Thursday, November 30, 2006

Facilitation

My father’s mobility is already extremely impaired and will continue to decline. My mother is filing out the paperwork to acquire handicapped license plates for their Honda Accord–which either my mother or I will be driving as my dad is no longer able to drive himself. The plates will allow my mother to park nearer to, among other places, hospital entrances.

Ca 40.078*

As I write this, my father is at Kaiser in Oakland, having a two hour calcium drip. (I originally thought it was going to be last Tuesday.) I had written that I was unsure of the purpose of the procedure. A friend of my father who is reading this blog sent me an e-mail to explain:

With regard to the calcium drip, I think I can illumine the situation. My mother received these in the advanced stages of her breast/bone cancer. The calcium is introduced with various other agents in order to try to strengthen bones that are on the verge of structural collapse. It is done to try to prevent fractures that might occur just in the context of simple weight-bearing exercise, like just walking to the toilet.

This make sense especially because the cancer has metasticized to his bone.

Enough said.

*Calcium’s atomic symbol and weight.

Roll Tape!

I now understand. The previously discussed audio recording of my father’s description of his professional life is being paid for by the L.S.B. Leakey Foundation (‘LSBLF’) but the actual work is to be performed by the Bancroft Library of the University of California at Berkeley, which has the necessary equipment and experienced personnel.

During a discussion about my father yesterday morning with a friendly LSBLF board member, I stressed the urgency of trying to undertake this task—which I now believe has a chance of succeeding given the [temporary] improvement in my dad’s mood and energy. At dinner last night, my mother told me that she had been contacted by the LSBLF staff person charged with overseeing the recording, late that afternoon.

My turn.

Wednesday, November 29, 2006

But not too Deceiving

There are seventeen steps between the first and second floors of my parents’s home, where my parents and I just finished dinner with and brought by some dear family friends. I arrived while they were already eating and found my father sitting up, laughing, talking and eating. It was really nice to see. In an aside, one of our friends told me that you feel like s*** for the first week after chemotherapy, then you gradually feel better. It has been nine days since my dad’s first course.

But in spite of the evidence and our friend’s statement, I remained reserved. I know statistics. My feelings were justified as I later watched my father walk slowly through the halls of his home, cane in one hand and our friend supporting him at the other. My feelings were underscored witnessing the extraordinary effort my father expended in climbing those seventeen stairs up to his bedroom. He had to stop three times before reaching the top and was winded throughout his labors.

Appearances are Deceiving

I am sitting with my parents, in their ‘TV’ room. We’ve just finished dinner with some close family friends. My father is sitting up, animated, laughing, joking, talking quickly. He ate a reasonable amount of food. He looks and acts the best I’ve seen him in several months. He is shaved. From his tired appearance, his house coat and the cane at the edge of his chair, one might guess he is recovering from a minor illness. But the statistics and the assessment of his oncologist hang in the air.

At the very least, there may yet be a chance at personal and professional audio histories.

Please Come Visit!

Please come visit my parents! My father truly enjoys having someone to talk to and I know my mother appreciates the distraction. Just don’t expect my father to be shaven.

Note: Even after you’ve scheduled a visit, please treat the date as provisional. Call my mother just before you come because my father’s state is protean and he may not be able to receive visitors just then. Thank you.

Calls are also welcome, and don’t require prior arrangement. Just pick up the phone and dial (punch?) [removed]! Do it today. Both of my folks would love to hear from their friends and my father likes catching up with colleagues.

Besides by phone, you can reach my my mother by e-mail at [removed]. I am reachable at [removed], or by cell at [removed].

Tuesday, November 28, 2006

The Truth Hurts

I admit it. Writing this blog is quite cathartic for me, unexpectedly so. I have at times injected a great deal of the emotion I am feeling. It is often the profoundness of the moment that virtually compels me to write. I have discovered this is a common compensatory behavior during times of [severe] depression.

When I began this blog, I declared to myself that I would write honestly and candidly, not shading the truth. You, who are my father’s friends and colleagues deserve no less. Nor, certainly, does my dad. If I were to withhold the truth about his prognosis, his chances for long–term survival, you might come to harbor unfounded hopes or delay actions that in fact demand urgency. But such honestly forces me to be pragmatic and realistic in assessing the facts and circumstances. These assessments necessarily arouse great emotion in me. I love my father dearly and it hurts beyond expressibility to watch him die, both for his pain and suffering and for my impending loss—although I have already lost much of him, and more each day.

As part of this commitment to honestly, I also stipulated that I would not alter what I’ve already written, save for minor edits, principally to correct errant punctuation and misspellings. In particular, I would not delete a post. I’ve violated my deletion rule once, with good, personal reason. I shan’t do it again. I have not forsaken my editing strictures. Thus, I have left in statements that reflect my anguish and pain that were written reflexively as I reported on his condition. (It is reasonable to assume that you or others have already viewed these statements by the time I’ve regained sufficient composure that I have thoughts of eliding them, rendering such actions moot.)

