The Ecology of Cancer, and What do Ants have to do with it?

Ants are like cancer cells. Conversely we might say that cancer cells are like ants.

Even though they sometimes feel more mammoth-like and slothful, lumberingly prehistoric rather than tiny and socially frenzied. “They feel.” Of course cancer cells do not have feelings so far as I know. What I mean is that they feel to me, these colonies of CLL cells that circulate through the bone marrow and the blood and the lymphatic system, they feel to me massive and heavy and slow. Or more accurately, they make me feel like a sloth, I imagine myself as one of those creatures I saw a few weeks ago in the Tar Pits in Los Angeles: slowly dragging my massive body over the never-ending earth. But in the last few weeks I have also been having nightmares, dark and jagged dreams in which a massive sloth-like creature is out there, lumbering over the horizon, coming closer, filling the screen, threatening to engulf me. This CLL beast exists, I guess, both within and without.

When I heard Deborah Gordon declare that ants are like cancer colonies I experienced a rush of resistance. I did not welcome the idea of analogizing my condition to a common-and-garden insect that lives in colonies, rather than to the singularity of an exotic species of mega fauna now extinct. I was alarmed not charmed by the image of colonies of ants scurrying around in my body. But also in some peculiar way I did not yet quite understand, this analogy—of cancer cells to an ant colony—struck a chord. Suddenly a new image, one not immediately accessible to my habits of thinking and feeling, began to reverberate.

Ants, the ants that I know, live in my garden, not in my body. It has always been mysterious to me the way ant colonies would spring up in the garden, how they would know where the aphids were congregated, how they would march and scurry from their nests to my favorite rose bush, devastated by a colony of aphids. Aphids are small insects that suck the life out of plants and then secrete a sugar-rich sticky honeydew that ants love. In fact they “farm” the aphids, protect them from predators and parasites and nurture their eggs. In the face of this alliance—a mutualistic relationship or type of symbiosis—I would feel very small and ineffectual. All I could do would be to hope for an invasion of ladybugs (to eat the aphids, and thus deflect the ants) or I could spend hours everyday hosing off the aphids with jets of water. Sometimes you would sink a pitch fork into the compost pile and as if from nowhere a black mass of moving matter would crawl up your arm. After initial panic—rushing around dementedly shaking arms, trying in a frenzied manner to brush the ants off—I figured out that in the process of pursuing their own ends, foraging for fabulous stuff to take back to their nests, they were doing me a favor. Like worms, they were doing their bit to toss and turn and hasten the process of decomposition in the compost. In the end by leaving things be—as much as is possible for a neurotic controlling gardener—the garden settled into its own ecology. Or rather, it became more possible to observe the interaction of plants and creatures. To see, for instance, which plants attracted bees and when. African blue basil and rosemary are bee magnets. The weedy fennel, when it’s younger is a host for the swallow tail caterpillar that turns into a spectacular butterfly, flits around the garden and then sashays off to Mexico. Later, when the garden is festooned with the fennel’s yellow umbels the bees come swarming in.

But the story is not so simple, not such a paean to natural balance and harmony.

Enter the chickens.

Nowadays there are no infestations of ants, no plagues in the garden. The beak of a chicken and a squirrely squirming ant—these things exist together in a powerful force field of attraction. Heaven if you are a chicken, pretty dismal, I guess, if you are an ant. Though maybe the ants have just changed their habits, become invisible to chicken and human eyes, or moved on over to my neighbor Mrs Tam’s garden. Chickens also love worms, but since the birds are surface scratchers and since the vegetable beds and the compost are barricaded the worms survive there, in fact they survive everywhere deep in the soil, doing their work, sifting and turning.

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Ants are like cancer cells, says Deborah Gordon, in so far as they are regulated but without central control.

An ant colony is regulated, its survival depends on the distribution and co-ordination of tasks and roles. Communication, or an exchange of cues, exists between the ants. The tasks and roles themselves are not fixed, but shift and change as the environment shifts and shapes. The ants exist in a dynamical social network. A hub may form for instance simply by ants moving into a space where there are lots of interactions. Gordon calls it the anternet. Ants do not always behave the same way. Foraging behavior for instance changes in times of drought. If one element changes (e.g. the availability of water) then the behavior of the colony changes. These changes, in turn, shape social and reproductive patterns. By observing these changes in patterns of behavior or modes of regulation, scientists can observe how natural selection is working on this colony.

There are many biological systems, apart from ants, that function without hierarchy. Bird flocks, without a leader, turn in the sky, fish schools swerve to avoid predators, tropical forests develop patterns of diversity… and cancer cells mutate and metastasize. For all of these systems, we still don’t fully understand how the parts work together to produce the dynamics, the history, and the development of the whole system.

It has often felt to me as though the garden is a battlefield. The march to the rose bushes and the swarming in the compost bin seem to be ant maneuvers carried out with all the efficiency of military campaigns, masterminded by some center of control (and sometimes the body too feels like and is popularly conceived of as a battle zone where the war against cancer is waged). Indeed this is how the great and pioneering ant scholar E.O. Wilson described ant society—in terms of hierarchy, conflict and regimental organization. So why should we relinquish this view (or feeling) in favor of the model proposed by younger scientists, including Deborah Gordon? Most significant for me, in terms of the efficacy of the analogy, is that Gordon and others tell a different sort of system story, emphasizing situated (therefore variable) processes of recognition and response. They understand the ant colony as composed of flexible units (whose functions change according to situation) and propose a system characterized by different architecture and components. Nodes of interaction are at the heart of Gordon’s model and frequencies of interactions at nodes are what shape material social orders. It is this that grounds the argument against the way that Wilson’s analogy works, wherein the behavior of ants is offered as a sociobiological model for human behavior. Ants, Gordon argues, don’t provide moral lessons or insight into behavior or feelings, but they do provide insight about the dynamics of networks, systems without central control.

It’s a tricky business, this maneuvering (is it a dance or a battle?) between feelings and conceptual models, between the garden and the body, ants and cancer cells. Sometimes new images, just as much as new data, can interfere with feelings and reorient one’s thinking.

What matters in networks is the ecology of the system.

So, taking our cue from ant colonies, how might we think about the ecology of cancer? What are some of the ways that cancers diversify and spread? How is organization regulated? How, with answers to some of these questions, might we approach intervention in ways less dramatically belligerent?

Cells in the body act collectively—for example, as networks of neurons to produce sensations, or as patrolling T-cells that mobilize other immune cells to respond to pathogens. It seems they communicate with one another. In the process of metastasis, the cancer cells may use signals from healthy tissue to recruit other cancer cells to a new location, where certain areas of tissue constitute an attractive resource. If researchers can figure out how cancer cells are recruiting then maybe they can set traps to prevent them from doing this.

All very well, but it doesn’t solve my problem (and my oncologist’s) which is how to understand the malignant cells of my cancer, Chronic Lymphocytic Leukemia (CLL), as part of a cancerous system, given that it is a cancer of the blood not manifested in solid tumors. In CLL the cancer cells (malignant B cells, a type of white blood cell) course through the marrow and travel through the blood and lymphatic system. What happens in a “normal” body is that the B cells are recruited to fight infection, they die off often and regularly and new ones grow. In CLL, because of some genetic glitch, they don’t die off but in fact relentlessly proliferate, interfering with and crowding out the production of healthy white cells, red cells and platelets.

Although the cancer is in the blood and not localized in tumors the cells do cluster, they form hubs just like ants. They cluster in lymphoid tissue. Research has identified a form of regulation in this lymphoid tissue, or micro-environment, whereby malignant B cells communicate with other healthy cells. Curious about the relation of the cancer cells to certain healthy cells Dr Kipps and his colleagues looked at this relationship in the lab. They found that when the CLL cells were removed from the “suspicious” healthy cells, the CLL B cells began to die, whereas the same cells, when replated back onto the healthy cells, perked up immediately. Because they supported the survival of CLL cells and because CLL B cells became attached to them, the researcher group called them “nurse-like cells,” or NLC. They concluded that one of the ways CLL cells survive is by recruiting these protector cells.

