Chemotherapy Diary #2: Cycle Two

It's strange how something as outwardly scary as chemotherapy can become so routine. That's just how it felt this morning as we took our little patient over to the Sarawak General Hospital Oncology Unit for her next cycle.

The place was just the same - the familiar brightly lit waiting room and the nice soothing water feature next to the pharmacy counter. The same paintings on the walls in the corridor outside. And the same wait for me while Annie, accompanied by her sister, went off for her routine blood test.

While I waited for them to come back, I struggled to concentrate on an excellent Stephen King short story collection I had been reading, which I suppose in a dark way was appropriate reading for this place. I couldn't help noticing that this time there seemed to be so many more people waiting for treatment. Most of them were fairly old - there was one papery old guy in a wheelchair, his bone-thin arms and legs framing a sunken, shrivelled face with the pallor of a Holocaust survivor. I remember wishing that the remaining days left for him will be happy ones.

Had that many more people got cancer since our last visit three weeks ago? Or were they the same people? When Annie came back from her blood test half an hour later, she recognised a plump Malay lady who was also undergoing chemo, and they chatted for a while. After not very long, Annie was called into the chemo day care room, to receive her latest drugs. Just to remind you, gentle readers, here are some photos. Annie is the one wearing pink:



This time, her session was a little longer, just over two hours. The drugs were the same - the cherryade and the lemonade! Afterwards, she felt ravenously hungry, and we took her to Chillipeppers for lunch!!

Many of you reading this will obviously want to know more about the effects of chemotherapy and, after seeing it first hand for three weeks, I can fill you in. Annie has gone through all kinds of weird symptoms since her first cycle last month. Here are the most notable:

• vomiting. Especially the first couple of days. Drinking fizzy drinks such as Coke or 100-Plus (isotonic) definitely helped. Plus she had drugs to control the vomiting!
• Burning sensation in the nerves and veins of the arms and hands. In the first week mainly, and this was again controlled by taking steroids
• Headaches and fever
• Painful ulcers inside the mouth, and irritating acne around the mouth and face
• Lack of energy
• Loss of appetite and taste (though we made sure she ate!)
• Slight bloating of the face and stomach
• Mood swings (well, wouldn't you?!?)
  
• Black stools
• Red urine and, of course:
• Severe hair loss. Annie has now lost over 80 percent of the hair on her head. But this will grow back once the chemotherapy treatment stops. Just look at a recent photo of Kylie Minogue if you don't believe me!! Mind you, I hope Annie doesn't become blonde like Kylie!!
  

So chemotherapy is not much fun, and different people experience it differently. They say the cure is worse than the disease, but then again, the cure doesn't kill you.

Annie is in fairly good spirits, considering. We know she will be OK, but that's hard to internalise for her sometimes, I am sure. All we can give her at the moment is love and support. And lots of Coke and Cherryade!!

Coining It In

Ever since the Americans buggered up the world oil supply by invading Iraq, the price of oil has rapidly headed North, making it more important than ever for frequent flyers to get value for money. And here in Malaysia, that means Air Asia – the fastest growing low-cost airline in Asia.

If I’m not travelling on official business (when I use Malaysian Airlines (MAS)), I use Air Asia, mainly because it’s a little bit cheaper than MAS. But cheap does not necessarily mean cheerful.

Being a Low Cost Carrier, Air Asia exists only to cut costs and therefore maximise profits. You see evidence of this all throughout their operations - the ground staff often double up as cabin attendants, you don’t get a guaranteed seat unless you pay extra on your ticket, and once you get on board, you have to pay for the in-flight meals and drinks. Also, you often find the interior of the cabin is slightly less clean than on other airlines, because Air Asia saves on cleaning costs.

Now that the price of a barrel of oil is creeping towards $100, I’m beginning to wonder how many more ways Air Asia can economise, apart of course from adding lots of hidden extra charges to the ticket price and forcing travellers back onto MAS.

