Cancer and Life at Hay Bay

Death is always with us.  We maintain an illusion of life in which we know that death and life abound but somehow we are permanent.  Yet this life is by its very nature impermanent.
Each night I sleep.  I enter this death like equation where to my subjective self I leave the objective world of community and enter a dream like state, another world, as memorable as memories themselves.
Cancer is a disease of threatened death.  Immunologically we think of it as the body turned against itself, some auto immune phenomena, that is either a lack of recognition of the good self and hence destruction; or a lack of policing of the bad self and hence destruction.
This phenomena of cancer has been associated with environmental disease as in those poor ladies who painted watch faces with radioactive paint till they succumbed of cancers or the mining men who breathed in asbestos.  That's the environmental stressor model.
Then there's the genetic angle.  Genes mutate and cancer is a mutation associated with age or the bombardment of the genetic code by various waves of unseen energy and particle some travelling through the ozone layers while others come from more proximal microwave emissions.  The Russians so certain of the science of the latter  spent millions bombarding the American embassy with hoped for disease causing EMF.
There are viruses too that trigger cancer, infections such as Herpes Simplex II which was so thoroughly associated with cervical cancer that it gave rise to the Pap Test as the principle preventative protective strategy.
Ever since I became a doctor cancer has been being cured with greater success though the greater length of life has resulted in this miracle being obscured by the apparently increased death in the elderly from cancer.  The wear and tear of the Australian beach crowd has with time created a whole group of melanomatous skin cancers with each year of excessive sun exposure and recurrent damage to the skin till cancer arises from the suns bombardment and aging.
Meanwhile, everywhere cancer is still being cured.
Psychiatrists have long held that physical illness of chronic disease and even some acute illness is ‘anger turned inward’.  One is by definition either outwardly homicidal in attitude or inwardly suicidal in attitude.  As with all the physical attributes psychologically there is a balance, a right place between the polar extremes.  At that point the homicidal and suicidal tendencies of Freud’s forces of life and death drives, eros and thanatos,  balance.
Chronic disease follows the upset of the golden rule, that fundamental equation, ‘love thy neighbour as thyself’.  One must show a healthy balance of self care.  Too much narcissism and self centeredness results in hypochondriasis or real disease and the attraction of illness if only by shadowing doctors who work always around disease.
The other psychiatric and philosophic aspect of the cancer which is considered from a communications perspective is that ‘ cancer is that which you can say in no other way’.  Communication theory sees us as essentially ‘communicating units’ and all we say and do are expressions of seeking and giving help.  A child cries and a mother comforts him or her.  Disease is a way of seeking help or solving a puzzle.  Gods come to us in disease is a saying that relates to the idea that when we are well and outwardly rewarded we do not tend to turn inward to consider the meaning of existence or to communicate our questions about existence or even our individual lives. Disease is doubt.   Faced with cancer there is an inward turning.
When I am wounded in battle my sword arm, until that moment so strong, is suddenly cut and no longer answers to the command of my ego.  What is the relationship between fate and free will, I ask myself. How is it that my enemy has found this weakness I did not know myself or what was I thinking to let down my shield.  Why does the zen master say one's enemy is a friend who teaches us our mistake. Why does the psychiatrist call disease the great teacher?
In the Bible the wound of note is the struggle between the angel and man which eventually lead to the naming of Israel.  These ideas are not new.  All philosophy and religion have been given to answering some questions about disease and death with cancer, the big "C" being the metaphor for "satan incarnate' or 'living death', the primo disease.  One surgeons seeing it called it 'disease run amok".
There are similar stories of wounds and myths around the world.    The crack in creation is where the light comes in.
In sickness we are forced to consider the aloneness of sickness and life. I am born between piss and shit and I die, ashes to ashes.  Cancer is but  a slow death or a speeded up life.  My minister friend with cancer told me he'd only begun to really live when he was first diagnosed with cancer. He described an intensity of life he'd not known since childhood and how he'd been mostly a spectator for many years and now was pulled fully and completely into the game of life.
There’s no sudden and acute motor vehicle accident death or death by beheading in war.  Cancer a slow struggle, a marathon. The fight against the slow death is likened to Sisyphus.  Kierkegaard said , Life is suffering unto death".  It's a simmer rather than a boil.   It’s a ‘siege’ by comparison to a charge.
The recovery changes a person.  It’s a near death experience on a daily basis with a whole reconsideration of the means of dealing with the external exigencies of reality. If a person ‘solved’ life’s problems one way cancer may well demand a whole new set of tools to overcome it.
Cancer is that which I can say in no other way is a consideration that if I can find another way of communicating then I might no longer need the cancer.  The pessimist becomes the optimist and the cancer disappears.  The independent soloist turns to the community for aid and surrenders to the care of others who experiment with their various ideas of cure and success.  Witches brews and chemotherapy all contribute to the natural self healing of the individual who once was a neut like creature capable of regrowing tails and limbs, a genetic code which exists within, which hasn’t been lost, which we are again awakening with the help of the lab in stem cell research.  Stem cells differentiate into whole new body parts.  We have the stem cells still.  We all are self healing.  Medicine and surgery simply assist.
It’s not like we plant the seeds but more that we weed the garden. All the seeds are there to grow resplendent but we must prune and care for the flowers we wish.  Cancer is it’s own robust weed.  There’s something incredible at the cellular level when we contemplate cancer. It’s dandelions on a golfers green.
We are always messing with creation. We are dictating to the universe that we want this order, this life we have created, not this other mutation. We are ‘stewarding’. We are leading. All self doubt is left behind because to cure cancer we must give it our undivided attention and solve the rubrics cube in a race against time.  Meanwhile all that is past is demanding equal attention as it did when one was well. The war goes on but my sword arm no longer lifts the sword. If I don't pay attention I can find myself kicking my feet like a kangaroo while dragging my sword arm behind me.  For 80,000 years I learned to slink off to the cave where I nursed my own wounds or formed a pact with a medicine man or woman and hopefully a child or wife or husband fed me in my monastic vigil and struggle with God. We are herd animals, not lizards. There's comfort in companionship.  I never admit it but I still like when a friend brings me soup when I am sick.
I want to live, I say and God, or the Great Unknown asks me ,how much or am I sure. It’s a Job like place this narrative of Cancer. .  The siege is on and the enemy is at the door.
I am here with my brother who was diagnosed as having pancreatic cancer.  He only learned when he was first diagnosed with pulmonary embolism. . Breath is the sacred nectar of life the rhythmic wonder of existence.  He was literally breathless when he began this journey.  The healing care and brilliance in Napanee and in Kingston has been stupendous to behold.  As a doctor I've been so thankful to know my brother has had the care of the oncology team there.  Pulmonary embolisms, blood  clotting oddly in lungs is so often a harbinger of cancer so the Sherlock Holmes began and found this pancreatic mass where it did not belong. The anomaly was called 'cancer'.
To date my brother hasn’t had any symptoms attributable to the cancer itself except fatigue. His loss of appetite, nausea and malaise have come with nerve sensation loss from the treatments.  It’s the same as if a terroist cell has taken up a presence in the centre of the city infiltrated key areas and is planning on setting off bombs and destroying all from within. No one knows they are there, except the police and soldiers who enters with the intent of getting them out. The only thing the city notices are the apparent wars started by the police and soldiers. It's so easy then to blame the cure for the disease.  We hear it all the time in politics.  There is a politics of disease.  The internet is rife with insanity and special interest groups, pseudoscience and marketing.  My brother, always wise, trusts in what is really known.  He trained as a scientist at the University of Manitoba.  He understands the depths of what the loving doctors are telling him. He has worked well with the Kingston oncology team and the Napanee outreach.
Now a year later and my brother’s cancer has not gained to any degree.  The battle has waged.  The weeding and pruning have taken place. The seeds of new plants have grown while some of the old have been demolished. There is new life but there is also death.  Having survived that first day of breathless near death he’s gone on to succeed a year against a Borg like phenomena whose kill ratio is 9 out of 10.  Only the A plus student solves the puzzle and lives to five years. (But then maybe the good die young.) He's one fifth of the way along that life journey. It’s been a sharp learning curve.  My brother is a genius though. He was the smart one in the family. I was the slow learner by comparison.  I don't doubt his capacity to live. Cancer is a minor matter compared to the challenges he's faced so far and overcome.  His family are a testimony to his love and skill and merit.
The central question of life is ‘fate’ and ‘free will’.  Buber described the idea of “I and it’ and then the move to “I and thou’.  The "other" is the whole world.  Here the "other' is cancer. "I and Cancer".  There is to immunology the central theme of ‘self’ and ‘not self’.  I have a white blood cell response to a foreign bacteria that invades my body.  My basic immunological system has ‘boundaries’ and the foreigner is removed.
We all have cancer. Our bodies are restoring the homeostasis daily by the minute and hour.  The self healing structures are removing mutations and clearing the diseased cells away.  Our treatments expedite this.  We assist the self healing process.  We fight the invader and we strengthen the host.  The terminology of medicine is full of ambiguity.  We call a person the ‘host’ as if they have invited cancer for dinner and are now having their own personal party but can't alone throw the cancer 'bore' out of the party.
 I have gratitude for today. I am here at Hay Bay and have known another day with my brother. He’s an amazing man, his marriage and home and children a reflection of he and his wife’s dreams.  I love seeing his love in action, all the years I’ve watched him devote himself to his family in a world where individualism and selfishness are the halcyon call of our Kardashian and Myla Cyrus day.  I don’t even think he’s ever snapped a ‘selfie’ of himself.  He’s a quiet man in that way.  At the same time he can talk a person deaf with tale upon tale, a trait we both share with our beloved Irish mother.  On the surface he might at times chatter but with him still waters run deep, not stagnant.
He’s angry as all cancer patients are.  There’s a grieving process that Elizabeth Kubla Ross described regarding dying.  As cancer is the offer of a slow death or a chance of recovery , the horns of the dilemma are met with all the range of appropriate emotions. We daily grieve to some degree the lost dreams of yesterday. I never was the astronaut I wanted to be as a kid and became instead the prosaic doctor. My brother would have loved to fly but walked instead and now must even crawl awhile to get a head.  We're not stationary in our family.
I am grateful to be here.  So much of family and medicine is being present.  The world as a whole run away from disease thinking fearfully living a life of trying to avoid all distress.  Cancer is like lepracy.  Disease is stigma.  The struggle is personal. It’s not a public matter. It’s a private matter. The parasitic people would still like to take advantage of another's misfortunes.   Family and friends gather.  We are there as much for protection as our own learning.  Socrates is speaking.  He never did need to take the hemlock. He did not wish to be exiled so did, but he could have left.  I can live or I can die. My brother has chosen life and I'm glad to be a cheer leader if only that.He has my rapt attention. I am honoured to be welcomed by this great artist and he creates his masterful Houdini trick of escaping cancer and death for this time, for another day at least. We both accept that 10 or 20 years from now we may wish to succumb but not now, not when we are both so young. My father lived till 94. My mother said she was tired and wanted to go at 89.  A son should outlive his parents.  My brother has the will and gifts.  He loves life.
Having worked in medicine some thirty years with tens of thousands of patients and so many facing cancer, disease and old age, along with the gun shot wounds, I’ve been never certain what the outcome will be.  The house always wins in the long run , but countless winners gladly take their millions even from the lotteries.  It’s never over till the fat lady sings. It’s also not over unless the bullet has your name on it.  A WWI soldier who survived Vimy Ridge taught me that. He was my patient in his 80's.
The success of this generation is in the longevity. We are all living a decade longer and all the killers of a while ago are cured.  Even these new diseases of deadly destruction are being beaten with alacrity. I know so many cancer survivors.  
Even the old go on and on so that there are nursing homes galore and the courts are all about physician assisted suicide not because people are dying but because they refuse to.  Life is so good that the historic killers of war, disease and starvation aren’t doing their former job to the satisfaction of politicians. Our society, thanks to science, technology and wisdom is living longer and better than ever before.  And not just millions, but billions more than ever before.
The media is sick.  That is a central source of societal disease.  Fear mongering negativity and deceit.
The successes are amazing. But yes, when we are a hundred, we may wish to remain asleep. Neither my brother or I am there yet.  Now we celebrate life .  But at a hundred I wouldn't care so much if he left me.  I would have liked for my mother to have stayed another year or two but even Dad was ready to leave at 94.