Dr K describes CLL as a very social beast. By this he means that the survival of the cells depends upon a network of relations, which indeed amounts to a form of regulation, without central control. The relation between the NLC and the CLL B-cells is symbiotic just like that between ants and aphids. In a dynamical system like an ant colony it is possible to observe how when one element changes (e.g. the introduction of drought) the behavior of the colony changes. So, similarly, by focusing on the microenvironment of another dynamical system – a colony of cancer cells – it becomes possible to envisage forms of intervention more akin to the strategic introduction of drought, rather than war. Rather than therapies which are the equivalent of carpet bombing, indiscriminately destroying good blood cells along with the bad (which anyway doesn’t work with CLL which is notably resistant to standard chemotherapy), the solution might be to try and intervene in the signaling system to change the behavior of the cancer colony. Or, as Dr K puts it: to foster therapies that isolate the CLL cells so that they die of social neglect.

To observe how cancer colonies evolve, how cellular activity is regulated, how selections are made: this chimes with other ideas vibrating in the air in this second decade of the twenty first century when the Darwinian inheritance is being reconfigured. We humans have made such a mess of the planet that perhaps our only hope lies in attending more closely to other forms of organization, to looking more closely at ants and fungi and chickens (with whom we share about 60% DNA) and extinct species like the sloth from the Paleolithic era to species like bees that are disappearing by the day, as we poison the environment and our own bodies. By looking outside the human body to other “bodies” or clusters of living cells in the natural world it seems to me that we have more chance of figuring out solutions, or ways of being in the world, perhaps even ways of living with cancer rather than definitively conquering it. Just as in certain approaches to invasive species in habitat studies. It’s a reversal of the gaze or perspective. Rather than trying to understand the natural world through the lens of human society, we reverse the perspective so that a description of a natural society—an ant colony in this instance—can illuminate how we think about modes of organization in the human body. Or, more pertinently (since reversals always carry the dangers of dualism) we can begin to think of the nature-society play as itself like an ant colony.

I don’t for a moment think that Dr K and co are spending their time out in the desert down on their knees observing the behavior of ants. They are in the laboratory working late at night, separating the malignant B-cells from their nurse-like protectors and replating them, and trying to figure out how to intercept the signals. They are running algorithms. In defining the various cells, structures and molecules that protect the CLL cells they are working on the development of novel anti-leukemia agents such as monoclonal antibodies and immune-based treatment strategies and genetically engineered T-cells. No, they are not looking at ants; but for me, as a gardener and a non-scientist and someone with cancer, bells start chiming.

In writing this I have become less alarmed by the ant analogy, more attuned to the reverberations sparked by hearing Deborah Gordon speak. At some point analogy clicks and opens up a different link. A link to the ecological.

Even though he places emphasis on the environment Dr K is cautious: We still don’t fully understand how the parts work together to produce the dynamics, the history, and the development of the system, he says. There isn’t a single explanation for how CLL happens, let alone how it evolves, adapts, transforms. Unpredictable things happen. Needless to say there also isn’t a single solution.

Nevertheless, this perspective gives me hope. Not that a cure for CLL will be produced tomorrow, but certainly that more efficacious and less damaging possibilities are opening up that might prolong the life expectancy of people with CLL (so far this has not been possible). The outlook is considerably brighter than when I was first diagnosed six years ago.

It fills me with energy and hope: that this research can be understood in terms of a larger project, within an ecological matrix encompassing micro and macro environments, time scales ranging from the big bang to now, symbiotic relations as apparently diverse as the relation between ants and aphids in a garden and malignant B-cells and nurse-like cells in a CLL environment.

It gives hope when things are going well (like now, when treatment is resting in a sweet spot). Not when you are teetering on the edge of a chasm filled with black rising sludge and you see death edging its way up out of the tar pits toward you, like a massive land sloth.

In the dark times it is the sloth that imaginatively materializes, rather than a colony of ants. Although the ant analogy has greater scientific resonance, the sloth connects affectively to my bodily experience. But in the process of writing this piece I have relinquished the idea of ants scurrying around inside my body, am more able to situate ants and cancer cells in an analogous relation, within the framework of dynamical systems. This I realize: it is not necessary to feel ant-like in order to grasp the import of the analogy. You might say my cognitive apprehension has marginally improved. On the other hand, it is only through sensation, through ways that the body experiences being in the world, being in the garden as well as in the hospital and the lab, that understanding grows. Figures of speech, often fantastical, may seem to be at odds with scientific data, but the human sensorium involves a rich patterning of signaling networks. The connections between science and imagination are myriad and marvelous.

 

Notes

“Ants are like cancer cells”…….. Deborah Gordon in her talk “The evolution of collective behavior in ant colonies.” at the conference, “Anthropocene: Arts of living on a damaged planet,” May 8-10, 2014, organized by Anna Tsing at the University of California, Santa Cruz. Her writings include Ant Encounters: Interaction Networks and Colony Behavior (Primers in Complex Systems) and Ants At Work: How An Insect Society Is Organized.

“the researcher group called them “nurse-like cells,” or NLC”….. “Blood-derived nurse-like cells protect chronic lymphocytic leukemia B cells from spontaneous apoptosis through stromal cell–derived factor-1”

Jan A. Burger, Nobuhiro Tsukada, Meike Burger, Nathan J. Zvaifler, Marie Dell’Aquila, Thomas J. Kipps,  Blood. Oct 2000,96(8)2655-2663; http://bloodjournal.org/content/96/8/2655?variant=long

“chickens (with whom we share about 60% DNA)”….. NIH 2004 News Release. “Researchers Compare Chicken, Human Genomes: Analysis of First Avian Genome Uncovers Differences Between Birds and Mammals” National Human Genome Research Institute. Last Updated: November 17, 2011http://www.genome.gov/12514316.  Accessed May 15, 2014.

 

 

Frenzied Calm

The obsession grows slowly, building in momentum. In the beginning it tickles, a feather playing whimsically over the surface of your skin, a pleasurable sensation. Delicately a world opens up, a world of the imagination, a “what if” universe.

It begins as a stray thought, a meandering fantasy. You are into your sixth month of chemo treatment, and have made a radical, anxiety fraught decision – to retire. On the one hand this is an acknowledgement that time is running out and on the other hand it’s a hedging of bets: that this way you can stretch time, make more of it, more time of your own choosing, less time whittled away in academic responsibilities and more time spent writing, gardening, cooking, with friends. Fuelled by a fantasy of slow time and slow food you nevertheless imagine rapidity: what if you had a stove that heats up more quickly, that cooks more speedily, that responds to your touch the way his car anticipates James Bond’s every tactile desire. What if there were gas burners that could alternate between flames shooting into the sky and the merest whisper of heat. Imagine not having to get down on your knees to use the broiler. Imagine having all four rings that work, tossing that pair of pliers you use in place of a missing knob.

And then you think well why not, why not give myself a retirement present? An idle thought.

You start dreaming, in a desultory way, about kitchen ranges. Just occasionally, while waiting for the clothes to dry, the water to boil, the chickens to lay an egg. The thought starts idling, seldom switches off, purrs away this side of consciousness. You encounter some beautiful ranges on line. Italian. Far too expensive. Gorgeous primary colors and great design – chunky yet streamlined. Suddenly kitchen ranges seem to pop up in conversation everywhere. Everyone has an opinion. Even people you’d always imagined as rat runners, always eating out, grabbing fast-food-with-the works and eating on the run, they too have range stories. Every house you visit lures you into the kitchen, every kitchen range you encounter elicits a story, a saga of mishaps, opinionated suggestions, alarming anecdotes. In Nasser’s kitchen you come face to face with the desired Italian range, magnetic, gleaming redly. You feel that this undoubtedly is it, the decision is made. Then you open the oven and it’s the size of a shoebox. So that puts a kibosh on that, and the search is on. You start visiting show rooms, department stores, specialty appliance shops, talking to the sales people and experts, reading reviews and users’ comments on cooking sites. And all the information you receive is totally contradictory. Nevertheless there is some pleasure in the exercise. It takes up time, time that could be devoted to other things. It takes up space in your head and on your desk where bits of paper are strewn, scraps on which are scrawled notes about ranges, scraps mixed up with insurance elective forms, with thick booklets on how to fill out retirement forms, and receipts for drugs that have to be checked against the FAS list, and lists of foods that are poisonous to chickens. You chuck that list, the chickens eat everything. You start a folder called Ranges.

