File: gutting.txt Cont: evisceree-to-be gets clues, experiences The Fear, watches the dance. Is there any diagnostic value in observing what people do in the face of impending doom? Sunday night, I ate some pizza, dropped a book back to someone off whom I had borrowed it, then whizzed around to a friend's place in Newtown, and to a backdrop of Disposable Heroes of HipHoprisy, we shagged each other to an absolute standstill (surprisingly good music to shag to, I think). I guess impending massive trauma is as good an excuse as any for a spot of debauch. Once we could stand up again, I threw on some clothes and fanged it home on the understanding that the reason we have license demerit points is, you're supposed to lose 'em. I know for sure now the speed camera on the Princes Hwy at Kogarah won't get ya if you drive a 'cycle right in the gutter out of the field of the induction coils they embedded in the middle of the lanes. Tho, doin' a hundred k's with your footpeg one inch from the kerb is somewhat dogdy. No user servicable parts within. Refer to qualified service personnel. Monday morning, I went to meet the guys who are going to gut me, Mr Aslam, and Mr Cozzi. Aslam does kidneys. Cozzi does lymphatics. I'd address 'em as doctor but I've been deconditioned of that habit, since it's not how I address dad, who has been a DokTa for longer than I have been alive. He came along for a listen, and also because he's my immediate next of kin. Aslan and I had a look at the CT scans on a fluorescent backlit screen. On the right side of my body is a normal kidney. On the other side is a smattered veneer of (surprisingly, still functional) recognisable kidney trying desperately to hang onto a fuckin' big chunk o' mutant cellular bureaucracy gone mad. It is dimensionally about the same size as my head, if you were to cleave my head down the centre first. I'm not quite sure how I fit it all in. Into my head popped a quote from Parker (Yaphet Kotto) in the movie Alien, who delivers the line with exactly the right emphasis for this circumstance: "That son of a bitch is HUGE." The consequences of just how huge were finally revealed. It's not gonna come out through the usual renal incision. When people as conservative as surgeons invoke the word _radical_ and follow it with nephrectomy, there's a gonna be some serious slashin'. They're gonna insert a blade just above my pubic symphysis, run it all the way up the middle of my six pack (can they do something about that protruding navel while they're there?) to the base of my sternum, then do a left turn through my abdominus rectus (that's gonna fuckin' hurt while I'm healing) and run along under the margin of my ribs, then go through the pleura of the left lung (which will collapse for a while, which sucks but I guess I'll find a bicycle pump and reinflate it later) and through the intercostal muscle between the eighth and ninth rib. Same thing again with the peritoneal wall. Then they ligate a lot of heavy-gauge vasculature. I am so glad of the existance of anasfuckinthesia and really sharp knives carefully wielded. Let me quantify this. I just measured these distances with a tape measure. I'm up for ghastly half-meter gash in my torso, half midline, half centre-to-edge. I am gonna fuckin' fuckin' fuckin hurt for fucking weeks and it scares me a lot. I hope they have a sewing machine or a staple-gun handy for when they finish removing the thing, and a spare 44 gallon drum of refined opiates to dunk me in. Regardless to what level of accuracy it is executed, it'll more or less be tactical butchery getting into and out of my carcass. Aslam reckons they might damage the spleen in the process of doing this procedure, and damaged spleens tend to bleed all over the place, so they might have to chop that out too. I don't have a spare one of those, unfortunately. I'll be more happy if I keep it. To cover the possibility that I lose my spleen, this arvo, in each arse cheek, via inch-long 23-gauge needles, were administered recombinantly engineered vaccines against pneumococcus and meningococcus, which are two kinds of bacteria to which you have an increased (forty times!) probability of succumbing when you're asplenic. My bum hurts bilaterally. I can sit down, but not move about without a strong ache in the bottie. Vaccination's a pain in the arse, but it beats being eaten alive by an opportunistic microbe. Part of why they need an opening redolent of something I'd normally find on a CityRail vinyl train seat is because Mr Cozzi is gonna resect all the lymph nodes up and down my inferior vena cava, in the event that the suspect lymphatic drainage from our friendly mutant has contaminated them with metastatic cells. Tumours all begin as one cell. The one I'm nursing is now several _billion_ cells, all of whom took time to execute their capitalist genetic imperative of "go forth and uncontrollably exponentiate". Today arrived some other clues; first, a pointer to when it might have started; second, how I could have known about this thing earlier; and third, an