news is that on one level this is a relatively straightforward procedure these days. He said that over 100,000 SCTs have been done in the US by now, and the Really Bad Reaction rate is very low. He also said that I might experience some nausea and pain, but they wouldn't be as terrible as I had imagined.
The 'knock you down dramatically' part of it all is the intense fatigue that occurs. This is the bad news. Although I may be sent home from the hospital in two weeks, my recovery afterwards won't be a simple 2-3 additional weeks of rest. It's more like 2-3 months. He really stressed how drained I would be. In the hospital, once the heavy-duty drugs kick in and the stem cells are re-introduced into my bloodstream, he said I would be so exhausted that I probably wouldn't be able to lift a spoon or fork. When I arrive home, he said my tiredness would be so great that I probably wouldn't be able to do simple math. Yikes! This is a level of body-lowness that doesn't even make sense to me right now. Jill asked about negotiating our stairs (I do most of my work upstairs at home). Dr. Mark said that I could probably climb them after a couple of weeks if I took several "rest stops" on the way up. Yikes again!
I've heard from friends and neighbors who are reading this blog, so I want to write a few more random pieces of information. First of all, be aware that this stem-cell (bone marrow) transplant is what is called an 'autologous' transplant, meaning they will use the stem-cells I had harvested four years ago. This means there is almost no risk of the dreaded graft-vs-host disease, the thing responsible for the nearly 20% mortality rate for the 'allogeneic' find-a-matching-donor transplant. The weird thing is that even if I did have an allogeneic transplant with bone-marrow cells from a completely different person, the myeloma would still likely recur. This is one of the aspects of multiple myeloma that is still not understood. So why risk it? They don't.
The second thing I want to write is how amazed I have been at the level of support and heartening words/wishes I have received from friends, neighbors, and in particular my colleagues at Columbia. These kind gestures and expressions of support really do matter, and I feel one of the luckiest people alive to be surrounded by such wonderful people. Obviously I'm leaving my family off this list, because they already know how much this all means to me. Yeah, yeah, maudlin I know, but I wanted to be sure I've said somewhere: "WOW! THANKS!"
I was saddened that I would miss a fair amount of springtime, one of my favorite seasons. But the bizarre weather we've been having -- up in the 70's last week and predicted to be there again in the coming week -- has delivered some springtime already. Our crocuses have already bloomed, the daffodils are out, some of the early red-bud trees are red and budding, it seems May in the middle of March. I used to love to carry Lian and Daniel around the yard in April and May when they were very young, stopping to 'sniff the flowers'. I have a suspicion that I will need memories like that to help get through the heavy psychology that will surely accompany the kind of physical exhaustion Dr. Mark described.
The best excuse I can offer for not posting more is that things are relatively insane. Last week I had to complete a goodly number of medical tests to be sure I was healthy enough to undergo the transplant. I even needed a dental exam to be certain I didn't have any lurking tooth-decay. I don't mind this thoroughness -- death by dental decay sounds particularly unpleasant. I guess when you have no immune system, you're fair game for about any bacteria that decides to stage a takeover.
I've also made a HUGE list of "thing I need to get done" before entering the hospital. All of the administrative and teaching duties at Columbia, all the work around the house, musical projects I'd like to have in pretty good shape, etc. Essentially I need to try to complete, or make arrangements to complete, all of the work that should be done as the term ends. Students need to graduate! Yikes! I told (grad student/collaborator) Damon Holzborn today that it was like packing for an Everest expedition. I know I will be totally out-of-contact for at least a month.
This is when I gain a renewed appreciation for the collegial and supportive environment that exists at the CMC and Music Department right now at Columbia. To a person, everyone has been extraordinary in their willingness to help. My family too, of course, but from what I've been reading most of their hard work lies ahead.
Speaking of students and Columbia, I taught my last "Music Humanities" class this past Tuesday. It's a great class this year, and it was a bit more emotional than I expected: "By the way, this is the last class I will be with you this semester." What really got to me, though, was a card signed by all the students that my TA (Elliott Cairns -- he has to take over the whole class!) delivered to me today. Words, thoughts, and gestures do make a difference. Wow.
Speaking of reading, one of the books that has given me a little more insight into what the transplant experience will be is titled Love, Olivia written by Olivia Chin, a transplant patient of Dr. Mark's. Dr. Mark co-wrote it with her, adding 'medical commentary' to her observations. I don't know that it it would be of good general interest, but for me it was a delightful read. Very informative, too, although I realize that every patient is going to have a different experience. I also like the fact that my doctors care so much about their work that they write books about it.
Gregory Taylor was out for most of the past week, too. We had planned to do a lot of PGT recordings over the break, sessions with musicians we like and respect. The idea is to create a "PGT+" series of pieces that will form an on-line release at some point in the future. The recordings were great fun, and all seemed to go remarkably well. I gotta say that the distraction from Transplant Life was very welcome, too. Stay tuned for future PGT news...