It seems you might have to stretch the budget a bit to get the kind of range you want.

The horizon of desire expands. Eating your breakfast you imagine your beautiful new stove, you imagine it orange. You look at the timber floor, scratched, worn down to paper thinness. You look at the dingy walls, you look at the grungy greyish cabinets, painted an aeon ago. You look at the bulky energy-guzzling lights. They look back at you.

So you start researching sustainable flooring. Seized by nostalgia you are seduced into the world of linoleum, bewitched by the range of colors and patterns, play dough colors, gorgeously marbled, slightly unreal. You order samples and they come in great big boxes and take up lots of space. You start cruising around paint shops picking up swatches, speculating, merely speculating, what color walls, you wonder, would set off a Pop Rocket floor. Idly. Just for fun.

And so it begins. You rename your Ranges file: “Kitchen.” The idling revs up. You imagine a creamy color for the walls, not-quite-white, off-white perhaps, though your purchase on color is clearly precarious. The descriptive confusion, however, is just beginning, you are about to enter a forest, a delirious entanglement of names and colors that seemingly bear no relation to one another, and yet are always presented categorically in columns and rows, or in families, as though they accord to genre specificity, to taxonomic logic. Puppy Paws, French Manicure, Cappuccino Froth, Papaya, Frappe, Squish-Squash, Little Angel, Pineapple Fizz, Havana Cream.The difference between Moonlight and Morning Sunshine is infinitesimal if it exists at all. You wake in the gloom of indeterminacy, gathering strength to face the forms, the endless insurance forms in which you have to find exactly the right words to describe your disability, make elections, decide once and for all how much income you’ll get each month versus pay-outs to your partner when you die. The more you get now, the less he gets when you pop off. You put the forms away, unfilled-in. Nevertheless you feel pleased with yourself, your capacity to make at least a few decisions, today you will narrow the range of possible kitchen paint colors. You cruise around the city collecting paint samples. You get home and try them out and they all look different in situ, all wrong. Start again. Like a lepidopterist organizing their butterfly collection you are completely immersed in the project, captivated by detail, utterly content.

Details, ah yes, the myriad swarming details. Such as knobs for the cabinets. On the industrial edges of the city you find Knob Heaven and float amidst the offerings, a Holly Go Lightly buoyed up by treasure in this Tiffanys of Hardware. Ebay opens up even further opportunities and choices. You spend hours and hours there, discover a glass color called Coke bottle green, aka Depression Green. It is warm ice: clear, pale, translucent. You purchase samples to compare, one or two here another few there, you will send them back if they aren’t right. Now the house is full of boxes of knobs. Most aren’t right. It seems translucent green is a difficult color to render, and not all depression green glass is created equal.

And another detail—those bulky dim energy-guzzling lights, they have to go, cannot survive in your new streamlined gourmet paradise. LED ceiling lights, this you can get a handle on, but under-the-cabinet lights, this is mysterious. What is the difference between strips, tapes and diffusers? You find an environmental lighting place and a charming engineer who is happy to explain it all to a dumbass Martha Stewart wannabee.

Could it be that the knobs are a way of screwing down anxiety? It’s true that the more you screw the more a calm seeps into the kitchen, but it is a calm infiltrated by willowy strands of frenzy.

This frenzied calm is not unfamiliar. It comes with fixation, especially a new one, a new one displacing or not inconceivably augmenting, old obsessions. It brings pleasure: You wallow luxuriously in endless rolling waves of choice.

Painters come, inspect, frown and then smile and say: this is easy, will take no time. They estimate a week, ten days at the most. We choose a guy called Jack, he’s worked with a lot of old houses, he flatters our small Californian bungalow, he says that when he’s finished it will look like an original craftsman. He is reassuring. He tells us he teams with an electrician, a whizz at working with old houses, at figuring things out. He’s Jack too. The painter says, I’m Little Jack, he’s Big Jack. Big Jack, when he comes on board, tells me that he taught Little Jack everything he knows.

To compensate for the mid-high-end range it will be a modest “remodel” – no tearing down of walls or installing new cabinets. You will keep the deep green formica counter and the old wooden cabinets even though the Jacks have called them “carcasses.” Just a simple paint job, new flooring, new stove. Oh and what about the rusty clugging fridge? You narrow your choices, make decisions about things, use this opportunity to expunge the clutter. There is a long list of things, big things like a commercial stove (heavy but petite, adapted to a small domestic space), a new bisque fridge, a shiny hood, and small things like hooks and knobs and icy glass splash back tiles. All these things will make your kitchen cleaner, sleeker, more stream-lined, easier to work in.

Speaking of things, this is a period of transition. As a retiring Buddhist, or a Buddhist retiring, I am in the process of letting go, infinitesimally, of material things. This relinquishing isn’t like renouncing pleasurable things for Lent. It isn’t really about things as things, it’s more about a state of mind. It’s Ok to love plants and cultivate them, but not to lust after the cerise blossoms of the peach called Baron. It’s ok to raise chickens in your backyard, but not to love them immoderately. It’s a question of proportion. This I know.

I think of this kitchen adventure as a last fling with things, a slow waltz with the sensuous cushioning of daily life.

I had no idea how slow that slow waltz would be.

It begins with a rearrangement of the whole house. Everything has to be taken out of the kitchen. It’s a small kitchen. Not much stuff, you’d think. Yet box after box after box fills up. We starting by labeling scrupulously, in the end the garlic press and paintings and the iron and cans of cat food are flung into the same box. At two o’clock in the morning we run out of boxes, so stuff is just carried through to the spare room where the bed is upended to make space. Cook books are all over the living room. You have to step over large containers of vinegar, toilet rolls, tins of tuna.

The house has to be entirely rearranged. The entry to the attic is through my miniscule closet overcrowded with clothes, with fantasies of a more fashionable life than I get to lead in my mundane chicken-bound existence. The Jacks have to enter the attic in order to ascertain where the beams are in the kitchen, to construct a duct from the newly installed hood out through the ceiling. They return through the attic and into the bedroom in clouds of spurious grey matter. So I have to drag all my clothes out. It begins systematically but in the end, or very soon, I start throwing things randomly into black plastic trash bags. For the next six weeks I will wear the same three articles of clothing again and again, day after day.

We are all discombobulated, but the cats most of all. Elvis and Roxy are freaked and suspicious. Nothing is in its right place. They cannot enter the house through their normal way – a cat door that leads from the back garden into the kitchen. We have to rig up a ramp to the back bedroom and leave the window wide open. The chickens take this as an open invitation: Mi casa es tu casa. Chickens and cats pick their way over a forest floor of things—boxes of kitchen items and bags of clothes, a blender, toaster, food processor, quesadilla maker, cake tins, wooden spoons, my mother’s fish knives. The detritus of human hubris. Elvis who has ignored J for twelve years turns his back on me each night and curls up in the crook of J’s leg. He holds me responsible. He is right, and my heart is crumbling.

As work begins on the kitchen clouds of dust, shards of dried (old and toxic) paint, globules of grouting, slivers of rotten wood fly into the air and spread through the open doors and windows into the rest of the house. You fight your way through a fog of filth, space travelers entering an alien planet. Big Jack and Little Jack, and J too, are all indifferent to what I consider filth. And all three are indifferent to the difference between open and closed doors. You cough and splutter and seethe and go around closing doors and windows. Two minutes later they are open again. You close them. You watch the dust settle daily over the few bowls and plates that have been secreted in the living room for eating off laps, over clothes, CDs, plants, the cats’ food, tea towels, books, bread. My skin is scaly. Irritation and stress fester and bubble. I cannot comprehend this indifference to filth. The three men no doubt consider me fanatical and as Buddhists and Painters and Electricians and Husbands know, fanaticism is pointless. What does it matter? Well to me matter out of place is dirt. The more displaced the more alarming. I imagine the filth as endemic, the project of cleanliness never ending. I have become the suburban Woman of the Dunes, endlessly removing sand that seeps back through the cracks, rising up, engulfing the universe.

