Category: Healthcare

Osimertinib

Yes, Osimertinib. It’s an anti-cancer drug. It derives its power to fight my particular cancer from a test having been done to determine the genetic nature of the cancer that I now have.

Journalists often like to describe those of us suffering from it as “battling” cancer. Well, with me, there is definitely battling going on, thank goodness, but I am only a very minor warrior in the battle. My major involvement is that my body is one of the many battlefields in which this sort of battle is happening. (I seem to recall that Christopher Hitchens said something like this in this.)

My “strategy”, if you can call it that, has been to proceed on the assumption that the judgement of the Royal Marsden’s cancer experts, about what will give me the best chance of a bit more life, is my best bet. I’m not second guessing these people. I have done very little reading to determine if their treatment makes sense. I am simply of the belief that their best guess is better than anything else available. Friends who have dug deeper, including my sister the former NHS GP, have given me no reason to doubt my bet. On the contrary, they agree about how very lucky I am to be living near to the Marsden.

I am taking my Osimertinib in the form of tablets, one each day, because this is what my seniors in the battle judge to be the best treatment. This evening, I just swallowed the sixth of a course of thirty such tablets that I have been proscribed. I have been told that right around now, I might start feeling rather better.

So, am I feeling any better? I think so, but I’m not sure. I have recently been rather ill. Headaches, shivery skin, weakness in the limbs, increased coughing, a runny nose, that sort of stuff. This felt like it was the cancer getting worse. But what if I was just, you know, ill, as a distinct thing? And is all of that illness getting less bad now? Rather hard to say, but I would say, probably, yes. It all feels complicated.

I have retreated into my comfort zone. By doing daily postings for here. By keeping more than half a nocturnal ear on the cricket, both in Australia and in Sri Lanka. By listening to music and by reading stuff. And, in addition to more nutritional food, I’ve been having occasional servings of salted caramel ice cream. Basically I am taking the pills, and waiting for them to work.

Wish me luck.

A quota photo – and why I (and 6k) like quota photos

Rough day today, what with the steroids having stopped. They definitely had a mental as well as physical effect. So quota photo time, this photo has been picked pretty much at random from the archives:

What made me pick it is that that’s not just the Shard, in a general way. It’s the Shard while they were still building it, the photo dating from March 2012.

The quota photo was one of the notions that South African based blogger 6k was kind enough to write about recently in connection with my blogging. And I do indeed think quota photos have value (as does quota blogging more generally). Just shoving up a photo like the one above is hardly going to spoil anyone’s day. After all, a photo can be skipped past in seconds if it does not appeal. On the other hand, it might just pack a bit more punch than that. So what’s to lose? I’m in a rush now, but maybe I’ll manage a comment, with a link or two maybe, to the effect that some of my favourite 6k photos over the years were often first posted as mere quota photos, which he posted just so as to post something. Yet I especially liked some of these particular photos in particular.

Maybe part of it is that a quota photo can be one of those photos that you just like, for no very obvious reasons that makes you want to attach an essay to it. Normally, you might hold it back until you decide what it means. This way, you just shove it up, and then others can like it too.

As for my quote photo above, I have, I think posted various versions of the above, where the Shard is aligned with one of the pinnacles of the Tower of London, but not this particular one.

I like that it includes a crane.

Hitchens talks to Paxman

I fear that I may now be an I-may-be-about-to-die bore. In the sense that I can think of nothing which I am now doing or saying or even thinking which is not happening under the shadow of my recent lung cancer diagnosis. And given the subject matter of this particular posting, any pretence along such lines would be absurd. Which is why I start with that now. Which could get very boring.

Anyway, what I want to link to is this video, lasting about half an hour, in which Jeremy Paxman talks with the late and then staring his about-to-be-lateness in the face Christopher Hitchens.

Here’s a still from this video, which I think I am presenting because one of the many things I like about this conversation is how Hitchens looks. His head entirely shaven, his face serious, the very picture of a ancient stoic, looking both at death and at the kind of life he might have to suffer before death with an unflinching gaze:

Hitchens’s appearance reminds me of that of my friend and fellow Samizdatista, Paul Marks. “The Sage of Kettering”, as the Samizdata commentariat refers to Paul, looks a lot like this already, despite the fact that to the best of my knowledge Paul is only going to die in the same medically relaxed sense that we all are.

The link to this video was, of course, sent to me, by a friend who had learned of my current medical predicament and thought that I might appreciate learning about it and watching it. Which I very much did, having missed it the first time around.

The friend picked out a bit right at the end, where Hitchens says that he especially appreciated communications from strangers who had in one way or another appreciated something that he, Hitchens, had said or written or done. “If in doubt about whether to send me such a message, do not hesitate. Send it.” Or words to that effect.