insight into its general nature. Once Was A Kidney looks about as ugly in NMR images as it does in CT images, but there's better resolution of the arterial and venous supply. Tumor cells aren't very clever, collectively; they're effectively clones, all equally unimaginative and proliferative, rather like an insidious subspecies of middle management. Whilst busily reinventing half my renal system as the sort of disease for which abattoirs reject slaughtered carcasses, the stupid fucker grew into, and blocked off, most of the renal vein which the kidney uses to return piss-depleted blood to the inferior vena cava (which is a BIG pipe, I could (very uncomfortably) fit my thumb into it). NMR shows the occlusion fairly clearly. I thought for a moment it'd have been funny if it occluded the renal artery and effectively starved itself before it got a chance to get massive (well, duh), but that'd just kill my kidney, which would become necrotic and would need to be removed anyway. Less slasho, but slasho nonetheless. Natch, the progressively-less-kidney is still being force-fed a load of pressurised arterial blood from my descending aorta. So ...the thing... had to find some other place to drain its venous output. Sure enough, it decided to head downwards, and involved itself in my gonadal vein, on the left side. When it did this, it raised the venous pressure therein and de-elasticised the collagen in the veins which take circulatory drainage from, you guessed it, my left testicle. I have no idea if this means I'm gonna lose a 'nad, but hey, I have a spare one of those too. Bilateral symmetry has its privelages. I've been walking around for a couple of years with a 'nad sac which occasionally feels like a bag of worms hanging off my pelve, but it doesn't bug me. I had it checked out by a GP the same day I discovered it while having a shower at my old squat in Annandale, and he told me what it was and said, well, if it doesn't bother you, don't worry about it. It didn't, so I didn't. I mentioned it to dad and he didn't think of anything, but then he generally operates on people with no scrota. I didn't think of anything, either. I rationalised it as age-related idiopathic collagen failure, I'm getting it in my lower legs, too. It seems, however, that bags are the embryonic form of these cans of worms to which I hear people refer every so often, one of which I have recently opened. Chatting to Aslan today, mentioning my complete lack of symptoms other than splenomegaly... no night sweats, no pissing blood, no pain ... I was just in the process of mentioning that I had a left varicocele but he got the words out two seconds before me. Encouraging - therein lay the correlation. But when did this appear? I had to trawl my email archive for "scrotum" to get a clue when this started, 'cos I remember emailing someone about it. Must have looked odd in the process table entry on conway - predator@conway:~$ grep -r scrotum * | more which for those of you not conversant with the gnu/linux command line shell means: search everything under my home directory for the occurence of scrotum and display anything you find, chopped into individual screenfulls. Visualise that process as you will. According to the datestamps on vasquez.zip.com.au and conway.cat.org.au, a message mentioning my varicocele appeared a few days before Thurs Feb 28 2002. So I've been an oncogene farmer for at least 21 months, and probably for a few months longer than that, since when the initiating cell started down its proliferative career path, it needed a few months to get enough buddies to block a a vein. This is, in its own way, sort of encouraging. Big, slow growing tumors are generally less prone to metastatis than their malignant, aggressive, fast-spreading, fast-growing, kill'em all and let god sort 'em out relatives. If it was likely to be malignant, it's probably had at least two years to figure it out. It has involved ONE lymph node. So if we're lucky it still hasn't figured out how to take over the rest of me, and it can be scooped out more or less entire. Good riddance, fucker. You can propagate all you like... in a cell culture bottle where I can feed, nurse and autoclave you at will, bwahahaha... say... fancy spending the rest of your life in vapour phase liquid nitrogen, with a handy preservative of 10% DMSO and 5% dextrose? I'm starting to lose confidence in GPs and not simply 'cos of the "forget about the varicocele" incident in Feb '02. I popped along to another GP while I was doing some kitchen renovation a couple of weeks ago (probably late October), moaning faintly about this splenomegaly and that for some reason the waist strap on my backpack didn't fit comfortably any more. He checked for enlarged lymph nodes, palpated my guts asked me if there were any other symptoms, and when I said no, said not to worry about it. I'm glad I worried about it a bit more and asked dad to feel my guts one night in front of the (you guessed it) footy. If I'd taken the same "don't worry about it" approach to this thing as I did to