If only I were a chicken. The greatest joy for a chicken is to take a dust bath, to hunker down into the earth under the pepper tree to scrabble and scratch and hurl the body around and fluff the feathers and make sure grit infiltrates every feathery layer, and then to shake and shimmy and fill the air with clouds of dust.

For meals we have to perch on the edge of chairs clutching our plastic bowls of cereal, or hard boiled eggs, or sandwiches bought down the road. At lunch we turn on the TV and we are in a courtroom drama. Today, June 10th 2013, the trial of George Zimmerman begins. Trayvon Martin was shot and killed by George Zimmerman on February 26, 2012, in Sanford, Florida, while visiting his father in a gated community in which Zimmerman was a neighborhood watch volunteer. Trayvon Martin was carrying skittles and a can of iced tea. He was not carrying a gun.

We aren’t the only people in this country, and in the world, to be drawn to the TV today, to cell phones, to laptops, to radios. This trial has been much anticipated, preceded by protest and by media debate about racial profiling, vigilantism and, given the proliferation of guns in this country, laws governing the use of deadly force. The protests were prompted by the failure of the Sanford police to arrest Zimmerman. Before a special prosecutor assigned to the case ordered Zimmerman’s arrest, thousands of protesters gathered in Sanford, Miami, New York and elsewhere, many wearing hoodies like the one Martin had on the night he died. President Barack Obama said that if he had a son, “he’d look like Trayvon.”

Forty four days passed before Zimmerman was arrested and charged with second-degree murder, to which he is pleading not guilty. In order to secure a conviction prosecutors must show that Zimmerman acted with ill will, hatred, spite or evil intent.

One day follows another, dates crop up and fall into line, stories follow a sequence, history is narrated. Sometimes, however, the flow of time is barbed. Time spins furiously in slow motion, in Spartacus time spinning wheels are intercepted by spurs, spokes, foreign bodies. Collisions occur: Time is derailed.

Perhaps I have grown more particular, sensitive to dirt, to alien microscopic creatures, since having CLL. With a damaged immune system you get to be more cautious. Neurotic even. You imagine things: you imagine the state of Jack’s lungs and skin as he scorns to wear a mask, you ask yourself what if those lurgies glom onto my wonky immune system? What if Elvis’ asthma is exacerbated and he has a fit and dies? The line between pathology and realism is a fragile line. One thing leads to another. What if the colors are all wrong and Big Jack and Little Jack become fixtures in the kitchen, here to stay forever, forever never ending, never completing. The “what if” universe in which you wallowed, purring, fed by and feeding a luxuriously obsessive fantasy has changed its contours and tones. ‘What if’ is now a perpetual unrelenting anticipation of disaster.

Conceivably, it has nothing to do with CLL, is simply a matter of categorical dissonance. Mary Douglas speaks to me in magisterial tones: Categories, she says, are in and of themselves spurious. There is no absolute distinction between clean and dirty, no invincible boundary, what is dirty in certain societies or circumstances may be clean in another. The point is not any absolute difference but rather the processes and attempts and elaborate rituals erected to instantiate those distinctions, to make sense of the world, to ensure order. Mary Douglas speaks to me and I listen, and it makes no difference. Or put it this way: the fault line between filth and cleanliness, purity and danger, opens an invincible crack of opportunity for that night stalker: obsession.

Again, we find ourselves in front of the television. Every lunch time we turn our backs on the chaos in our house and enter the public courtroom. The trial begins with jury selection, a process that, as it turns out, will take nine days. Prosecutors and defence lawyers cannot overtly use race as a reason to challenge a juror. But jury selection is a space where the insularity and focused particularity of the court is haunted by ghosts and demons that infest the larger location and culture. Animated, those ghosts invade the courtroom: invisible, but not nameless. Emmett Till, the Scottsboro Boys, Martin lee Anderson …Remember Rodney King—an African American man brutally beaten by white cops in Los Angeles in 1991, an incident vividly captured on videotape. Nevertheless a jury without black representation (after the venue was moved from Los Angeles to the virtually all-white Simi Valley) acquitted the officers of state criminal charges.

On Day 5 of Jury Selection a middle-aged black man who works in a school describes his family and friends’ reaction to Martin’s death as “typical,” given a history of violence against African-American men in the U.S.

Day 9.  A six woman jury is selected, five are white and the other black/Hispanic.

 At the end of the day we turn to the news and analysis and interviews. It is becoming a habit, a fixation, an obsession.

Every so often, randomly it seems, Word announces that it’s in Compatibility Mode. What, I wonder, is Incompatibility Mode? Computer dumb, relationship savvy (or battle scarred) I can say with some confidence what Incompatibility Mode is in a relationship. It occurs in the kitchen. J and I, after some years of frustration in a shared kitchen, worked out a modus operandi, or compatibility mode. The key is not-sharing. He is easy going, unmindful, non-judgemental, a great cook, full of invention and surprise. I’m the sort who cleans up as they go, and can’t help offering generous dollops of free advice—albeit well considered, based on many years of perfecting a range of kitchen techniques, of doing things just so, this way precisely, and no other. He’s the sort of person who produces utter chaos in the kitchen, using every available pan and pot and utensil, several different kinds of oil and flour and sugar much of which lands up on the floor along with vegetable peelings and a few fugitive oily anchovies. All squished and trodden under foot. Out of all this apparent chaos and disorder J invariably produces a marvelous meal, a wondrous alchemical concoction. But then, afterwards, replete and sated I would be left to face the chaos and would have to spend many hours washing, cleaning, sorting. There would be moaning, whingeing, recriminations. For him, after my turn at cooking, clean up would be a breeze. Moaning, whingeing and recriminations would follow—from me. The solution we found was to reconfigure the division of labor: whoever cooks, cleans – the kitchen is theirs for the night. Peace ensued.

“Fucking punks. These assholes always get away.” Prosecutor John Guy quotes Zimmerman from a tape of a call he made to a non-emergency police number after he spotted Martin walking around the gated community where he lived. We are riveted to the television for the first day of testimony. June 24.The opposing attorneys set the scene today. “We think that this is a simple case,” says Benjamin Crump, the family’s solicitor, outside court. “There are two important facts in this case. Number one, George Zimmerman was a grown man with a gun, and number two, Trayvon Martin was a minor who had no blood on his hands. Literally he had no blood on his hands.” Defense attorney West: “George Zimmerman is not guilty of murder. He shot Trayvon Martin in self-defense after being viciously attacked.” The claim is that, after the two got into a scuffle Martin was slamming Zimmerman’s head into the concrete pavement when he fired his semi-automatic pistol and shot him in the chest.

“Stand your ground” is not mentioned today – and indeed the 2005 law will not be mentioned or actively invoked in court during the entire trial. But it is this law that provides the scaffolding, that makes it easy to plead self-defense in a killing in Florida, and it is what will put the onus of proof in this case on the prosecution. The State will have to prove beyond a reasonable doubt that Zimmerman did not act in self-defense. Zimmerman’s team will merely have to argue that Zimmerman felt threatened.

Prior to 2005 most states required you to retreat from a confrontation unless you were inside your own home. But in 2005 Florida, urged on by the extremely powerful gun lobby headed by the National Rifle Association, became the first state to pass a “stand your ground” law. Now 25 states have these “shoot first” laws.

Imagine Jack arrives at my house one day while I am in the garden planting bulbs, dibber tucked into one side of my belt, hand gun on the other side. I refuse him entry, say I’ve had enough, cannot bear this home invasion a moment longer. He becomes abusive, starts cursing and lunges at me. I feel threatened and so, in self-defence, pull my gun and shoot. He falls to the ground, dead. Painter dead as a dodo. Under protection of “shoot first” laws I am authorized to use deadly force even if the person who makes me feel threatened, let’s call him Jack, is—like Martin—unarmed. An upright and righteous citizen-sheriff I am safe from prosecution.

