12/4/14 Drumbeats in the Distance

I can hear them.

Thump! Bumba-Bumba! Thump Thump! Bumba-Bumba! A-rap-a-rap-a-rap! Bumba! Thump! [repeat and increase in tempo]

Hearing the drums is one thing, but the increasing tempo is mesmerizing, even paralyzing. I hear it ringing in my ears, my pulse matching the increase of the tempo.

Last May, I got the message back from the BATCC lab that things were not going to continue in quite the same manner as my complete remission. Here’s what they had to say.

PB CLINICAL FLOW CYTOMETRY RECEIVED

Other tests ordered on the same accession number are available below.

MRD CLL Panel Interp, PB
Specimen is peripheral blood
PANEL TYPE: MINIMAL RESIDUAL DISEASE
Interpretation:Positive for residual chronic lymphocytic leukemia/small
lymphocytic lymphoma.
All markers were assessed on a specimen that was 24 hours old with 72%
viable cells.

Aberrant cells (as a percentage of total analyzed events):0.21%.

Assay sensitivity: 0.01%.

CD38 is positive on 85.0% of CD19+CD5+cells.

POSITIVE:CD5,CD19,CD20,CD22 dim,CD43,CD79b dim,CD81 dim,and
monoclonal immunoglobulin kappa light chain.

Electronically signed by:
Vishinaihadderdrinkov Guttennauldfashunkindervisky, MD,
MMDD (that stands for double-doctor) PhD, DDS, DMD, PharmD, ThD,
MBA, DD, LLD, JD, BA, BS, CPA, CFP, CLSW, FACS, CLU, EMT, CRT,
33° F&AM, PE, RLS, EdD, DVM, et. al. 05/30/14

You remember Dr. Vishinaihadderdrinkov Guttennauldfashunkindervisky. You first met him here at The Chronic Diaries, Vol. II, 5/1/11 Good News for Some, Tragedy for Others; The World Keeps Turning, p. 169. He has as many languages as he has advanced degrees. It’s a fearsome thing to hear his name as he is paged over a hospital intercom. “Paging Dr. Guttennauldfashunkindervisky. Paging Dr. Guttennauldfashunkindervisky. Please report to the doctor’s lounge for a drink of the good and old fashioned kind of whiskey….I mean an important conference sponsored and catered by Big Pharma. Your colleagues are waiting. Dr. Guttennauldfashunkindervisky, report to the Doctor’s Lounge.”

Maybe they could just shorten it to “Dr. Viskey.” I’d likely answer to that one, too.

Dr. Guttennauldfashunkindervisky had looked at my peripheral blood and decided in his trained clinical experience that there were detectable CLL cells where there had been none for four-and-a-half years.

Thump! Thump!

The drums sounded, as if in the distance, over two ridges of hills, the sound only carrying through a foggy night, unsuitable for seeing, but perfectly thick for sound transmission. The drum’s low frequencies reverberated over the ridges, straight into my ears, until my heart matched their rhythm. Though I could hear them, they broadcast no sense of urgency, just a slight restlessness. Their drumming sent forth a sort of morse code, saying, “Watch and Wait! Watch and Wait!”

Of course I called up Gooday. “No worries, mate. Watch and wait. You know the drill.”

Thump-a-whacka-tack-tack-tuuum.

I called up the very competent Nurse Alice. “Watch and wait, Mr. Sharp. We’ll keep an eye on it. No worries.” She has been around the Melbourne-born Gooday long enough to have picked up the “no worries.”

A-whacka-whacka-tuum-tuum-tic-tic-toc.

I went to see Hemosapien. “You know the drill,” he said. “Watch and wait.” So we watched in September, and I go back for another watch this month. We will see how the blood numbers look. We’ll see how long the wait. We’ll watch some more. We’ll likely worry in the meantime.

Bop-bop-a-lula-bop-bop, whacka-whacka-tac-tac, and sham-a-lama-ding-dong, the tempo increasing now, perhaps doubling from its original 60 beats per minute. I think about that.

“Hmmmmm!” I say to myself. “Drum tempo doubling in less than six months. That is a bad sign.” As I said this to myself, the tempo increased at least ten to twelve percent. So did my heart rate. I needed a diazepam and some Rolaids.

Boom-ka-boom, ta-whomp, thump-thump.

I needed some aspirin.

“You need to calm down,” I could almost hear Dr. Guttennauldfashunkindervisky saying. “Among my many degrees, I am a theologian, psychologist, social worker, and counselor. I am here if you need me.”

“I don’t need you! You’re the one who started all this with that damnable report of yours,” I said to myself since Guttennauldfashunkindervisky was hidden away in BATCC’s Doctor’s Lounge for an important conference which I am sure included oysters on the half-shell and four inch long boiled shrimp. The more I thought about those oysters, which I could never eat again, the madder I got.

I thought of the ever-enlarging lymph nodes under my arms and in my groin area, and the tender ones in my neck. Those weren’t there quite last year. Well, they were there, but they weren’t so large or so tender. Gooday, Hemosapien, and the pompous Guttennauldfashunkindervisky didn’t know about these yet. But I did. I also thought about the tell-tale signs of an enlarged spleen, or splenomegaly, as they referred to it.

Drum Rollllllllllllll. Tap. Tap. Whomp!

The diazepam didn’t help. The Rolaids might as well be battery acid. The aspirin is less effective as some M&Ms. Thinking of that, I reach for the jar with the M&Ms only to find it empty, beaten to it by my granddaughters, or my daughter, my son, or my wife, but beaten just the same. It’s everyone for themselves around here on the M&M jar.

Drum Rollllllllllllll. Tap. Tap. Whomp!