the varicocele, you'd be reading this rant in late 2004 or maybe 2005, about my impending death from inoperable cancer, and how it came to be that I'm up on a charge of the manslaughter of my general malpractitioner. Maybe I'm getting infinitesimally smarter about these things as I age. Am I enough of a prick to send him a copy of the CT report? Yeah. Lift your game, pal. Ar, shit. It just occurred to me I'm gonna miss Jello Biafra on Thursday at the Enmore. I bagged TISM member Jock Cheese's album Platter today and it's pants shittingly funny and also sad in some places. I wonder if this guy's brain isn't somehow entangled with mine. Vote me for President. I'll ban patriotic sentiment. Introduce a virus pest control that reacts to the mention of green and gold. Up there Calici, in there and fight, wipe out jingoism overnight there's no marketing that can stop it I don't care if there's ten Tony Locketts. I caught the bus home and remembered how much I like the feeling of my head vibrating against the glass to the throb of the diesel engine under the floor of the bus, and that cloud of hot, almondy burnt diesel which you often walk through when you walk towards the folding entry doors. I went to a service station and stuffed my wankerfone full'o credit in anticipation of a ton of SMSs I will have to send in coming days. I walked up the hill in the rain and enjoyed the light splashing and the cold, wet, astringent smell that the trees emit when their kino is washed down their trunks. I've walked up it thousands of times, it was one of my first big excursions, on the way to and from primary school. I get home and the dog whinges to me, wanting a walk, but my arse is complaining about its brush with bacterial proteins, tetanus toxin and aluminium hydroxide adjuvants and I'm not going to walk much tonight. I'm getting short with mum. I tell her stuff and she asks questions which indicate she didn't listen, which is the worst kind of question to ask me since it makes me uninterested in answering again, making her ask more questions which indicate she didn't listen the first time. I don't know if she's going deaf, or senile, or something. Or maybe she's always like that and I'm getting stroppy. Tuesday, 10am. This time tomorrow I'll be on the table, halogen floodlit, peeled open and hovered over by people who dress in funny green smocks with blue masks, and wield sharp, disposable blades, various 316 stainless alloy tools, pass each other the right instruments without asking for them 'cos they're _in the loop_ and to whom clings the hope of those who would be glad to see me come out alive. A machine will be doing my breathing for me. I'll be very thoroughly paralysed, deprived of sensibility, and bits of what used to be my guts will accumulate, detached, on the table beside me. I go into the hospital, starved from midnignt tonight, at 6:30 am tomorrow morning. They carve me up at 9am. They reckon it'll take 'em about 90 minutes to take the freakshow out, and about two and a half hours to get all the lymph nodes and other shit, then insert a drain and sew me up. Procedures of this length are known as major ops in the trade. I'll spend about four hours splayed on the table, total. By a perverse twist of fate, dad will be in the theatre next door, operating. It won't surprise me at all if he comes over and gives me a haircut while I'm out. I'm gonna be drugged out of it, in intensive care for a day after this trauma. I hope someone has the good decency to tell me what day it is if I wake up. I popped into dad's office this arvo. I figured I might as well make him the executor of my will, which should be logistically easy, since I can't think of any instructions and have no worthwhile stash of desirable goodies for distribution. His parents wrote him completely out of their wills, which has pissed him off for about thirty years. I don't know if it'd be appropriate or ironic to leave all my stuff to him. I figure he can do what he wants with my stuff, but knowing dad, he'll chuck it out. What would he do with a climbing rack, a 60MHz CRO, weird computer shit, a stack of CDs, twice his bodyweight in books, a motorcycle? Nah. I don't care just yet. There in every classroom, in every secondary school and in every workplace and every typing pool, there beside you on the bus with the lifeless stare nervously outside surgery waiting for doctors there. Together, loser. Loser. Loser, loser, losing, lost. Loser, loser, losing, lost. There's cancer in the south of France Cancer lurks in Rome. Cancer circles the whole globe 'Till it finds you home. In heart and liver it is waiting for all of us or most our very cells join hands and sing loser, loser lost. Loser, loser, losing, lost. Loser, loser, losing, lost. "Lose your Delusion I" (from TISM - the Beasts of Suburban) I'm starting to think I should choose more carefully what I slap on the CD player. Pink Floyd's "Breathe (Reprise)" sprung out of my speakers and stopped me in mid-breath. I'm not frightened of dying, either. I'm just frightened of the pain