My pancreas is on fire!

http://news.bbc.co.uk/1/low/england/london/7168206.stm

Dire-gnosis

Well, this happened to my dad: misdiagnosis of pancreatic cancer. How can anyone get it so wrong? All you have to do is have a biopsy before you tell people that they have an incurable and rapidly terminal condition.
A word to the wise: if ever you're in hospital for abdominal pain and they tell you it's a cancer, ask them how they know. If they tell you it's shown up on CT or ultrasound, ask them how they know it's not gall stones causing pancreatitis. If you continue to eat, the head of the pancreas will be so inflamed that it'll look like there's tumour there. The only way to confirm the tumour is to go nil by mouth (this may be for several weeks) until any swelling disappears, and then do a needle biopsy. It ain't pleasant, but it's accurate.
By the way, this is a particular problem for men over 50. I don't know the situation behind this particular case, but doctors may put abdominal pain and an elevated PSA count together and call it pancreatic cancer: 2 + 2 = 5. Now it may be that these are indications of malignant tumour, but you need to wonder where the other 1 in that equation is coming from. In this case, the diagnosis was clearly incomplete.

Hardball or softball

Following my resignation, the offers keep coming:

• A more senior position in the company.
• A salary raise commensurate with that position.
• Charge of the graduate recruitment programme in consulting and research.

I've spoken to the Employment Tribunal Service however and they tell me that in only 1% of cases does the board believe that a grievance is sufficiently malicious for them to award employer costs against the employee. I also have an idea of costs for a legal representation through an employment tribunal.
The question I have to ask myself is, what would be able to let me stay? Is there a way I could draw a line in the sand and continue in employment here? Or do I want to burn all my bridges when I'm going to be looking for other work in future?
The easiest -- but least satisfactory -- course of action is just to walk away. I'm not prepared to do that:

• I don't want it said that I left because I just couldn't hack it, that I got a poor review and got arsey over it.
• I need to establish that they discriminated against me because of my cancer.
• Could I be really onboard for the graduate programme if I have doubts about the company?

So, there's nothing that'll make me stay, because I've lost faith.

Updated:
Now I've articulated my position to the head of HR, things have turned a little more hardball. They're completing the grievance process at a subsequent meeting and will take the view that they've made every attempt to resolve the issue. I will say that they did this only once I'd resigned. They'll say that the process wasn't complete and that I could have appealed before I resigned, but chose not do do so. They told me the process was complete, but I have no witnesses to that, so it'll be difficult to prove. I'll tell them that I'm going to an Employment Tribunal. They'll say fine and won't do anything until they hear from the service, which means I'll need to pay hundreds of pounds for a lawyer when I shouldn't need to. If the tribunal sits, they will lose, but I won't win much because they'll claim I didn't follow the whole process. It's a stupid way of doing things, but they forced me down the hardball route.

Coursing adrenalin

I quit just now. There's a tinge of regret, no doubt.
My head of department admitted to me that comments in my appraisal related to my cancer and that he should have transferred me to the newly merged company at a higher level. So there's some concession there, but it's too little too late. I don't want to be a hard arse over this, but if I knew about someone else being treated as they've treated me, I'd be really pissed off.
The head of HR came to see me within about 5 minutes of me resigning, asking me to reconsider, so I'll spend tonight discussing with Helen and try to take as open a mind as possible.

Time recovery

Fed up with having lost an hour's sleep at the weekend? Take a look at the benefits of power napping.

Snippets of apocrypha

I don't drink alcohol much anymore these days, but I recognise that some people are still susceptible to hangovers. Where are they going wrong? Should they be drinking a pint of water before they go to bed or making themselves curried scrambled eggs when they get up the next afternoon? No, these are myths, in comparison with the hangover cure pillow. It appears that all you need to stand bright lights and loud noises are some Himalayan herbs wrapped in cotton.

On a separate, similarly mythical note, I refer you to a story which is quite feasible, given how much money Alen Boksic used to earn.