This idle speculation led me to think of a particularly dark and somewhat comical possibility which I would not be surprised to see happening in reality. What if, in order to save fuel costs, one of the Low Cost Carriers such as Air Asia actually passed on the cost of the fuel the aircraft was using to the passengers, while they are actually flying?

Imagine this if you will: instead of including fuel surcharges in the ticket price, the Low Cost Carrier installs little coin meters next to every seat in the cabins of its aircraft. Once the plane takes off, and reaches cruising altitude, an automatic switch on the flight deck will cut off the fuel supply to the engines.

Then, A little voice will announce over the PA system: “good evening ladies and gentlement, you are advised that in order to restore fuel supply to the aircraft engines, guests must insert the sum of five Ringgit Malaysia into the coin slot on your seat. Only 50 sen coins are accepted by the machine at this time. If you require change, please approach one of our cabin attendants. Have a nice day and enjoy your flight!”

You can imagine the ensuing scramble for 50 sen pieces and the mad rush to feed them into the little slots, just like the slot machines in a Vegas casino. Everyone in the plane will be frantically feeding coins into their slots, shouting and cursing when they drop some, anxiously eyeing the little display monitor on the cabin bulkhead that tells them how much money has been collected, and how much more needs to be fed in.

And as the required amount is reached, the plane’s engines will start to whine again, the aircon and lights will power up, and the aircraft will come out of its nose-dive after the pilots have managed to steer it away from catastrophe.

Don’t laugh! Don’t think this can never happen. Remember, how many people twenty years ago would have believed that we would be flying around on an airline that makes you pay for your food? How many people would have thought it possible that free-seating would become the norm on a major international airline? And how many people would have dreamed that the price of oil would approach $100 a barrel?

Certainly not me.

No Escape...

Well, gentle readers, rather than smashing my video camera against the wall, I managed today to transfer some video content to my PC. It seems that my mistake was to assume that I could transfer the data straight onto a CD. Instead, I had to transfer it to the hard disk first.

Easy when you know how, isn't it?

On the subject of technology making our lives less not more pleasant, I read a very disturbing news article on the BBC Website yesterday. It seems that scientists have worked out how to stop mobile phone signals from interfering with the navigational equipment on airliners. They have developed a system for allowing mobile phones to be used inside the cabin of an aircraft, as long as it is flying above 3,000 metres.

Now I'm all in favour of scientific research and human progress and all that Star Trek stuff, but come on, don't you think these scientists have gone a bit too far in "giving the customers what they want"? I mean, don't they realise what a hellish Pandora's Box they have just opened?

Imagine what flying in a plane will be like about two years from now, when the system has finally been approved and all the airlines slavishly install it in their cabins. You get yourself comfortably seated and buckled in, the in-flight magazine nicely balanced on your gut, or your favourite novel open in your hand and, just after takeoff, a soft little 'beep' will sound in the cabin, announcing that 'mobile devices such as phones and laptop computers can now be activated safely'.

And activated they will be, oh yes, and pretty damn quick! The cabin will suddenly metamorphose into a beeping, clicking, flying coffee-house; a great loud Babel of different tongues gabbling and barking and quacking and yelping into their PDAs, bluetooth earpieces, mobile phones and God knows what else. If you're lucky, the staccato chorus of 100 thumbs clicking SMS messages into existence will quietly permeate the aisles and rows of the plane. But more likely, the passengers sitting RIGHT NEXT TO YOU will be those special people blessed by God Almighty with the loudest and most irritatingly nasal voices ever to have been produced by human vocal apparatus.

And that's just Business Class!!

Imagine what this cacophonous Inner Circle of the Damned will be like back in Economy where you are squeezed together like on a Slave Ship. It's bad enough at the moment when someone a few rows behind you makes up for his lack of mobile fix by speaking exceptionally loudly to his neighbour about something utterly and confoundedly dull and stupefyingly boring. You just want to get up out of your seat, reach back and commit an outrageous act of Air Rage just to SHUT THEM UP!!!!