Now I sit and wait by my phone, in between working through the HUGE list. I don't know when they will ask me to come in for the transplant. It could be this weekend. It could be mid-April. The uncertainty is a little unsettling. Once we made the decision to do the transplant, we just want to do the transplant already! I'll probably be thinking totally the opposite a few weeks from now. Realistically I think I'll be going in towards the end of next week. Dr. Mark seemed to think we would be there before the end of the month. So fast, but never fast enough.
There is one more potential schedule complication happening, but I can't say anything about it. If it happens, it will be something. It looks now like it won't happen, though. That's probably for the best, given the way life is unrolling at present.
What doesn't seem to be happening early is the transplant, although there are good reasons. I have to go back over to the hospital early this coming week for additional tests (head CT scan, EKG). There was some sinus congestion that showed up on one of the x-rays done last week, and they need to be as sure as possible that I don't have an incipient infection. I doubt I do, I'm feeling fine, but the waiting-game tension is definitely building. I suspect I'll be going in towards the end of the week, but I'm just guessing. They'll have to do it soon, or all the tests will be invalid. I'm ready!
At least this time is allowing me to get most everything set for the time away. Once I get the date established, I'll go get my head shaved. Bald Brad again.
Once the heavy psychology starts to set in, the dreams rise again. I've been having a series of dreams that are remarkable for their vividness and also for their relatively benign and mundane content. Sitting here typing this, I can recall four from the past week:
2. In this dream, Gregory Taylor and I were in our house in Roosevelt, and Terry Pender was out in the back yard playing his mandolin. Gregory and Terry are, of course, the "P" and "T" of our two-laptop-plus-mandolin ensemble PGT. Again, it was a very pleasant day. I wish I could recall what Terry was playing, because in the dream I remember it being wonderful music.
3. I dreamed that I was admitted into the hospital (finally!) for the transplant. Jill and I walked in, Ed the transplant coordinator was there along with Dr. Mark and others. Everything seemed good. It really did. That was it.
4. My colleagues Douglas Repetto and Jon Kessler at Columbia are teaching a class together on sound and kinetic sculpture. A guest speaker was presenting his work, showing slides and playing audio from sculptures he had created. I asked at the end a suitably academic question: "I enjoyed that your work wasn't falling into the trap so many other contemporary artists don't avoid, the excessive 'monumentalism' that has been resulting in ever-larger works." The speaker asked what I meant, and I replied: "For example, I'm happy to see that you haven't shown us a work like 'Sounding the Grand Canyon'' (to my knowledge, this work doesn't actually exist, nor does a 'trap of monumentalism' -- all part of the dreeeeam).
At that point I stepped out of that dream into an enclosing dream, imagining these 'monumental' sound-sculpture works. Sounding the Grand Canyon was apparently a work in which an ingenious set of large air-moving plates was engaged to set up a standing-wave resonance inside the Grand Canyon, kind of like blowing across an EXTREMELY LARGE Coke bottle. When I woke up I wondered what that might be like. Hmmmm, perhaps I could get funding for such a project, sort of a Christo-of-sound venture. I could start with resonating a few famous buildings, perhaps Notre Dame cathedral or (closer to home) the Cathedral of St. John the Divine in NYC.
Although the bed-crunch at Weill-Cornell has given me a 'mini-sabbatical', I'm anxious to get this thing over and done with. The problem lately has been thinking too much about what's ahead. Silly stuff, like "this may be the last time I'll be able to walk upstairs for several months" or "this may be the last time I'll be able to feed the cats for several months." Meow.
I've been able to get some good work done while waiting, including a new piece:
After Princeton had made the job offer to Perry, Paul Lansky called me to ask if I would meet Perry for dinner and oh-so-subtly convince him to accept the offer and join the happy group. We went to the newly-opened Triumph Brewery. For some reason, the original interior designer had installed intensely ferocious lights over the booths, the kind that made you want to say "Where were you on the night of June 24? Why won't you accept the offer?" Perry decided to take matters into his own hands and pulled out his ever-present 'universal tool' and proceeded to dismantle the lighting-fixture. The waitress ran over and said "Excuse me sir, but what are you doing?" Perry replied: "Don't worry -- I have a PhD in Electrical Engineering!" The waitress sighed audibly and responded: "That's what I was afraid of..."True story! And in fact I have many exciting Perry-stories. You look back on your life and you realize how much certain people have been a part of it. Perry and I had a lot of fun adventures together. Then things change. I will miss you, Perry, but the past is there.
In any case, I spent today -- indeed most of the past week -- getting ready for what looks to be a fairly long 'trip'. The first few days are relatively benign, so my hope is to stay in touch with people when I can. Then it seems you crash and burn big-time when your body realizes that something really, badly strange has happened. "Hey! I gots no immune system! YIKES!" Dr. Mark put it this way: "About the fifth or sixth day, you will start to feel exponentially worse." Then it all slowly turns around and the months-long recovery begins.
