caveat: the fundamental goodness of people

im not sure if this kind of thing is really about fundamental goodness or rather the goodness of specific people but either way i found it confirmational.

almost a decade ago i had a coworker at aramark corp named tracy. she was an accounts rep of some kind, while i was in my eccentric role of data analyst / programmer / billing troubleshooter. we didnt work together particularly closely, and i even recall a run-in or two over some passionately held opposing ideas about what might be right for a customer. we never interacted socially outside of work. you could say we were colleagues but not truly friends.

and yet despite this social and temporal distance, yesterday at facebookland tracy took the time to write the following.

>Waking up today I clicked on a link my friend posted. He shares links all the time but in the daily hussle and bussle of life, I've never read them. Today I clicked on the link about "fruit" of all things…only to learn that this is his blog and he has cancer! To say I'm sad and upset right now is an understatement! This is a person that I think highly of…he's smart, very funny, kind and one of the many blessings you hope to come across in your life!! Today I'm sending prayers for a speedy recovery and trying to pull myself together! If anyone can turn this around and be cancer free it's him! Sending you lots of love, hugs and positive thoughts Jared!!!!!

i am flattered beyond belief. to imagine that after a decade there are coworkers who remember me on these terms and will take the time all these years later to express them to me truly warms my heart.

kindness repays kindness repays kindness. . . ad infinitum. humanity aint such a bad thing as long as we do the right thing.

caveat: fruit

ever since my major surgery i have been craving fruit: apples, peaches, blueberries, apricots, even fruit i dont normally prefer, like plums and grapes. andrew and my friends have been accommodating, too, so ive been eating a lot of fruit.

this evening my friend seungbae stopped by and brought even more. i consumed a peach and some watermelon.

what i wonder is what this craving represents. ive always believed that strong food cravings generally mean the body knows about something it needs. what does the fruit represent?

what im listening to right now.

[link to track to be added later.]

Foster the People, "Helena Beat."

caveat: just kinda lyin here. . .

. . . and thats okay.

andrew went off with peter. i insisted.

so now i have the semi pseudo solitude of my bed enclosed in its curtain, with something appropriately loud on headphones to drown out ambient noise.

what im listening to right now.

[link to track to be added later.]

Depeche Mode, "Useless."

caveat: 조용행 선생님 잘 가세요

mr cho, my best friend by far that ive made in the cancer ward, checked out today.

i never imagined i would feel jealousy for people with colon cancer, but its by far the most common cancer being treated on the 10th floor (i cant speak for the other floors), and they have a veritable assembly line set up. even with complications, mr cho only stayed 10 days, and mr park was through in 7 days flat. meanwhile i languish here, watching the comings and goings of roommates and caregivers.

i will miss mr cho but feel confident that i will stay in touch with him. he and his wife were among the kindest and most inquisitive people i have met here. i wish them and their family the best. here is a picture of his wife, him (already in civvies) and me.

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caveat: your little taste of heaven, sir

while i was slogging through my breakfast juk, andrew went down to the cafe in the lobby and got his own breakfast. when he returned, as has been our evolving custom, he gave me a few tablespoons of coffee "just for the taste."

"your little taste of heaven, sir," he said like a deferential butler.
"oh thank you, good brother," i replied. i pushed my tray of half-finished hospital cuisine toward him. "and here is your little taste of hell."
we had a laugh, and then when my coffee was done i said, "my heaven is concluded."
andrew riffed on this into a joke. "a man dies and goes to the gates of saint peter only to find them closed and dilapidated. the guard at the gate is surprised to see someone. he says, 'this place closed years ago. that experiment is definitively concluded.'"

for some reason this caused me to laugh longer and harder than i have in a long time. we went on to discuss the novelistic potential of running with the idea of an "outsourced" or "privatized" heaven.

caveat: 會者定離. 去者必反.

