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Pharmako/Thanatos– late July

July 18
At UCSF, with Dr. Katie Kelley, my oncologist. She has never minced words or been anything other than completely open. She is also a researcher and a mother with a life. I feel blessed.

We asked Dr. Kelley about our plans to go to Africa in March. Laura had found a fabulous safari site in Kenya, and with some extra effort had just booked us onto several safaris, as well as two nights in Giraffe Manor, where the tall giraffes stick their heads in through the windows in the upstairs dining room.

Had I doubted that I would be fit for travel in ten months? I sure recognized it now. Dr. Kelley, I think, was slightly shocked. And that was enough to, somewhat immediately, assume a more defensive strategy. As delicately as possible, Dr. Kelley outlined (once again) that with metastasized liver cancer, too many things can change too quickly

Maybe I’m not sure that I ever believed I had that much stamina. Could I do it in a week, a week from today (no); in a month (unlikely); in six months (???),

On reflection Laura and I quickly agreed that Africa was a continent too far. That there are closer places to get licked by the long blue tongue of a giraffe. At this point Dr. Kelley, who had not completely enjoyed her role as killjoy Prophet of Doom, told us about Safari West—a half-day’s trip on our own latitude.

Next appointment was with Nancy Lopez, N.P., of Symptom Management Services. I was skeptical at first, but no longer. I was doing pretty well with oxycodone, but wanted something shorter acting as backup for break-through pain—which was pretty often. We agreed on morphine.

New Age Friends

And in my circles, there is always New Age advice: “It sounds like you are going to have to learn how to make friends with cancer.”

Oh Really? If I make friends the cancer you think the cancer might be nicer to me?
You don’t think I should just frag them all with a grenade? On sight?

And more:
“Why do you think this is happening to you? What do you think it is trying to teach you?”

Such remarks are usually followed by a curt dismissal of Western Medicine. And also of the whole scientific tradition: that is, that truth can be separated from falsity by experiment.

Like the “alternative healer” who treated my first wife. She had lupus. And so our friends said “Oh, go see this AMAZING healer . . . he works with [circle which apply: energies, colors, auras, herbs, …]
And you can’t say no: your wife is sick, very sick.

     “No, I’m not going to go to that quack.”
     “Oh, you’re just going to let your wife die, huh?”

So we go. She’s suffering. Of course he doesn’t take insurance: it’s cash up front—and a lot of it—a lot more than a licensed doctor would charge. And he has a two page handout explaining how paying him money is part of the healing process—that if you don’t pay money you can’t get well because you are not being responsible for yourself.

So we borrow the money. But that was just getting in the door. The doctor holds crystals and advises the patient to stop wearing silver jewelry: it’s blocking her energies. Then we shell out another two weeks wages for a bottle of vitamins (but very good vitamins).

When she had a flare-up, her temperature spiking into dangerous heights, he folded his hand, shook his head, and said “Well, you made your choice. You went to Western medicine. I can’t help you.”


Western medicine, with much attendant suffering and many false starts has been seeking out evidence-based, replicable, scientific knowledge for some centuries now. All of the doctors and researchers at UCSF are on salary—none of them are getting rich. They work long hours, they treat rich and poor alike, they are astonishingly selfless and compassionate. The anti-intellectualism of my generation, and the frequent dismissal of science, is a cause of deep sadness for me.

That anti-intellectualism, so long a part of America, that had such a resurgence in the Sixties, does not stop with denying medical science. It also denies climate science. I know a physicist (who should know better) that seems to think that leading climate scientists such as James Hansen or Michael Mann are ignorant of atmospheric physics, that they are stupid, lying, or just trying to hang onto their jobs.

It is, I’m sorry, useless to try to convince deniers with evidence. They get their views from spiffy denier blog sites with big budgets. They don’t read the scientific articles. Both Science and Nature seem to be part of the conspiracy. They cheer at funky put-downs of nerdy scientists naïve enough to go on right-wing talk shows for “debate.”

My best friend for several years working at a start-up in Silicon Valley was an “IQ Chauvinist.” He was a brilliant engineer, an amazingly strong mathematician, and a fun guy to work with. But he had no respect for anyone ignorant of his own specialties. Or for people with children (“why should I pay taxes for education—I don’t have any children”). Or for environmentalists (Ozone hole, hoax; rising temperatures, wrong).