I hope that you are not offended or leastwise put off by these inclusions. Regardless, I ask that you please see them for what they are: A written testament of a son who deeply admires, respects and loves his dying father, his best friend.

Brian

A Minor Load off my Mind

I am pleased to hear that my mother has some temporary day help, a Tibetan woman who normally works for a family friend. My mother is very impressed with her energy and capability. She will be at my parents’s house through Thursday, and then on and off until December 18th. At least now I don’t have to be as concerned about my mother’s health; that she might further injure her back trying to take care of my dad.

Correction

I’ve misunderstood: The calcium drip is scheduled for Thursday. The PET scan is apparently on Friday. Last we talked about it, she wanted him to have a fluid–balancing IV today.

Calcium Drip

Today my father will have a two hour calcium drip at Kaiser, in Richmond. I tried reading up on calcium drips on Google, but what I found was excrutiatingly esoteric. I don’t know whether he will also have an IV to stabilize his fluid levels. I think it might make sense to do it with the calcium drip.

My mother assured me that she would have assistance in getting him to the hospital. Without pressing her, I’m assuming it’s the American Cancer Society.

On Thursday my dad will be given a PET scan to examine his bone density.

Irony

The U-Haul is ordered, pizza promised, and commitments made by several close friends. The lease has been executed. I am committed. I move on Saturday. I offered to live with my parents during this period but my mother was adamant that I have my own home. This was said even as she pointed out that living elsewhere did not preclude my staying in their house, sleeping on my old bed as [she or my father] needed.

Then, Monday night she came to me after dinner (which we ate in her bedroom, while my father picked at his food) and sought my assurance that I would come whenever she wanted me. (I knew that she actually already knew that I will, but I sought to reassure her, even so.) By the looks of things, that will be quite frequently. She has tasks for me to do whenever I am to be at her home and I am sure that their number will increase rapidly. Granted, we are just beginning to discuss hospice care—I am investigating—which would alleviate some of the need for my presence. Still, I expect to be at my parents’s house quite a lot in the near future, sleeping in my childhood bedroom. I hope my furnishings will happy and comfortable in their new home.

Monday, November 27, 2006

He is Dying

I don’t see any improvement. I don’t think the chemotherapy is having any effect. He is worse every day, sleeping more and more. He complains of pain. He is constantly nauseous, hence he eats little. I don’t think there will be an audio history, whether mine, Cal’s or the Leakey Foundation’s. What a tragic loss. The speed of all this is staggering.

I feel so incredibly helpless, watching him die.

Green

Green is the color of money.
Green is the color of nature.
Green is the color of renewal.
Green is the color of the sea.
Green is the color used in the United States to mean oxygen.

Three green and silver cylinders of oxygen, together with a trolley, regulator, extension hose and nose tubes, have arrived.

Snapshot

Scenes from my father’s 81st birthday:

  • He is chronically argumentative and frustrated.
  • He is staying in bed all the time. He has not left it, other than for bathroom breaks, in two days.
  • He is not eating, nor drinking nearly enough.
  • He continues to lose weight.


My mother is concerned of dehydration and is pushing him to have an IV tomorrow to restore his fluid balance.

Oxygen is due to be delivered momentarily.

Friday, November 27, 1925

Today is my father’s 81st birthday.

Hereafter I am celebrating each day.

11/27: A Very Important Date

2003 Scientists warn of potentially vast influenza epidemic
2000 NASA satellite photo of the earth at night
1997 Second Souhane massacre in Algeria
1990 Britain’s conservatives chose John Major to succeed Margaret Thatcher
1989 France performs a nuclear test on Muruora island
1983 Colombian 747 crashes in Madrid, killing 185
1978 SF Mayor George Moscone and Supervisor Harvey Milk are gunned down by Dan White
1975 Ross McWhirter, co-founder of the Guiness Book of World Records, is murdered by the IRA
1974 The ‘Prevention of Terrorism Act’ is passed by the U.S. Congress
1973 Senate votes 92–3 to confirm Gerald R. Ford as VP
1972 Pierre Trudeau forms Canadian government
1966 Uruguay adopts a constitution
1965 1st French satellite launched, France becomes 3rd nation in space
1962 U.S. performs nuclear test at the Nevada Test Site
1961 Gordie Howe becomes first NHL player to play 1,000 games
1958 U.S.S.R. abrogates Allied war–time agreements on control of Germany
1956 F. Goodrich and A. Hackett’s “Diary of Anne Frank,” premieres in The Netherlands
1953 Eugene O’Neill, American writer and Nobel Prize laureate, dies
1951 Cease–fire and demarcation zone accord signed in Panmujon Korea
1950 The Great Thanksgiving Storm ends in Ohio after four days
1948 Honda opens first facility in the United States.
1947 Joe DiMaggio wins his 3rd MVP, beating Ted Williams by one vote
1946 Jawaharlal Nehru appeals to US and USSR to end nuclear testing and to start disarmament, stating that such an action would “save humanity from the ultimate disaster.”
1945 A photograph from the Nuremburg War trials
1944 MacArthur wins battle for Peleliu (the Palaus); a strategic step in recapturing the Phillippines
1942 French Navy at Toulon scuttles ships and subs so Nazis don’t take them
1941 U.S.S.R. begins a counter offensive, causes Germany to retreat
1940 Nazis signs Technical Hague court Delft
1939 The Nobel Committee of the Norwegian Parliment announces that no Peace Prize will be awarded this year
1932 Poland and U.S.S.R. sign a non-attack treaty
1928 Total lunar eclipse
1927 The Persian and Afghan governments sign a second Treaty of Friendship and Security
1926 Italy and Albania sign peace treaty
1925 My father is born

