I spent Thursday in the hospital getting a bone marrow biopsy, and having a port installed in my chest.  The biopsy wasn’t much fun, but was over fairly quickly.  The results from it should give the doctors confirmation that there is no marrow involvement with my lymphoma (a very good thing), as well as give them as baseline for how my bone marrow is functioning, in case that becomes important down the line.

The port, let’s face it, is way cooler.  Stage 1 of my cybernetic transformation has begun.  A port is essentially a small, quarter sized valve that sits just below the skin.  Attached to this is a tube leading up into a major vein in the neck.  This allows doctors and nurses to take blood and give medication through the a needle to the port, rather than sticking my arms trying to find veins every time.  Considering the vague junkie-like appearance of my inner arms these days, this is a capital letters Good Thing.  It also will cut the time needed for Chemo infusions down considerably.

It’s also going to leave a cool scar.  I took off the dressing for the first time tonight, and realized why it’s been so sore the last few days- there’s a lot of stitches there.

So, between the biopsy to remove the first lymph node and the port, I’m getting a good collection of scars from this whole process.  I’d like to open the floor for suggestions of stories for how I got them.  For now I’m going with “got into a fight with a honey badger… and won.”

Treatment should start this week.  Keep your fingers crossed for me.

Lesotho is a very religious country.  Eighty percent of the population describes itself as Christian, mostly Roman Catholic, but some evangelical Churches have been making inroads.  Talking with local friends, it was a matter of time before they asked if I believed in God.  For some of them, it was a simple question of what church I went to, but others seemed to be asking for something more- what is at the core of how I look at the world?

The question of belief in God is a difficult one for me.  I was a Religious Studies major in college, and it seems unlikely that someone could come out of a semester of critical interpretation and still believe the Bible (or any holy book) is the literal word of God, or even divinely inspired.  Religion is without a doubt a human construct, and man if nothing else is a deeply flawed animal.

Of course we created God in our image, what else were we to do?  Religion may provide a salve for the existential horror of the human condition, but in the current age of knowledge it’s like a cold compress to lower a fever just before antibiotics were discovered- it may help the symptoms, but we know it doesn’t cure the problem.

But really, a negation of religion is not enough to make up a worldview.  When people in Lesotho asked me if I believe in God, I generally answered yes.  While it certainly made the conversation easier, my belief of religion as human construct does not preclude the existence of something which many people call ‘God.’

The very fact of human existence is miraculous.  It certainly doesn’t require a personal God meddling in the affairs of us earthbound omnivores, nor even an omnipotent or omniscient creator.  All it needs is nature and the chance inherent in natural selection.  Through the uncountable generations since life began on this planet somehow things ended up so that I am sitting at this desk, typing this essay with technology that uses processes that cannot even be observed to function.  This simple fact leaves me with the same awe and gratitude that many people attribute to God.

On a day-to-day level, I am constantly amazed by humanity.  The greatest minds of our time are working to develop a unified theory of the most basic, fundamental forces in the universe.  It is an almost impossibly difficult task.  To even predict the behavior of a large wave formation in the ocean is nearly impossible.  Compare this to a relatively simple, common human interaction, say a dinner party, and wave theory looks like simple arithmetic.

Human nature, and people’s interactions with each other, are the most complex systems I can imagine.  Reinhold Neibuhr wrote:  “man has always been his own most vexing problem.” It is here that I believe religion and philosophy still have something to teach us.  I am hard pressed to think of better students of the human condition than Confucious, Spinoza, Okham, or Tolstoy. Even in the last century we’ve had Gandhi, King, and John Paul II.  Science has tried in Freud and the whole field of psychology since to provide an explanation for human behavior, but in many cases finds ground already covered by the great religious thinkers of previous generations.

So I keep religious writers on my bookshelf, and when asked in Lesotho, I told my friends that I believe in God.   I take the jaw dropping wonder of existence, the sheer improbability of it all, and choose to label it God.  A matter of semantics maybe, but one that I feel allows me to better reconcile a fundamentally scientific, rational understanding of the universe with a rich intellectual tradition of studying humanity.