My pulse races to about 120bpm. So do the drums. Of course, that means my absolute lymphocyte count is doubling, too. Watch and wait! Watch and wait! I am driven to the gates of delirium. What I need is a good dose of stoicism, not self-indulgence.

Then, along comes Seneca.

“A man who suffers before it is necessary, suffers more than is necessary,” he says, almost in a whisper. I sure seemed to be suffering from a bout of something I could do nothing about, yet.

“So what do I do about it?” I ask, as much to myself as to the thought of Seneca.

“Expecting is the greatest impediment to living. In anticipation of tomorrow, it loses today,” was his reply, though I wasn’t really expecting one. I thought about this. What was I losing in the investment in worry today about what may or may not happen tomorrow? I may be paying too much and getting too little.

“Exactly,” said Seneca, apparently reading my mind.

“Wait a minute,” I said, “You can’t read my mind.”

“No,” he said, “But I can read your face. You’d make for a poor poker player. You have a poker face about like Mr. Bill…’Oh, noooooooo!..’” Seneca made a joke. We both laughed: me at his joke and he at my foolishness.

“A gem cannot be polished without friction, nor a man perfected without trials,” he said.

“Are you saying I’m a gem. A diamond in the rough, as it were?” I asked.

“We all are. We just need some polishing so we’ll sparkle. Remember this: A person;s fears are lighter when the danger is at hand. When the danger is in your face, you’ll have much less to worry about, since you will have focus.”

I didn’t like the sound of the focus part. A general malaise of fear seemed better than a focused fear, but perhaps he was right. Well, most likely he was right.

Suddenly, the entire room was filled with a brace of stoics. My living room of contemplation had become sort of the doctor’s lounge of stoics, as Zeno of Citium piped in. “Fate is the endless chain of causation, whereby things are; the reason or formula by which the world goes on,” said Zeno.

“I don’t think that is applicable here, Zeno. I don’t think it’s fate that caused my leukemia, or fate that caused the failure of my remission,” I said as I found a bag of M&Ms and emptied them into the jar. Before I could get me a handful, Zeno and I were interrupted by Zeno of Elea, not a Greek stoic, but more of a mathematician famous for his series of paradoxes, which he seemed to think applicable here.

“Someone call for me?” Zeno #2 asked. Without waiting for an answer, he started in, “When a rabbit is overtaking a tortoise, the rabbit must first make up the distance the tortoise has already traveled in the elapsed time from and since the rabbit’s start while the tortoise is still moving. It is possible that the rabbit may never catch the tortoise if it keeps moving in the same direction.”

“I don’t see the application here,” I said.

“He’s always taking advantage of the way people confuse us two,” said Zeno #1. A single room containing two Zenos is perhaps not large enough. Seneca just sat there silently, not stressing over the hijack of our conversation, perhaps merely thinking of the M&Ms. Before I could sort out all the chatter, my old nemesis, Calvin, entered the fracas.

He said to Zeno#1, “I see you have studied me at length. Fate, or God’s providence, has everything to do with everything else. All has been decided. All has been predestined.”

“Who are you?” Zeno#1 asked the great reformation theologian, who seemed indignant at not being recognized. I stood there with my hand in the M&M jar, slack jawed over this exchange.

“I am John Calvin,” he said.

“I have not ever heard if there be any such person as a John Calvin. Your name is not in the records of the Greek Philosopher’s Hall of Fame.

“I’m not Greek,” said Calvin, who, not used to being spoken to this way disappeared in a huff. Zeno#1 asked me to tell him just who that person was.

“John Calvin. Swiss reformer. He put forth the idea of salvation by predestination. He’s hard to argue with. He drops by from time to time to keep me on my toes. I’ve gotten used to him. He’s more or less a friend, but he can be abrasive at times. He goes away about as fast as he shows up when he gets some guff back from me. You died about 1400 years before he was born. It is entirely likely you’re not familiar with his work, though I daresay he has studied yours.”

And with that, Zeno#1, Zeno#2, and Seneca were off to hot debate on some minor point of philosophy that was lost on me. I sat in the chair by the kitchen window and drifted off to sleep, dreaming of oysters and four inch long boiledLate Night Guests shrimp, and M&Ms. I must have slept for an hour or two when roused fro a deep sleep, Debbie was standing over me asking, “Who were you talking to? There was so much noise in here it woke me up.”

I remembered my dream. “I must have been dreaming,” I told her.

As I got up to go to bed, I looked over on the counter. There was an empty M&M bag. I reached into the jar, and there was not an M&M to be found. I had this deja vu feeling all over again, thinking of the philosophers and what they had said as they no doubt enjoyed eating all my M&Ms. Suddenly, fresh into my mind, sprang the best and most fully formed philosophy I had heard all evening, coming as it did from the greatest philosopher, the One who could actually read my mind and not merely observe my bad poker face.

“Take no thought of tomorrow. Sufficient for today are the evils thereof,” He said to me in the softest, kindest tone. I smiled when I heard that, and went to put the top on the M&M jar, but noticing that it seemed to be more than half-full when I had thought it was empty. I looked at the bag. I looked at the jar. There were obviously more M&Ms in the jar than the bag would contain, as if to prove Zeno#2 wrong by example. The inside was bigger than the outside.

I grabbed a few of the M&Ms and popped them into my mouth in the silence. The silence! The silence. The drums had stopped beating. I felt my pulse…60bpm. I chewed on the M&Ms in a moment of peaceful reflection.

My, oh my, were they good! And far better than Rolaids.

“I like the peanut kind,” said Calvin as I turned out the lights. It figures. Anything for attention. The stoics? They would have eaten any kind you offered them, but not Calvin. He wants peanut, which I’ll have to admit, I like, too. Maybe I’ll get some which might just sweeten ol’ Calvin’s disposition a bit.

It can’t hurt.

©2014 Mississippi Chris Sharp

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