My roommate and now close friend Mr Cho taught me the following Buddhist proverb, today – despite himself being a catholic deacon or something like that. Thats the sort of openmindedness that warms my heart.
會者定離.                     去者必反.
회자정리.                     거자필반.
hoe·ja·jeong·ri.            geo·ja·pil·ban.
meet-people-intention-part. go-people-again-come.
This pair of sinisms refer to the great wheel: we all are cycling through the rebirths and deaths. “We meet and then we part again. People go and people come again.”
Incidentally, the vow of silence has been relaxed somewhat, with doctors’ permission. 

caveat: granularity

i just thought of a conceptual connection between two of my struggles right now. the two are utterly unrelated, but i see some thematic tie in the concept of granularity.

the first struggle is rice. yes – quite simple: RICE. almost every meal has rice. i have nothing against rice – i habitually comsume at home not much less than im served here daily. i like rice. but by some twist of fate it turns out that a blob of sticky korean rice is almost ideally designed to confound my new, untrained tongue. upon putting the rice in my mouth the individual grains separate and go rogue. i cant chew them all. . . some escape and lodge in places my tongue cant find or reach. maybe half a dozen grains end up in my lungs with every meal.

unfortunately, it being rice, this creates a social disaster. eating everything on my tray except the rice is perceived as if im refusing to eat. im accused of having a lost appetite (obviously a bad sign), im accused of being a picky westerner, im accused of having a poor understanding of nutrition.

ive taken to calling my neighbors over and showing them the rice grains i cough up after a meal, to prove my point. i can eat things that are creamy, no problem. and larger granularities – chunks of fish or meat or fruit are fine too. "hardness" vs "softness" is not the axis of my problem, but people have so much trouble conceptualizing what im talking about. andrew bought me some apple and a woman complained i couldnt possibly eat it given my other food troubles, but i savored it easily.

the second struggle is with a lack of solitude. i have a social job and those social interactions are important to my psychological well-being, but i also not only enjoy but NEED solitude – preferably on the order of at least 8 hours per day. in the hospital, there is never solitude – nurses, fellow patients, anyone can interrupt into my space at any moment. im like a single grain of rice, where to be isolated from the collective implies a certain risk. the social granularity of cancer ward life isnt per se a bad thing, but for me its proving to be a sort of subtle poison no different from the grains of rice, sapping my strength in a way others are incapable of understanding.

the social space here isnt all bad of course – that is far from my meaning. most people show immense kindness and generosity. but i need my reparative solitude.

caveat: infection

i had consult with dr jung just now. he tends to be more communicative than dr ryu, but i dont see him as often since hes only a superstar guest reconstructive surgeon and not a resident surgeon like dr ryu.

dr jung helped me understand some of the urgency of yesterdays surgery, which id picked up on but hadnt been clear on details. although the tongue reconstruction was solid and healthy, the infection in my neck had spread to part of the vulnerable transplanted flesh. so the neck infection, while not life-threatening, was at the least suddenly tongue-threatening.

hopefully they can control the neck infection. dr ryu added a second antibiotic this morning, and dr jung said my immune system was "way above average" whatever that means. they installed a fluid shunt during the surgery yesterday and in the last 24 hours since ive had much less problem with the liquid (pus&blood) ending up in my lungs and mouth.

dr jung was his usual very blunt self. "at first your surgery was an amazing success. now because of the infection its just a so-so result but i think youll be fine."

caveat: the unbearable slowness

with yesterdays surgery, expectations of a miraculous two week recovery from the major surgery on july 4th have faded. now dr ryu has suggested that we move the radiation back a week or two from the intended first-week-of-august start. the concern is achieving full healing on the neck site, which is proving challenging. a persistent but non-life-threatening infection is slowing things, and so my hospital stay is stretching out to at least three weeks and probably more at this point.

im grateful that andrew is here as caregiver, and for my other friends for their continued support.

the monotony of the hospital stay grates. i cant write much – each blog post such as this is a painstaking hunt-and-peck on my smartphone that takes ten times longer than i feel it should. i read but my attention wanders. many of my roommates are kind and courteous but a minority make it their constant business to second guess my doctors, my diet, my beliefs. i wish them a speedy recovery to full health so they can take their negativity elsewhere.