And that, my dear friends, is only a merest taste of what it's going to be like on every flight, everywhere in the world IF these scientists get their way and their damned system gets the green light. Everyone will be able to piss you off BIG TIME for hours and hours on end, without being told off by the cabin staff for causing a danger to the other passengers. You can forget about concentrating on your Stephen King or Harry Potter. You can completely forget about sitting back and soaking up the calm, stratospheric peace of air travel. And you can forget about being able to hold a conversation with that pretty girl/handsome guy next to you because he or she will be too busy clicking away!!!

The only respite you will get is mealtime and, if you are lucky enough to be on a long-haul flight, the in-flight movies. But apart from that, if you are like me and think of travel as a much-needed stretch of calm in between the chaos of departure and the madness of arrival, then you will not be a very happy chappie at all.

So I would like to make a request to all airlines, especially Malaysian Airlines and Air Asia, which I use frequently. Please, Oh Please do not adopt this technology which will bring Hell and Misery to the cabins of your aircraft! Please go on believing that mobile phone signals will have catastrophic effects on an aircraft, and cause it to go off course and crash.

If you grant my wish, I will be soooooooo happy, and I will sooooo keep on enjoying your in-cabin experience. If you don't, well, I suppose I'll have to fall back on Plan B: stuff my ears up with cotton wool. Then I'll be able to read my book!

Hitting My Head Against A Wall

I have a video camera.

I have a PC.

I have a cable for connecting the video camera to the PC.

I have the software to tell the video camera how to connect to the PC.

I have a manual to tell me how to tell the video camera to connect to the PC.

So far so good...

I follow the instructions in the manual. Switch the camera on. Set the camera to 'USB Stream' mode. Connect the camera to the PC with my dinky grey USB cable. Picture Package software should start automatically.

But no. Picture Package software does NOT !*&^$#@ start automatically. It just tells me I have to install Macromedia Flash Player first.

So I go to the Internet, download Macromedia Flash Player. Install said player. Restart the PC. Start Again. Picture Package software still tells me I have to install Macromedia Flash Player first. I download and install the !$%%*& thing twice more. Still the same thing.

I eat ice cream.

I have a brainwave. Maybe I don't have the latest version of Picture Package Software. So:

Off to Sony website. I nearly drown in an ocean of menus. Eventually I find what I'm looking for. Download new version of Picture Package Software. Restart the computer. Start my camera. Set it to USB stream mode. Connect it to PC with dinky grey USB cable. And...

Picture Package Software starts automatically, as per the manual!!!! YAY!!! Victory!!!

My heart beating with anticipation, I follow the instructions for making a CD: adjust special effects settings, music settings, etc.

But the START button still remains ghostly grey. This wasn't supposed to happen.

So I go to the USB Stream Adjust menu. Oops! Camera Not Detected. Even though the ?*&^%$# thing successfully connected to a USB port on my PC!

So I restart my PC, this time selecting a different USB port. The driver software seems to load this time. And Picture Package seems to recognise my camera, because I am able to adjust the USB stream this time and view my video content.

But: The Start Button is still grey. Cannot copy the movie to the CD. And when I go back to adjust the USB stream again. Guess what: Camera Not Detected!

So I disconnect everything, sincerely desiring to smash it all against the wall.

I drink tea.

I go to my blog, where everything is simple.

Tomorrow, perhaps?

A Matter of Context

It was the great linguist and political activist Noam Chomsky who, when discussing the structure of sentences, came up with one of the most talked about linguistic examples in the history of linguistics. It was this:

Colorless green ideas sleep furiously.

I retain the American spelling for the sake of authenticity. Now, as we can see, this sentence is perfectly grammatical. It has a Subject ('colourless green ideas') a Predicate ('sleep') and an adverbial Adjunct ('furiously'). But the point Chomsky was making when he constructed this sentence was that it is possible to create sentences which, despite being grammatically correct, are totally meaningless.