(I found this draft written 6/23/16, a year before my brother's death.  When he died he was ready though said always he'd have liked more time with his family. )

Napanee Vacation: Death, Cancer, Life

Death is always with us.  We maintain an illusion of life in which we know that death and life abound but somehow we are permanent.  Yet this life is by its very nature impermanent.  And each night I sleep.  I enter this death like equation where to my subjective self I leave the objective world of community and enter a dream like state, another world, as memorable as memories themselves.
Cancer is a disease of threatened death.  Immunologically we think of it as the body turned against itself, some auto immune phenomena, that is either a lack of recognition of the good self and hence destruction or a lack of policing of the bad self and hence destruction.
This phenomena of cancer has been associated with environmental disease as in those poor ladies who painted watch faces with radioactive paint till they succumbed of cancers or the mining men who breathed in asbestos.  That's the environmental stressor model.
Then there's the genetic angle.  Genes mutate and cancer is a mutation associated with age or the bombardment of the genetic code by various waves of unseen energy and particle some travelling through the ozone layers while others come from more proximal microwave emissions.  The Russians so certain of the science of the latter  spent millions bombarding the American embassy with hoped for disease causing EMF.  There are viruses too that trigger cancer, infections such as Herpes Simplex II which was so thoroughly associated with cervical cancer that it gave rise to the Pap Test as the principle preventative protective strategy.
Ever since I became a doctor cancer has been being cured with greater success though the greater length of life has resulted in this miracle being obscured by the apparently increased death in the elderly from cancer.  The wear and tear of the Australian beach crowd has with time created a whole group of melanomatous skin cancers with each year of excessive sun exposure and recurrent damage to the skin till cancer arises from the suns bombardment and aging.  Everywhere cancer is being cured.
Psychiatrists have long held that physical illness of chronic disease and even some acute illness is ‘anger turned inward’.  One is by definition either outwardly homicidal in attitude or inwardly suicidal in attitude.  As with all the physical attributes psychologically there is a balance, a right place between the polar extremes.  At that point the homicidal and suicidal tendencies of Freud’s forces of life and death are balanced.  Chronic disease follows the upset of the golden rule, that fundamental equation, ‘love thy neighbour as thyself’.  One must show a healthy balance of self care.  Too much narcissism and self centeredness results in hypochondriasis or real disease and the attraction of illness if only by shadowing doctors who work always around disease.
By contrast one can spend time mostly in the love of others, altruism and selflessness.  My brother is a husband and a parent and worked for the government which treated its civil servants psychologically as they did their military servants, expendable and hierarchically, socially stressful places despite their apparent union benefits.  There is stress from the juggling of the roles too and fulfilling the duties of society.
My brother has stayed. He’s a brick. I’m  He is the Rock of Gibraltar . He's the army to my navy.  He's the artillery and I’m calvary. He’s taken a tremendous amount of bombardment by staying whereas I’ve charged and retreated from the bullies that abound in our present day 'uncultured' society
The other psychiatric and philosophic aspect of the cancer which isconsidered from a communications perspective is that ‘ cancer is that which you can say in no other way’.  Communication theory sees us as essentially ‘communicating units’ and all we say and do are expressions of seeking and giving help.  A child cries and a mother comforts him or her.  Disease is a way of seeking help or solving a puzzle.  Gods come to us in disease is a saying that relates to the idea that when we are well and outwardly rewarded we do not tend to turn inward to consider the meaning of existence or to communicate our questions about existence or even our individual lives. Disease is doubt.  Happily ruling Wall Street with hookers and cocaine and simulated battles or impressing the ladies with ones muscles and tattoos in government circuits one can remain shallow and fatuous.  However faced with cancer there is an inward turning.
When I am wounded in battle my sword arm, until that moment so strong, is suddenly cut and no longer answers to the command of my ego.  What is the relationship between fate and free will, I ask myself. How is it that my enemy has found this weakness I did not know myself or what was I thinking to let down my shield.  Why does the zen master say one's enemy is a friend who teaches us our mistake. Why does the psychiatrist call disease the great teacher?
In the Bible the wound of note is the struggle between the angel and man which eventually lead to the naming of Israel.  These ideas are not new.  All philosophy and religion have been given to answering some questions about disease and death with cancer, the big "C" being the metaphor for "satan incarnate' or 'living death', the primo disease.  There are similar stories of wounds and myths around the world.    The crack in creation is where the light comes in. In sickness we are forced to consider the aloneness of sickness and life. I am born between piss and shit and I die, ashes to ashes.  Cancer is but  a slow death or a speeded up life.  My minister friend with cancer told me he'd only begun to really live when he was first diagnosed with cancer. He described an intensity of life he'd not known since childhood and how he'd been mostly a spectator for many years and now was pulled fully and completely into the game of life.
There’s no sudden and acute motor vehicle accident death or death by beheading in war.  Cancer a slow struggle, a marathon. The fight against the slow death is Sisyphus.  Kierkegaard said , Life is suffering unto death".  It's a simmer rather than a boil.   It’s a ‘siege’ by comparison to a charge.
The recovery changes a person.  It’s a near death experience on a daily basis with a whole reconsideration of the means of dealing with the external exigencies of reality. If a person ‘solved’ life’s problems one way cancer may well demand a whole new set of tools to overcome it.
Cancer is that which I can say in no other way is a consideration that if I can find another way of communicating then I might no longer need the cancer.  The pessimist becomes the optimist and the cancer disappears.  The independent soloist turns to the community for aid and surrender to the care of others who experiment with their various ideas of cure and success.  Witches brews and chemotherapy all contribute to the natural self healing of the individual who once was a neut like creature capable of regrowing tails and limbs, a genetic code which exists within, which hasn’t been lost, which we are again doing with the help of the lab.  Stem cells differentiate into whole new body parts.  We have the stem cells still.  We all are self healing.  Medicine and surgery simply assist.
It’s not like we plant the seeds but more that we weed the garden. All the seeds are there to grow resplendent but we must prune and care for the flowers we wish.  Cancer is it’s own robust weed.  There’s something incredible at the cellular level when we contemplate cancer. It’s dandelions on a golfers green.