In roughly that order:

• Insurance ended up being surprisingly straightforward, after a few days of working on it.  Yup, that’s the story I’m sticking to.  Short version, if anyone you know badmouths the recent Health Care reform act, use me as an example.  Several provisions have already taken effect, and between them it’s the difference between having to pay a few thousand dollars, and several hundred thousand– likely bankrupting myself and my parents.  Take that Tea Party.
• One of the better things to come out of the insurance discussions was being referred to University of Maryland’s Medical Center.  I’m now working with an Oncologist there who specialized in Lymphoma, and who has been superb in every conversation I’ve had with her.  UMMC is a teaching hospital, and it seems like every time I go in I end up helping someone with some kind of research they are working on, be it having another vial of blood drawn or testing out a new machine to see if it works as well as the standard one.  This kinda works for me– I keep joking that I’m building up good karma for when I’m begging people to sign consent forms for studies I work on.
• Staging has been rough… Last week I had a PET/CT scan, as well as a few other tests, and they turned up a slightly more progressed form of the disease than we would be hoping.  I’m technically Stage IIB, but the distance between the affected areas (groin and lower back) rules out radiation as a possible treatment.  Which brings us to…
• Treatment.  Chemo.  What a lovely word.  I’m meeting with my Oncologist next week to go over the last battery of tests, but it looks likely that I will be starting a 12 cycle course of ABVD, a four drug chemotherapy cocktail that is the “gold standard” for Hodgkin’s treatment.  Unfortunately, NLPHL is a bit of a different beasty, so while we expect the treatment to work well in the short term, there’s a good chance it will come back in ten years or so.  There’s a lot of research being done right now on this sub-type right now though, so the hope and expectation is that treatments will have progressed considerably in that time.

That’s all for now.  Knee deep in finals until Tuesday, but I’ll try to start updating this more often after that.

A month ago I sent out the following email to friends and family:

Hey All,

I’m sorry I’m not calling you all, but as you can see from the list above, there’s quite a few people here.  Most of you know that I’ve had some health trouble recently.  This morning, I was diagnosed with Nodular Lymphocyte Predominant Hodgkin’s Lymphoma (NLPHL).  So… that sucks.

NLPHL is a relatively rare subtype of lymphoma, making up about 5% of Hodgkin’s disease diagnoses.  The silver lining is that, even as lymphomas go, NLPHL is very treatable, generally with an excellent prognosis.  I’m young, in good health otherwise, and we think we caught it early.  This isn’t to decrease the severity of the situation, it’s still a big deal, but one that I feel like I’ll be able to handle.  Johns Hopkins is one of the best cancer treatment facilities in the world, and I have an excellent support network of friends and family both here and around the country.

In the next week or so I’ll be meeting with an oncologist at Hopkins to start the process of staging, to figure out how far the disease has progressed.  We’re pretty sure it’s early, but we need to be certain before starting the next step.  Following staging we’ll put together a treatment plan, which sounds like it will probably include radiation, and chemotherapy if it has progressed far enough.  This won’t be an easy process, but the oncologist comes highly recommended and I have the support of my supervisor at work and all of my professors.

I really appreciate all of your support, both in this difficult time and throughout my life.  If I’ve forgotten anyone blatantly obvious, let me know.  I’d rather tell everyone myself, and don’t want to miss anyone.

I love you all,

Oscar

_________

Update to follow in the next post.

Dear Oscar,

It is my privilege to announce that the Master’s Admissions Committee of the School of Public and Environmental Affairs (SPEA) has reviewed your application file and offered you admission to our MPA graduate program.  Congratulations on this achievement!  Please look for our admission packet in the mail.