How can an idea be colourless AND green? And how can an idea, which is an abstract concept, be said to sleep, which is an attribute of animate, concrete things like people or dogs? And how can anything sleep furiously? Isn't sleep supposed to be peaceful?!?!?

Now many linguists, myself included, believe that in his theory of language, Chomsky misses the point. Yes, we agree that the above sentence and others like it lacks meaning on one level, but surely, Chomsky ignores the fact that there may be a context or a number of contexts in which such a sentence MIGHT be used appropriately. One of them is in books on linguistics and grammar! If we ignore this linguistic truth, we cannot truly understand how language works in the real world.

So, with these thoughts in mind, I couldn't help noticing the following example of fairly grammatical but "meaningless" language, which I found recently in a shop near my house in Kuching:



In case you can't make out the words, this is a picture of a child's toy rifle, with the somewhat disturbing epithet "Every Styles Fully Wonderful" printed quite cheerfully on the packing.

Now, apart from the obvious agreement error with 'every styles', this sentence is fascinating and demands attention from grammar loonies like myself. Now what, I was asking myself, on Earth has a child's toy rifle, complete with shoulder strap and telescopic eye piece, go to do with "every styles" being "fully wonderful?"

This, I argue, is the source of the ambiguity. Styles, in my own idiolect, are not usually thought of as being wonderful, fully or otherwise. And how can the word 'style' be applied to a toy gun?

Perhaps this is some LSD-crazed post-911 comment on the beauty and wonder of guns and warfare. Or, more likely, this is a poorly translated sentence, probably rendered by an overworked Chinese or Japanese translator with no time to use a good dictionary.

The point of all this is that, even though the sentence appears strange, we can still understand it on one level. This is because, even though we don't have any access to the context in which it was created, we can create the context as we go along. We are forced to make sense of the sentence, even though it doesn't really fit into our normal frameworks of meaning.

Here is another example that came to me recently through the Internet, in a spam email message:

"The now? Then, I've been overcome safely
and his mouth eyes".

This example, which was intended to fool Internet spam filtering software, is grammatical but semantically odd, rather like the colourless green example above. However, it might not be as ambiguous as it seems. I'm sure many of you can think of a science fiction world in which this example makes sense - a world in which "the now" is a real place in which one can be overcome safely by a creature who can see with his mouth!! We could of course go on speculating: maybe the eyes are inside the mouth...whatever!

The moral of this piece, dear readers, is that when we encounter language, it is not enough to merely ask "is it correct?" or "can we say that?" or even "should we say that?". If we do this, we are placing ourselves in a judgmental straitjacket which restrains us from really understanding the nature of language. This is because all writing and speech takes place in a context. Everything we utter or write down, even if it doesn't appear so, has some meaning when seen in its context. And if the context isn't apparent, we create one.

The consequence of this is that if language is meant to communicate, then even when we appear to get it wrong, we are still getting it right! Pedantic language teachers and linguistic purists would do well to heed this.....

A Case of Identity

The other day, I had a very engaging conversation with one of my former colleagues. She was depressed because she was unsure about her identity. She is half Chinese and half Iban (one of the component native races of Sarawak), she married a Muslim, converted to Islam, yet is unsure about whether she is Chinese, Muslim, Iban or Martian!

"I just want to be Malaysian!" she exhorted desperately, yet she felt pulled from different directions, all vying to claim her identity for their own. Her Muslim in-laws and friends want her to be a good Muslim. Yet she also feels drawn towards her Chinese roots and culture, but cannot join in totally because she does not speak Chinese!

Now, as a proud Englishman who has never had any doubts about his identity, I find these concerns somewhat petty and insignificant. I just wanted to say to my colleague: "look - you are what you are. You are you. Be comfortable with multiple identities, because it makes you unique. Don't allow others to put you into pigeon-holes" etc etc etc.

But we must remember that Malaysia is a highly multicultural society where the variables of identity - race, gender, age, class, religion, marital status etc - often interact with one another in complex and unexpected ways.