We are always messing with creation. We are dictating to the universe that we want this order, this life we have created, not this other mutation. We are ‘stewarding’. We are leading. All self doubt is left behind because to cure cancer we must give it our undivided attention and solve the rubrics cube in a race against time.  Meanwhile all that is past is demanding equal attention as it did when one was well. The war goes on but my sword arm no longer lifts the sword. If I don't pay attention I can find myself kicking my feet like a kangaroo while dragging my sword arm behind me.  For 80,000 years I learned to slink off to the cave where I nursed my own wounds or formed a pact with a medicine man or woman and hopefully a child or wife or husband fed me in my monastic vigil and struggle with God. We are herd animals, not lizards. There's comfort in companionship.  I never admit it but I still like when a friend brings me soup when I am sick.
I want to live, I say and God, or the Great Unknown asks me ,how much or am I sure. It’s a Job like place this narrative of Cancer. .  The siege is on and the enemy is at the door.
I am here with my brother who was diagnosed as having pancreatic cancer.  He only learned when he was first diagnosed with pulmonary embolism. . Breath is the sacred nectar of life the rhythmic wonder of existence.  He was literally breathless when he began this journey.  The healing care and brilliance in Napanee and in Kingston has been stupendous to behold.  As a doctor I've been so thankful to know my brother has had the care of the oncology team there.  Pulmonary embolisms, blood  clotting oddly in lungs is so often a harbinger of cancer so the Sherlock Holmes began and found this pancreatic mass where it did not belong. The anomaly was called 'cancer'.
To date my brother hasn’t had any symptoms attributable to the cancer itself except fatigue. His loss of appetite, nausea and malaise have come with nerve sensation loss from the treatments.  It’s the same as if a terroist cell has taken up a presence in the centre of the city infiltrated key areas and is planning on setting off bombs and destroying all from within. No one knows they are there, except the police and soldiers who enters with the intent of getting them out. The only thing the city notices are the apparent wars started by the police and soldiers. It's so easy then to blame the cure for the disease.  We hear it all the time in politics.  There is a politics of disease.  The internet is rife with insanity and special interest groups, pseudoscience and marketing.  My brother, always wise, trusts in what is really known.  He trained as a scientist at the University of Manitoba.  He understands the depths of what the loving doctors are telling him. He has worked well with the Kingston oncology team and the Napanee outreach.
Now a year later and my brother’s cancer has not gained to any degree.  The battle has waged.  The weeding and pruning have taken place. The seeds of new plants have grown while some of the old have been demolished. There is new life but there is also death.  Having survived that first day of breathless near death he’s gone on to succeed a year against a Borg like phenomena whose kill ratio is 9 out of 10.  Only the A student solves the puzzle and lives beyond five years.  He's one fifth of the way along that life journey. It’s been a sharp learning curve.  My brother is a genius though. He was the smart one in the family. I was the slow learner by comparison.  I don't doubt his capacity to live. Cancer is a minor matter compared to the challenges he's faced so far and overcome.  His family are a testimony to his love and skill and merit.
The central question of life is ‘fate’ and ‘free will’.  Buber described the idea of “I and it’ and then the move to “I and thou’.  The "other" is the whole world.  Here the "other' is cancer. "I and Cancer".  There is to immunology the central theme of ‘self’ and ‘not self’.  I have a white blood cell response to a foreign bacteria that invades my body.  My basic immunological system has ‘boundaries’ and the foreigner is removed.
We all have cancer. Our bodies are restoring the homeostasis daily by the minute and hour.  The self healing structures are removing mutations and clearing the diseased cells away.  Our treatments expedite this.  We assist the self healing process.  We fight the invader and we strengthen the host.  The terminology of medicine is full of ambiguity.  We call a person the ‘host’ as if they have invited cancer for dinner and are now having their own personal party but can't alone throw the cancer 'bore' out of the party.
 I have gratitude for today. I am here at Hay Bay and have known another day with my brother. He’s an amazing man, his marriage and home and children a reflection of he and his wife’s dreams.  I love seeing his love in action, all the years I’ve watched him devote himself to his family in a world where individualism and selfishness are the halcyon call of our Kardashian and Myla Cyrus day.  I don’t even think he’s ever snapped a ‘selfie’ of himself.  He’s a quiet man in that way.  At the same time he can talk a persons deaf with tale upon tale, a trait we both share with our beloved Irish mother.  On the surface he might at times chatter but with him still waters run deep, not stagnant.
He’s angry as all cancer patients are.  There’s a grieving process that Elizabeth Kubla Ross described regarding dying.  As cancer is the offer of a slow death or a chance of recovery , this horns of the dilemma is met with all the range of appropriate emotions. We daily grieve to some degree the lost dreams of yesterday. I never was the astronaut I wanted to be as a kid and became instead the prosaic doctor. My brother would have loved to fly but walked instead and now must even crawl awhile to get a head.  We're not stationary in our family.
I am grateful to be here.  So much of family and medicine is being present.  The world as a whole run away from disease thinking fearfully living a life of trying to avoid all distress.  Cancer is like lepracy.  Disease is stigma.  The struggle is personal. It’s not a public matter. It’s a private matter. The parasitic people would still like to take advantage of another's misfortunes.   Family and friends gather.  We are there as much for protection as our own learning.  Socrates is speaking.  He never did need to take the hemlock. He did not wish to be exiled so did, but he could have left.  I can live or I can die. My brother has chosen life and I'm glad to be a cheer leader if only that.He has my rapt attention. I am honoured to be welcomed by this great artist and he creates his masterful Houdini trick of escaping cancer and death this time. We both accept that 20 or 30 years from now we may wish to succumb but not now, not when we are both so young. My father lived till 94. My mother said she was tired and wanted to go at 89.  A son should outlive his parents.  My brother has the will and gifts.  He loves life.
Having worked in medicine some thirty years with tens of thousands of patients and so many facing cancer, disease and old age, along with the gun shot wounds, I’ve been never certain what the outcome will be.  The house always wins in the long run , but countless winners gladly take their millions even from the lotteries.  It’s never over till the fat lady sings. It’s also not over unless the bullet has your name on it.  A WWI soldier who survived Vimy Ridge taught me that. He was my patient in his 80's.
The success of this generation is in the longevity. We are all living a decade longer and all the killers of a while ago are cured.  Even these new diseases of deadly destruction are being beaten with alacrity. I know so many cancer survivors.  
Even the old go on and on so that there are nursing homes galore and the courts are all about physician assisted suicide not because people are dying but because they refuse to.  Life is so good that the historic killers of war, disease and starvation aren’t doing their former job to the satisfaction of politicians. Our society, thanks to science, technology and wisdom is living longer and better than ever before.  And not just millions, but billions more than ever before.
The media is sick.  That is a central source of societal disease.  Fear mongering negativity and deceit.
The successes are amazing. But yes, when we are a hundred, we may wish to remain asleep. Neither my brother or I am there yet.  Now we celebrate life .  But at a hundred I wouldn't care so much if he left me.  I would have liked for my mother to have stayed another year or two but even Dad was ready to leave at 94.