Or maybe not. It would be easier I imagine if the hoody that Jack habitually wears were pulled low over a black face. My sense of threat would be more believable to a jury. Or then again, maybe not. Remember the Florida case of Marissa Alexander, who last year cited the Stand Your Ground law to justify firing what she said was a warning shot to protect herself from her abusive husband. No one was killed or injured.But that defense was rejected and she was convicted by the same state attorney’s office prosecuting the killing of Trayvon Martin. She is currently serving a 20-year sentence.

No doubt there are many legal complications, loopholes and explanations to be taken into account. Nevertheless, U.S. Rep. Corinne Brown, of Jacksonville, an advocate for Alexander, seemed to have touched a nerve when she said at the time of sentencing, “The Florida criminal justice system has sent two clear messages today. One is that if women who are victims of domestic violence try to protect themselves, the `Stand Your Ground Law’ will not apply to them. … The second message is that if you are black, the system will treat you differently.”

Brown is a woman not afraid to exercise rhetorical flair, and not afraid to say the R word. During the Haiti crisis in 2004 she referred to the Buah administration policies on Haiti as “racist”, and called his representatives a “bunch of white men.” When Assistant Secretary of State Roger Noriego said that, as a Mexican American, he deeply resented “being called a racist and branded a white man,” Brown lobbed back: “you all look alike to me.”

Peace ensued. But now, in the domain of the kitchen, our orbits collide, a ferocious incompatibility reigns.

Exchanges might go something like this:

These light switches looked elegantly off-white, in their packaging in Home Depot, I say to J, but up on the wall, here in the kitchen, they look grey and murky. We’ll have to go back and change them.

“Oh, they aren’t so bad. I can live with them.”

Live with them! For the rest of your life you can get up every day and face this ugliness and live with it?

Or like this:

Do you have any receipts?

“Receipts for what?”

Well, for instance the wax furniture paste we had to buy to fix the scratches on the counter top the painters made? Or the extra primer, or the screws for the knobs, or the drill we had to buy to cut the glass tiles……

“Hmmm, I wonder where they are. Don’t worry they are somewhere, they’ll turn up.”

Or

“Everything went well today, it’s looking great!” Thus J entices you into the kitchen. You look, nothing seems to have changed. You look closely, peering into every corner, into the back of every cupboard. Aha! There’s only one coat of paint on this shelf. “Oh, I didn’t notice. Do you think it matters? When there are things on the shelf no one will notice.” No one?! Who is this phantom No One? This No One reconciled to half assed mediocrity.

“Through time, in this country, what I like to call bleeding-heart criminal coddlers want you to give a criminal an even break, so that when you’re attacked, you’re supposed to turn around and run, rather than standing your ground and protecting yourself and your family and your property.” These are the words of former NRA president and longtime Florida gun lobbyist Marion Hammer, championing the “stand your ground” law.

You feel you are losing your kitchen and it may never come back to you. I think about Zimmerman on the look-out for outsiders, for people who (as he said in a police interview) “victimize the neighborhood”: Criminals, punks invading his space, intent on destroying the gated calmness of his community. I don’t want to leave the house, because there’s always something left undone, overlooked, incompleted, botched. But I have to leave the house, have to keep returning to the paint shop because we can cut costs this way, Big Jack and Little Jack get paid by the hour and run by the seat of their pants, fixated on the job, unmindful of how the future unfurls. We are always running out of primer, out of this, out of that: rollers, paint trays, rolls of plastic, sand paper, buckets, primer, more primer, just another quart of trim. You also have to keep returning to the environmental lights shop to consult and get advice. Big Jack, who is also Old Jack, knows nothing—it turns out—about LEDs. When I try tentatively to explain the difference in voltage he looks at me contemptuously and says “I’ve been installing lights for sixty years.” He proceeds to fuck up grandly. So over the weekend we call in another electrician, a green guy J knows through yoga circles, who unearths the problem, fixes it and charges quite a lot. You are nervous about raising this with Big Jack so you raise it with Little Jack who says he’ll sort it. And then he adds, “Big Jack’s not as young as he once was. But he taught me everything I know.”

Day 7, July 1st. Detective Chris Serino takes the stand, and audio and video recordings of police interviews with Zimmerman in the days following the shooting which had been made public during the discovery phase of the case were replayed in court today. In these interviews Serino appears skeptical and pushes Zimmerman, suggests that he was running after Martin before the confrontation, suggests that he shouldn’t have followed Martin after a police operator had told him he did not need to, asks Zimmerman if it hadn’t occurred to him to ask Martin what he was doing there. Racial profiling aside, the cops seem not entirely happy with these law enforcement mavericks who take it upon themselves to do a job the police can do quite well themselves. Yet today, very calm and considered in the box, Serino explains that the questioning was tactical, a “challenge interview” where detectives try to break someone’s story to make sure they’re telling the truth. He was persuaded that Zimmerman was indeed telling the truth. “In this particular case, he could have been considered a victim, also,” he concluded.

There is however, one interesting moment in the interviews that contests the (not without foundation) stereotype of the profiling proclivities of the Florida police.

Serino: What is that you’re whispering? Fucking what?

Zimmerman: Punks.

Serino: Fucking punks. He wasn’t a fucking punk. (clears throat)

Serino had initially recommended a charge of Manslaughter, which most legal experts agree would have had a much greater chance of conviction than second degree murder. Why did he change his mind? What pressures and negotiations and deals occurred? This we might never know, but for sure we can assume that the judiciary and the police and the neighborhood watches and various political pressures intermesh in complex and contorted ways.

On this day too an audio analysis expert for the FBI testifies that the origin of the screams on an audio tape of the altercation cannot be determined. Contradictory evidence will be submitted: Both Martin’s mother and Zimmerman’s will attest that the voice is that of “my son.”

How electricity is generated and how it moves in circuits from the sun and through a dwelling is hard to imagine but not as complicated as circuits of indebtedness, circuits of giving and receiving, owing and repaying, commissioning and paying by the hour for services received, for immediate labor embodied in skills accumulated over years of experience. Priming—this is tough and meticulous work, tedious and slow. You are appreciative of the Jacks’ attentiveness to this part of the process, you bear witness to the pain in a sprained wrist, the back that’s a bit crooked, the legs that buckle occasionally. You know that even though Little Jack in a moment of exasperation told you your cabinets were a piece of crap and should be trashed this hasn’t prevented his patient persistence, pride in a job well done, in cabinets that begin to gleam as the final coats of filtered sunlight slither on. You forget sometimes to ask them what they think, to show appreciation, you don’t want to behave like a Madam, but you want the guys to know that you know what you want. Yet the more the job progresses and drags on the less you feel you know what you want, and the more perfection bays at your heels, aggravating everyone’s anxiety.

Day Fifteen. It has felt as though this trial will never end. Day after day we pull the plastic shroud off the television, dust cloths off the sofa, prepare our feast of hard boiled eggs and switch on the cable news. Now, after almost three weeks of testimony, after the interrogation of 58 witnesses, it is over. July 13. Not guilty. Race has hardly been mentioned in court. The Prosecution said, today, after the verdict, “This case has never been about race or the right to bear arms. We believe this case all along was about boundaries, and George Zimmerman exceeded those boundaries.”

The processes and attempts and elaborate rituals erected to instantiate and often to blur boundaries, to make sense of the world, to ensure order. Clean and dirty, black and white, a threatening act and an act of self-defence. Lines of continuity, jagged lines of differentiation. Consider the line of continuity between the old lawless South and the South today where racial violence might enjoy legal sanction. Boundaries. Categories. Where are the fault lines?

There has been one witness who’s rocked the boat, who’s raised the issue of race. Rachel Jeantel—spiky and insolent, contemptuous of protocol, uneasy in court, ungroomed for public appearance—was Trayvon Martin’s friend. He called her just before he died. Over nearly two days, days 3 and 4, Jeantel’s testimony was broadcast live, nonstop, on cable news. It was riveting, not just because of revelations and certainly not because of her persuasive powers, but because of the dissonance she introduced into the proceedings, her disturbance of the tacit agreement to not discuss race or gun laws. In her reluctant laconic sullenness she danced into the court, out through the television set, into the world and into my dusty house like a skirmishing corkscrew. Jeantel said she overheard Martin demand, “What are you following me for?” and then yell, “Get off! Get off!” before his cellphone went dead. She testified that he described being followed by a “creepy-ass cracker” as he walked through the neighborhood.

