Sunday, September 23, 2012

Day 99 - let out alone today

Exeter sewer pond or canals of Brugge?

Neither picture is as good as I'd like, but I am willing to keep trying
I continued making progress today in terms of strength and endurance. I was able to walk downtown by myself and go shopping. After a little nap, I was able to go for a walk with Maggie for about 1.5 miles. It was a gorgeous day and we walked around the overflow pond and by the river. A huge surprise for me was that there were swans on the pond. I had never seen swans there before; in fact, the closest swans I had seen before were in Rye. I don't know if they have been there all summer and I've been unaware or if they are just passing through. The people I saw were too busy with their (poorly behaved) dogs for me to be able to ask them and the swans weren't saying. I am hoping for cygnets next year. The swans were completely unruffled by the dogs walking on the path around their pond (it's sort of an earthen levee) so hopefully they would not feel threatened by every passerby if they had chicks next year. In Minnesota, we used to bicycle on a rail to trail occasionally that would have geese families in the spring. The parents would start hissing and get all upset as you sort of zipped by on the bike and it was a little ridiculous and a little intimidating. Of course, it was easy to see why they would feel threatened, but the bikes would go by before the geese could react very effectively (fortunately) and they would end up looking puzzled and foolish. I don't want my beautiful swans to look foolish so hopefully they will be less twitchy.

In other news, I have a big yarn package coming next week. Ellie has requested a new baby blanket because the last one I made for her didn't turn out as well as I would have liked. I did, however, learn an important lesson about rayon yarn: avoid it as I do not understand how to work with it. I also bought some green yarn to make myself a shawl because regardless of the weather for other people, I think it may be a cold winter for me. Several new colors of the cotton that I have been experimenting with round out the package.

{four paragraph warning for discussion of dreams--many people find other people's dream tedious quite understandably. if so, skip to below.}
Last night I didn't sleep very well because I had two flavors of the same weird dream, both of which woke me and made it hard for me to return to sleep. In the first one I was in the front yard and a dilapidated van pulled up and a family unloaded a very ill man on a blanket into my front yard. He was very sick: obviously had an out of control internal malignancy and a huge sacral decubitus ulcer that went through to the bone but was not painful. He was incontinent of urine while I examined him. He was very confused, telling me he was in "the promised land." It was clear to me in the dream that he was going to die very soon. His family said that he wanted to go to the beach. I told them that he was sick and they had to take him to the hospital; they said they didn't want to, that his last wish was to go to the beach. They could not tell me why they had unloaded him in my front yard. This was where I woke up and the dream man reminded me about a patient I had admitted to CMC a few weeks before my diagnosis and so I lay in bed and perseverated about him for a while.

Then, when I finally fell asleep, I dreamed that a bird somehow made me and Tommie understand that it wanted us to follow it. We had to get in the car and drive on the highway even, but eventually, it showed us where to park, we crossed the oncoming traffic and were at a beach where the bird had a nest partially behind museum glass. The bird wanted Tommie to take a feather out of its nest (which she did) and then a ranger appeared and began screaming at us that we shouldn't be there; the bird was nesting and it was dangerous for us and the bird. Again, I could not figure out why I had been involved in this drama.

It seemed like both dreams involved quests/journeys that I was invited to be involved in for unclear reasons and then uninvited. I don't know if the bird's quest was finished when Tommie took the feather, but I find the unfinished nature of the first guy's journey unsettling. I wonder who the guy is? my leukemia? free floating anxiety? some unfinished/interrupted task in my life? I like the guy as my leukemia because it seems significant to dream about the leukemia dying especially at a time when it would really be dying, given that I had chemo last week. If the guy is my leukemia, though, what is his family? After I finished perseverating on my real life patient, I redid the dream while I was awake and told the guy's family that I thought they should load him back up in the car and take him to the beach afterall. Clearly he was going to die soon no matter what was done, so I thought he may as well die with the breeze he wants. His family was right; the hospital had nothing to offer him; might as well let him smell the salt air.

With that interpretation of the old man, the bird dream becomes like an echo of the Carlos Casteneda I read back in the 80's. It's almost like the bird is the giver of the first dream about the old man and has brought me to the leukemia's nest. I cannot figure out the ranger. What is striking about her is how angry she was that I was there and that her worry about my safety was quite strong. I am curious to see what I get tonight and also to see if anyone has any good ideas about this.
{end of dream discussion}

I also had a nice conversation with Stefan about chemotherapy and how 100 years from now, doctors will be stunned that we used such primitive tools as cytarabine, analogous to how we feel about doctors in the fifties using radiation for acne. This dovetailed with an article in the NEJM about medical progress that talks about taking an antibiotic for an infection as the model for cancer chemotherapy and how in the future we'll probably think of cancer treatment more as a chronic disease. I'm ready to take my daily pill with minimal side effects that will keep my AML under control and let me continue my life uninterrupted. Perhaps the bird will bring it to me tonight.

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