Napanee Vacation: Death, Cancer, Life

Death is always with us.  We maintain an illusion of life in which we know that death and life abound but somehow we are permanent.  Yet this life is by its very nature impermanent.  And each night I sleep.  I enter this death like equation where to my subjective self I leave the objective world of community and enter a dream like state, another world, as memorable as memories themselves.
Cancer is a disease of threatened death.  Immunologically we think of it as the body turned against itself, some auto immune phenomena, that is either a lack of recognition of the good self and hence destruction or a lack of policing of the bad self and hence destruction.
This phenomena of cancer has been associated with environmental disease as in those poor ladies who painted watch faces with radioactive paint till they succumbed of cancers or the mining men who breathed in asbestos.  That's the environmental stressor model.
Then there's the genetic angle.  Genes mutate and cancer is a mutation associated with age or the bombardment of the genetic code by various waves of unseen energy and particle some travelling through the ozone layers while others come from more proximal microwave emissions.  The Russians so certain of the science of the latter  spent millions bombarding the American embassy with hoped for disease causing EMF.  There are viruses too that trigger cancer, infections such as Herpes Simplex II which was so thoroughly associated with cervical cancer that it gave rise to the Pap Test as the principle preventative protective strategy.
Ever since I became a doctor cancer has been being cured with greater success though the greater length of life has resulted in this miracle being obscured by the apparently increased death in the elderly from cancer.  The wear and tear of the Australian beach crowd has with time created a whole group of melanomatous skin cancers with each year of excessive sun exposure and recurrent damage to the skin till cancer arises from the suns bombardment and aging.  Everywhere cancer is being cured.
Psychiatrists have long held that physical illness of chronic disease and even some acute illness is ‘anger turned inward’.  One is by definition either outwardly homicidal in attitude or inwardly suicidal in attitude.  As with all the physical attributes psychologically there is a balance, a right place between the polar extremes.  At that point the homicidal and suicidal tendencies of Freud’s forces of life and death are balanced.  Chronic disease follows the upset of the golden rule, that fundamental equation, ‘love thy neighbour as thyself’.  One must show a healthy balance of self care.  Too much narcissism and self centeredness results in hypochondriasis or real disease and the attraction of illness if only by shadowing doctors who work always around disease.
By contrast one can spend time mostly in the love of others, altruism and selflessness.  My brother is a husband and a parent and worked for the government which treated its civil servants psychologically as they did their military servants, expendable and hierarchically, socially stressful places despite their apparent union benefits.  There is stress from the juggling of the roles too and fulfilling the duties of society.
My brother has stayed. He’s a brick. I’m  He is the Rock of Gibraltar . He's the army to my navy.  He's the artillery and I’m calvary. He’s taken a tremendous amount of bombardment by staying whereas I’ve charged and retreated from the bullies that abound in our present day 'uncultured' society
The other psychiatric and philosophic aspect of the cancer which isconsidered from a communications perspective is that ‘ cancer is that which you can say in no other way’.  Communication theory sees us as essentially ‘communicating units’ and all we say and do are expressions of seeking and giving help.  A child cries and a mother comforts him or her.  Disease is a way of seeking help or solving a puzzle.  Gods come to us in disease is a saying that relates to the idea that when we are well and outwardly rewarded we do not tend to turn inward to consider the meaning of existence or to communicate our questions about existence or even our individual lives. Disease is doubt.  Happily ruling Wall Street with hookers and cocaine and simulated battles or impressing the ladies with ones muscles and tattoos in government circuits one can remain shallow and fatuous.  However faced with cancer there is an inward turning.
When I am wounded in battle my sword arm, until that moment so strong, is suddenly cut and no longer answers to the command of my ego.  What is the relationship between fate and free will, I ask myself. How is it that my enemy has found this weakness I did not know myself or what was I thinking to let down my shield.  Why does the zen master say one's enemy is a friend who teaches us our mistake. Why does the psychiatrist call disease the great teacher?
In the Bible the wound of note is the struggle between the angel and man which eventually lead to the naming of Israel.  These ideas are not new.  All philosophy and religion have been given to answering some questions about disease and death with cancer, the big "C" being the metaphor for "satan incarnate' or 'living death', the primo disease.  There are similar stories of wounds and myths around the world.    The crack in creation is where the light comes in. In sickness we are forced to consider the aloneness of sickness and life. I am born between piss and shit and I die, ashes to ashes.  Cancer is but  a slow death or a speeded up life.  My minister friend with cancer told me he'd only begun to really live when he was first diagnosed with cancer. He described an intensity of life he'd not known since childhood and how he'd been mostly a spectator for many years and now was pulled fully and completely into the game of life.
There’s no sudden and acute motor vehicle accident death or death by beheading in war.  Cancer a slow struggle, a marathon. The fight against the slow death is Sisyphus.  Kierkegaard said , Life is suffering unto death".  It's a simmer rather than a boil.   It’s a ‘siege’ by comparison to a charge.
The recovery changes a person.  It’s a near death experience on a daily basis with a whole reconsideration of the means of dealing with the external exigencies of reality. If a person ‘solved’ life’s problems one way cancer may well demand a whole new set of tools to overcome it.
Cancer is that which I can say in no other way is a consideration that if I can find another way of communicating then I might no longer need the cancer.  The pessimist becomes the optimist and the cancer disappears.  The independent soloist turns to the community for aid and surrender to the care of others who experiment with their various ideas of cure and success.  Witches brews and chemotherapy all contribute to the natural self healing of the individual who once was a neut like creature capable of regrowing tails and limbs, a genetic code which exists within, which hasn’t been lost, which we are again doing with the help of the lab.  Stem cells differentiate into whole new body parts.  We have the stem cells still.  We all are self healing.  Medicine and surgery simply assist.
It’s not like we plant the seeds but more that we weed the garden. All the seeds are there to grow resplendent but we must prune and care for the flowers we wish.  Cancer is it’s own robust weed.  There’s something incredible at the cellular level when we contemplate cancer. It’s dandelions on a golfers green.
We are always messing with creation. We are dictating to the universe that we want this order, this life we have created, not this other mutation. We are ‘stewarding’. We are leading. All self doubt is left behind because to cure cancer we must give it our undivided attention and solve the rubrics cube in a race against time.  Meanwhile all that is past is demanding equal attention as it did when one was well. The war goes on but my sword arm no longer lifts the sword. If I don't pay attention I can find myself kicking my feet like a kangaroo while dragging my sword arm behind me.  For 80,000 years I learned to slink off to the cave where I nursed my own wounds or formed a pact with a medicine man or woman and hopefully a child or wife or husband fed me in my monastic vigil and struggle with God. We are herd animals, not lizards. There's comfort in companionship.  I never admit it but I still like when a friend brings me soup when I am sick.