and stupidity of the likely routes to that end when the process isn't under my control. I am In Harms Way already, but the escape route is risky, and includes possible iatrogenic damage (a spleen is a terrible thing to waste) and nosocomial infection. I hate hospitals for a number of reasons mainly associated with getting a knife in ya, but also 'cos they're full of microbes which eat antibacterial drugs for breakfast... cyclosporins, beta-lactams, chloramphenicols, tertacyclines, you name it. Rip off a couple of atoms and, Borg-like, assimilate them into the molecular collective. Humanity trained these microbes to learn these resistance tricks over the last fifty years by overprescription of antibiotics, and failure to complete courses thereof. I've seen the plasmid maps of the antibacterial resistance genes these bugs pass between each other, molecular cassettes of free software, shared by the bacterial community to defend itself against the semisynthetic chemical onslaught we throw at it. If anything gets into me while I'm laid open, I'm up for an ugly septic cytological shitfight, 'specially if I lose my spleen somewhere in the theatre. Even if everything goes brilliantly, it's still gonna fucking HURT. Yesterday, the patho lab upstairs did a blood group and hold on yet more of my brachially extracted claret, but I noticed they didn't ask for a crossmatch on the stuff they took out of my arm. This is a good sign. They're not expecting to need to transfuse me. I found out that the noise cancelling headphones are three hundred bucks from Sony, and I think I'll just bring my normal squishy earplugs instead. Amazingly, for three hundred bucks, they do no digital signal processing at all - it's all fast analog circuitry. Three hundred bucks is a fuck of a lot for a small mic, an SMD operational amp and a couple of passive components on each side of your head. I think I'll have to go track down a circ diag off the net and go from there. If I get out alive. Welcome to my last shower before The Slashing. I've chemically mowed off most of my pubic hair with some thioglycolate goop, so some stranger doesn't have to do it with a razor leaving pointy ends on the hairs, which would make it more likely to itch when it grows back. It doesn't help the scar heal if I scratch it all the time. Anyway, I'm not happy to have some random person doing alien crop circles in my short'n'curlies with soap and a razor blade. I might get cut. Or hard. Or something. I wake up early tomorrow morning with a load of clothes (black), a toothbrush, a hairbrush, mobile phone (and charger), Kuhn's "The Structure of Scientific Revolutions", an artline texta. This will all be waiting in a black backpack which dad insisted upon my using on the grounds of hygiene (I can't argue - my main backpack amounts to a nylon-substrate ecosystem which uses me to get around Sydney, and turns wash water black when I wash it) - but the black backpack is another of dad's `image' requirements wrapped up in med-speak justification, and it isn't like I'm gonna go deliberately smearing my backpack on my wound or anything) but it's unfamiliar to me, and I've had, and sometimes lived out of, my other pack for ten years. I think the BOEING emblem looks better since I coloured the E and I out of it. Amazing amounts of bullshit went into keeping control of what I finally put into the pack. My impending hospitalisation appears to have awakened some long dormant parental pack-yer-kid's-stuff-for-them genes which are usually only activated when preschoolers are notified of their first trip to the zoo and need their globites stuffed for the epic land and sea journey to the far flung gates of Taronga Park. As part of her melodramatic propensity, mum went on a pathological ironing frenzy and presented me with a load of razor-pressed tee shirts and shorts to wear in hospital - all of 'em are dad's, various pharmo company shit decked in advertising for such things as implantable contraceptives. I'm think I'm supposed to be grateful for the work she's done on these things, given as a gift from the concerned. No offense, but fuck off. I'm wearing what I usually wear, I pack my own shit, and if I had a religion it would prohibit ironing. It's all my stuff, 'cept for a dressing gown an acquaintance wore while they were having their guts chopped out last year, and gave me for the occasion on the grounds that it will bring me luck. Which is crap, of course, but it will bring me a better R (thermal transfer co-efficent) if I wear it. It is an unseasonally cold November. So I took it. Some strange concepts come out when the shit hits the fan. People ring up and wish me good luck, knowing nothing whatsoever about the treacherous mathematical randomness underlying such a wish. There is something sort of equivocal about a cancer patient saying luck isn't something they've had a lot of lately, since I did spot the thing, too, hopefully in time to chop it all out. Nobody seems to notice the contingent Markov chain: in order to `get lucky' and spot cancer in time