The world conspired to remind me just how breathtaking it can be during the past week. We're in a near-drought situation in New Jersey, and the weather is still uncannily warm (not as insane as it was in March, however). This was what the sky looked like most of time during the last several days:
So another slight delay. The good news is that Ed said it wouldn't affect the course of therapy. The plan is to infuse my stem cells on Monday, and that still hasn't changed. I've gotten a few e-mail queries about this whole process, so perhaps I should outline what will happen in the next week or so:
Monday, then, is the day, even with the slight delay now. To tell the truth, I completely enjoyed today. After the catheter was placed (again a nice surprise, it was only put into my arm instead of the 'central line' in my chest -- full anesthesia required for that one -- that was necessary for the original stem-cell harvest), we (me/Jill/Daniel) spent a very nice day enjoying some beautiful spring weather. After a wonderful dinner near the apartment, I think I'm more ready than ever to face this stuff. Plus tomorrow is no longer the 13th, instead it's my birthday. Bring it on!
They started the heavy chemotherapy this afternoon, and so far (it's about 7-8 hours later) I seem to be tolerating the initial stages well. The crash won't come for awhile, but I was a little worried that I might have had a bad reaction to the drugs. Again, good luck on my birthday.
I hope I get to post this to my blog soon, especially for family and friends using it to keep informed about what's happening to me. I'm having a strange problem with the wifi-internet connection. The signal is very good, and I'm able to visit and download from sites all over the web, with one exception: any net address in the columbia.edu domain cannot be reached. Yikes! New-York Presbyterian is a part of Columbia! I guess they don't get along.
Today is essentially the real start of 'what this is'. In the regimen here it is called "Day Zero". I've been bashed by two days of massive chemo (and was very happy to have tolerated it well... so far). In about an hour the will infuse me with my stem cells, and that's that. Then another waiting game to see when the infused cells make their way to the bone marrow, where they will engraft and grow. That's when the rest of my body crashes and burns.
I'm still a bit freaked out by the DANGER signs around my room -- INFECTION RISK! PROPER HYGIENE REQUIRED! -- and a new one just appeared -- DANGER! FALL RISK! It took me while to figure that one out. It means that soon I will require assistance to get out of bed. I asked one of the oncology fellows how bad this exhaustion will be. Here's her reply (Jill was with me, so she can attest to the veracity!):
Last night I was looking out the windows of our "suite" here, and it kind of hit me: I had no immune system. Gone. I could see people walking along a promenade by the East River, enjoying the day. I realized that if I decided to go down and join in that walk, I would certainly and unpleasantly die. What an amazing system life is, the way our immune cells operate, the way millions of microbial entities work to defeat those cells. At this point I am totally isolated from physical life.
I took some ambien last night to get some sleep. The steroids were doing the 'jittery' thing to me again. Intense dreams as a result, but these were all oddly the same. In each one, someone I knew or a group of people I knew would show up in the room here. Then we would decide to go out and do something, go for a walk, go get some coffee, dinner. Everyone would be gathering purses, jackets, etc. and I would suddenly realize: "Hey! I can't go out there!". End of dream.
On dates like this, it is easy to slip into remembrance, especially when you are feeling very tired and drugged-up. I can so easily recall the days I arrived home from the hospital after both of our children were born. I can also see the outline of my bald head in my laptop monitor as I type this. How in the world did all this happen? Where will it go next?
Our hope is that the next station will better, although I'm not sure what we can really know of "better" until we arrive. If it isn't, that's when the real work begins.
The signal event they monitor is the white blood count in the bloodstream. Yesterday my 'count' was at 1.7 (normal is 4.5 -- 10.0). Today Dr. Niesvizky, colleague of Roger Pearse's and the Director of the Myeloma Center here at Weill-Cornell, stopped by with several of his colleagues and fellows. I had seen him before around the clinic but had never met him. He said my white-cell count was down to 0.4, and he expected it to be near zero by the end of the day. That's the Big Reboot. With a reassuring east-european accent he said: "you are do-ink every zing by zee book." Two things -- I hope it's a good book, and I wish I could skip ahead to the end of the chapter.
This morning I was listening to this piece:
The recording I've linked is actually from a reincarnation of the band. This version was organized by by Arthur Jeffes, the son of the original founder Simon Jeffes. Sadly, Simon Jeffes died from a brain tumor in 1997. Simon Jeffes had this to say about the music he was doing with the PCO: "[it is] a very big yes to the survival of the heart in a time when the heart is under attack from the forces of coldness, darkness and repression."
Yeah, music can still do that for me. It's nice to be reminded -- through music -- that life can be light, that your soul can always play. Silly sentiments, I know, but I think that's my point.