July 19
A pleasant day at Mantis Hill. Cool enough so that, for a change, we didn’t turn the swamp cooler on, and the house was quiet.

It is beginning to seem that my back pain is not gong to go away.

And that, as I feared, this may be the best I feel for the rest of my life.

It’s been difficult to work. “Work,” well, ok: I do know what real work is. It’s been difficult to write, that’s what I meant—to write with any plan, thought, or discipline.

It’s been difficult to find the motivation.
So I thank you, old friend, for your interest.

In the Bardo of Increased Permeability, besides easy tears for the least tragedy, there is a whole band of imps encouraged by the breach in the defenses,

My old nemesis, “She’ll Be Hurt,” and her big sister, “She’ll Be Angry” are still in the mob, somewhere, I’m sure. But they have been upstaged by “You!? Gimmeabreak” and “Don’t You Think You’re Being A Little Dramatic, Dear?” And, of course, “No One Will Want to Read it Anyway.”


     Pull down thy vanity, I say, pull down.

Well guess what kids. . . .
Maybe it is “You’re Being Overdramatic” who is in denial. Death threatens her. She wants me to be in denial.

So, well then darling, you little shit: here’s the deal. I can offer you immortality. Now shut up for a while.

(and she is so afraid of death
	she accepts the offer:
I can feel her backing off

     Here error is all in the not done,
     all in the diffidence that faltered.

July 19, 20
Down to UCSF. “High-Risk Post-Transplant Dermatology Clinic.”

21 July

Trump and his Extended Family of Liars

How do you deal with shameless liars? With those who have embodied the capitalist ethic so completely–that is, that the only good, the only virtue, is self-interest–that they have become mockeries of civil beings. And of human beings.

Adam Smith took a basic sense of fairness, shame, and integrity for granted. Perhaps he missed that it was his own “economic man” that poisoned the social contract by its definition.

American history is already so thick with blood and corruption, with being the bully in the neighborhood, that we all have to ask whether or not the American Republic worth saving? I do know conscientious anarchists who answer that question “no,” that it is not their job to save late-stage corporate capitalism. And I know conscientious Buddhists who don’t believe it is their place to work for social change at all, in the political sphere.

And Lordy, they may be right. And as far as saving “the masses,” a lot of them have joined the reactionaries. We may have to accept defeat.

     And tell sad stories of the restoration of kings.

The slave owners stacked the deck against democracy over two hundred years ago. Only men of wealth and property (= slaves) were given extra standing as a bulwark against the demos. When the property owners finally lost the presidency in 1860 they said “Oh, we only support elections when we win, our property is more important than the Constitution.” When Barack Obama was elected they announced that they would oppose every word he uttered, even if the words were their own.

So now they have their revenge. But let’s clarify a few things.

*They don’t believe in “states rights” unless it suits them—look at Jeff Sessions restarting the War on Drugs,

*They don’t believe in “original intent” in the Constitution either, unless it suits them—-look at “money is speech” and “corporations are people.”

*They don’t believe in “fiscal responsibility” either, except when they are out of power—which party has created the biggest deficits, and which party has brought them down?

What do they believe in? Tax cuts for the rich, consistently. They also are quite aware that without chains, shackles, and bull-whips, literal or economic, people won’t willingly work until they drop, which is what “master” wants them to do. They used to make up names for “theories” to defend their raiding of the public till, such as “trickle-down economics.” Now they don’t bother: they just tell lies.

Trump lies. Trump Jr. lies. Jared Kushner lies. Jeff Sessions lies. Mike Pence lies. This is not gut instinct: this is recorded history! Not one with the honor of a frog.

You could wash your hands of the current farce—it would be less headache. Besides, it’s up to the majority party to stop the debacle, and thus far they have shown no inclination to do so. So: pursue art, or money, or spirituality, or pleasure—all democracies fail, all republics fall.

Yeah. Or. Resist.

22 July
Wrote for three or four hours—too much maybe—missed my nap. But wrote easily

28 July
Can’t do it. So much is personal and family stuff. And has little to do with my dying.

And I need my journaling . . . for myself. And I can’t do that if I’m thinking of it as a book.

29 July
worked in lab, cleaning up. First .

30 July
3 pills, one s.

31 July Tuesday
3 pills, 2 s.

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