sometimes my own positivity falters. i begin to feel i have reached a new "normal best" – that this now is the best i can do. i walk my orbits and say my affirmations inside my head, but a side voice expresses a cynicism: these affirmations arent working blah blah blah. its just the frustration of each moment, piling along. sleep comes more easily but still in never more than one hour chunks – marked out by my IV-driven bladder, a glowing red digital clock, and diffuse nightmares of vampire roommates and liquid-filled lungs.

caveat: silent verbosity

several people have wondered at my implemention of the vow of silence. i carry a pad and pen and write notes. i had to do that in the icu, too. it is my intention to publish some of those handwritten “icu diaries” if i ever go home from this hospital. meanwhile, here is a somewhat representative sample from earlier today.

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caveat: photo from orbit 12

this nurse is the best nurse of all – shes a clown (in this picture shes climbing on the counter) and shes a goofball and she talks to me in the most adorable korean baby talk that i find incredibly easy to understand and she tolerates my strange korean with smiles and effort at understanding. shes a natural-born language teacher.

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caveat: second surgery both more and less intense than first

it was shorter – just one hour instead of nine. no icu afterward – just some tongue and mouth rearranging.

the process. . . the feeling of starting and ending the procedure – were radically different. going into my first surgery i didnt have much awareness of pre op stuff – they put me under early. this time, i was awake and alert during most of the pre op, including long minutes in the OR. discussing and placing tubes, medicines. monitors – awake for all of it. and i knew almost half the staff – the surgical interns faces familiar behind their masks, giving dr seok a nod as he squeezed my hand, making a wan grin at dr jang. letting the anesthesiologist patter on about minnesota.

coming out was less like icu too – it was just a post op wake up room and people bustled around but rather than the intense attention received after the first surgery, this time i was mostly ignored. finally they wheeled me out and andrew was there and i returned to 10th floor ward. 

dr ryu came and gave me a summary, but i missed details, still feeling fuzzy. ill have to find out later. but he seemed happy with the outcome.

so more later. . . im home in my ward and already ambulatory.

caveat: photos from orbit 9

mr park was an awesome and inspiring neighbor. he was not talkative but very strong willed. he was always pushing himself despite evident pain and discomfort. once he was lying in bed and suddenly he bounded up like a martial artist on meth and killed a fly in mid flight with a pillowcase, snap!

he checked out today. i will miss watching his facial expressions in response to the preachy familys discourses.

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caveat: vow of silence

so i had consult with dr ryu this morning. it was a good news bad news moment.

the good news is that the neck infection whose leakage and pus ruined my night last night appears to be gradually clearing up. . . ie the leakage was a good sign. there is no fistula in my mouth.

the bad news is that my excessive enthusiasm for talking was a bit premature. even dr ryu had been impressed but hes noticed some slippage in the sutures as a consequence. he finally got more than a bit gruff with me and said "just. stop. talking."

i nodded. point received. andrew, attentive as usual, handed me a note pad. on it, i wrote, "1 week. vow of silence." dr ryu said good.

but. . . because of this slippage the good doctor wants to do a brief "touch up" surgery which he suggested will require general anesthesia just because of the pain potential. so later today or tomorrow (dependent on scheduling) i go into surgery again – but less than one hour.

i talk too much. this is my lesson.

caveat: luke 6:41~42

my cousin sylvia, a christian, wrote the following in reply to an earlier post of mine. since im up at 5 am anyway due to some unexpected disgusting discharge from my neck wound, i found myself taking the time to think about what she said. she wrote. . .

