One Year After

June's blood test results were similar to May's: Normal chemistries and proteins, somewhat low but acceptable blood cell counts and immunoglobulins. In addition to the blood tests, this month I also got a skeletal X-ray survey, and an ultrasound on my legs.

The comparison of the current skeletal survey with the last one, done in October of last year, indicates that, if lytic lesions can be taken as evidence of the presence of the myeloma, then the disease has more or less been stopped in its tracks. There is no evidence of spreading, for example, to the arms, legs, or pelvis. Although the skull and spine are unchanged and seemingly stable, the ribs show improvement, which comports with the (ever so) gradual reduction of the pain that I have endured in that area.

The ultrasound, taken as a precaution against the threat of blood clots introduced by the Revlimid that I have resumed taking, revealed no such clots.

The oncologist expressed great satisfaction with these results; he appeared as jocular as such a very reserved individual gets. As of this month, in my case he can give himself credit for one year of survival. Survival, where cancer is concerned, is measured from the date of positive diagnosis. This seems somewhat arbitrary, since the patient has clearly already "survived" having the disease for some period of time already by then; but there is really no other way to objectively measure it, since there is no way to determine exactly when the onset of the disease occurred. By June of 2009, I may have had multiple myeloma for six months or six years. In any case, survival, thus defined, is nearly the sole measure of success or failure in the oncological world. The survivor's quality of life, as important as that might be, is too subjective in nature to serve as a scoring mechanism. Moreover, cancer is such a rapacious adversary that the oncologist must be resigned to burying most of his patients sooner or later. He counts a success if he manages to cheat the statistics by some span of time. If he is very good or very lucky, he somehow pushes the patient out onto the long right-hand tail of the life expectancy distribution. In the case of multiple myeloma, the long tail begins around five or six years. So I still have a long road to travel to reach it.

Frankly, I am avoiding using the occasion of this anniversary to indulge in any extensive reexaminations of the road traveled thus far. This strategy for maintaining some kind of emotional equilibrium in the face of -- dare I use what seems an overused term -- horror, has some disadvantages. The worst of it is that I can seem ungrateful for the truly herculean efforts that have been made by many other people (my wife in particular) to keep me from sliding into the abyss. I can only offer a simple apology, and the excuse that dwelling on the events of the past year will do nothing to help me get through the next one. Also, doing so creates a certain feeling, that I would prefer to avoid. It reminds me of the feeling I experienced on emerging from the Holocaust Museum in Washington, when I visited it years ago -- a feeling of inescapable involvement in an enormity that roams the world, devouring souls without justification and without mercy.