I want to live, I say and God, or the Great Unknown asks me ,how much or am I sure. It’s a Job like place this narrative of Cancer. .  The siege is on and the enemy is at the door.
I am here with my brother who was diagnosed as having pancreatic cancer.  He only learned when he was first diagnosed with pulmonary embolism. . Breath is the sacred nectar of life the rhythmic wonder of existence.  He was literally breathless when he began this journey.  The healing care and brilliance in Napanee and in Kingston has been stupendous to behold.  As a doctor I've been so thankful to know my brother has had the care of the oncology team there.  Pulmonary embolisms, blood  clotting oddly in lungs is so often a harbinger of cancer so the Sherlock Holmes began and found this pancreatic mass where it did not belong. The anomaly was called 'cancer'.
To date my brother hasn’t had any symptoms attributable to the cancer itself except fatigue. His loss of appetite, nausea and malaise have come with nerve sensation loss from the treatments.  It’s the same as if a terroist cell has taken up a presence in the centre of the city infiltrated key areas and is planning on setting off bombs and destroying all from within. No one knows they are there, except the police and soldiers who enters with the intent of getting them out. The only thing the city notices are the apparent wars started by the police and soldiers. It's so easy then to blame the cure for the disease.  We hear it all the time in politics.  There is a politics of disease.  The internet is rife with insanity and special interest groups, pseudoscience and marketing.  My brother, always wise, trusts in what is really known.  He trained as a scientist at the University of Manitoba.  He understands the depths of what the loving doctors are telling him. He has worked well with the Kingston oncology team and the Napanee outreach.
Now a year later and my brother’s cancer has not gained to any degree.  The battle has waged.  The weeding and pruning have taken place. The seeds of new plants have grown while some of the old have been demolished. There is new life but there is also death.  Having survived that first day of breathless near death he’s gone on to succeed a year against a Borg like phenomena whose kill ratio is 9 out of 10.  Only the A student solves the puzzle and lives beyond five years.  He's one fifth of the way along that life journey. It’s been a sharp learning curve.  My brother is a genius though. He was the smart one in the family. I was the slow learner by comparison.  I don't doubt his capacity to live. Cancer is a minor matter compared to the challenges he's faced so far and overcome.  His family are a testimony to his love and skill and merit.
The central question of life is ‘fate’ and ‘free will’.  Buber described the idea of “I and it’ and then the move to “I and thou’.  The "other" is the whole world.  Here the "other' is cancer. "I and Cancer".  There is to immunology the central theme of ‘self’ and ‘not self’.  I have a white blood cell response to a foreign bacteria that invades my body.  My basic immunological system has ‘boundaries’ and the foreigner is removed.
We all have cancer. Our bodies are restoring the homeostasis daily by the minute and hour.  The self healing structures are removing mutations and clearing the diseased cells away.  Our treatments expedite this.  We assist the self healing process.  We fight the invader and we strengthen the host.  The terminology of medicine is full of ambiguity.  We call a person the ‘host’ as if they have invited cancer for dinner and are now having their own personal party but can't alone throw the cancer 'bore' out of the party.
 I have gratitude for today. I am here at Hay Bay and have known another day with my brother. He’s an amazing man, his marriage and home and children a reflection of he and his wife’s dreams.  I love seeing his love in action, all the years I’ve watched him devote himself to his family in a world where individualism and selfishness are the halcyon call of our Kardashian and Myla Cyrus day.  I don’t even think he’s ever snapped a ‘selfie’ of himself.  He’s a quiet man in that way.  At the same time he can talk a persons deaf with tale upon tale, a trait we both share with our beloved Irish mother.  On the surface he might at times chatter but with him still waters run deep, not stagnant.
He’s angry as all cancer patients are.  There’s a grieving process that Elizabeth Kubla Ross described regarding dying.  As cancer is the offer of a slow death or a chance of recovery , this horns of the dilemma is met with all the range of appropriate emotions. We daily grieve to some degree the lost dreams of yesterday. I never was the astronaut I wanted to be as a kid and became instead the prosaic doctor. My brother would have loved to fly but walked instead and now must even crawl awhile to get a head.  We're not stationary in our family.
I am grateful to be here.  So much of family and medicine is being present.  The world as a whole run away from disease thinking fearfully living a life of trying to avoid all distress.  Cancer is like lepracy.  Disease is stigma.  The struggle is personal. It’s not a public matter. It’s a private matter. The parasitic people would still like to take advantage of another's misfortunes.   Family and friends gather.  We are there as much for protection as our own learning.  Socrates is speaking.  He never did need to take the hemlock. He did not wish to be exiled so did, but he could have left.  I can live or I can die. My brother has chosen life and I'm glad to be a cheer leader if only that.He has my rapt attention. I am honoured to be welcomed by this great artist and he creates his masterful Houdini trick of escaping cancer and death this time. We both accept that 20 or 30 years from now we may wish to succumb but not now, not when we are both so young. My father lived till 94. My mother said she was tired and wanted to go at 89.  A son should outlive his parents.  My brother has the will and gifts.  He loves life.
Having worked in medicine some thirty years with tens of thousands of patients and so many facing cancer, disease and old age, along with the gun shot wounds, I’ve been never certain what the outcome will be.  The house always wins in the long run , but countless winners gladly take their millions even from the lotteries.  It’s never over till the fat lady sings. It’s also not over unless the bullet has your name on it.  A WWI soldier who survived Vimy Ridge taught me that. He was my patient in his 80's.
The success of this generation is in the longevity. We are all living a decade longer and all the killers of a while ago are cured.  Even these new diseases of deadly destruction are being beaten with alacrity. I know so many cancer survivors.  
Even the old go on and on so that there are nursing homes galore and the courts are all about physician assisted suicide not because people are dying but because they refuse to.  Life is so good that the historic killers of war, disease and starvation aren’t doing their former job to the satisfaction of politicians. Our society, thanks to science, technology and wisdom is living longer and better than ever before.  And not just millions, but billions more than ever before.
The media is sick.  That is a central source of societal disease.  Fear mongering negativity and deceit.
The successes are amazing. But yes, when we are a hundred, we may wish to remain asleep. Neither my brother or I am there yet.  Now we celebrate life .  But at a hundred I wouldn't care so much if he left me.  I would have liked for my mother to have stayed another year or two but even Dad was ready to leave at 94.