“Do people that you live around and with call white people, ‘creepy-ass crackers’?” the Defence asked.

“Not creepy. But cracker, yeah,” Jeantel said.

“You’re saying that in the culture that you live in, in your community, people there call white people crackers?”

“Yes, sir,” she said.

When the defence suggested that Martin attacked Zimmerman she blurted out “That’s retarded, sir.” It was the conjunction of those two words—“Sir” and “Retarded”—that sparked a macabre levity, for the first time in weeks J and I roared with laughter. It was as though the unconscious of half the US erupted for a moment, shattering the precarious compact of civility, exposing how frenzied is the calm.

You imagine a deep dark hole in this country into which all the puddles, all the rivers of heartache and injustice perpetrated by the judicial system trickle and disappear. They don’t always mesh: justice and the efficiency of the system.

The chickens are neglected. They are fed and watered, let out in the morning and locked up at night. There is no time that isn’t kitchen time, or Trayvon time, no time to pick up Holly and stroke her neck, watch her eye lids flutter and close as she sinks into sleep.

So when Katie and Susan visit they pick up the chickens and murmur sweet nothings. I am thrilled that they are here, not only because they are who they are, but also because it gives me license to shut the door on the kitchen for three days, walk away from it, not think about it. But Katie and Susan discern a cranky demeanor and try shucking, teasing, easing out the oysterish story. To deflect their attention from my fixations I tell them a story about my maternal grandmother who lived in the inner suburbs of Salisbury in colonial Rhodesia. Every night she drank a lot of whisky. But her drinking was not random. It was ordered, repetitive and ritualized. She would never touch a drop during the day, would only begin at six o’clock in the evening, just as the television news came on, though the news was preceded by preparations, undertaken by the cook but overseen by her: ensuring the soda siphon was full, the tray laid with her special glass, a tumbler of ice and a decanter of whisky. Two minutes before six she would rush from the verandah into the living room, settle into her armchair, switch the TV on and as the news began take her first sip of whiskey and soda. After the news she would continue sipping, dreamily edging into blotto land. I remember how she would regularly complain to my father about the weekend shabeens held by all the servants who lived in the neighborhood, they would make illegal stills of skokiaan during the week and have loud parties on Saturday night. “You simply can’t imagine, Jack,” she would say, “how strong skokiaan is, how it induces violence, it shouldn’t be allowed.” And he would roll his eyes, and say “And what about whisky?”

Katie and Susan look at me, incredulous, and they say, in unison: “Jack? Your father’s name was Jack?”

You imagine a small but deep and dark hole opening up in the middle of the kitchen, a deep dark hole which sucks, dollar by dollar, all your retirement savings.

The obsession grows slowly. At first a feather stroking your skin, teasing. Then you start making decisions, a mix of torture and delight. Then the renovations begin, and the obsession takes a turn. For the worse. No longer in control of a fantasy world, the world starts intruding, making demands, taking up time, insisting. The feather insidiously sprouts razor teeth, becomes a baby shark nibbling, nosing you into a corner, drawing blood.

 

 

Notes

Mary Douglas speaks to me …. Mary Douglas, an anthropologist and cultural theorist, wrote the highly influential Purity and Danger: An Analysis of Concepts of Pollution and Taboo (first published 1966).

there are many legal complications, loopholes and explanations .… mandatory-minimum sentencingnot the least of it in this case.

 

 

 

 

 

 

Some Musings on Metaphor

A good month, June. Feeling considerably better, with miles more energy. It has been amazing to look at the print out of my labs the last few weeks. Bloodwork shows much improvement, many items that were flagged too high or too low have settled into the normal category. Looking at the results each week (they come up on the computer a few hours after the labs these days) is like watching a soccer ball, soaring in slow motion, peeking and then descending. Hold your breath: where will it land, inside or outside the line?

My white blood cell count fell into the normal range fairly soon after starting treatment. But actually there are many kinds of white blood cells, and there are at least two kinds that are crucial indicators for CLL, or since each case is idiosyncratic let’s say for me at the moment. My neutrophils are slightly low – most likely induced by the revlimid. If they go much lower it means likely neutropenia (when you are dangerously at risk of infection, when you have to eat only cooked vegetables and fruit, wear a mask etc …. everyone probably knows someone who has had cancer and endured a period of neutropenia, induced by the chemo) but so far very borderline. Then there are lymphocytes. In the last month the absolute lymphocyte count has normalized. Marlene Millen, my primary care physician, said no wonder you are feeling better, when your lymphocyte count is up its like you have a constant virus, you are fighting it, day in and day out. My first reaction was Whoa, what would you know what it feels like. Stick to science, doctor, don’t presume to tell me how it feels. A flashback to hot flashes and the gynecologist (young, compassionate, efficient, female) who said, just think of it as a normal part of life, everyone gets hot, I get hot sometimes, and I just take a deep breath and drink some water and it passes. Well bully for you lady, may you wake one day in your best silk blouse suddenly sweating swinishly as you address a room full of bright-eyed and bushy tailed gynecology students. A moment ago they were hanging on your every word, now their eyes are fixed on the sweaty stained blouse clinging to your breasts. But Millen is not that gynecologist. She is tough and vigilant and frank. She is also a go-between, mediating between the various specialists I encounter, ping ponging from one to another. She was the one who really kicked me into treatment the first time. Listen, she said, Kipps will always say “it’s maybe time to start thinking about treatment, here are the options, of course it’s your choice.” “But I’m not Californian,” says Millen, “and not afraid to cut to the chase. You have put it off for long enough, and now you are saying well I think I’ll wait a while. You really need to start treatment NOW.” She must be about half my age, but she calls me “Sweetie.” “Well done Sweetie,” she will say when she thinks I have conquered the denial impulse and recognized some danger signal and given her a call. I find it very endearing to be called Sweetie. Bitter sweet like the Jane Campion movie.

Friends are curious and always asking: what is it like? Much of the time we look quite normal, when you go the CLL support group you might think you were in a room of perfectly healthy people, the swollen lymph nodes and spleens are not visible, nor the haywire white blood cells, cavorting platelets, nor the havoc being played in bone marrow. Nor the sense of utter exhaustion and fluishness. People often say to me “how are you? You look great!” On bad days this can be a trifle irritating, because typically they ask a question and answer it themselves, pronouncing you well and fine. This was a refrain after my dance with death just before our Boxing Day party, though on this occasion not in the least irritating. Boxing Day is the day after Christmas and this last year it was also the day after I came out of hospital. The cause was an infection that went haywire over night, landing me in the ER. Four nights in hospital and then I was fine, immensely relieved, and we went ahead with our Boxing day tamale party. Teddy Cruz gets the most delicious Guatamalan tamales from a source he refuses to reveal. They are wrapped in banana leaves and steamed. Unwrapping is at once a delaying mechanism, a stringing out of anticipation, and a process of revelation. As you unwrap the smells start swirling, not just one smell but many. The masa (or corn dough) inside the banana leaf wrapping is in turn wrapped around the filling—pork or chicken—and a sauce that is beginning to ooze out so you have to lick your fingers to get a taste of what is to come. You pause, fingers in your mouth, imagining. And then you break into the tamale. Inside there is pork and a piece of fruit, and even though there is a melting moment flavors are distinct—sharp, sweet, meaty. You scoop a bite of tamale into in your mouth, and enter heaven.

I have never met this woman who works in her kitchen at home and conjures these magical tamales into being. Teddy is the go-between. But I do know something about her. A week before Christmas her husband, who had been living and working in San Diego for years, was walking along the street not far from our house when a Homeland Security van pulled up and stopped him, requesting his papers. He had none. He was pulled into the van and deported from the country.