Merit-based financial aid decisions will be rendered through a separate review process.  Most award recipients will be notified, via email, in mid-March.  If you have any questions please feel free to contact me at xxxxxxx or xxxxxx.

Again, our sincere congratulations,

Jennifer L. Medlin

Assistant Director, Admissions & Financial Aid
MPA/MSES Program Office
School of Public & Environmental Affairs (SPEA) Indiana University

So that’s that.  Looks like I’ll be somewhere in the fall, and SPEA’s a pretty good somewhere.

I had some visitors this week, PCVs from Namibia who were taking some time after they finished to travel around Southern Africa, staying with volunteers and generally having a good time.  I couldn’t have hoped for better guests.  We hiked, made borsht (not a huge hit with the clinic staff), and goofed off with the cat.  Apparently Nelson (new name has caught) is not a big fan of tree climbing, but Natalie was determined that he should learn.

So, pictures.

Still, I am writing a note that will be read by people all over the world, and have recently spoken on a wireless, satelite assisted phone with my grandparent in Michigan- about as far from here as you can get.  So maybe there is hope.

In other news, it’s finally 2010!  It’s a little strange to actually be here.  I’ve been writing 2010 on Peace Corps material for awhile now, and when Basotho have asked me how long I’ll be here, my usual response has been “A long time, until 2010.”  Not so long anymore.

Updates from the last few months:

• Spent three weeks traveling with Grandpa and Grandma, Carol, Pat and Ernie, and various other OAT tour group people.  It was a great time, and a well needed vacation.  Seeing South Africa through different eyes than you have as a Peace Corps volunteer was a valuable experience.  I was reminded of just how incredible South Africa is, and how unlikely it was twenty years ago that it would turn out as well as it did.  Also, being able to go on safari and see “Africa” as it’s viewed on the discovery channel was a lot of fun.  To those back home that are convinced living in Africa means dodging lions on my walk to work, at least I’ve seen them now.
• My lady cat is, well, not a lady.  While on vacation, I left her (him?) with another volunteer, who also has a lady cat.  Ema matured considerably in the time I was gone, and did not act the gentleman to poor lilly (the other cat).  The volunteer taking car of them ended up getting her cat spayed, a few days before I came back to take both cats up to my site while the other volunteer was on vacation.  Poor Lilly was stuck in a cat-carrier with Ema, on a flight, and then in a new house.  To add to the indignity, uncle Oscar force fed her antibiotics for a week and removed her stitches.  While she’s well recovered, I don’t think we’re going to be friends anytime soon.  Which leaves us with Ema, now a boy.  I’ve been trying to come up with a good name, and I think I’ve settled on Nelson, the name for the first cat I was going to get last year.  (Bonus history points for getting the connection between the two names).
• I’ve gotten results for both the GRE and LSAT.  Without false modesty, I did quite well (710/720/5.0 on GRE, 168 on LSAT), and so now need to figure out what I’m doing with my life after I go home.  I’m putting together applications, and will hopefully have answers in a few months.

That’s about it.  The internet has been really sketchy the last few days, so I don’t think I’m going to be able to upload pictures today.  Next update, I promise.

From this description: “The spectacular sight which keen South African sky-watchers were privileged enough to witness during the evening of Sunday the 18th of October, from approximately 8:45 to 9:30pm, – a spectacle resembling something out of a big budget UFO movie – turned out to be a great visual demonstration of experimental rocket science in action. From Hermanus to Jo’burg and even Nambia, reports started to flood into the South African Astronomical Observatory’s field station in Sutherland, as two bright objects were seen to be passing overhead from South-East to North-West at rapid speed. What made the reports so sensational was the repeated description of the leading object emitting bright, spiralling pulses of light which ‘looked like the kind of ripples you get when you throw a stone into a pond’ radiating over the whole sky.” Emphasis mine.

Pictures can be found here.  It was quite a sight, and good to know what it was.

Hat tip: Mom, for finding the description.

Just a few pictures from Mozambique, now that I’m able to post them.