http://www.brainyhistory.com/days/november_27.html
http://en.wikipedia.org/wiki/November_27
http://www.brainyhistory.com/events/1926/november_27_1926_86239.html
http://worldwar2database.com/html/peleliu.htm
http://www.trumanlibrary.org/photographs/search.php?access=selectbydate&date=1945-11-27&labeldate=November+27%2C+1945&page=1

Sunday, November 26, 2006

Sidebar

Ever purchase a birthday card for your cancer–ridden father? It is an interesting challenge.

At length the one I found was perfect.

Green Cylinders (redux)

The oxygen has been delayed. Kaiser won’t provide O2 without a diagnosed need. The diagnosis is made through spirometry. Last I knew, my parents were talking about circumventing Kaiser and just buying it directly. This is probably the best course of action regardless, because given my father’s failing health, I am doubtful that he could sit through the procedure. I’ve had one myself, so I know what it entails.

81 Years

Tomorrow is my father’s 81st birthday. The event is at best bittersweet.

He is not eating, at least enough to be significant. Today he had a can of Ensure® and a glass of orange juice. It is simply insufficent nutrition for his body to stave off the cancer. He is getting weaker every day. I have little hope in the retardant effects of the chemotherapy.

My mother is seeking part–time assistance to help my father with basic physical needs; e.g. showering, shaving. Her bad back simply prohibits her from performing these tasks herself. And yet she has turned down my offer to live with them through my father’s decline. I am nonplussed.

My mother has asked the American Cancer Society to drive my father to two upcoming medical appointments. The service is contingent upon my father being ambulatory at the time of pick–up. We’ll have to wait and see. I will take off work if he isn’t.

Apparently the LSB Leakey Foundation will be recording my father, in addition to Cal. All I can say is that both organizations had better get to it damn fast! The window may already be closed. If you can expedite either activity, I encourage you to do so without delay.

Come visit him. Now.

Friday, November 24, 2006

Green Cylinders

Oxygen is coming. My father couldn’t even walk on a level floor today without being winded. My mother and I are discussing with him about moving downstairs. He is stubborn.

Episode

My dad’s late night perambulations concerned me. I was glad I was around. He eventually wandered downstairs, into the ‘TV’ room, where I joined him and for a while we watched Charlie Rose interview Bill Gates. I then went back to the still smoldering fire and he headed back upstairs, to his bedroom. I heard him gasping for air before he finished the climb. His struggles for breath woke my mother, who called out and must have turned on the light that suddenly shown under their door as I reached the upper floor. At that point I made my presence known and entered their room.

I found my dad sitting on the edge of his bed, hunched over, heaving. It took several minutes for his breathing to ease. When he finally caught his breath, he looked at my mother and rasped “Tomorrow we have to buy some oxygen.” My mother turned away so that my father could not see her expression. As much as I know he will hate it, he will have to move downstairs soon.

Downfall

It is extremely heartbreaking to watch my father’s enfeeblement. Independent. Always youthful for his age. Naturally strong and robust; never broke a bone in my lifetime. Yet just three months have depleted him of strength and energy, and aged him at least a decade. I’ve had to help him up and down stairs. At this moment, I can hear him shuffle–walking through the hallway overhead, his cane thumping on the floor.

And soon the walker, then a wheelchair, then bedridden....

Thursday, November 23, 2006

A Recent Acquisition

It is late. I have been sitting by the waning but still warm fire in my parents’ home. They both went to sleep about an hour ago. It must have been there earlier, but I just noticed a walker, such as are associated with the elderly and infirm, resting folded by the front door. It has a sales receipt from Apria Healthcare, made out in my father’s name. It is mortally depressing in its implication.

Ex Post Feasto

Dinner is over. We are as stuffed as once was the turkey, and drowsy from the overload of tryptophan. My mother’s dear friend Gabriella provided a filling and succulent repast. Together with her daughter and my cousin, they left little for either me or my mother to do. They even washed and put away the dishes. My mother and I are grateful as we are both suffering stress–born cumulative exhaustion.

My father didn’t come down. He just wasn’t strong enough. He remained in bed, in his pajamas. We brought up his dinner, most of which he pecked at. (He’s lost nearly thirty pounds.) Downstairs, I sat at the head of the Thanksgiving table for the first time, a poor stand–in—though I remind myself that I am to own the role hereafter.

