(2) 3 May 2012 – Morning of Surgery

No breakfast for me, or lunch either. I’m not even allowed to drink clear fluids, since it’s less than four hours before my 10:30 AM check-in. But I cheated and had half a glass of water.

I like the surgeon, and feel I am in good hands. Nevertheless, I will talk to him carefully before the surgery, just to make sure he knows the lymph node to be removed is in my left armpit. I will point to it. You can’t be too careful about these things. A friend of mine had cancer surgery on the wrong breast. She was told, “Good news, we got it all!”

Thus I natter on, moaning and fretting about what I have to do, what the day will bring. I already feel out of whack, missing my morning coffee, grapefruit, fried eggs and toast. I anticipate the hospital gown, tied at the back, probably light blue. The funny socks, possibly green. The waiting, fully conscious, for the anaesthesia to knock me out—and not noticing, of course, when it does.

I rehearse the post-surgery conversation, about ten days from now, when the pathology report is in. I must question the surgeon. What is his level of confidence? Does he think he got it all? If there is doubt, my case could be reclassified as “unresectable,” and I might qualify for a trial of a new drug called ipilimumab (known as “ipi”). It will be a crucial conversation, very important to handle correctly.

Hearing this voice narrating the above paragraphs, I recognize a certain, familiar character. It’s the voice of Gordon, anticipating the rest of his day, planning his moves, managing his life. I can listen to it with detachment. Thus I achieve what Mark Johnston describes as “a feat of auto-alienation.”

Early this morning, as I lay in bed in the dark, I thought about writing this post. Therefore it is somewhat contaminated, by too much thought. To get past the contamination, to where the stream runs clear, I’ll have to write more.

Listening to my own voice in this way, hearing my thoughts—it is not as though my ‘true self’ has now emerged, and is observing my ‘false self.’ I don’t believe in a ‘true self.’ Really, there is no such thing. They are just voices, and they are distinct. They are both ‘my’ voices, but that thought has no content you can hang your hat on.

All this planning, imagining the future in detail, is our great strength as a species. It is an amazing ability, one to be marvelled at. All the worrying we do, all the meticulous planning, is responsible for our success—and, of course, it makes us miserable. Or it can do so. I observe it—this is an image I had last night—as a crazed animal in a zoo cage, obsessively running around its well-worn track. (How’s that for auto-alienation?)  But that image hardly describes my own reality these days—or describes it only occasionally, when my emotions get the better of me. My life was quite different at times in the past. I can remember weeks and months of life in the zoo cage, the endless circuit, compulsive gnawing of a sore spot, rendering it hairless and bloody.

I don’t know where this is going, or whether I will post it. (I’m not feeling quite alert, to tell the truth—the lack of coffee and food.) It’s interesting to think about what it would be like to have the choices available to me that I imagine people will have in fifty to one hundred years—the choice of dealing with a medical problem like mine by being scanned and having my information saved in a digital file, which could then be edited—it would be so easy to run software to identify the melanoma cells, which have a distinct genetic signature, and edit them out—prior to using the edited information to build a disease-free replica of myself. No fuss, no messy surgeries and healing, no uncertainty about micrometastases. If we had the technology, I’d do it in a heartbeat.

And then there is the variant on the same technology, the use of human replication capability for life insurance purposes. If my cancer had progressed too far, if it had damaged my body so much that editing my file wouldn’t cure me, I could turn to a backup scan—one made before the melanoma nodule first appeared on my arm December 14th. Suppose I was scanned last December 1st. (Today is May 2nd.) I would order my diseased body to be destroyed, and replaced by a replica built from that December 1st scan. I would also set wheels in motion for my replica to have surgery, to have the incipient melanoma lump removed at the very first sign of its appearance, long before it grew to a depth of 8 mm and ulcerated.  Caught that early, it could almost certainly be removed without any further complication.

Wouldn’t I be surprised—my self of last December 1st—to wake up tomorrow, May 3rd! At first I wouldn’t know why I’d been revived. I’d be astonished to learn it was because of cancer, which I never expected! (I have no family history of cancer.) I’d have to bone up on all the intervening events: the news of the day (easy, nothing much has happened), and my own projects. Catching up on my own work would be quite manageable, because what I mainly do is write. Once I had read and understood all my notes and completed pieces, I’d be pretty well set to carry on. Going through my emails and talking to Claudia would be enough to bring me pretty much up to date. Exercising my life insurance policy is also something I would do, in two heartbeats if not one.

Now it is about time to go to the hospital.


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