Napanee Vacation: Death and Cancer

Death is always with us.  We maintain an illusion of life in which we know that death and life abound but somehow we are permanent.  Yet this life is by its very nature impermanent.  And each night I sleep.  I enter this death like equation where to my subjective self I leave the objective world of community and enter a dream like state, another world, as memorable as memories themselves.
Cancer is a disease of threatened death.  Immunologically we think of it as the body turned against itself, some auto immune phenomena, that is either a lack of recognition of the good self and hence destruction or a lack of policing of the bad self and hence destruction.
This phenomena of cancer has been associated with environmental disease as in those poor ladies who painted watch faces with radioactive paint till they succumbed of cancers or the mining men who breathed in asbestos.  That's the environmental stressor model.
Then there's the genetic angle.  Genes mutate and cancer is a mutation associated with age or the bombardment of the genetic code by various waves of unseen energy and particle some travelling through the ozone layers while others come from more proximal microwave emissions.  The Russians so certain of the science of the latter  spent millions bombarding the American embassy with hoped for disease causing EMF.  There are viruses too that trigger cancer, infections such as Herpes Simplex II which was so thoroughly associated with cervical cancer that it gave rise to the Pap Test as the principle preventative protective strategy.
Ever since I became a doctor cancer has been being cured with greater success though the greater length of life has resulted in this miracle being obscured by the apparently increased death in the elderly from cancer.  The wear and tear of the Australian beach crowd has with time created a whole group of melanomatous skin cancers with each year of excessive sun exposure and recurrent damage to the skin till cancer arises from the suns bombardment and aging.  Everywhere cancer is being cured.
Psychiatrists have long held that physical illness of chronic disease and even some acute illness is ‘anger turned inward’.  One is by definition either outwardly homicidal in attitude or inwardly suicidal in attitude.  As with all the physical attributes psychologically there is a balance, a right place between the polar extremes.  At that point the homicidal and suicidal tendencies of Freud’s forces of life and death are balanced.  Chronic disease follows the upset of the golden rule, that fundamental equation, ‘love thy neighbour as thyself’.  One must show a healthy balance of self care.  Too much narcissism and self centeredness results in hypochondriasis or real disease and the attraction of illness if only by shadowing doctors who work always around disease.
By contrast one can spend time mostly in the love of others, altruism and selflessness.  My brother is a husband and a parent and worked for the government which treated its civil servants psychologically as they did their military servants, expendable and hierarchically, socially stressful places despite their apparent union benefits.  There is stress from the juggling of the roles too and fulfilling the duties of society.
My brother has stayed. He’s a brick. I’m  He is the Rock of Gibraltar . He's the army to my navy.  He's the artillery and I’m calvary. He’s taken a tremendous amount of bombardment by staying whereas I’ve charged and retreated from the bullies that abound in our present day 'uncultured' society
The other psychiatric and philosophic aspect of the cancer which isconsidered from a communications perspective is that ‘ cancer is that which you can say in no other way’.  Communication theory sees us as essentially ‘communicating units’ and all we say and do are expressions of seeking and giving help.  A child cries and a mother comforts him or her.  Disease is a way of seeking help or solving a puzzle.  Gods come to us in disease is a saying that relates to the idea that when we are well and outwardly rewarded we do not tend to turn inward to consider the meaning of existence or to communicate our questions about existence or even our individual lives. Disease is doubt.  Happily ruling Wall Street with hookers and cocaine and simulated battles or impressing the ladies with ones muscles and tattoos in government circuits one can remain shallow and fatuous.  However faced with cancer there is an inward turning.
When I am wounded in battle my sword arm, until that moment so strong, is suddenly cut and no longer answers to the command of my ego.  What is the relationship between fate and free will, I ask myself. How is it that my enemy has found this weakness I did not know myself or what was I thinking to let down my shield.  Why does the zen master say one's enemy is a friend who teaches us our mistake. Why does the psychiatrist call disease the great teacher?
In the Bible the wound of note is the struggle between the angel and man which eventually lead to the naming of Israel.  These ideas are not new.  All philosophy and religion have been given to answering some questions about disease and death with cancer, the big "C" being the metaphor for "satan incarnate' or 'living death', the primo disease.  There are similar stories of wounds and myths around the world.    The crack in creation is where the light comes in. In sickness we are forced to consider the aloneness of sickness and life. I am born between piss and shit and I die, ashes to ashes.  Cancer is but  a slow death or a speeded up life.  My minister friend with cancer told me he'd only begun to really live when he was first diagnosed with cancer. He described an intensity of life he'd not known since childhood and how he'd been mostly a spectator for many years and now was pulled fully and completely into the game of life.
There’s no sudden and acute motor vehicle accident death or death by beheading in war.  Cancer a slow struggle, a marathon. The fight against the slow death is Sisyphus.  Kierkegaard said , Life is suffering unto death".  It's a simmer rather than a boil.   It’s a ‘siege’ by comparison to a charge.
The recovery changes a person.  It’s a near death experience on a daily basis with a whole reconsideration of the means of dealing with the external exigencies of reality. If a person ‘solved’ life’s problems one way cancer may well demand a whole new set of tools to overcome it.
Cancer is that which I can say in no other way is a consideration that if I can find another way of communicating then I might no longer need the cancer.  The pessimist becomes the optimist and the cancer disappears.  The independent soloist turns to the community for aid and surrender to the care of others who experiment with their various ideas of cure and success.  Witches brews and chemotherapy all contribute to the natural self healing of the individual who once was a neut like creature capable of regrowing tails and limbs, a genetic code which exists within, which hasn’t been lost, which we are again doing with the help of the lab.  Stem cells differentiate into whole new body parts.  We have the stem cells still.  We all are self healing.  Medicine and surgery simply assist.
It’s not like we plant the seeds but more that we weed the garden. All the seeds are there to grow resplendent but we must prune and care for the flowers we wish.  Cancer is it’s own robust weed.  There’s something incredible at the cellular level when we contemplate cancer. It’s dandelions on a golfers green.
We are always messing with creation. We are dictating to the universe that we want this order, this life we have created, not this other mutation. We are ‘stewarding’. We are leading. All self doubt is left behind because to cure cancer we must give it our undivided attention and solve the rubrics cube in a race against time.  Meanwhile all that is past is demanding equal attention as it did when one was well. The war goes on but my sword arm no longer lifts the sword. If I don't pay attention I can find myself kicking my feet like a kangaroo while dragging my sword arm behind me.  For 80,000 years I learned to slink off to the cave where I nursed my own wounds or formed a pact with a medicine man or woman and hopefully a child or wife or husband fed me in my monastic vigil and struggle with God. We are herd animals, not lizards. There's comfort in companionship.  I never admit it but I still like when a friend brings me soup when I am sick.
I want to live, I say and God, or the Great Unknown asks me ,how much or am I sure. It’s a Job like place this narrative of Cancer. .  The siege is on and the enemy is at the door.
I am here with my brother who was diagnosed as having pancreatic cancer.  He only learned when he was first diagnosed with pulmonary embolism. . Breath is the sacred nectar of life the rhythmic wonder of existence.  He was literally breathless when he began this journey.  The healing care and brilliance in Napanee and in Kingston has been stupendous to behold.  As a doctor I've been so thankful to know my brother has had the care of the oncology team there.  Pulmonary embolisms, blood  clotting oddly in lungs is so often a harbinger of cancer so the Sherlock Holmes began and found this pancreatic mass where it did not belong. The anomaly was called 'cancer'.
To date my brother hasn’t had any symptoms attributable to the cancer itself except fatigue. His loss of appetite, nausea and malaise have come with nerve sensation loss from the treatments.  It’s the same as if a terroist cell has taken up a presence in the centre of the city infiltrated key areas and is planning on setting off bombs and destroying all from within. No one knows they are there, except the police and soldiers who enters with the intent of getting them out. The only thing the city notices are the apparent wars started by the police and soldiers. It's so easy then to blame the cure for the disease.  We hear it all the time in politics.  There is a politics of disease.  The internet is rife with insanity and special interest groups, pseudoscience and marketing.  My brother, always wise, trusts in what is really known.  He trained as a scientist at the University of Manitoba.  He understands the depths of what the loving doctors are telling him. He has worked well with the Kingston oncology team and the Napanee outreach.
Now a year later and my brother’s cancer has not gained to any degree.  The battle has waged.  The weeding and pruning have taken place. The seeds of new plants have grown while some of the old have been demolished. There is new life but there is also death.  Having survived that first day of breathless near death he’s gone on to succeed a year against a Borg like phenomena whose kill ratio is 9 out of 10.  Only the A student solves the puzzle and lives beyond five years.  He's one fifth of the way along that life journey. It’s been a sharp learning curve.  My brother is a genius though. He was the smart one in the family. I was the slow learner by comparison.  I don't doubt his capacity to live. Cancer is a minor matter compared to the challenges he's faced so far and overcome.  His family are a testimony to his love and skill and merit.
The central question of life is ‘fate’ and ‘free will’.  Buber described the idea of “I and it’ and then the move to “I and thou’.  The "other" is the whole world.  Here the "other' is cancer. "I and Cancer".  There is to immunology the central theme of ‘self’ and ‘not self’.  I have a white blood cell response to a foreign bacteria that invades my body.  My basic immunological system has ‘boundaries’ and the foreigner is removed.
We all have cancer. Our bodies are restoring the homeostasis daily by the minute and hour.  The self healing structures are removing mutations and clearing the diseased cells away.  Our treatments expedite this.  We assist the self healing process.  We fight the invader and we strengthen the host.  The terminology of medicine is full of ambiguity.  We call a person the ‘host’ as if they have invited cancer for dinner and are now having their own personal party but can't alone throw the cancer 'bore' out of the party.
 I have gratitude for today. I am here at Hay Bay and have known another day with my brother. He’s an amazing man, his marriage and home and children a reflection of he and his wife’s dreams.  I love seeing his love in action, all the years I’ve watched him devote himself to his family in a world where individualism and selfishness are the halcyon call of our Kardashian and Myla Cyrus day.  I don’t even think he’s ever snapped a ‘selfie’ of himself.  He’s a quiet man in that way.  At the same time he can talk a persons deaf with tale upon tale, a trait we both share with our beloved Irish mother.  On the surface he might at times chatter but with him still waters run deep, not stagnant.
He’s angry as all cancer patients are.  There’s a grieving process that Elizabeth Kubla Ross described regarding dying.  As cancer is the offer of a slow death or a chance of recovery , this horns of the dilemma is met with all the range of appropriate emotions. We daily grieve to some degree the lost dreams of yesterday. I never was the astronaut I wanted to be as a kid and became instead the prosaic doctor. My brother would have loved to fly but walked instead and now must even crawl awhile to get a head.  We're not stationary in our family.
I am grateful to be here.  So much of family and medicine is being present.  The world as a whole run away from disease thinking fearfully living a life of trying to avoid all distress.  Cancer is like lepracy.  Disease is stigma.  The struggle is personal. It’s not a public matter. It’s a private matter. The parasitic people would still like to take advantage of another's misfortunes.   Family and friends gather.  We are there as much for protection as our own learning.  Socrates is speaking.  He never did need to take the hemlock. He did not wish to be exiled so did, but he could have left.  I can live or I can die. My brother has chosen life and I'm glad to be a cheer leader if only that.He has my rapt attention. I am honoured to be welcomed by this great artist and he creates his masterful Houdini trick of escaping cancer and death this time. We both accept that 20 or 30 years from now we may wish to succumb but not now, not when we are both so young. My father lived till 94. My mother said she was tired and wanted to go at 89.  A son should outlive his parents.  My brother has the will and gifts.  He loves life.
Having worked in medicine some thirty years with tens of thousands of patients and so many facing cancer, disease and old age, along with the gun shot wounds, I’ve been never certain what the outcome will be.  The house always wins in the long run , but countless winners gladly take their millions even from the lotteries.  It’s never over till the fat lady sings. It’s also not over unless the bullet has your name on it.  A WWI soldier who survived Vimy Ridge taught me that. He was my patient in his 80's.
The success of this generation is in the longevity. We are all living a decade longer and all the killers of a while ago are cured.  Even these new diseases of deadly destruction are being beaten with alacrity. I know so many cancer survivors.  
Even the old go on and on so that there are nursing homes galore and the courts are all about physician assisted suicide not because people are dying but because they refuse to.  Life is so good that the historic killers of war, disease and starvation aren’t doing their former job to the satisfaction of politicians. Our society, thanks to science, technology and wisdom is living longer and better than ever before.  And not just millions, but billions more than ever before.
The media is sick.  That is a central source of societal disease.  Fear mongering negativity and deceit.
The successes are amazing. But yes, when we are a hundred, we may wish to remain asleep. Neither my brother or I am there yet.  Now we celebrate life .  But at a hundred I wouldn't care so much if he left me.  I would have liked for my mother to have stayed another year or two but even Dad was ready to leave at 94.