We took our deserts upstairs. My dad was clearly by cheered by our presence. He became more animated and talkative than I’d seen in a while. He also vigorously consumed a slice of my mother’s sole contribution to the meal: her famous “not from canned” pumpkin pie. (Yes, I realize that the pie did require some effort of my mother. But it was her election, not obligation. And using a prepared crust made things simpler.) Afterwards, my mother told us that he really enjoyed having people to talk to. He had clearly appreciated recent visits by several colleagues and former students, chatting with them for hours. So please visit him, if you can.

Heroes

I’ve never been much for heroes. As a young child in Illinois during the 60s, my friends dreamed of being Daniel Boone or Davey Crockett. My late and beloved maternal grandmother even gave me an official Daniel Boone faux coonskin cap, which I wore till I outgrew it. Historical and cinematic cowboys, notably Marion Morrison, er, John Wayne, were popular too. Finally, there were the inevitable sports stars; baseball and football players, mostly.

Not for me. My earliest hero was the 16th President of the United States, born in Kentucky but the adopted first son of Illinois. Of course I mean Abraham Lincoln. I would experience a little thrill every time we drove through Springfield on the way to visit my Nana in St. Louis (birthplace of my mother and where my parents met). Granted, Lincoln was an unusual choice of veneration for the typical seven–year–old, but I wasn’t a typical child.

I found additional people to admire as I grew older, including Benjamin Franklin (a remarkable Renaissance man) and a few presidents: Washington; Jefferson; Madison; T. Roosevelt; and FDR. And I’m reading up on Wilson, who is just beginning to get his due. (The Founding Fathers were all remarkable men and uniformly worthy of admiration.) I also discovered the late, great physicist, Richard Phillips Feynman (sometimes called ‘The Best Mind Since Einstein’). But still no athletes or performers. ...I have gained significant respect for Boone and especially for Crockett.

I will never forget last Tuesday. First, an aside with my mother, when she said she didn’t want my father receiving chemotherapy unless it would really benefit him. Then, a little later, sitting in Dr. Cainin’s office on Tuesday, as my mother addressed that very issue with my dad’s oncologist. Finally, listening to my father pragmatically discuss his biopsy, asking to where the cancer has metastacized: “It’s spread to the iliac crest?” After being told that each was positive, I was floored when my dad asked Dr. Cainin whether all of the four biopsy samples had been easy [surgically] to obtain. Dr. Cainin assured him that they were, to which my father happily replied “Good!”

Even as they each face the ultimate truth, albeit from starkly different perspectives, my parents’ composure–without a hint of denial–bravery and selfless compassion for one another–and for me–amazes me. I am proud to say that I’ve gained two new heroes: Clark and Betty Howell.

Foreshadowing

He is very weak today, presumably—or so my mother and I hope—a side effect of the Taxol® and other components of the chemotherapy cocktail administered on Tuesday. But even if only a side effect, his state reflects an inevitable and close future.

Taxol was brought to market in the early 1990s, to great fanfare, after it became possible to produce commercial quantities. The drug was known by the 1970s but production was limited because of difficulties in extracting large amounts from Pacific Yew tree bark, from which it was first isolated. Almost no other drug has been proven to be as effective in fighting cancer, both in terms of efficacy and spectrum. Until just two days ago, I never anticipated my father being a recipient. If only for its palliative effects, today I am thankful for Taxol.

One Last Time

Thanksgiving has always been my favorite holdiay. I adore Independence Day and love Christmas. But Thanksgiving has always been special. Quiet, reflective and familial, free of consumptive pressures (all which Christmas really should be). And an abundance of things I like to eat.

Today is my last Thanksgiving with my parents. Next year, it will be only with my mom. My cousin and my mother’s best friend and her daughter are preparing dinner for us, freeing my mother of a burden I know she couldn’t shoulder, even with my considerable assistance.

Happy Thanksgiving to all who are reading this. Be thankful for those you love and for those who love you. Cherish every moment.

Wednesday, November 22, 2006

Contacting me and my family

Please e-mail me at [removed]. I will happily forward messages to my parents.

Audio History

Last night my father informed me that the University of California at Berkeley is arranging to record an audio history of his professional accomplishments. Cal has apparently committed $30,000.00 to the project. I am bouyed by this. However, there is much more to my father’s life than his extraordinary career, such as the many personal factors that oriented and fueled his life trajectory. My father has agreed to chat with me on such topics, which I shall record.

As interesting as the professional history certainly will be, I think my personal history ultimately will prove the more significant.

Living Space

I have offered to live with my parents. I am extremely concerned for both of them. My mother’s herniated spinal (inter-vertebral) disc debilitates them both. For years my father has been my mother’s arms and legs for heavier tasks—save for the big ones that they always left for me. Now he needs her to help him. And they both need me. My mother said that at the appropriate time she would hire live–in help. I argued the economic sense of having to hire only daytime help and having me, for free, the rest of the time. But in our discussions last night, both were adamant that I live my own life.

Happily, the new apartment to which I am scheduled to move on December 2nd is just over two miles away, on the corner of Gilman and Santa Fe, in Berkeley. (Go north on Santa Fe to Marin. Turn right on Marin and follow it to the Arlington Circle. Thence up Indian Rock to San Luis and on to San Antonio. Under seven minutes.)