He added that he regretted having failed to do this for others in similar circumstances.

I agree on both counts. I am being very cheered up right now by all the kind things that I have persuaded various people, not a few of them pseudonymous Samizdata people whose identities are otherwise unknown to me, to say to me about my own various sayings and doings over the years. And I too regret having failed to do as much of this as I could and should have, when I saw valued friends and intellectual comrades nearing their ends.

New category in the category list below: Death. Here’s hoping that at least some of the remaining postings I manage here are not thus tagged.

By the way, that could be quite a few more. Hitchens was facing the certainty of death, pretty soon, when he did this interview, and he duly died soon after it, I believe. Not long, anyway. All I can really say about my lung cancer is that it sounds pretty bad. But that might merely mean it being pretty bad for quite a while longer.

Piece at Samizdata about the diagnosis/treatment imbalance in the NHS

Not much here today, what with yesterday’s dramas, but I have just ripped off a Samizdata piece, based on my recent medical experiences, entitled On the British National Health Service imbalance between lethargic diagnosis and really rather good actual treatment of serious medical conditions.

It features a link to this mighty beast:

That’s “Brunel”. Brunel has been giving me my first actual doses of cancer treatment, the third dose having been this afternoon. Two more, tomorrow and on the 31st. These treatments have been merely defensive, to stop my spine being damaged by the lung cancer tumor. Next week, if all proceeds as I hope, the actual attack on the tumor and on its spreading consequences will get under way.

I have lung cancer

This afternoon I sent out an email message to about fifty or more of my nearest and dearest, saying that I now have lung cancer. Since among my nearest and dearest are those who read this little blog of mine with any regularity, here is the full text of what that said, for all you good people also:

A message from Brian Micklethwait to as many of his friends, relatives and loved ones whom he can now think of to include in this email list.

Please pass this on to anyone else who you think would appreciate hearing about it, with whatever added apologies make sense for me having neglected to include them on the list to start with.

*****************

Dear friends, relatives, loved ones and well-liked ones:

About a week before Christmas, I learned that I am suffering from lung cancer. I had known for a while that something bad was happening. Apparently I have had it for some time, and it has been spreading. From what doctors are now telling me it seems that I may die quite soon. They don’t put it quite like that, but that is how it now sounds.

But, it may not be quite that bad. Being doctors, they are also giving me reasons for optimism, in among the gloom.

First, I do not have the usual sort of lung cancer, the sort brought on by prolonged and heavy smoking, having never been a smoker of any kind. I am told that this sort of “anomalous” lung cancer tends to respond better to cancer treatment than regular smoker-cancer usually does. I suspect that my very dusty home may be part of what set my cancer off, but the doctors prefer to doubt that, at any rather when they speak to me. Genetics? Other unknown environmental triggers? They prefer not to speculate and just to get on with treating me.

Second, cancer treatment has come a long way in recent years. A doctor recently told me that, had I been in my current condition a decade ago, his advice would have been: “Call your lawyer, your priest, and your undertaker, in whichever order you prefer.” Now, my chances are much better.

Third, because I decided to throw the kind of money I can spare at the private medical sector for the diagnosis part of my problem, my condition is now well understood, and I am now, already, getting cancer treatment, from London’s Royal Marsden Hospital in the Fulham Road, which is about as good as cancer treatment can be nowadays.

And, I’m getting this treatment on the NHS. The NHS is overwhelmed by people who have or say that they have medical problems of all kinds and degrees of severity. Had I relied on the NHS to learn the bad news I needed to know, I would probably still not know it. But, once the NHS knows that you have a serious and potentially fatal condition, it then moves fast, and not just technically well but with great human sympathy, if my early experience of treatment is anything to go by, and if what my doctors and my medically expert friends and relatives (such as my sister who was an NHS GP until she retired) are telling me is so. Especially if you are lucky enough, as I am, to live a mere walk away from the Marsden.

So, wish me luck. I may yet live for quite a while. My condition may stabilise. I may even recover. I now doubt that, but you never know.

Some of you will be content to tell me you are very sorry about all this, and that is fine. Such messages mean a lot, and if that is all you want to say to me that’s still a great deal. Just knowing that there are people out there who sympathise means a lot more than you might suppose. (A word of warning. Those who phone me may be subjected to some coughing at my end, a continuous cough having been one of the early signs of trouble.)

If, however, you would like to know more about how to help me in my weeks or months of misfortune, then keep reading, and I’ll tell you. (I have already embarked upon the years version of this scenario, being already over seventy years old.)

The problem is that, especially in these very socially separated times, physical help can be rather hard to contrive. Besides which, very close friends and relatives are already supplying crucial support in ways that are already helping me and cheering me up enormously. Thanks to them, and to the treatment I’ve already been getting, I have had a surprisingly cheerful Christmas.