I still feel terrible, but nothing like last week (there is a reason they put you in a hospital for this!). One of my fun things to do is invent metaphors when people ask how I'm feeling. Here's one: back in Indiana we used to say when feeling bad "I feel like I got run over by a Mack truck". My variant is the same, except I add that the driver turned the 18-wheeler around and drove over me a few more times for good measure. Another one I sent to my faculty colleagues at Columbia: "I feel like Donald Rumsfeld personally interrogates me at night using steamrollers."
A lot of the badness is mitigated by drugs, though. I spent most of today -- yesterday was almost nothing but sleep -- either napping or staring out our windows at the trees. Lovely trees. I told Jill I think I have a perfect zen mind. The drugs take care of the nausea and pain along with other bodily fun. Mainly right now I am simply exhausted. I also get freaked out about the possibility of infection, but that is lessening each day. The doctors seemed much more relaxed about things when I checked out of the hospital ("just be sensible").
The ride home was a bit harrowing. When Jill came out from our apartment on Sunday to go pick me up, she found that some jerk criminal had smashed in our passenger-side window. About 9-10 other cars were also hit. They only took some loose change, and the car was otherwise undamaged. Jill said they left some rolling papers on the floor. So what... they smashed our window to sit in our car and get high? Poor Jill had to take the car to a repair shop -- they couldn't fix it but did vacuum out the broken glass and put a plastic wrap around the window. The drive on the NJ Turnpike was VERY LOUD with the flapping plastic, but we arrived home without further mishap. Car got fixed today.
I've been having a ton of interesting dreams. Most I can't recall at all, but I can latch vague fragments of them, and they're all bizarre. I did remember another "second-order" dream that I had a few days ago. I'm calling "second-order" a kind of dream within a dream, one of my favorites being the dream of all possible dreams I had early-on in this myeloma adventure. The recent "second-order" dream had to do with an intensely fascinating dream I was having. I realized while in that dream that I was dreaming, but I liked the dream so much that I wanted to remember it. I then popped up a level into an 'enclosing' dream, and in that dream I dreamed that I remembered the first dream. When I finally awoke For Real (or at least I assume this is Real...), I could only recall the dream of remembering, with nothing of the content of the first dream.
This entry is rambling way too much now, so I'd better stop typing. Also, thanks Douglas! for putting in the 4/29/2012 post. It is good to be home.
I still feel the push of pain and nausea, but not nearly as much as last week. The drugs continue to do a good job of controlling them.
Jill took me to Weill-Cornell yesterday for my first follow-up appointment after I was sent home. Drs. Mark and Pearse both stopped in to see me. Apparently I'm doing even better than they expected -- my stats are looking solid and my general health and vitality is definitely improving. I don't even need to come back for several weeks. We won't know about the success of the transplant in eradicating the myeloma for a few months yet. Dr. Pearse said again that his hopes are high, given my particular cytogenetics.
The trip up and back really wiped me out. Working to get ready to go on time in the morning, negotiating through Weill-Cornell from the blood-draw to the myeloma clinic, the whole drive up-and-back through NJ and NYC (and lack of naps I would normally take), when I got home I was utterly drained. It's taking awhile to recover. Last night I awoke around 2:30 AM to go the bathroom, and I was so utterly exhausted that -- this is the best I can explain it -- the hallway didn't seem to make sense to me. Somehow I got the bathroom, then back into bed where I fell asleep immediately. I'm really glad I don't have anything planned for the next week or so.
I'm still having lots of dreams, although I can only recall vague impressions from them. I did have one last night that I remember well: I was telling jokes and Lian and Daniel were laughing a lot. Nice dream.
Today is a different story. I guess I'm paying the piper, or the price, or whatever malevolent entity there is to do this balance sheet. When I woke this morning, I thought I'd feel pretty decent. Instead I was really hammered. Not so much "badness", but a huge feeling of exhaustion. It's 1:30 PM and I still haven't managed to get it together to take my shower. Two steps forward, one step back. Maybe more like 1.5 steps.
My blog has once again turned into a litany of physical complaints and reports. When the simple act of existing becomes something uppermost in your awareness, then your physical, whiney ego trumps most everything else. I watch the trees through the windows, my mind about as empty as it can be, and I think: "I should be having some deep-spiritual-enlightening thoughts right about now" (of course, that encroaching thought alone probably precludes any such satori from taking place). Instead I just see the trees and the sky. The branches move back and forth, back and forth.
Franzen also seems like a guy I would enjoy hanging around with (the good writers generally do). We're both about the same age, had what seems the same kind of Midwestern upbringing, similar politics and interests. However, I ran across this statement in one of his Farther Away essays:
Yesterday, however, "politics" directly affected my life. I had just fallen asleep for the afternoon. I had forgotten to turn off the ringer on our phone, so of course the phone rang. It was a robo-call from Mitt Romney! Here?!? In New Jersey?!?! With no election in sight for months? And how did they get my name/number on their obviously-flawed list? It was also one of those truly annoying calls that don't stop when you hang up your end of the phone. For the next minute or so whenever I tried to dial out I heard Mitt telling me how evil health-care reform was.
