Sunday, February 6, 2011

Adaptability

Late night greetings, everyone. I hope you don't mind some mental ramblings.

Round two of chemotherapy ended today, and again, Nancy is doing well with it. No reactions, rashes, or real discomfort so far, although the next couple of days could be different. She got two more units of whole blood this evening to keep her hemoglobin levels up, one a directed donation from her sister-in-law Karen Kristensen. It's special to get gifts like that. She now has bits of Edward Nattenberg and Karen and myself orbiting in her veins, along with the dozen unknown hero donors who have volunteered some of their essence.

I've had a couple of hours of sleep tonight, squeezed next to her on the hospital bed, and it's time to let her have the whole thing so she can settle fully into herself. I'm unable to reenter dreamland on the rack, er, the pull-out chair that doubles as a bed for guests, So I've been contemplating the nature of our adaptability as human beings.

It's quite astonishing how we mold our world; sitting on the 11th floor of the hospital, on the northern slope of Mount Sutro in San Francisco, I am looking out the window at miles of transformed landscape, continuously coated with a dense fabric of buildings and roadways, lights, churches, moving cars. It's also amazing how we adapt ourselves; Nancy and I have created a cozy home away from home, with nothing more than some altar objects, an LED candle, our laptop computers and iPhones. We can feel ourselves as a connected couple in this structure of healing technology, to the point that we bicker as always. She has even created big parts of her outer life here, coaching a workshop, and becoming command central for Vangie's funeral on Monday.

Our complexity is key. Simple organisms cannot adapt to changing environments. Fortunately, leukemia cells are simple, and the intense levels of chemo drugs are more than they can tolerate. The process of programmed cell death is called "apoptosis", and it's the malfunction of that process that allows leukemia cells to multiply. The genetic error that creates leukemia should never have been allowed to propagate in the first place.

Apoptosis. I love the word, as it sounds like something exploding. As the chemo hurries leukemia cells to their timely death, I imagine Nancy in a popcorn haze of apoptosis, thousands of little leukemias committing suicide each minute. Thank god for their simplicity, their inability to adapt to cytarabine and daunarubicin.

And thank god for Nancy's adaptability and determination, not to mention my own. Perhaps I can adapt to the rack now, which has adapted to the shape of the hundreds of humans before me, that have slept here as they watched their loved ones go through this trial. It's too bad they all seemed to be only five feet tall, as the hip and shoulder indentations require me to adapt in some odd ways in order to find sleep :-)

The ventilation sighs, Wallie the IV softly chitters, and apoptosis crackles under the covers nearby. I can sleep with that.

With love,
-tdc

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