to head it off, you have to `be unlucky' and contract the disease first. Yea, verily, stochastic processes giveth, and stochastic processes taketh away. Three people rang me up this evening and said they'd pray for me, which I'm sure will make them feel better but otherwise be a waste of their perfectly good CNS activity. One gave me a couple of quotations from, if memory serves me correctly, a little tome called Life's Little Instruction Book, a million-selling publication which I recieved as a present over a decade ago and disgustedly flung in the garbage as a collection of meaningless, and in some cases self-contradictory aphorisms. Someone else, a rello, rang up, concerned because their mum called them after my mum blabbed to their mum about my illness. We ended up having a long rant about oncogenic cervical viruses and tumor processes in general. She said she would worry about me, and I said that would have no impact on me, and she should just rock on down to BOC Gases, lug home a cylinder of nitrous oxide, crack open the reg' and just try and fuckin' relax. She thought that was kind of funny. I hope she doesn't light up a spliff at the same time, since NOX is known for its propensity to, uh, vigorously accelerate combustion. An old workmate of dad's rang up, and asked how I was, but I couldn't identify him by his voice on the phone, and I answered, `That depends on who you are. So who are you?' Eventually he coughed the beans. I knew he knew what I was in for. "I am up for a ghastly slashing - rad nephrectomy minus optional extras." This dude's a surgeon too, and he knows the outcomes are not down to luck either. As confused and crazy as they all seem, being aware that people give a shit does feel good in an egocentric sort of way. But why do they do it? Do people feel bad if they don't tell me they're worried? I'd much prefer people just got on with their lives, heedless of my problem, not worried. I'll tell 'em the news when it's all over. In a few hours I'll wake up, get over to the hossie, sign in and dump my junk. I'll be running a circulatory system increasingly full of catecholamines, and the cerebrospinal fluid sloshing around my ventricles will be sodden in home-grown neuropeptidyl trepidation. But fear is OK provided it can be kept under some sort of control, and I can do that. Dad blocks all inquiries as to his state of mind, and appears unreadable, which is worrisome. Makes me feel like he's masking something. I don't know what to do about mum breathing her cigarette-flavoured, desperation-tinted, canned wisdom in my direction, borne aloft on a wheezily delivered aerosol of pathogens freshly exhaled from her disintegrating, tobacco-plundered alveoli. She's had some hellish bodily slashes too, in her life, but I know already what I'm in for and it isn't gonna help to have her dissolve in front of me. I feel for the poor thing, but I'll be glad to see the back of her weepy preoperative histrionics when the orderlies mercifully shoo her out of the ward. I'm not equipped to look at them, they're terribly contagious, and more than anything else, I don't want to catch the vibe they harbour within. At half-eight, they'll stick in a main line, get me into the drapery, get me onto a gurney and wheel me down to the OR. I'll be strongly inclined to sing this as I glide along the corridors: The angel of death hovers overhead. My family come gather round my bed. Come my colleagues, come literate friends here is my life wish as my life ends - I wish I'd slept with more girls. I wish I'd done more drugs. I wish you'd all go and get fucked. (Professor Derrida Deconstructs - TISM "Faulty Pressing Do Not Manufacture") provided, of course, I can stop laughing long enough to get the words out. Stuck in the circumstance, it will hit me as astoundingly silly that the last thing a considerable proportion of the community sees before they die is hospital ceiling tiles. It's also the first thing they see again if they survive their surgery. You are on a planet of pressed, painted, rectangles of suspended bagasse. What a reason to bother to regain consciousness. I'll be glad to see them again. Who'da thunk it. I won't need to pack the texta: from my {umops apisdn} perspective with respect to the intended audience, I got it right on the first go. Since dad's on a medical tribunal which hears cases in which doctors are dismissed for rank incompetance, I've been exposed to too many shocking stories of instruments left in, wrong organs removed, wrong ops performed, to not try and help out all I can. So on my right abdomen is inscribed a morbid joke so bad it could almost serve as an epitaph, but if it works, it won't need to. Hopefully they'll see it after I lose consciousness. . . . \_/ PLEASE OPEN OTHER SIDE --> (I had to do it like this 'cos it wouldn't all fit across my abdomen). Gimme the succinyl choline, Captain Snooze, let's get it fuckin' over with while I can still maintain the delusion that I'm really not scared shitless. (next in the series is conway.cat.org.au/~predator/gutted.txt)