After months of extensive and fruitless searching, in Oakland, Piedmont, Albany and Berkeley, I walked into an apartment open for viewing and immediately knew it to be ‘home.’ It was almost exactly what I had been seeking. In what probably will prove to be the only serendipity in these extraordinary circumstances, I found a very nice apartment, that was by chance close to my parents, minutes before I drove to my parents’ home for dinner and they informed me of my father’s cancer.

I know I cannot completely surrender my life for the sakes of my parents. I know I have to continue to work to earn a living. And I have other people in my life who need and deserve my attentions and love as well, principally Kate. My parents know all these things, too. Nonetheless, as they set aside their own pressing needs for me, I find their generosity and love overwhelming. I really do wish they could be a little bit selfish.

Irreversibles

Having seen the considerable effort he expended and discomfort he endured yesterday, simply to get from the hospital parking lot to his oncologist’s office, I am certain that my father is never going to his lab again. Well, maybe for one last tour in a wheelchair, but certainly never again under his own power, to sit at his desk and read or write.

In the packet of materials provided yesterday by Kaiser, in the wake of my father’s formal diagnosis, is an application for a handicapped license plate which will find its way onto my father’s white Honda Accord.

In short order, my dad will be moving from the top–floor bedroom he has shared with my mother for 35 years (one year after they moved to Berkeley) to the guest bedroom on the first floor. This is a consequence of his declining mobility. The stairs are a depleting and challenging obstacle. A cane is already a necessity and a walker and then wheelchair are not far in his future.

Unfortunately, the guest bedroom is equipped with two twin beds. I am considering recruiting several friends to move their queen bed to the guest bedroom so that my parents may continue to sleep together, although such effort probably would be short–lived as Dr. Cainin has suggested a hospital bed for my dad’s comfort.

Tuesday, November 21, 2006

End of a Very Long Day

My father and mother just arrived home from his first chemotherapy session. It took five hours. This was following two hours of dosage calibration. He actually seems better now than he did this morning. Much of that is probably due to a change in his pain medication, which is more powerful and reduces his nausea. I harbor no illusions.

Illusive Time

My perception of time is completely bollixed. It was two weeks ago this evening that I arrived at my parents’s home for dinner and they told me about the cancer, but it seems like the day before yesterday. Yet I feel as if I’ve lived ten years since. It seems like I’ve been writing this blog for a long time. But I just checked and it’s been only six intense days.

Regardless of my perceptions, time is extraordinarily precious–I’ve long striven to live in acknowledgement of that fact but now its value is underscored. There is so little time to do so many essential things; to capture, to learn, to enjoy, to remember, to love, to grieve, to accept.

I knew it...

I knew it when I first heard the diagnosis: metastatic lung cancer. (I understood metastasis.)
I knew it before I looked up the symptoms and statistics at the NCI Web site.
I knew it when I figured out it was stage 4.
I knew it wasn’t lymphoma, the progress was just too fast.
I knew it as I watched him decline, as he suffered.
I knew it when I sat with my parents in Dr. Cainin’s office this morning, and held my mother’s hand. (Dr. Cainin is a very thoughtful, kind man.)

But now it’s official: My father is terminal.

My dad is going to die.

The only issue is when. 50% of lung cancer patients are dead within eight months of diagnosis. 98% are dead within five years, and most of the remaining 2% were young, healthy and caught at stage 1 or 2. More than 80% of its victims smoked regularly. Given my father’s age, health and advanced stage, it won’t be long.

For cancer victims like my father, chemotherapy is not a curative—though it may be a palliative. At best it is a retardant: It typically extends life 2–3 months, albeit some patients respond while others don’t at all: “The cancer doesn’t seem to notice it.” [Dr. Cainin] My father is having his first round of chemo even as I write this. We’ll know within two weeks if it is having any effect in retarding the advance of his disease.

Happy Thanksgiving.
Happy Chanukah.
Merry Christmas.
Happy New Year.

It doesn’t matter how much he has accomplished. It doesn’t matter that he will be 81 next Monday (yes, his birthday) and has had a reasonably long life. It doesn’t matter.... There is no consolation. I am going to lose one of my two best friends in the whole wide world. (My mother is the other.) My dad is going to die. Soon. And I have a front row seat. My pain is indescribable.

Monday, November 20, 2006

If someone you care for smokes...

Please, please, please do everything you can to encourage and help them quit. Right now. In the past twelve months both my aunt (my mother’s sister) and my father have contracted lung cancer. Both were long–term smokers, though both eventually quit—my father eight years ago, after 63 years. The risks are far too high, for your smoker and for you.

Recommendations

Please come see my dad. Soon.

Please tell people who should know about my dad’s condition. Now.

Deduction

I am my father’s son. Like him, I tend towards empirical, deductive reasoning:
  • Lymphoma, the most treatable form of lung cancer is treatable with a pill.
  • My father is going to be given chemotherapy (which is not a pill).
  • My father does not have lymphoma.
  • My father has a much more serious form of lung cancer.
  • The odds for his long–term survival, not that they were good to begin with, just dropped significantly.