It was this that got me all riled up. I'll make a blanket statement here and say that anyone who is in favor of rolling back health-care reform has never had to deal with insurance companies in the face of life-threatening disease and accompanying unbelievable expenses. With Jill's MS and my own happy myeloma adventure, things like "cap on lifetime benefits" and "pre-existing conditions" take on a frightening concrete reality. And basic research into diseases like MM and MS? It will be seriously curtailed. Jeez, the current Republican party barely 'believes in' science. [By the way, the notion that government can't create jobs is simply false. I know dozens of friends and colleagues at Columbia -- researchers -- who, in fact, do have jobs created by the government.]
Just last week I spent four days dragging myself to the phone to make calls to secure a refill (a refill!) for my anti-nausea medication. When I called to renew the prescription I was told that our insurance company had denied the claim. Why? Because the refill(!) hadn't been "pre-authorized". Insanity! Without the medication, I would not have been able to eat, and life would not have been pretty. Fortunately we had called for the renewal early -- four days -- and I had enough medication to last through the limbo period. We finally convinced them that the necessary authorizations were in place. This is exactly the kind of irritation I need to help me recover.
Perhaps you're not a big fan of President Obama. Perhaps he isn't progressive enough, or perhaps he's too 'socialist' for you. The alternative is far worse. It scares me.
Ok, end of short-burst political rant. Now I plan to enjoy the beautiful afternoon we have here today.
Jill and I stayed up in our apartment last night. It's amazing to me how tired I can get just riding around in a car.
Tomorrow Daniel and I head up to our NY apartment for the rest of the week. As part of his senior year at Biotech High School, he does an 'internship' with a company, research lab, office, etc. My good(!) friend Dave Sulzer said that Daniel could come work in his research lab at the Columbia Medical Center, about 15 blocks from our apartment. We'll be home on the weekends, but I'll be lying around the apartment for the next three weeks. I can lie around there just as easily as here. Dang this recovery is sloooooow!
The last few days have been overcast and rainy, but we had a span of
excellent springtime weather over the past weekend. When I wake
in the morning, I lie around (yeah) and watch the trees outside our
windows. Going through my recent past blog entries, it seems that
watching trees is now one of my favorite activities. Coated with dew
from the night, the sunlight filters through the new leaves
to create a shimmering display of virtual diamonds:
However, it turned out that our saintly neighbor Jeff Ellentuck was planning to come in to New York to stay at his apartment (he has a very nice place downtown) for some business meetings on Friday. He stopped by our house in Roosevelt and became my drug-courier connection. Yay! It was really out of the way for him to come up to the upper west side to do this. At least Daniel and I were able to repay him by ordering some Thai food when he arrived. Of course, he confirmed his saintliness by going out in the miserable weather we had yesterday to pick up the Thai food for us. Daniel was involved in cooking his own food -- not a Thai fan -- and I'm playing my role of Howard Hughes of Cabrini Boulevard and not going out in public.
This act of kindness came on the first day of Daniel's internship with Dave Sulzer, another good friend. Daniel was totally engaged! Dave has Daniel doing some amazing work at his lab at the Columbia Medical Center, neurophysiology research. I also got a nice note out of the blue from Michael Baraz, my sophomore college roommate. Add to this all the on-going expressions of concern and good thoughts through this whole transplant process, and I can bask in the reflected glory of my friends' kindness and pretend that it's a life well-lived, for sure.
One really bad thing did happen on Thursday, and this involved another very close friend. We had a meeting planned for the Computer Music Center staff (I used skype to attend virtually), but Terry Pender was completely missing. He also missed a summer class session he teaches earlier that afternoon. We were a little concerned, but thought perhaps he had an emergency child-care issue or something. Terry is usually pretty good about getting us e-mail or a phone call when things like that happen, though.
It turned out he was in a serious car accident on the Saw Mill River Parkway. Fortunately he's ok, but he did sustain some back and neck injuries and will need orthopedic rehabilitation. At this point we don't know the full extent of his injuries. His car was totaled, of course. Terry, if you chance to read this in the future, know that we're all thinking of you and hope for a very quick return to normal. Life can change so dramatically, so quickly.
When seasons change, I find that my memories go into hyperdrive. All my past experience of each season comes flooding through. With summer hitting so dramatically this week, I was reliving summers-past; days on our lake, nights making music, various jobs, good friends... A few nights ago while lying awake waiting for the oxycodone to work, I started making a mental a list of all the summer-times I could remember. Such richness! I wonder how this summer will appear in my future recollections? I feel I'm an observer of things, not participating at all but watching it pass. Daniel is really enjoying his internship, Jill is involved in her work, Lian is running and Amazon-ing, the family is coming in a few weeks for Daniel's graduation. Here I sit, remembering.
