SLAP!

The sound of the open palm of reality encountering the unsuspecting face on the front of our clueless heads (for the sake of this exercise, I'll use "our", meaning "my"). 

I saw the endocrinologist (Dr. Rosen) yesterday.  It was a good visit, in which he explained a few things to me, like how the results of the blood just drawn from my arm would be analyzed for a number of constituents, most especially thyroid stimulating hormone (TSH).  A result of over 30 on that analysis would be the key to triggering the next phase of my treatment, a dose of radioactive iodine, or, in cool scientific parlance, I131. 

In fact, I was almost getting comfortable with this whole thyroid cancer thing.  The more I read, the more oral testimonials I heard, the more I was becoming convinced that medical science had a near-total handle on papillary carcinoma.  Even from the medical professionals.  It is the most common form of thyroid cancer.  It is usually metastatic, but, even then, I131 is effective, with no recurrence, in 93 percent of patients.  Those are pretty good odds. 

SLAP!  The odds are much better you'll never get a nodule on your thyroid, let alone a cancerous one.  I remember the sting of that initial diagnosis.  Pay attention now!

One of the "bedrock" tenets of geology is The Principle of Uniformitarianism, which holds that slow, steady processes are the major agent of change on Earth, and which has been popularly (at least in the annals of geology) boiled down to the phrase "the present is the key to the past" (and, presumably, the future).  Without thinking, we apply this principle to life all the time.  Today is as yesterday was, and tomorrow will be as today is. 

SLAP!  We proceed with peril when we forget about The Principle of Catastrophism, which holds that a smaller number of drastic events are the major agent of geologic change on Earth.  Catastrophism counterbalances Uniformitarianism.  Slow and steady most of the time (deposition of sediments on the sea floor, resulting in near-flat sedimentary strata), punctuated by drastic events (sudden uplift and downcutting of streams, resulting in the Grand Canyon). 

Life goes on, as it is wont to do.  We observe it through the lens of today.  We make plans for today based on yesterday, we make plans for tomorrow based on yesterday and today.  We get caught up in possible outcomes which are beyond our control.  It is a game, and the universe laughs at us. 

Late yesterday afternoon, Dr. Rosen's office called.  The nice lady said they were sending my file to North Kansas City Hospital's nuclear medicine group.  Those folks would be in touch with me to discuss scheduling I131 ablation, my radioactive iodine treatment.  I said "oh, I guess that means you have at least some of the results back from my blood draw already…".   Yes, she said, my TSH was "over 100". 

"Wow!" was my response.  I would have expected to have felt worse, based on what I've read about surgically-induced hypothyroidism, which, at least in cases in the literature, usually produces severe fatigue.  My symptoms were limited to very mild fatigue, general chilliness (not surprising, given the weather), and vocal hoarseness.  The medical people chalked it up to me being in pretty good shape going into this whole episode.  Pretty good, I suppose, except for that very large tumor which had been growing in my neck, the one they'd removed 4 weeks ago to the day of my visit with Dr. Rosen. 

After the call, Mary and I went for a 4+ mile walk, then out to dinner.  It was a kind of celebration.  The next phase of treatment was about to begin.  I'd get through the administration of I131, the phase of my temporary radioactivity, the next phase of renovation on the house, the period of extreme work busyness, oh yeah, spring was coming…

SLAP!  Pay attention.  Now.  It couldn't have been more plain.  After dinner, I checked e-mail, and saw a small bit on Yahoo about Roger Ebert.  I hadn't been tracking what was up with Roger Ebert, but it seemed he had been having some health issues.  I read on…

Thyroid cancer.  That got my attention.  Ebert appeared in some forum with Oprah Winfrey recently, unable to speak but for the assistance of a vocal synthesizer.  Papillary carcinoma, removed to clean margins in 2002, had spread to his salivary glands and jaw.  Additional operations, extra radiation treatments, complications ensued.  He nearly died when his carotid artery, weakened by the radiation, had burst.  Part of his jawbone was removed, replaced by a bone graft from elsewhere in his body.  He has to take nutrition through a feeding tube, being unable to eat or drink.  It probably happened while he was planning his next move. 

I think I felt the palm of reality on my face that time.  I think it woke me up pretty well.  We have this moment.  Hear the universe laughing, and laugh along with it.  It tells you "you have a disease which is manageable.  Unless it isn't."  You have right now.