I am beyond the ability to express the depths of my saddness.

The Results Are In

In spite of earlier estimates of ten to twelve days for an assay, the results of my father’s bronchoscopy are already completed. Drs. Lin and Canin, my father’s pulmonologist and oncologist, respectively, called this morning. They want to discuss the results tomorrow morning with my parents, in person. (I am very apprehensive.) At least we won’t have to spend another week suffering in ignorance and fear.

My father is going to have his first round of chemotherapy tomorrow—after which I know he will feel completely awful—immediately after he meets with his physicians.

Please help spread the word

My father has friends and colleagues around the world. Please help me publicize his condition by e-mailing a link to this blog to anybody you know in common with him. If you are uncomfortable being the bearer of such news, please provide me with a phone number or e-mail address and I will make contact. I can be reached at [removed].

In particular, I would like to notify:

  • Richard Leakey
  • Don Johanson (long estranged from my father, but hopefully bad feelings can be set aside at this point)
  • Leslie G. Freeman (former graduate student, longtime collaborator and good friend; emeritus of the University of Chicago, now living somewhere in Montana)
  • Yves Coppens

I will be amending the foregoing list as names come to mind.

Thanks,

Brian

Sunday, November 19, 2006

A Correction and an Update on the Audio History

My father’s next oncological appointment is this Tuesday, not Monday. I’ll post afterwards.

I will be beginning the Audio History on Tuesday.

Saturday, November 18, 2006

The F.C. Howell Audio History Project (update)

If you don’t already know about the project, please read this post first.

I believe time is of the essence. I’m dubious as to whether my father will have the strength to complete even a portion of the topics I’ve outlined—save any that you care to suggest. With the recording equipment due to be delivered on Monday, I want to start on the history Tuesday.

As much as I would like to commit every of my waking moments to this essential effort, I cannot. Therefor, I ask for your help. Come, visit my dad. Choose a topic and ask him about it (while recording). My father would certainly appreciate the company and the results of this project will be very worthwhile.

Sincerely,

Brian

Post–bronchoscopy Update

My father underwent a bronchoscopy and biopsy yesterday, at Kaiser Foundation Hospital in Walnut Creek, California. The procedure took 4.5 hours, during which my mother waited alone, I’m sorry to say. Four tissue samples were taken for analysis. It will take from ten to twelve days to perform the assay (culture and examine the tissue). For more details on the procedure, issues and risks, and for definitions of terminology, please see these previous posts:

He and my mother are now at home. He is resting comfortably.

Apparently to my mother’s surprise, after the procedure they were given an appointment with my father’s oncologist for Monday. I think my mother didn’t expect any further interaction until after completion of the assay. My imagination runs wild with possible reasons; few are optimistic.

His condition clearly is worsening. Just since the diagnosis a week ago Tuesday, he as lost an appreciable amount of additional weight, is more depleted, and is frequently nauseous. The odds for his long–term survival are poor and declining.

Friday, November 17, 2006

Stormy Weather

I arrive at my parents’ home. My mother greets me rather cheerfully. I head upstairs to my parents’ bedroom, where my father is spending most of his time. He is in bed, under the covers. He smiles and says “Hello.” We chat amiably. He asks me about my date.

We feign normalcy. Tempests of depression, fear, frustration and helplessness rage in each of us, just below the surface. We are all lousy liars.

Today’s Activity

In a few hours, my father will undergo a bronchoscopy. The doctors will examine the 3" long mass (tumor) near his trachea and perform a biopsy to determine whether it is lymphoma, relatively treatable, or a different, more dangerous type of cancer. The entire procedure will take 4.5 hours. Then we just have to wait ten to twelve days for the results.

For more details and links to definitions of terminology, go here.

I’ll write a follow–up post after the operation.

Thursday, November 16, 2006

Equilibration

After many years of searching, long past the threshold of optimism, a void in my heart is being filled. I see her face and the world scintillates, the sky turns bluer, the air smells purer. I hold her hand and warmth spreads throughout me. I kiss her lips and I am filled with joy. I want to revel in these precious moments, while love is still new.

And then I see him and the color drains from the world. I hold his hand and desperately wish I could give him my strength, a portion of my very life, to help prolong his. I kiss his forehead and have to leave his room for the tears start to stream. And now I fear a new void is incipient. One nothing ever will be able to fill.

The universe is capricious and heartless.

Your Comments, Questions and Messages

At the bottom of each post (dated entry like this one) in this blog, you will find a comments link, preceded by the number of comments to date for the post. Click on this link to provide your feedback or comments to the post. Regardless of the post’s topic, you are also welcome to add questions to me and messages for either of my parents, which I promise to forward to them.

Thank you.

Audio History Topic Outline

In thinking about topics for his audio history, I am struck by the remarkable breadth and depth of my father’s life. What follows is just a start, a fraction of the possible topics on which I know he could expound (and propound). And any one of them probably could serve for many hours of discourse. I expect to add to it myself and from your suggestions.

