Day +6

I am happy to share an important life lesson that I have learned over the course my stay at the transplant unit: If you have to rinse your mouth several times a day with two different medicated mouth washes, one of which you find foul, repulsive, and dreadful, rinse with the bad one first. It would be too embarrassing to tell you how long it took me to figure out that doing it in that order helps to mitigate the lingering wretched taste.

The medication regimen imposed on me is impressive. Orally I take 14 different kinds of medications, most of these more than once a day. Additionally, through the IV there flows various immuno-suppressants, antibiotics, and hydration infusions. The medications tend to proliferate as some are aimed at facilitating the success of transplant and others deal with the side-effects of the first kind of meds. For example, I take an immuno-suppressant, which dials down the immune system so as to reduce the severity and incidence of battles between the emerging immune system and my organs. But the one that I take has the side-effect of increasing blood pressure, which in my case was already slightly elevated. As a consequence I had a couple mornings this week when my systolic pressure (the top one of the two) was through the roof. Dealing with that requires taking another kind of medication. And all of this, of course, has a certain learn-by-doing character; every organism is different and differently complex. So, doses need to be adjusted to achieve the desired effect. But, of course, sometimes you can’t just tweak one dosage because it has side-effects that have to be managed.

My homework every evening is to lay out all my pills in a tray with four compartments for the different times during the following day that I am supposed to take them. Not a day has gone by when the plan that I have followed has been the same as the previous day. In some cases the milligrams of the actual medication differ from the milligrams on the plan, in which case I have to do the calculation and either halve or double the dosage. When I was in chemo this was really taxing work. It took all my powers of concentration, and it was exhausting! It could be that the nursing staff just doesn’t want this job. But I have a hunch it is some kind of competency test because when I was receiving chemo the night nurse would check my work. And once or twice she playfully scolded me for screwing up.

In an effort to reincorporate aspects of normal life into my life here, I’m meeting this evening with my internet book group. There are three core members of this group, and we have met off and on for over ten years, first in person when we all taught at the same university after that virtually when two of us moved. We cover the fields of classics, political science, and philosophy. We pick a hard piece of philosophy that we are all at least somewhat interested in and we work through it over the course of many months. We’ve read lots of different things, including Plato’s Statesman, St. Augustine’s City of God, Nietzsche’s The Gay Science, and Adorno’s Minima Moralia. For some time now we’ve been reading volume one of Ernst Bloch’s The Principle of Hope. I cherish this group and my friendship with the other members. It’s wonderful to get back to meeting with them.

The section of Bloch that we are discussing tonight is relevant to my earlier invocation of Epictetus in the “Patience” post. Epictetus’s attitude of focusing on what is in one’s control is a tonic against anxiety, but perhaps it also rules out more positive future-oriented attitudes about things that are uncertain, attitudes like hope. Rightly or wrongly Bloch interprets ancient thought as skeptical about the value hope due to the unhappiness that unfounded hope may cause. His major purpose in the book is to vindicate the really fundamental importance of hope. In his conclusion of a discussion of ancient skepticism about hope, he says the following: “And founded hope especially, that is, hope mediated with the real Possible, is so far removed from evil…that it in fact represents the at least half-open door appearing to open on to pleasant objects, in a world which has not become a prison, which is not a prison.”


Day +7

What Single Payer Means to Me