But, there is something else I ask you to do, should you be so inclined. Don’t just email me about what you can do to help, email the person who is acting as my Senior Coordinating Friend, so to speak. This is Elena Procopiu (she at the top of the email list above). She is the elder sister of my beloved Second GodDaughter, and I am very close to her entire family. Email her, as well as me. Communicate with her about what you might be able to offer, should you be inclined.

I’m sure that all kinds of assistance, such as experience of similar circumstances as well as merely physical help, may materialise in this way.

But, let me now tell you what would really boost my morale.

Tell each other which of my writings you have most liked, and do so just as publicly as you feel inclined. Blogs postings, blog comments, social media, the lot. My circumstances are now no secret. If I do die soon, I would greatly prefer to do this in the knowledge that various things that I have said and written over the years have left behind them a trail of enlightenment and entertainment, and might be fondly remembered, for a while at least.

This is quite a lot to ask, because I fear that my more impressive pronouncements are scattered in amongst a vast pile of trivia and obfuscation. But, if you want now to cheer me up, try to dig out some of the more worthwhile things that you think I have said and done – often just sentences or paragraphs rather than longer and rarer stretches of eloquence – and hold them up for a bit of admiration and reflection.

Maybe there are photos I’ve taken over the years that you happened particularly to like. Recycle or link to them too.

Here might be a good place to start.

Or you could try here here.

Or here, which still seems to be working after a fashion.

Or you might care to sample some of these recent efforts, if you have the time.

If you recall having attended one or some of my last-Friday-of-the-month meetings at my home, perhaps because you were kind enough yourself to be the speaker at one or some of them and found that particularly helpful and stimulating, then please take the time to tell any other people who might be interested about that.

This is a lot to ask, but if you don’t ask for what you want in life, or in my case potential death, you are far less likely to get it, and this is what I want. If only a few people feel inclined to say and do things along these lines, it would cheer me up lot as I make my exit, if that is what is about to happen.

A late thought. My deadly sin has always been sloth. Had I merely died, one fine day, just like that with no warning, it is almost certain that I would have died failing to say or do many of the things I would have most wanted to say or do before going. As it is, having now been told about my possibly imminent death before it actually comes may turn into something of a blessing for me. Live every day as if it is your last, we are often told. That is pretty much what I am now doing, as best I can manage in my now weakened state. I still have a few public pronouncements that I’d like to offer to the world before I go, and there is every chance that I may now manage to say at least some of those things, the way I probably would not have done had I just died with no advance warning, and even if I had lived for quite a bit longer.

Which I may yet be lucky enough to do. If so, win-win.

Even if it goes win-lose, I don’t feel that I deserve the sort of send-off I am asking for. All my life, I have been showered with advantages, not least in the form of more unearned wealth than most inhabitants of this planet could ever dream of having bestowed upon them. I have not done nearly well enough as a communicator, given all the chances I have had, for me to be able to expect the sort of send-off that I would like and for it to happen of its own accord.

But, I nevertheless ask for it. This is what I would like.

It is putting it mildly to say that not everyone on this email list shares my political inclinations and attitudes, or for that matter aesthetic tastes and opinions. So if all you really want to say to me is: “Bad luck mate. Nice, on the whole, to have known you”, well, I’ll gladly take that.

I’ve tried quite hard to avoid grammatical errors and mis-spellings in this, but some will inevitably remain. It’s now time to stop this and just send it out. More to come, I hope, maybe from me, maybe from others, with news of medical progress, or perhaps just with news of how it all turns out. But if not, then: not. It was certainly good knowing all of you.

All the very best to you and yours,

Brian Micklethwait

If you are personally known to me and want to get in touch with my very dear friend Elena Procopiu, mentioned in the middle of the above text, I suggest you leave a comment below to that effect, and I’ll be sure that the connection is made.

But not such a merry Christmas for her

Most dogs whom we encounter in nice, polite, safe little England are dogs who have bonded with humans, whom the dogs love, unconditionally. But what happens when dogs don’t bond with humans, but only with one another? Then, they are liable to love humans in another way, as in: I love duck, or I love rabbit. To eat. Ooh look guys, fancy some tasty human?

DOCTORS are today fighting to save the life of a woman whose face was completely skinned by a pack of stray dogs.

Where did this horror happen?

Relax. In Russia:

The predators ripped off all Tatyana Loskutnikova’s clothes and gnawed her flesh down to the bone during the sickening attack in Russia.

In Russia they have hungry packs of dogs. Like these, who were only doing what surely made perfect sense to them. Hellishly bad luck on the woman of course, but maybe she might have known better? Yes, you shoot the dogs, as they did. But you can’t really blame them, the way the Sun seems to.