Jill and I went to Ruth and Roy's gravesite on Memorial Day. Their memorial is located in the Brigadier General William C. Doyle Veterans' Cemetery because of Roy's outstanding service in WW II. It was a beautiful day, and they had placed small American flags on every marker. A breeze gently ruffled them, waves of wind blowing over the hillside. Good memories, indeed.
What makes it passable is the on-going good wishes I get from people. Gregory and Terry have both written several pieces over the past month to 'help the healing process'. Little did Terry know that he would need it himself! He's doing much better, by the way. Gregory had a bad bought of bronchitis over the weekend, too. Good thing we're not heading to Portugal in the next week or so. Darn.
Three recent items in particular helped mitigate my slow-recovery depression, though. Several weeks ago, Luke Dubois sent me a link to this project:
Then I get e-mail from Sam Pluta out-of-the-blue (well, he had warned me after his successful dissertation defense at the beginning of May that he had something in the works...) with this attached:
Aw, shucks! Yeah, "I'm not worthy!", all that. I would be lying through my teeth if I didn't say that these made me feel happy, though. If my illness can help inspire good works like this, then maybe my ordeal is worth more than just a chance for me to grab a little more time here.
Don't mis-read that as a pathetic wallowing in self-pity (well, maybe a little wallowing). I'm selfish enough to want to grab as much time as I can. Here's a big reason why, and the last of the three items that made this weekend and today a little more livable:
Hello, As you may know, for the past two years I have been running the full marathon at the Nike Women's Marathon event in San Francisco, CA. I've been doing this to raise money for the Leukemia and Lymphoma society, as part of Team in Training. My dad was diagnosed with Multiple Myeloma (a type of blood cancer) in 2006. He went through treatment and was in remission. The cancer relapsed, and in April he went through a bone marrow transplant treatment, using cells harvested during his remission. So far he is recovering well! I've raised about $8000 over the past two years towards researching for better treatments and cures. This year I'll be running the marathon again (joined by wonderful friends - Tatyana and Jillian!), and as you guessed, raising money again. I realize that not everybody can donate, and the support people have given me over the past few years has been incredible and priceless. But if you can donate, that would be appreciated too! You can find my fundraising page, with more info about my dad and updates from me about my progress, here: http://pages.teamintraining.org/wa/nikesf12/lgarton Thank you again for all the support and kind words - it means the world to me! - Lian Garton P.S. I would appreciate it if you would forward this email to as many people as you can to encourage them to donate as well. Thanks again.My sweet daughter! My wonderful girl! This really got to me. My non-self-pity selfishness: I want to be around a long time (with Jill!) to watch her and Daniel grow. They absolutely amaze me.
Even with this protracted recovery, I can't help but make sounds. It's kind of a feeble thing to hold up as a reason for being, but there it is. Yikes I'm full of self-pity today. Lousy physical feelings seem to do that.
Here is a piece I finished yesterday. I started it while in the hospital and kept poking away at it throughout the last month:
By the way "really sick" means this is the first time I've typed on my laptop in over 24 hours. Jeez I hope I'm ok to see Daniel's graduation tomorrow!
Last Monday (6/11), Daniel came back to the apartment after his final day of internship at Dave Sulzer's lab. He had a wonderful experience. I really owe Dave massive good-karma points. We had a nice dinner and got ready to head for Roosevelt. I started feeling some minor stomach pains, kind of like I had eaten too much. After arriving home in Roosevelt and attempting to go to sleep, all hell broke loose. Massive amounts of pain, and nothing I did seemed to make any difference.
I called Karen/Dr. Mark the next day. I wasn't running any fever at all, so they did not think I had an infection. I thought perhaps I had encountered one of the bad side-effects of the anti-nausea medication I had been using, so I stopped taking it in the morning. Bad idea! The rest of the day was extremely unpleasant. No subsidence in the pain. I spoke with Faiza at the Myeloma Center later that day, and we made plans for me to come up for evaluation the next day (Wednesday). Still no sign of infection (fever).
Jill had to take an emergency day from work and hauled her poor husband up to Weill-Cornell on Wednesday morning. Dr. Pearse was there in the clinic, so we discussed possibilities for my condition with him. He suspected I had some kind of gallbladder attack, possibly gallstones. They set me up for a sonogram scan, and Jill got to schlep me over two blocks (in the rain!) to the imaging facility.
No gallstones, but a very enlarged gallbladder. Dr. Pearse also noted that my white-cell counts were elevated. This was both a good thing and a bad thing. The goodness was that my immune system is indeed beginning to work The bad news was, of course, that something was going on. Dr. Pearse said that we probably could go home, and perhaps treatment with antibiotics and higher-dose pain medication might just work. However, he suspected that we would probably be heading back up to Weill-Cornell again tomorrow.