> I have to challenge you on this one. Calling these people evil or even calling their evangelistic efforts evil is rather "over the top." Think about what they believe (since I'm guessing it has similarities to my own beliefs). They care a lot about you in order to brave the cultural and language barriers to even talk to you. They are much more concerned about you than they are about gaining a possible proselyte. This is hardly 'solipsistic' and neither it is selfish. If this world is not all there is, they are not even 'devoid of human empathy.' Rather they are obeying the command +to 'Love your neighbor as yourself.' And how can you be sure they are wrong in what they believe?

i am unconvinced.

if it increases my discomfort and unease, if it causes those around me to flinch, then it it is devoid of empathy. you could argue that they believe that what they are doing is true and that therefore the imposition of discomfort is necessary (like a surgeons knife creating necessary discomfort in order to heal). but that opens the door to the practitioners of all religions having a right to impose their spiritual concerns. voodooists could run in and sacrfice chickens, witch doctors may wish to dance or sing. do these wellwishers of my spiritual health have a right to enter my personal space on my behalf?

no spiritual practice on my behalf has the same right of imposition as the surgeons knife for a very simple reason: i invited the knife. if i were one of those religions where my belief prohibited me from modern treatment, and i refused the knife, would you respect my wishes? likewise, can you respect my wish not to be histrionically prayed for in public, in my personal space? if you cannot, you are placing something in your worldview in a position of moral primacy over mine – invading my moral sphere with yours because you have a strong confidence that you are right and i am wrong. that is not only solipsism, but is unkindness – you give expression only to your intention, your heart, your action, and you deny me mine. allow me my autonomy and follow instead the precepcts of kindness and "do unto others."

imagine you are sick with cancer in a hospital. i care about you and im deeply concerned about not just your health but the wrongness of your beliefs. so i decide to loudly explain to you that a belief in god is wrong and you need to see the truth that there is no god so that you can have the same solace from that that i feel. would you not ask, "really? here? now? are there not more appropriate times for this conversation?"

luke 6:41~42.

caveat: gratefuller and gratefuller

ive said it before but need to repeat: i am so profoundly grateful to all my friends who have taken the time to support me with anything from posts in facebookland to visits to my room. two unexpected visitors came by today – helen, who is the karma subdirector, and kelly, a former karma teacher and on and off korean tutor for me.

they gossipped about work things while i ate my lunch very slowly and enjoyed hearing the familiar patter of work-related korean, which naturally is the topic where i have the highest level of comprehension.

earlier, id talked for a few minutes with bestfriend bob in wisconsin, too. im feeling very loved, and so for that, my gratefulness expands without bound.

caveat: like evil in a newly made world

andrew and i have had many wide ranging conversations about diverse topics. earlier today on the banal topic of if itchiness was unmitigated unpleasantness or instead might have some redeeming aspect, he used the following metaphor: "it is like evil in a newly made world."

we laughed. we both agreed that as a metaphor for itchiness it was a bit of overkill, but the phrase has echoed in my mind since then as utterly brilliant. evil in a newly made world is surely a particularly egregious variety of evil.

after i ate dinner andrew went out to exercise. the woman sitting with the sick man from the next bed over came over and started making conversation with me – in korean. she gave the standard 3rd degree about family, etc, and said my brother was very handsome. but then she asked me about my church and religion.

im ok making small talk in korean but debating religion is far beyond my ability. she was persistent, so i became more assertive that i was buddhist (which provides fewer angles for attack than claiming atheism), but this was one case where she could not let up. she dissolved into an almost tearful pleading with me in which really i could only make out the korean words for prayer and jesus and god.

i felt uncomfortable. i tried to broaden my smile and said only, in my poor korean, i have my strength. i pressed by hands together in the gesture shared by buddhists and christians.

these neighbors are hardcore pentecostals of some kind – they spend most of their time in bible study and prayer vigils – and who am i to begrudge them their solace? but this is not the first time one member or another of that family group have decided to direct their evangelical zeal outward. i had thought i was immune, being the foreigner in the room, but clearly i was mistaken.

it strikes me as an expression of deep, almost solipsistic selfishness that could impel this kind of behavior in a cancer ward. perhaps it is to this class of evangelism-devoid-of-human-empathy to which i might decide to apply andrews metaphor: like evil in a newly made world.

caveat: caregiving

an observation in an email from my friend bob made me realize there is probably a lot about undergoing medical treatment here in korea that is quite different from what similar treatment in the US would involve, that i have either failed to explain or have elided over.