This is especially so if you marry outside your own race, or if you have mixed parentage, as is the case with my ex-colleague. This can result, sometimes, in serious identity problems, which are not trivial lifestyle issues, but which can have long-lasting real world consequences.

This is especially acute here in Sarawak and also in Sabah, where there is a great deal of racial intermarriage compared to the more culturally polarised Malay Peninsula. So it's not a surprise that cultural and racial identity can become profoundly important, and can lead to the kind of angst experienced by my old colleague.

So, all this discussion of race and identity set me thinking about my own case. Now I said I have no problem about my identity, yet sometimes I'm not sure. I know I'm British, specifically English, racially a Caucasian (subject to the White Man's Curse!!) and a Muslim by conversion (anyone who marries a Muslim must become one by law in Malaysia).

I am an Orang Puteh, a Mat Salleh (epithets for Westerners in Malaysia), an Expatriate, a foreigner.....

I am a university academic, a government officer and a Toastmaster. These are my professional identities. So far so good.....

Yet, I have to ask myself why it is that I feel like I don't quite fit in? I increasingly feel that I don't belong here, that my identity as a stranger in a strange land is becoming more and more crystallised.

I think it's because no matter how hard I try, I can never be completely like my local colleagues. Take my official status for example. I work for my university on two year renewable work permits. Every two years, when my contract expires, I have to trundle off to the local immigration department and get a new work permit. Permanent Residence is a possibility, but extremely hard to get - many of my fellow expats have been living here for decades without getting PR.

As a consequence, my status at work is that of a contract worker, albeit a high-status one. I can be, in theory, fired at any time. Another consequence is that when it comes to getting grants for research projects, I cannot be the head of the research team, even though I am the most qualified and experienced.

When there are meetings at work, the meetings are mostly held in the Malay language, even though everyone present knows I am a foreigner. My Malay has never really progressed beyond marketplace level, because there are so few places in Kuching to learn the language. This may be because they expect all foreigners to magically be able to speak Malay as soon as they step off the plane. So this cements my status as The Other even further.

Yet I don't consider myself a typical Expat, and have very little desire to mix socially with my own kind, nor to go back home to England. My experience of British Expats abroad is one of sex, drinking and incessant moaning about the climate and the government, football, cricket etc. I just don't want to hear it. I don't drink, I don't do adultery, I hate football and cricket and I love Malaysia. It pays my wages and it's the country that gave birth to my dear wife, so I don't want to be spending all my time sitting in loud bars listening to my ignorant fellow-expats complaining about it, thank you very much.

So what do I do? I blog, that's what! I observe, comment and try to amuse. And my identity, Prof. Madder, gives me some semblance of sanity whenever I feel lonely and left out. So please keep reading my blog, gentle readers. Help to keep this lost ship close to port, where he can find some safe haven in a turbulent ocean of confused identities!

Chemotherapy Diary #1: Cycle One

That feels much better!

It does one good to have a minor rantette every now and then. But I must come back down to earth, because my wife Annie had her first chemotherapy session on Wednesday (yesterday).

In Annie's case, the good news is that she only has to have four cycles (sessions) spaced three weeks apart, followed by radiation treatment. And it seems that her bone scan and blood work were normal, and that the cancer has not spread.

Now, you hear all sorts of horror stories about chemotherapy. Yes, it does make you sick as a parrot. Yes, it does suppress the appetite. Yes, it does make your hair fall out. Does it hurt? Not so far, according to Annie. The only pain she felt was the needle going into her vein to establish the intravenous feed for the drugs.

If any of you out there are anticipating with dread the possibility of chemotherapy, here is our story so far. I will update you every now and then, with pictures where possible. So yesterday, then, Annie went into the Oncology Department of the Sarawak General Hospital for her first chemo session.

After a blood test and an interview with the oncologist, she was issued with a little prescription that she took to the pharmacy counter, and was led into a small but pleasant room full of fellow-cancer patients, all sitting in comfortable chairs accompanied by their very own personal intravenous drip feeds hooked up to metal poles on wheels.