This is the fun part: the "tomorrow" being bandied about was the day of Daniel's graduation. Aaaaaaaarg!!!!!!! My mom and dad had already had to cancel their trip to see Daniel graduate (that's another story involving back pain for my long-suffering dad). Fortunately Lian had arrived with no difficulties from Seattle earlier in the morning. If I had to be carted back to the hospital from Roosevelt, though, it would wreak havoc with the remaining graduation plans.
Jill and I could also guess that Dr. Pearse probably thought it a good idea for me to go ahead and be admitted to the hospital right then and there. So we did. This was one of the better decisions we've made lately.
I was seen by many doctors, and wound up in a shared room with a delightful roommate (Larry; perhaps more on these things later). Thursday the pain had not lessened at all, but I was beginning to receive decent pain meds intraveneously. They decided to do a 2-3 hour nuclear medicine procedure to find out what they could about my situation. The results showed again no gallstones, but a very inflamed gallbladder and, worse, a blockage of some kind between my gallbladder and my liver. The official diagnosis was "acalculous cholecystitis", a fairly serious disease characterized by wall-thickening and inflammation of the gallbladder.
The doctors decided that a full-blown removal of my gallbladder wasn't such a great idea, given my compromised immune state, etc. There wasn't an acute need to do this because there were no gallstones present. Instead they inserted a catheter to drain the gallbladder and continued with the high-dose antibiotics I had been receiving (and of course the good pain meds...). This all happened on Friday. Jill, Lian and Daniel were able to visit later that day so I was able to hear the report of Daniel's graduation. They had a wonderful time, a nice dinner together at the Sushi King, Daniel's historically favorite restaurant. Daniel also won several awards -- a "gold" award of some kind for outstanding academics, and a "best essay" award for a paper he wrote for the IB-required "Theory of Knowledge" class. What a Daniel!
I was feeling a whole lot better on Friday afternoon when Jill and the kids visited. Later, however, I started to feel pretty terrible again. During one of the doctor + medical residents/fellows visits (there were many!), one of the doctors explained: "you do realize that we had to anesthetize the gallbladder and surrounding area to insert the shunt, right?" Well duh. Yes, Brad, anesthetic does eventually wear off.
But I was still doing much, much better. The relieved gallbladder pressure and the antibiotics were working. I was able to be discharged on Saturday morning. My sister and her family had planned to come for a family dinner/celebration that night, so at least I was able to spend a little time them and Lian(!) and participate at least a little bit in Daniel's accomplishment.
I think again of my "don't ever underestimate the fundamental randomness of life" maxim. We had planned the whole stem-cell transplant timetable so that I would be able to be there for Daniel's graduation. And then a stupid gallbladder. Now I sit at home, drugged up on pain meds, with all the bile draining out of me.
Here is our amazing son:
I'm totally depressed. Summer is indeed settling in, and I feel completely detached. All I can do is sit and watch, and the sitting is accompanied by the fact that I feel marginally lousy all the time. The "marginally" qualifier is only because of the increased pain meds from the gallbladder episode last week; otherwise it would be plain "lousy". When will this end? How will it end? What use am I?
I know the strain is getting to Jill. Poor Jill, her job is no picnic, she has been dealing silently with her own health issues, and her help-mate (ha!) is a lump whose Major Accomplishment for the day might be getting the laundry done. I darkly imagine she's thinking of ways to dump this pathetic husband of hers and get on with her life. I bring nothing but misery and annoyance to our relationship.
Yesterday I was in Lian's room, putting away the bedding that I somehow had managed to wash. Daniel was working at the chocolate factory, Jill was at the DEP dealing with beach-waste issues. There I was, standing alone in my absent daughter's room. I thought of the wonderful times we had together when the kids were younger, when I was healthy, when we were all happy. I miss those times so much. I miss them so very, very much.
Yikes, I'm really wallowing in self-pity this week. I probably shouldn't have posted my previous text, but I was feeling pretty low. Things seem a little better now, mainly because of several supportive (and unexpected!) e-mails from good friends -- and of course my family (hi mom!). Words do matter, we're that kind of animal.
In my replies to friends, I said that I knew going into this process that I would probably hit an emotional trough at some point. I hope there aren't too may more. If I can get get through this stupid gallbladder thing, then I'll start looking again towards the 100-day mark and the gradual return of "real life". I wonder how that will be? For now, however, the solstice is here, and I'm going to try to appreciate the sunlight.
I'm still feeling a little down, but much better than I was. Tomorrow I have an appointment with Dr. Eachampati at Weill-Cornell, hopefully to 'cap' my gallbladder drainage shunt. Nothing does a better job of reminding you that you are dealing with serious health issues than a drainage bag attached to your abdomen. Oh the fun.