bob was mentioning when i undergo speech therapy (for the tongue) or occupational therapy (for the right arm). i think it unlikely i will experience anything like these US concepts. the doctor tells me things to do – move your tongue like so or move your fingers like so and asks if ive been doing them later, and thats the extent of it.

patients are expected to be much more autonomous and self-providing, because the patient includes the family caregivers. patients without caregivers end up hiring them – a bit like hiring a home hospice worker to come help you in the hospital. every bed has a cot next it, and those cots are almost always occupied by caregivers – family, friends or paid workers NOT on the hospital staff. the cot by my bed is occupied by andrew, now – and was occupied by peter my first night out of icu.

an example of “caregiving”: the hospital doesnt provide for patient hygiene. caregivers handle bedpans, spongebaths, emptying and maintaining various external subtance receptacles, etc. if the hospital has to step in its begrudgingly and at extra charge.

because of these caregivers, my hospital room has 5 beds but arguably 10 or 11 inhabitants. its crowded and like a campout.

patients are quite autonomous. for example, i am only escorted to “clinics” in the event their location is new to me. otherwise a nurse will say “go see dr ryu” and im expected to go to the elevator, get to the second floor, and find my way across the building to where his work area is.

andrew attached the flowerpot gifted to me by my friend seungbae to the top of my iv stand. i was a bit sceptical – i imagine a nurse oh dont do that. but the head nurses reaction was only 예쁘구나 [oh pretty – not sure i spelled the korean right].
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caveat: steps forward steps back

i was ecstatic earlier this morning. first the doctor drained a bunch more goo from my neck, which feels better and less worrisome. then, preliminary to removing my c-line (a sort of iv stuck into a vein in my upper chest near the collar bone that is used in major surgeries as opposed to the more familiar iv stuck into ones arm or hand or foot), they had removed the drip line entirely and so for a brief hour i was free of external tubing entirely. with no iv cart to have to trundle around, i was practically dancing the corridors of my familiar orbit and chatting animatedly with several men about our respective cancers and possible discharge dates. the removal of the c-line presaged a good prospect, as that indicates that the doctors dont anticipate any possible need to readmit me to surgery.

but then reality took some countermeasures. a conventional iv was sunk in my left hand, much less comfortable than by my collarbone, harder to work around. with only that one functional hand, it felt exceptionally onerous. then the actual c-line removal was more difficult than i anticipated – though not painful, i was required to lie still, on my back, for more than an hour. andrew kept me company.

finally, during lunch, due to tongue failure i choked on some food item so badly that i began to vomit slightly. most people know thats umpleasant. i lost my appetite quickly. so now i just feel exhausted.

while lying still for so long for the c-line removal, i composed a new bucket list.

jareds bucket list (post cancer first draft, short version):

1. learn korean.

caveat: pre breakfast

the charm of the hardcore, strictly korean menus of the hospital food has worn off. partly, since im still avoiding spicy food, that means the food thats left to me ends up pretty bland. but the big problem is that it turns out that the “tiny grains of rice” model of food is singularly maladapted to the demands of retraining my tongue. i do better with creamy substances or with things in discrete bite sized chunks. the grains of rice drift around my mouth uncontrolled and sometimes end up in my airways.

so yesterday we brainstormed some things that might be easier to eat, and andrew tromped off to homeplus and shopped last night.

this morning on waking i had a mini pre breakfast of a sliced plum and some yogurt. it was much less stressful than rice.

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caveat: medical horror genre (graphic image may prove disturbing)

for the sake of completeness i include the following. im NOT playing around – this is not for the squeamish.

in reverse order, i underwent two procedures today that indicated supposed progress or at the least a battle against retrogression.

second, they drained around 200cc of pus from the somewhat infected wound on my neck. it was painless, since severed nerves in that region leave everything numb.

before that, first, i had the splint removed and wound redressed on the donor site on my right forearm. it looks pretty gross but theres zero infection and its healing well. now instead of a cast i have just a loose bandage – just when id gotten used to using my forearm as a table.

here is a picture of my forearm. the round scoop of skin and muscle were used to build my new tongue. modern medicine is amazing.

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