Breast cancer

One of my wife's oldest friends, JE, who she's known since high school, has been dealing with metastatic breast cancer. She has it in her bones and, probably, elsewhere. I've been playing this voice of reality for my wife, cluing her in to the fact that the outlook is not good. JE is savvy about the science/medicine and has already been through the wringer having survived the first five years of this (I think she's about 7 or 8 years since her original dx). She's been outwardly projecting a calm, but mildly optimistic view of her prognosis, but ultimately I can't know how she really feels. This is all a little uncomfortable for me to have to sit through, having watched my mother die of breast cancer, but in the middle of it, I feel I can at least offer JE, as well as my wife, some advise on how to look at this with an eye toward, at least, not slipping into depression over it and, at best, maximizing the chances (whatever they may be) of surviving it.

I am admittedly, to everyone who happens to discuss medicine with me, cynical about how most (not all) doctors approach medicine, which demonstrates more often than not that (1) they tend to play the percentage game, ignoring any symptom suggesting a particular patient is not in the "typical" 95% of the population, (2) they are invariably more concerned about ego than the patient's best interest, (3) like it or not, they are driven by money, unless they are working for Medecins Sans Frontieres, and I don't know any that are, and (4) medicine, despite all the evidence to the contrary, still has an enormous amount of "art" involved, and the field is populated much more by barely competent technicians than it is by artists.

And yet, despite all this, I try to be optmistic about medicine to those around me. I just remind them to be realistic.

The take home message on this is do what you can, when you can and don't forget to realize that life is so painfully short that you absolutely cannot take it for granted. Do, say and be what you need to now.

Notes on a Thursday

The nature of business just continues to change. Terms like "sales and marketing" mean very different things now than what they did ten years ago, but what strikes me is that they mean something different now than they did even two years ago. Mine is an information business, of course, which makes it susceptible to the steady stream of new technologies -- paradigms (JMJ I hate that word) -- that are overhauling the information society. Electronic professional networking, RSS/blog marketing, search engine optimization, yada, yada, yada. I can't complain (too much). I like learning this stuff, but I wish I could make the whole process more active than it is now. It's all a matter of producing the right exposure in the right way so you are found, all very passive. I want to go out and GET the business.

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Molly's Type 1 is very well under control as a result of aggressive management by us (I do not tolerate bad blood glucose numbers) and a very rigorous soccer schedule including two practices per week, a weekly "speed training" session and two scrimmages (season hasn't started yet). Her last HbA1c was about 7.5, and I am intent on getting it lower and staying there. When she was first diagnosed almost four years ago, I had to adamantly assure Colleen that managing Molly's diabetes would become a matter of routine and that it would not ultimately limit Molly's activity, goals or anything else in any way and, in fact, she might end up being a stronger, healthier kid than other kids as a result of the increased attention on good diet, exercise. Four years later, she is at the top of her class, she's about the strongest kid in her class, she won the school jump rope contest (100+ jumps in 30 seconds!), and she's one of the most talented soccer players on her team. Yeah, yeah, I'm her dad, so I'm supposed to say this stuff. Well, I long ago stopped trying to impress people, since the only ones I really need to impress is my family, and they know the truth. Molly is a fantastic kid. Diabetes has been nothing more than an annoyance.

Ian is my fantastic son. Someone once referred to me as "spooky smart", but I think the phrase better applies to Ian. Long ago, I said that Ian must have been reincarnated, because he seemed to innately understand the world better than he should for someone of his young age, as if he's been here before. He's witty and ultimately a very, very decent kid. In two weeks, he will be testing for his yellow belt in karate. You could give him two weeks and he'd be ready to test for orange.