William Hay, Psychiatrist

I am thankful for my name. Wiliam has served me well.  I use the formal, long version, though have been nicknamed Bill or Will throughout my life. The name Hay is a name I acquired from my parents.  My grandfather was a Reeve and my father a man admired as a leader.  The problem for me was ‘psychiatrist’.
I had no problem being, William Hay, Physician.  Today I still commonly introduce myself as such.  The stigma against the mental ill which is so prevalent in this country also applies to their caregivers.
I’m proud to tell people that I was accepted into surgery and did a year of the three or four required to be a surgeon.  Mine was a surgical internship and my electives had been in plastic and orthopaedic surgery as a student.  I had concluded in my training that I wanted to be a missionary doctor and that best equipped missionaries were surgeons.  I was reading a lot of turn of century history at the time.  The problem was my wife, another doctor, by the time I was an intern, didn’t want to be a missionary. She wasn’t even a Christian per se.  She wanted to work in the university and stay in the city.  She wasn't adventurous and certainly didn't like camping when I introduced her to the wilderness.  Our marriage never did work out.
In those days, and the tendency remains, I thought if something was ‘good’ , like obviously being a missionary to me was, others would see it as such.  Today I know a whole group of people think missionaries are idiots.  My wife hated the idea of my becoming a psychiatrist.  She loved the idea of being married to a surgical resident.  She didn't like psychiatrists, possibly because she'd grown up surrounded by severe mental illness and wanted a life as far away from that as possible.
When I announced I wasn’t going to return to surgery and wasn’t going to stay a family practitioner, but rather I was going into psychiatry, my wife was ashamed.  My medical colleagues collectively expressed their astonishment.  The jist of their concerns were summed up in these repeated exclamations,
“You’re such a good doctor, you don’t have to be a psychiatrist’.  When I entered psychiatry it was thought to be a place where only the lowest level of doctors worked.  Often immigrants entered the country by agreeing to work in asylums because even psychiatrists didn't want to work in asylums in those years.
“You can be a surgeon, you don’t have to be a psychiatrist”.  The hierarchy in medicine was from the ‘seen’ (surgery is so obvious) to the ‘unseen’ - the work of psychiatry is by far the ‘subtlest”.
“You’re a real physician, you’re not going to get along in that quackery’.   As a ‘real physician’ this meant, that I was a scientist.  I’d come into medicine with a mixed arts and science background.  My arts background made me ‘suspect’ to those students whose only interest had been science or technology.  I felt I had to ‘prove’ myself as a ‘scientist’ and that having done theatre and arts and english, liking music and writing, well, I was suspect.  I ‘proved’ myself with outstanding performance and knowledge in biochemistry and a gift for surgery.  So having ‘proved’ myself, here I was’ forfeiting’ my ‘membership’ in the ‘elite’ medical group of the ‘scientist doctors’ or ‘surgeon doctor’ to become somehow ‘less than.'  This 'elite' group has made an ironic comeback with in recent years as the respect for medicine declines and everyone is turning to superstition versus science in the true quackery of so many 'alternative medicines' and 'health food stores'.  People don't want 'scientists' or 'technicians' as much as they want 'physicians' but I never could explain my decision to be a psychiatrist because that was what was most "needed" back then and I can't explain this to them now.
The real ‘money’ in medicine was in surgery and internal medicine.  The psychiatric patients were predominantly poor in comparison.  The richest doctors were surgeons and internists and the poorest were often psychiatrists. The billing schedules from the start were always against the psychiatrist.
We were often mixed up with ‘psychologists’ and psychologists were considered collectively as ‘flakes’.  Mostly the psychologists were girls and the counsellors were usually people who couldn’t do the heavy lifting, like radiology technicians so ‘just talked to people’.  They were likened to ‘high school teachers’.  Doctors were university men.
As a family physician and a flyin doctor in the north I’d seen that the ‘greatest need’ was in psychiatry and addiction. I’d become interested in ‘non compliance and ‘non adherence to medical regimen.  This was only addressed at my university by psychiatrists.  It was called ‘resistance’.
Alternatively I considered ‘immunology’, a fledgling speciality pre HIV, because it too discussed the idea of the organisms' ‘rejection’ of transplants, and ‘immunological vulnerability’ to disease.  
In surgery and infectious disease, the emphasis was on the terrible external environment.  Bad things like bulletts entered good bodies and good surgeons took out the bullets and returned people to wellness.  Bad bugs entered good bodies and good doctors made good drugs to kill bad bugs and restore people to healthiness.  I consider 'regular' medicine like playing chess (I played chess at university) whereas psychiatry was like three dimensional chess. In psychiatry I was juggling a lot of ideas whereas in medicine I was usually just following protocols.
My first patient who died that upset me so much had been given excellent care. His doctors had all given him good drugs and he had good education and all should have been well but he and his family rejected the ‘education’ and he didn’t take his medication and therefore died.  Nothing all the kings soldiers could do would put humpty together again.  I felt a personal failure despite having done above and beyond the call of duty.  I 'd pulled out all stops to save this man and in the end it changed my interest from surgery to understanding 'noncompliance' and 'resistance' and a renewed interest in 'spirituality'.
That’s when in research  I learned first that 30% of all patients are ‘non compliant’ and another ’30% of patients spontaneous remit.  I'd always been interested in 'placebo' effect and became even more interested in 'psychosomatic medicine' when it was a fledgling idea. Further in a lot of populations 50% of patients didn’t follow their treatment and in psychiatric patients the number was as high as 80% of patients. 80% of patients didn’t take their medications.
My  colleague, rich, and loved by drug companies always saw a patients lack of progress directly a consequence of the medication so he prescribed a newer more expensive medication. I went to the patients homes and found that their drug cabinets were full of unused medications.  I asked why they didn’t take their medications and learned a wonder of information about how humans behave which was wholly overlooked in the pharmacy training at the university.   I remained poor and eventually didn't even teach whereas my colleague because the richest and most admired and favoured physician and psychiatrist because he was the principal representative of the pharmaceutical industry. Their greatest promoter and richest retainer.  I continue to look in drug cabinets and do home visits and believe thats where the real money of medicine is.
I also saw that the most difficult patients to treat in my family practice were the ones with mental illness. They were the challenge and the businessmen doctors didn’t like these patients because they didn’t get better like ‘good’ patients did.
There was a fine line between ‘bad’ and ‘mad’ and everyone, despite their expressed ‘liberal’ and ‘politically correct sentiments’ about the ‘mad’ ultimately treated them as ‘bad’.  They were ‘non compliant’ and ‘resistant’ and ‘difficult’ and as doctors became family men and businessmen and pharmacists vied to prescribe, all people wanted to make money and have a good job and go home to their families with patients who came sick, got better quick and went home themselves. No one wanted psychiatric patients. And no one wanted addicts. These groups were complainers and angry and didn't get better.  This was the time before 'lifestyle disease' became a fashionable word.
Most mental illness is life long.  The ‘chronic’ diseases are a waxing and waning sort. They have relapses and recurrences and there is a ‘vulnerability’ that causes patients with psychiatric illness to often slowly deteriorate overtime or not quite get back to where they were. Or, even if they do succeed very well, whose to say they won’t have an episode a decade or so down the road.
Whereas we never looked at people who had recurrent respiratory infections as having ‘weak’ lungs because of the ‘bad bug’ idea of infectious disease, we tended to look at people who had recurrent depression as ‘weak’ because psychiatry focused on the ‘vulnerable’.  Indeed psychiatrists who focused on 'trauma' or 'stress' or 'toxic workplaces' were no more welcome than were jail doctors who faced with treating bones broken by guards questioned the breaking rather than just setting the fractures. There's 'preventative' medicine and 'preventative medicine'.
Psychiatric patients were therefore called them ‘weak’ and especially those  with addiction, a part of psychiatry.  They were told  ‘buck up’, “man up’, ‘quit your crying’, ‘toughen up’.  Don’t be silly.
It’s 25 years later and I’m still calling myself, William Hay, Physician, without any concern but when I say, I’m William Hay, Psychiatrist, I’m hesitant.  When I am an ‘advocate’ for a patient who has heart disease or is in a wheelchair or has infection, I’m seen as ‘doing my job’.  A physician is supposed to be an advocate for his patient.  It’s part of the code of ethics for physicians.
I am an advocate for my patients.  As a Christian I am a healer and know that Jesus was a healer and he was also a teacher and advocate.  Part of my becoming a physician, when I could as easily have been anything else, I was a straight A student in Arts and Science at the university, the golden boy, a very large part was that I was a Christian. The finest doctors I’d known were Christian to that time in my life.  When I studied the history of medicine I saw that the truly religious, not just of Christianity but of every religion were the ones who made the greatest contribution to the healing sciences.  Religions in general took care of the sick.   My hero was Albert Schwietzer.
But to be an advocate of a psychiatric patients, worse, an advocate of an addict, or even a former addict, was to be akin to the "despicable."  Even St. Peter denied his association with Jesus when Jesus was condemned by the courts.  I saw that psychiatric patients and especially the addicted were condemned by society at large.  I was condemned by ‘association’ from the time I said I wanted to be a psychiatrist.  25 years later I am still condemned by association. I’m the modern equivalent of the ‘leper’ doctor.
Advocating for the addicted and mentally ill makes one ‘bad’ and as everyone knows psychiatrists are ‘mad’ already.
So William Hay, Psychiatrist is still a thing I hesitate saying despite years of experience, years of healing, years of amazing restoration of health of thousands of individuals and the overwhelming evidence that what I’ve done as a psychiatrist is deeply ‘good’, I’m still afraid to be associated with the ‘fallen’ .  Just like Peter, I fear ‘association’ with Jesus. I fear association with the mentally ill and especially those in recovery because they, and we are punished.  
This is today, when all surgeons and all internists know that they are working in the area of 'chronic illness' and that their patients all suffer mostly from 'psychosomatic' illness. As psychiatry has learned it's somatic aspects with MRI and beneficial somatic treatments like surgery and medicine, the rest of medicine and surgery has had to come to grips with it's psychiatric aspects and especially address the issues of non compliance and non adherence to medical regimen.  
William Hay, Psychiatrist.
William Hay, Advocate of the Mentally Ill and Addicted.
It still doesn't sit as well as William Hay, Physician.
Some days William Hay, Psychiatrist is a truly frightening thing to call myself.   It's like putting a target on.  It's like wearing general’s stripes on a helmut in a war zone. It's  like painting a red cross on an ambulance in a war with people who see illness as weakness and weakness as something to be exploited. That’s like saying to the rich, I’m poor, and waiting for the condemnation and laughter.  That’s not something one says openly in a world of ‘survival of the fittest’.
William Hay, Physician. That’s something societies at large have grown to accept and live with. Physical illness isn’t viewed superstitiously or as ‘malingering’.  But mental illness is.
Mental illness and those who treat mental illness and the advocates of the mentally ill are actually ‘threatening’ to those who are the most mentally ill themselves but conceal this as people who have secrets and lies do.
People who are hiding mental illness, especially those with alcoholism or doing cocaine,  for instance, or pedophilia, or sex addiction, or sadism, like to ‘punish’ the mentally ill to distance themselves from themselves.  But that’s something psychiatrists know.
William Hay, Physician. I can live with that.  William Hay, Psychiatrist, most days I’m too cowardly to say that.  Just like William Hay, Christian, is hard for me to say.  Christians are the most persecuted group in the world.  So what’s worse in a secular insane society, William Hay, Psychiatrist and William Hay, Psychiatrist and Christian.  Might as well, lock oneself up in the asylum.  When I worked there and lived there I knew as we all did that the bars on the wall were to protect us from the outside.  We didn't want patients to escape, not because they were so much a risk to society but because society was so harsh on them.  Jails were where people were locked up to keep them from escaping by comparison.  Jails protected society from criminals.  It's a subtle difference but then psychiatry is 'subtle'.  
Anyone who ‘advocates’ for the mentally ill and the addicted has painted a bull’s eye cross on their forehead for enemies to take aim at.
Much easier to be William Hay, Physician.
William Hay, Psychiatrist.  I don't know.  It takes a better man to wear that title.  I think I'll wait for the cock to crow a few more times.