The windows had stained glass, like a church, and there were pictures on the walls, and air conditioning. The atmosphere was somewhere between a dentist's waiting room, an airport departure lounge and a ladies hairdressing salon, with patients constantly fussed over by a couple of nurses, who checked their charges before every now and then administering the drugs.

Chemotherapy is delivered to the patient intravenously, and it's usually an outpatient procedure, so you can go home the same day. Depending on how many doses you have, and how bad your prognosis, the process usually takes about two or three hours.

Annie made friends with a pretty little nurse who, it so happened, came from her home state of Sabah. Other patients chatted with her and reassured her that everything was OK. As you can see from the picture, the atmosphere was generally positive:



The chemotherapy drugs Annie has to take look somewhat fearsome, and come in several theatrically huge syringes, some the colour of water, and others just like cherryade:



But once these drugs were fed through to her system, she was able to get up and walk out, with a slight pins and needles feeling in her head and a raging thirst and desire to go to the toilet (luckily the ladies was right next door to the therapy room). Annie reported that when she went to the toilet, her urine was red - must have been all that cherryade!

Since coming home, Annie has been drinking water like a fish on amphetamines, and has to take some pills to reduce the effects of the drugs. She has vomited a couple of times, but otherwise she is just as chirpy and tough as she has always been! However, when I came home from work this evening, she told me that her hair was starting to fall out a little bit. Nine grey hairs were removed! This is an omen!!

I will keep you posted as soon as there is something to post about. In the meantime, you will be treated to the usual doses of banal drivel that I have been accustomed to trot out on this blog!!

And Lovin' It...

Now, I don't have a bad life, when all is said and done. Yet there comes a time, once in a while, when things just seem to stop being OK. And this is just what is happening at the moment.

They say that into each life a little rain must fall. Well, I'm getting a biblical shower right now. And my umbrella has holes in it.

Of course it all started back in June when my wife got breast cancer. She had her operation and got better and stronger, and she is now looking forward to a lovely dose of chemotherapy and radiation treatment that starts this week. It is normal for cancer patients to be given chemo, of course, even though Annie's case is relatively minor.

But naturally I couldn't help worrying for her, and that was probably why I ploughed into the back of a Toyota Hilux last month. That little episode, although it didn't cost me much financially, has made my life extremely inconvenient, as my car had to go to the workshop to have the dents undented.

And unlike in many other countries, the workshop doesn't give me a complimentary car so that I can carry on with my life and do my job like everyone else. Oh no. I have to use the wife's little ATOS which, for a big man of my size, is a bit like trying to drive one of those fairground dodgem cars except this one has a roof which my head keeps brushing against. Also, I have to push the driver's seat right back to accommodate my legs and stop them from developing deep vein thrombosis every time I get in the car!

And of course, because we are now temporarily a one car family again, this makes life hard for my niece, who needs to go to school every day, and it makes paying bills and going to the shops a logistical challenge. This makes me feel guilty and stupid for hitting that $%#@ing Toyota Hilux in the first place.

AND, to make matters even more exciting, the air conditioner in my office at work has died, plunging my office into stifling tropical heat. I find it hard to work or concentrate on anything because it's so hot. And I'm fasting of course, so there's no hope of water.

AND, my office computer hard disk went away for repairs the other say and when it came back after three days, I couldn't access the internet!

AND, the ATOS has developed a leaking fuel pipe and has required an air conditioner overhaul.

AND the tap in my bathroom at home is broken, and I need to change the strip light in the bathroom.

AND the air conditioner company haven't got any compressors in stock, so I will have to sweat and swelter in my office for another few days while my work piles up....

All I can say is, what could possibly go wrong next? An earthquake? A tsunami? An assassination attempt? Bring it on!!

The only light at the end of the tunnel is that my car will be ready on Thursday. I just hope that I can take my wife to hospital to have her chemotherapy.

God, I need my pills!! Where are my pills?!?!?