Although I sometimes find the “you look great” refrain irritating, receiving it as vacuous routine politeness, actually I know that when people say this they are more often than not performing an act of sympathetic magic: they are wishing that all is well, they want you to be well, they want to believe that everything is fine. And you participate in the performance. You are relieved to be alive and want to look as normal as possible. On Boxing Day I was particularly glad to be alive and celebrating. But the scary thing is the knowledge that it could be something like this that will take me out. Most CLL deaths (because CLL is a disease of the immune system) are from simple infections that flare up quickly and can’t be controlled. This is what Millen has always been trying to impress upon me: be alert to the signals, act immediately, don’t be so cavalier. She was pregnant and on leave when this happened, but when she came back she said, “Well done Sweetie, you got yourself to ER in time.”

Millen offered the metaphor of living with a virus. There is an aptness to it, it’s graspable, something one can offer to others. Kipps offered another. After my first treatment I said to him It’s like a miracle. I had no idea how awful I had been feeling. For years. This is the real normal and it’s a great sensation! Kipps said many patients say exactly the same thing. And he offered a metaphor: it’s like hiking up a hill with a back pack on your back. You start with a few pebbles in your back sack and after a while you add a few more, and then after another few miles the gremlin at your back tosses in just one more stone, but this one is a little larger, heavier. And so it goes, and as you climb you accommodate to the weight and the difficulty, and you come to imagine this as normal.

Rather than being affronted by Kipps’ simile, or his presumption in describing my sensations, I experienced a surprising sense of gratitude. His image was not exactly intricate or poetic, and certainly far from scientific. Perhaps though this is precisely the key to understanding how it works. How a simple metaphor describing an illness can spark delight. Why, I wonder. Clearly, on one level it’s because of recognition. It offers a mirror image, a confirmation of identity. Thus, it might be argued, it doesn’t do much to shift anything, simply confirms the way things are, the way you feel. And although I hate the kind of feel-good triumphalism that validates every feeling as evidence of self-worth nevertheless I think there is something crucial that happens when the language of medicine or science is blurred by the poetic impulse of metaphor. Many illnesses, particularly chronic ones, as well as many psychological states, are isolating, for the patient it’s hard to situate what they “feel” as anything other than ultra-personal. There are times when you think maybe it’s all in my head, or maybe I am inducing this illness because of the way I feel. So to have an image flashed up, from elsewhere, from someone else, that is evocative and feels accurate – this is like getting a hit of immunoglobulin. You want to shout out Yes! That’s it! Something surges through your system, is energizing, and it isn’t a drug. This kind of metaphor differs from the destructive metaphors that Susan Sontag so brilliantly described in Metaphor as Illness. Metaphor literally means a bridge between two things, two words, two images. The more unlikely the linkage the more powerful the metaphor, and the more it can be spun out the greater its capacity to inspire intrigue and wonder. But in addition to confirming the way you feel, metaphor has the potential to perform an intricate dance of difference. There is always that space of difference, of something incommensurate that stretches between the two unlikely images. A patient is and is not a hiker. In that tension, in the surprise, in the fact that the image flashes up from elsewhere – it is in this process that metaphor has the capacity to open your eyes, to introduce not just sameness and recognition, but newness. The drugs serve to lighten the load, but words too.

Newness and surprise are great medicines.

Much of the time I swim through Kipps’ language, feeling an idiot because I haven’t done my homework and there is still so much I do not understand, and sometimes despair that I ever will. And there’s not much time. And how will I ever make the right decisions about which therapy if I’m so clueless? He has a lot of patients to see on this one day of the week when he isn’t doing research or flying around the world talking about CLL. Often I call up Sheila Hoff, our CLL nurse and case manager, and she patiently spends hours going over it all, translating, helping with decisions by giving examples, and always she says, think about what kind of a person you are, how you want to live your life, which treatment will suit you best. Or I turn to a patient advocate site on the internet, like that of Chaya Venkat. Sadly she has announced this week that she is retiring. Her husband died of CLL. Though not a medical doctor she is a science writer and she started the site (http://updates.clltopics.org) to link her husband’s journey with others’, to mediate between the scientific community (and scientific language) and patients. For twelve years (eight while her husband was alive, four after, by herself) she has done a quite amazing job as a patient advocate, and as a magician of words. Understanding the language, yes, but something more. Finding the words. Saying the words. Her retirement blog is very poignant.

When I was looking for good crime novels (when not?), the kind you can lose yourself in, Patricia Montoya, my friend and neighbor (who has herself recently been through hell, survived a rough stem cell transplant, now back for the summer in her bitter-sweet home, Medellin), suggested I read Tijuana Straits. It’s a surf noir novel set primarily in the Tijuana River Valley, the area that stretches from Imperial Beach in the northeast corner of the Valley (and the US) along the border with Mexico. Twenty minutes from where I live. It begins in the Estuary, with the main protagonist whose charge is protecting certain migratory birds (most notably the western snowy plover and the light-footed clapper rail) discovering in the early morning dawn a woman in distress, who seems to have crossed by an illegal route where the border fence cuts the valley in half. Kem Nunn evokes the area vividly: the crashing surf, the Lighthouse in Las Playas on the Mexican side of the fence, Yogurt Canyon, Smuggler’s Gulch, the routes through the Valley on this side – Monument Road at the edge of Border Field State Park, Hollister Drive, Dairy Mart Road – and the maze of dirt roads and horse trails. I started reading the novel after a particularly hairy infusion, and experienced a peculiar delight in recognizing these places, even seeing these names in print, saying them out loud. There is the comfort of familiarity of course, but also there is always a slight, maybe infintesimal, mismatch between the image offered and your memories. There is a pleasure in puzzling out how the images cohere, form a landscape, in imagining even when you can’t be there. Nunn wrote this novel shortly before Homeland Security hacked into the landscape in 2003 so brutally, demolishing a mesa, filling in a canyon and building a new, second wall flanked by a perfectly asphalted wide road, a road where no one drives except the occasional border patrol vehicle. So sometimes he describes a landscape I hardly knew, and I try to conjure it, ripping out the new steel fence, and the asphalt road, and restoring the canyon in my mind.

You picture and imagine a landscape, a configuration of space shadowed always by various histories, some quite personal others social, unfolding oblivious to your personal existence. It is like this too with simple metaphors, thrown up in the haze of misrecognition, when you do not know how to make sense of this place where you find yourself.

For me the Boxing Day party was a celebration of being alive, of having escaped again, of friendship. The house was packed, the air was festive, people drifted in and out of the garden, unlikely people became entranced by the chickens and entered into chicken conversations. The tamales, however, as well as being delicious were a reminder that cancer is a card you can carry, it’s like having papers, if you are lucky enough to have medical care people are basically on your side, they want everything to be fine, they want you to be well. Of course you live with the fear of sudden, or slow, death. But as people who have cancer and Buddhists and even total strangers with whom you strike up a conversation in the long queque at the pharmacy remark: we are all going to die, death is a part of life, and anyway who knows you might walk under a bus tomorrow. True no doubt. But it is also the case that many people in this country live without any papers at all, let alone a cancer card, and they live in real and daily fear of a chasm opening up when and if the Homeland Security van pulls up one day as they stroll to work, to the shop, to neighborhood park.

Boomerang

Why did the Australian go berserk?

Because he got a new boomerang and then he tried to get rid of the old one.

Yesterday, an infusion day, Akos [Ronas] gave me a ride to the hospital. He was euphoric having just sent off his book manuscript. But, he said, his relief was shadowed by a joke. Akos is married to Judit Herskó, whose father was János Herskó, a Hungarian film director who would often enter his own films to tell a joke. He might for instance materialize at a trolley station, and for no very good reason, would tell this boomerang joke. I guess it was at the height of boomerang jokes, I vaguely remember them circulating when I was a kid, round about the time of hula hoops.