Reflections on 30 years of HIV - Lessons Learned - Allan Ronald MD -CMDS 2011

I was fortunate to have Dr. Ronald as my teacher in medical school.  He was one of the most favourite teachers then.  I remember the fear in the first days of HIV when it was an unknown disease and transmission uncertain.  Dr. Ronald was always courageous.  It's now so apparent that his Christian faith and walk were so much a part of his character and excellence.. It was a priviledge to hear Dr. Ronald again.  "I"m an internist, " he said. "All an internist has is pills and love." Dr. Ronald is a very humble man. In addition to the Order of Canada, this last week he received four awards of medical  excellence. CMDS awared him and his wife Myrna, the Doeksen award for Distinguished Christian Service for a Doctor and his or her partner. He seemed glad at last to share an award with his wife, Myrna. In accepting he didn't talk about himself but rather told a story of how Myrna had brought faith to a grieving scientist.
These are some of the notes I took from his slide and talk.  As one of the speakers said, there are medical 'giants' in the rooms of CMDS.  I so enjoy the annual meeting for the high calibre of CME that comes as part of the package. Working with infectious diseases and HIV in the addicted populations I treat I was thankful for this update.

Prostitutes rapidly infected (70% by 1986)  with subsequent spread to clients, wives, infants, - core populations hypothesis  (we have serum from prostitutes prior to 1980 and there is no HIV)

Not terribly infectious - 50% of couples where one is infected - haven’t transmitted after 12 months of marriage with unprotected sex

Concurrent STI’s particularly chancroid and HSV2 increase transmission by 3-8x (we published this in Lancet in late 80’s)  Epidemic can spread so quickly with chancroid.

Foreskin doubled chance of HIV.  50% uncircumcised with same risk behaviour

Recognition of 10% of prostitutes were ‘resistant’ to HIV despite long term sex with infected partners - began the major ongoing studies of a HIV vaccine led by Dr. Plummer.  (?If these sex workers leave and then some time later reenter sex trade a third of them develop the disease suggests  immune phenomena?)

Role of breast feeding in transmission  20% transmission.  (at least 50 to 55% don’t get infected )  We are treating these mothers during pregnancy and delivery so there is no detectable virus in breast milk.

Role of concurrency (15-25%) of men in transmission

Education, more income doesn’t reduce HIV - 9% of top quartile vers. 4% of lowest in Uganda  (this shows in Africa - AIDS makes people poor, poverty doesn’t make AIDS)

Training of 70 Kenyans with Masters or PHD

HIV Facts

HIV due to a virus that actually isn’t very infectious .3% chance of transmission penile vaginal sex act

2011 No Vaccine. No cure

An average of 8-9 years from infection until illness - then death for 80% within 2 years without HAART

HIV destroys the immune system; death occurs with TB, unusual infections , unusual tumors, HIV itself.

Since 1997 antiretroviarl treatmnet (can be one pill day) sustains life shortened by 10 years in Canada

Still expensive $15,000 a year, $500,000 a life time

Our Sexuality

Wonderful gift

Often not ‘logical’

Important but poorly understood biological drive

Rarely addressed effectively and Biblically within our Christian community

There is greater need for open discussion of sex

There was much more in the lecture. The question and answer period was especially helpful.  This is just a glimpse. Dr. Ronald said there are 50 things we know we should be doing about HIV.  We should always look to see if we're doing these 50 things and rate each item from A-F.

Asked by a colleague why he had done so much for the poor in Africa, he said, he thought about it and could only respond, "It was the right thing to do."