  • Personal Life

    • Growing up in Kansas and Nebraska

      • His parents
      • His sisters, Liz and Margaret
      • Going on sales trips with his father
      • Schools, public and private
      • Growing up in the depression
      • Bankruptcies, foreclosures and sheriffs’ sales
      • Contour farming (which my grandfather helped to pioneer)

    • Joining the Navy in WWII.
    • Attending the University of Chicago

      • Initially studying anatomy
      • Switching to anthropology (why?)
      • Friends and girlfriends
      • Listening to jazz and gospel music

    • Saint Louis

      • Washington University
      • Arthur Hess (my uncle)
      • Meeting and marrying my mother
      • His mother-in-law (my maternal grandmother)

    • My parents’ first apartment
    • Moving to Homewood, Il.
    • Adopting me

      • Heartbreaking delay (Thelma and Al Dalhberg’s party)
      • My epilepsy (seizures) and medical issues

    • Sabbatical in Berkeley

      • Model trains (discovered Ace Hardware)

    • Moving to Flossmoor, Il.
    • Adopting my sister, Jennifer.

      • Sailors knots on her crib

    • Nicknames for his children: JCH/JC, BDH/BD/Pooh[bear]

  • The offer from UC Berkeley
  • Leaving Illinois and moving to Berkeley
  • Errata

    • Politics (why a Liberal)?

  • Professional Career

    1. Early Man—writing the Time Life book.
    2. History of the L.S.B Leakey Foundation

      1. Who was Allen O’Brien and how did he meet my father?
      2. Gordon Getty’s role
      3. The Early Years

    3. Research and Fieldwork

      • The multidisciplanary approach (genesis of)
      • Isimila Tanzania
      • Ambrona and Torralba Spain (the early years)
      • Omo Research Expedition
      • Ambrona and Torralba Spain (the later years)
      • Turkey
      • Other places...


  • Friends, Colleagues and Students

    • Louis, Mary and Richard Leakey
    • Leslie Freeman

Qualification: Cold Facts

Yesterday, I said my father was at risk of an aneurysm. The proper phrasing is that he is at risk from an aneurysm he already has.

The F.C. Howell Audio History Project (cont.)

I’ve ordered both a digital voice recorder and a digital video camera from Amazon.com, with expedited shipping. They should arrive by Monday, November 20th.

The voice recorder is able to store over sixty-five hours of audio, without having to change tapes or perform any other maintenance. The recorded audio will be transfered to my computer where it may be edited. After transference, the recorder’s storage will be wiped clean, allowing it to store more audio. The edited audio will be put onto CDs, into audio files (such as could be played from a Web page), and eventually transcribed to print.

The camera records directly to recordable DVDs. Each DVD provides nearly two hours of recording time. Further, modern computers, such as my Macintosh laptop, can read the information from the DVD (not just play the contents). With the native applications provided on my laptop, I can then edit the video and subsequently write the edited video back to DVDs or into movie files that could be viewed from a Web page. As desired, I could also strip (take only) the audio, treating it as like the audio from the voice recorder.

Both devices will be powered by AC adapters (backed up with batteries), helping to ensure reliable and continuous operation.

I still have to find a good microphone and a camera tripod. I hope to procure those this weekend, and begin recording my father next Monday. Please join me in this effort!

Binary Math

Most of you know that I work with computers. As a consequence, I am very familiar with powers of 2; that is the number 2 multiplied by itself zero or more times. Mathematicians use the notation xy as a shorthand to represent a particular number x multiplied by itself y times. It’s read as ‘x [raised] to the y power.’ Thus, as shown below, 25 means 2 × 2 × 2 × 2 × 2 or 32.

2 (2 or 21)
4 (2 × 2 or (22)
8 (2 × 2 × 2 or (23)
16 (2 × 2 × 2 × 2 or 24)
32 (2 × 2 × 2 × 2 × 2 or 25)
64 (2 × 2 × 2 × 2 × 2 × 2 or 26)
128 (2 × 2 × 2 × 2 × 2 × 2 × 2 or 27)
256 (2 × 2 × 2 × 2 × 2 × 2 × 2 × 2 or 28)
512 (2 × 2 × 2 × 2 × 2 × 2 × 2 × 2 × 2 or 29)

Each successive number is double the previous. And they get big very quickly.Very quickly. Three more doublings (212) and we reach 4,096. Four more beyond that (twelve more in all: 29 × 23 × 24 or 216) and we get 65,536. Here’s a table of all powers of two through 21,058. Numbers that are powers of 2 are called binary numbers (bi is a Greek prefix meaning two).

When you plot (draw) these numbers on a regular graph, the result is an exponential curve resembling this one, which happens to be a curve describing population growth over time. As we progress forward in time, the steepness (slope) of the graph increases, approaching but never reaching true vertical. At no time does it trend back towards the horizontal. (This is discounting limiting factors such as nutrients, water, land, housing or senescence, which vary by the type of population. Nor does it recognize external events such as the death of the host in the case of viral colonies.)

Okay, so what does all this have to do with my father? Well, if you haven’t picked up the hints I’ve dropped so far (they were relatively sophisticated), replace the word doubling with generation, as in cell generation, and you can begin to understand how the cancer progressed and spread as quickly as it did.