Every writer knows this: The sense that your book is never really finished, it will keep coming back, there will be more revisions, and more and more. And now that all the versions are electronic, the old versions, full of typos and one or two crucial mistakes, threaten to reappear in the proofs. It’s only when you get the published book—that solid thing—in your hands, that it feels finished. Maybe. But of course all that is changing. That solid thing, the book, is disappearing, words materialize and evaporate as you write, as you read. This is not to say that nano publishing and the drive towards the short bite rather than the long book guarantees the sense of an ending. No, instead there is something far more precarious: ephemeral finality, ghosted by a labyrinthine digital archive. Words are like money. They melt into air and reappear in new configurations. Akos’ book is about plastic money, a history of the credit card in post communist countries. Some of these credit cards, linked to the state rather than banks, are used much more habitually and extensively than in the U.S, for instance. Money in the form of bank notes and coins and written checks scarcely exists. Credit cards have become a form of ID, they store information, can be used to receive, electronically, all sorts of things, like your pension payments. And even as I write, credit cards themselves are disappearing: into cell phones, into thumb prints, into eye scans. Not only in the post-Communist world. You know that dubious item you bought (no didn’t even buy, just perused in a browsing sortee late one night), well it will reappear for everyone to see on some social networking site as something you “like.” Even worse, that aberrant impulse will return to plague you in the form of endless haranguing from cheesy underwear companies. You might forget but the marketing machine will not. Your secret is never safe with Victoria.

The boomerang joke can manifest in many guises. You could give it a Zizekian spin, which might go something like this. The Australian wants to get away from Australia and start afresh. So he goes to California, say, and sets up an alternative market where he sells tea tree oil and water-wise Australian native plants and a unique new service, surfing therapy (therapy while you surf ) ……. No problem with the Californian surfing dudes – they take to therapy like ducks to vodka. But then comes a guy who looks and talks like Brian Brown. Laconic, gruff, handsome in a chiseled hard-knocks kind of way. Turns out he himself is a surfing analyst, and the question he asks, which sends the whole new age entrepreunerial enterprise for a loop, is this: “Why did the Australian go berserk?”

For me, in the infusion center later in the day, it bounced back in the spectral form of CLL. In the last week I’ve been feeling considerably regenerated, exhilarated, hopeful again. The lab results confirmed that the feeling isn’t merely illusory. So Dr Choi thinks we can now double the oral chemo dose; and reduce the infusion chemo to once a month. He warns that things will probably get worse again, before and if they get better. He says they do not know whether the increased dose correlates with increased effectivity (this is a trial, it’s one of the things they are trying to determine), it does seem to be the case, but it might be that because patients are improved before the dose is increased their systems are in a better position to deal with the ravages of the drug. In the Infusion Center, while keeping up a façade of cheerfulness, I experienced again the cul de sac sensation. The futility of it all. Although there may be periods of respite, CLL itself will always bounce back. Once it’s started progression it will move in a relentlessly linear fashion, gathering momentum, working towards a conclusion. But against this teleological drive, as a person who “has” CLL (and other kinds of chronically incurable diseases, I imagine) you experience periods of optimism, euphoria even. Just when you have forgotten about CLL, are getting on with life in an enjoyable day-to-day fashion, it whizzes through the air and hits you on the back of the head, sending you catapulting back into the ER, back onto antibiotics, back into a funk. The malevolence of repetition.

There is an extraordinary air of cheeriness in the Infusion Center. At its worst you might think of it as something akin to battery chicken farming. When you close your eyes and try to sleep the noise keeps you awake, the noise of beeping machines, televisions, people talking on cell phones, nurses reading out orders – all these noises merge together and sound like the strangled clucks of a thousand tormented chickens. All of us chickens chained by tubes that run between machines, that run from little packets of clear liquid hanging from hooks, into a multitudinous network of veins, ready and waiting for chemo plumping. But at its best everyone is cheerful in the Infusion Center, polite even, even as the day wears on. There is much joshing and spinning out of repartee, bits and pieces of verbal exchange are tossed hither and thither, everyone enters into the fiction that this is just an ordinary day, a day like any other. And of course for the nurses and staff it is, which makes it all the more extraordinary that under duress and repetition they are so alert and behave with such good natured equanimity, remembering names, histories, stories. And through this enactment of an illusion everyone rises to the occasion, enters into the spirit of the performative event, into this compact of civility.

I do appreciate the considerable theatrical skills, as well as the hospital experience, that it takes to generate and sustain a mood. Still, sometimes you want something to puncture the air of equanimity, you want something that hits the nail on the head, you want a joke that is grim, black, irreverent. The boomerang, as used by Australian Aborigines, was and is a tool and a hunting weapon, some are designed to return (in their flight frightening birds, say) but mostly they are intended to hit and bring down a prey, a moving target. Curiously, when it comes to jokes (and illness) hitting your prey can simultaneously be a way of releasing all those lurgy birds lurking in the wetlands.

 

 

 

 

 

 

Chickens Saved My Life

Chickens changed my life. Saved my life. Though it is also true to say that as we surf the stormy waves of birth, old age, sickness and death, many things, people and events change what we call our “life”. A life is merely a conglomeration, a concatenation of effects and affects, often unpredictable, though even when predicted things seldom turn out as expected.

And it was not by chickens alone that I was saved. But among all the therapies—chemo, meditation, acupuncture, naturopathic treatments, exercise—chickens, four glorious chicklets-becoming-hens—have changed things most dramatically. Holly, Lula Mae, Sabrina and Funny Face flap, flutter and jump onto anything that might resemble a perch, including human shoulders and heads. They frequently land together on one side of their feeder and tip it over. They also landed like a miracle, about six weeks ago, on me, and tipped the balance from death to life.

I have an incurable cancer, a form of leukemia called CLL (chronic lymphocytic leukemia), so like everyone else I am going to die but probably not tomorrow. Still, life was becoming rather hard to live. Now – after spending the summer in chemo-and-chicken therapy, I have been given a reprieve. I have been wanting chickens for years, and for years have been putting it off, there were always other things to do, work to get done, fetish desires to satisfy. CLL is one of the slow cancers, for some people it does not progress beyond what used to be called the “indolent” stage. For others it can race along alarmingly fast for a slow cancer. My symptoms just got gradually worse, though I wanted to defer treatment for as long as possible since once you start treatment you also start damaging your body’s ability to fight back. As my wonderful oncologist says, there are no such things as side effects. All drugs have a range of effects, some good some not so good (and sometimes the connection between good and not-so-good is knotted, complicated, only measurable over time). So when my oncologist said I think its time to start treatment and I saw the summer disappearing into an infusion center the absolute horribleness of my condition (so far no treatments have lengthened life for CLL patients) took hold, gloom defeated an habitual pollyannerish reflex. And then, in the midst of gloom, my thoughts turned to chickens. Chickens turned into obsession.

Soon I could think of nothing but breeds of chickens and what color eggs they lay and coops and ventilation and chicken manure and compost and predators and fencing and automatic watering and mites and fleas and worms and herbal remedies, and the chirruping noise that chicks make. I dreamed of collecting fresh eggs from free ranging chickens fed on weeds and greens and fruit from the garden. I could smell the omelettes made from these eggs, buttery and sizzling, sprinkled with herbs. I could also smell the chicken shit and rapturously and endlessly imagined the compost we would have, how contentedly my garden would grow. J, my partner, embraced the idea even more whole heartedly than I, encouraging a flagrant defiance of budget in order to get the project happening. I spent endless hours on the internet, ordering books from the library, reading back copies of Backyard Poultry, visiting friends and perfect strangers with hens in their yard. Planning in minute and exacting detail. My treatment lasted three months and some of that time was spent back-breakingly (not me) and obsessively (me) assembling “el palacio de las princesas,” so named by my friend Isabela. And then the ordering. And then the arrival one morning, through the mail, of a cardboard box containing four day-old-chicks. Through all this demented focusing on chickens I had been feeling not too bad, forgetting the C word. And now my forgetfulness morphed into full-blown happiness. We started laughing. The tiny chicks are fluffy and adorable but also absurd in their pomposity. As the chicks grow their absurdity develops along with their adorability, keeping us laughing, tickling a severely compromised immune system, kicking it into gear.

Two weeks ago I saw the oncologist and he told me what I already knew, could feel, that so far the results are good. This isn’t the end of the story, there will be more tests and more treatment sooner or later. But for the moment I’m feeling better than in years and it feels great. This blog—about chickens and therapy and cancer—will tell the story of the chickens from the moment a vague idea became focused as an all-consuming passion. But it will also be about other things, because just as a life can be changed by a chromosome going awry so it can be changed by a chicken or a book that one is reading or a feral plant that takes root in your garden, and grows into an intriguing presence, altering the culture of the garden and making you see and feel differently.