Physically I'm feeling a whole lot better, though. My stomach still isn't 100%, but I am only taking painkillers at night (and that's to deal with the minor peripheral neuropathy in my legs, which should subside as my recovery progresses). I have about thirty days to go before my "100 days" is up.
And then? What will the autumn bring? I suspect I'm going to be functioning at a fairly low energy-level for awhile. No matter how much you learn about the process of the stem-cell transplantation and recovery, you don't really know it until you do it. I wonder if I'll be a decent/contributing member of society. Department Chair Giuseppe suggested -- very nicely -- that I step down as Director of Undergraduate Studies. This is probably a good idea, although it does make me feel a bit more useless. I hope I can get back on track soon. I've said this before: my colleagues have all been wonderful through the entire cancer journey. But I hate to feel like I'm letting people down. What a social monkey!
I do recognize that these feelings are typical when you recover from a long illness. The future will happen, and you do the best you can. In the meantime, I'm enjoying this weather as much as I can. Yesterday a tremendous thunderstorm came through about 8 AM. I lay in bed and thought about the timeless but always-shifting nature of the weather. Right now it's windy, and the wind-chimes I hung out in back are sounding gently. The cool and dry nature of today seems like 'mountain weather'. I wish I wouldn't be sad on a day like this. I wish I could make Jill happy like I used to. I wish and wish again. Jeez, such blathering. Things are getting better.
Dr. Eachempati also didn't think I would need to have my gallbladder removed. Because there were no gallstones or other evidence of malfunction, his assumption is that -- in my immuno-compromised state -- I contracted a small infection that would normally have been suppressed. Hopefully my gallbladder will simply return to normal. He said we'll see how it goes with my shunt (the official name is a cholecystostomy tube) 'capped' and post-removal. He said we should probably wait at least six months also because of my recovering immune system.
I'm still pretty tired and drained(!) again, but hopefully back on track to remission. We'll see.
Yeah, I'm still in a kind of self-wallowing-land. I am definitely feeling much better, and with that increase in physical well-being comes the psychological realization of what has passed. Of course I now worry about another set-back like the gallbladder infection, but I'm just a few weeks away from the "100 days" mark now. What comes next? How much of my old self will there be?
Jeez, I think I'm asking these same questions with nearly every post I make here. Of course I can't answer them, but the answers will surely come as time passes. And of course it won't be anything like I imagine it will be, either good or bad. It will be different. It always is. The trick to living is to negotiate that difference as best you can. I gotta say, it will be a lot easier to do that 'negotiation' without a tube sticking out of my abdomen (forgot to say in an earlier post -- it has to stay in until July 27).
We lost electricity in a bad lightning storm last night for about 15 hours. It's back on now, and summer is still happening (the sound of "hot bugs", hundreds of magical fireflies at night, walking around town in the humid twilight, trying to figure what to do in the evening).
Here's what happened: My appointment schedule with Dr. Mark at Weill-Cornell got a little 'off' because of my gallbladder episode. Last week I had made arrangements to come in today for a check-up. I'm still about a week-and-a-half away from the official '100 days' mark for my immune system to be considered safe. Normally I would be seeing him on the 100th day, and I would have had an intermediate appointment with him prior to that appointment. The intermediate appointment was another casualty of my hospital stay. The appointment today, then, wasn't quite to the final mark as a result. However, Dr. Mark believed that (despite the gallbladder) my recovery has progressed well, and he decided that we would call today my '100 day' mark. Ho ho! At one point there was a bit of discussion about putting it off until I returned to the hospital to get my cholecystostomy tube removed in a few weeks, but then he realized that he wouldn't be here, so today became The Day.
This meant that I had a bone-marrow biopsy and a full skeletal X-ray scan. These had already been planned. Lots of blood-work, too. Now here's the cautious-optimism part: The results of the biopsy will determine how well the transplant worked, and those results will be decisive in saying whether or not I'm in -- I almost hesitate to type the word right now -- remission. The biopsy results won't be available for over a week. But the blood-work from today showed no evidence of cancer activity! Ho ho HO!!!!!!!
Dr. Mark and PA Karen both said that as far as they were concerned, I could start today to return to 'normal' life. So we did! An excellent day. I hope the final results from the biopsy don't temper this feeling. I didn't realize what a nice feeling it would be.
I'll take whatever comes -- I have to. Everyone does. Jill has a big week at work; she's leaving tomorrow at 3:30 AM(!) to coordinate a huge water-sampling effort in Barnegat Bay. Lian is heading for a "leadership retreat" that Amazon invited her to attend. Daniel is getting ready to move to Columbia. My gallbladder tube is scheduled to be removed this comin gFriday (yay!), the first day of the Olympics.
And a terrible tragedy happened in Colorado. News comes on the phone, news comes on the television, on web sites. Life changes. It always does.