Assuming that there was just one mutant cell on August 15th and a conservative eighteen hour cell division time, that means over 125 generations by today. 2125 is a very large number: 42,535,295,865,117,307,932,921,825,928,971,026,432. Even if we start accounting for senescence and other factors, we still wind up with incredibly unnerving values. And that’s how my father could appear to be fine in August and in such dire straits just three months later.

The clock is still ticking. Even as we wait ten to twelve days for the result of the first of several expected biopsies. I wish I couldn’t do the math.

You can learn more about cancer cell population growth here. Admittedly, it is a site aimed at those with a scientific or mathemtical background. However, the Model of Exponential Growth movie found below right on the page should be accessible to almost anybody. Click on the word Play to view it.

Shocking and Sweating

I think what is most shocking to us (my family) is the swiftness of the cancer’s progress. My father had a chest x-ray in August that showed nothing untoward. Just over two months later, he is stage 4: metastatic tumors—including one three inches long. And now it’s going to take ten to twelve days for the assay to be completed after tomorrow’s broncoscopy and biopsy. (I thought the procedure was today but I was mistaken.) Ten to twelve days before we know the main type of tumor we’re facing. My parents will need the support and love of their friends more than ever during this period of troubling uncertainty.

Wednesday, November 15, 2006

Cold Facts

Both my parents really need the support of their friends right now.

It’s stage 4. You can look up the statistics on Google (links to search results).

I had a long talk with my mother this evening. Contrary to what I was lead to believe earlier, there are multiple sites in his lungs and probably it is in his bone. I’m not sure now whether I was a victim of hearing what I wanted to hear, or that my father was trying to shade the severity of his illness.

He is also at risk of an aneurysm.

I’m devastated.

Pulmonary Appointment

Today my father saw a pulmonologist at Kaiser Foundation Hospital in Walnut Creek, California. Of interest is a prolonged “body of tissue” on the upper right side of his trachea. This is the major area of concern with regards to the cancer.

The issue is whether the tissue is a lymphoma or a malignancy. In the case of the former, treatment is simple: a series of pills that rapidly shrink such tumors “almost as fast as they grew.” However, if it is a malignancy, then treatment will consist of chemotherapy, probably followed by a course of radiotherapy. Tomorrow he will be sedated and examined using a bronchoscope and, presumably, a tissue sample will be taken for biopsy.

After further examination, the jury is still out concerning the spots in his lungs and the presumed metasticization to his bone; some or all of the musculo-skeletal pain he is experiencing could be due to age-related calcium loss. He will be given a PET (Positron Emission Tomography) scan probably on Friday, November 16th, to examine his bone density. A separate biopsy of his lungs is to be performed next Tuesday (November 21st). Possibly causes for the lung spots include damage from smoking and also several bouts of childhood pneumonia.

Both my father and mother tell me they like and are confident in the physicians caring for him. Given the incredibly high standards for which each of my parents are known, these assessments amount to high praise.

Thanks

I would like to thank everybody who has visited my father, or called or written to me or my parents concerning my father’s health. In the past few days he has seen a number of friends and colleagues, and we’ve heard from many others, including a former graduate student of my father from his days at the University of Chicago. I know both my dad and mom really appreciate the attention and many good wishes.

The F.C. Howell Audio History Project

At one time or another, many of you have heard some of my father’s remarkable stories. They range from tales of his midwestern childhood to comic, globe–trotting travel adventures with my mother to recollections of arduous and remarkable field seasons in Africa and elsewhere. I have long thought to capture them for posterity’s sake and now, given the exigencies with which he is faced, can think of no reason to further delay. To the contrary, immediacy certainly is in order.

I will be purchasing video and audio recording devices, and a collection of blank storage media. If you are local, I invite you to come visit my father, wherever he is (subject to my parents’ convenience, of course), and simply ask him to tell you a story, while recording. Those of you far away, I encourage you to think back to experiences you shared with my father, and e-mail me or post (add a comment herein) with the details, that I may prompt him to recount. The final output will be edited and cut to DVDs and/or CDs, and audio (MP3) files. A written transcription is also a possibility.

I look forward to hearing from and seeing many of you.

What we know so far

On Tuesday, November 7th, following a CAT scan, my father was diagnosed with metastatic lung cancer. The disease apparently has already spread to his lymph and bone. The scan was made subsequent to a chest x-ray which revealed irregularities. Prior to these procedures, my father had been coughing chronically for weeks and was feeling poorly—and he had lost and continues to lose weight. For now he is at home, spending most of his time resting.

We do not know yet what treatments are available. Presumably, because the cancer has already spread, he is not a candidate for either surgery or radiation, leaving chemotherapy. He will have a biopsy within the next few days and we should be better informed thereafter.

I am sure that my parents would appreciate hearing from you. I know that my mother would benefit from whatever emotional support you could provide.

You are welcome to post comments and questions. I will respond when I can.

Sincerely,

Brian Howell
(Clark’s son)