The return of the black-all-over London black cab

I was out and about in the Victoria Station area this morning, and it was very cold and very bad photoing light. But, taxis with adverts usually photo well. I saw two taxi adverts I’d not see before.

This, for perfume:

And this, for I don’t know what, but I’d not seen it before:

It had the look of the sort of advert that only happens when when the real advertising is happening a lot less, and they have spare slots going.

Because, that was my overriding impression. Hardly any taxis with adverts, whether I’d seen them before or not. And lots of taxis without adverts:

The ratio was about three or four to one, no advert to advert.

Then, the clincher:

That’s right, a taxi with an advert for taxi adverts. A taxi advert in both senses, in other words. An advert for taxi adverts, on a taxi.

So, here is just another business going through very bad times. Has anyone, I wonder, committed suicide because he’s in the taxi advert business, and is heading for unavoidable financial disaster? It’s not a silly question.

There are just fewer people, and in particular far fewer high spenders and deciders-of-these-things, wandering about in London being influenced by such adverts.

I hear conflicting rumours and stories about just how bad, medically speaking, the Coronavirus story really is. In particular, I am hearing that it’s not just deaths that are freaking out the decision-makers, but the serious and often long-term damage done to people who don’t die. But I am still strongly of the belief that the cure is one hell of a lot more damaging than the disease.

I have my internet connection back (thanks to The Guru)

Indeed. So that means I can post things properly, using all my fingers rather than just one, on a screen I can actually read without taking my glasses off and without putting that screen one inch away from my eyes. The nightmare, for the time being, has ended.

My thanks to Michael for yesterday’s posting, telling you all that I hadn’t died, but was merely out of touch, and for general moral support.

And my special thanks to The Guru, for talking me through all the intricacies of getting reconnected. My best guess is that in the aftermath of the Eclipse outage starting, I tried to rescue matters and that was when it really got bad, because then, when Eclipse got back on track, I didn’t.

One thing I can tell you. Internet outage trumps rather bad health. If you are poorly and without an internet connection, the priority is to get your internet connection back again. Then you worry about health. Or, maybe that’s just another way of saying that my health is not that bad. I suppose if you’re dead, getting your internet back wouldn’t make that much difference.

Anyway, hello, again, and it’s great to be back and gibbering away incontinently, rather than “texting” on the abomination that is my horrible, horrible, insane, mobile phone. Thank goodness (the goodness of The Guru) I don’t now have to start faffing about posting photos on that damn thing, and can go back to using a proper computer, in a big old suitcase, with a big old screen and a big (although actually not that big) keyboard with actual keys on it, and a mouse, as nature intended.

I’m pretty sure that’s not the problem

I made my trip (see below) to Chelsea and Westminster Hospital, and the trip had the effect of making the state I was in, i.e. the reason I went, worse. Any posture is uncomfortable for me just now. Even just sitting in a moving bus is a bit of an ordeal. So the X-raying was no fun, especially when I had to lie down. They wanted my toes pointing inwards, for some reason, and that was, it turned out, particularly uncomfortable. But they were very nice and didn’t waste any time, and here I am back home.

But not in any state to post more than one quota photo, of a sign, in the cubicle where I went to get changed beforehand:

As of now it is unclear what is/are the cause/causes of my present bodily discontents. For more about that, I must await the X-ray results. But I think we can cross that one off the list.

This did make me worry that I was in a seriously wrong place, though. No matter how much they smother a big and busy place in signs, if you’re visiting it for the first time, you get things wrong. I still don’t know if I committed any violations of a woman’s right to a safe space. I encountered no angry women, so no harm seemed to have been done.

Life at the top of the slope

I am about to journey to the Chelsea and Westminster Hospital, at the far end of the Fulham Road, to get two distinct sets of X-rays done. Chest, and hip. I have been coughing a lot. And I have pains in and around the arse, back, right leg, and nearby spots. It kind of moves around. “Pain in the arse” is now yet another of those hitherto innocuous phrases which have become filled with meaning in recent weeks. Not the actual orifice itself, you understand, just the bones – or is it the muscles? – in that general area. “Old fart” and “under the weather” are other common phrases that have both, for a while now, made a lot more sense than they did when I was younger.

I am at the top end of the slope, at the far end of which is: death. My body is just beginning seriously to disintegrate. Two years ago, I could stride about London for hour after hour, or babble away on the telephone without a care. Now, not so much. The majority of the efforts of the National Health Service seem to be devoted to looking after the likes of me, softening the blows of ever older age, and thereby prolonging it.

I am hoping that this first serious clutch of discomforts will be curable, or at least treatable after a fashion, to the point where I’ll be able to walk and talk more fluently than I do now. But I do not now assume this.