PDF to happiness

I've been doing some work for Dresdner Kleinwort recently, who conduct some interesting macro-economic research. One of their stars is a guy call James Montier, who writes about behaviours involved in investing. He's written a particularly interesting article on the psychology of happiness, which is well worth the read even though it's in a PDF.

First the good news

I just thought I'd drop a positive post in, amid all the crap I've been putting in before. After four and a half years of cancer, my interferon treatment is doing the trick and cancerous activity seems to be on the wane. It's too early to say whether existing tumour mass is receding, but all the latest scanning technology hasn't picked up anything new. My thanks to the medical team looking after me.

My son on TV

I'm not grooming him for a career in television, but he's started anyway. Go to BBC London TV and Radio and follow the link to Nursing to be cut in Barnet.
Oh yes, and the missus is on there too.
It's an important story, so worth watching, if parochial.

Preoccupations

Paul Hunter gave generously to neuroendocrine tumour charities. He wasn't even 28.
I'm sick of being sick: bloody diminished neutrophils. Can't walk down the street without feeling knackered.
Like Paul Hunter, I can't do my job properly on the treatment. Unlike Paul Hunter, the interferon should be less intrusive and I should have fewer metastases. I hope to find the interferon working miracles so I can get back to my normal self.
I also hope Hunter's popularity draws some extra attention and resources a largely unknown problem.

To HIV and to HIV not

Yesterday I went for an HIV test. There's a drop-in centre at the Royal Free: not that you'd know it's there unless you'd been told about it. There's no sign saying gays, sub-Saharans and the promiscuous this way. You're directed to the relevant common waiting room where you can speculate on each other's reckless shame. And of course, it's impossible to tell who's reactive just by looking. Strikingly impossible.
Here's an obviously gay couple being tested in tandem. A guy who looks west African. A young bloke who may have sniffed too much glue. Four young women of varying ages who appear distinctly un-slutty; I suspect one of them is a virgin, or maybe a one time only. Another guy in his forties who seems very straight. All of which reinforces the theme that you just can't tell and how glad I am that my wanton days are behind me.
So why was I there? I have cancer. I take interferon to treat it. Interferon lowers your sperm count, so I need to deposit some for future expenditure. The bank requires an HIV test. This rather long-winded explanation earned me the sympathy of of the nurse, who let me off the £30 fee to certify my negative result. So from the land of the incurable, I receive sympathy.
Clearly there's still a perception that people infected with HIV deserve it whereas people with cancer don't: people are victims of cancer but suffer from HIV. Yet for all he knew I could be a chain-smoking supplier of DDT. And the 25 million people who died over the last 25 years from AIDS-related illnesses weren't all reprobabtes.
Nevertheless, while I was surprised by his tea and sympathy, I want to highligh what an excellent service this is. It took about 45 minutes from walking into the clinic to getting my result and it's free (unless you need a piece of paper to prove your health). There's nothing that goes on your medical record, so it's as anonymous as you want to make it. If only it were advertised more heavily.

I left my voice...

in Old Trafford. And what a sham.
Whether Flitney was out of his area was difficult to tell from where I was and just as difficult for the referee. It was the assistant who gave the decision. Unfortunately the referee who hadn't been able to see the offence committed deemed himself able to tell whether it merited a red card.
It was the wrong decision technically and morally. There are those who will trot out the rebarbative mantra about consistency, but no one was denied a goal-scoring opporunity, even though Flitney was clearly the last man. That makes it a deliberate handball and a yellow card offence. Instead the referee crushed the atmosphere for all the fans and ruined the biggest football game of two players' careers: the goalkeeper Flitney and Louie Soares, who was substituted by the new keeper Scott Tynan without touching the ball.
There may well be some positives to draw. If we'd had eleven men and got stuffed it would have been really embarrassing. At least we scored. The club should now be out of debt. But we spent over £50 each and took the day off work, spending nine hours on a coach for the referee to screw things up; and people taking their family up during half term spent more.
Football is a sport and the professional game should also be about entertainment. Despite what the phone-ins say it's not about conjecture and debate. If I wanted that I'd have stayed at home and watched Question Time.
By the way, if you don't know what I'm talking about, you can find out here.
addendum
I have since discovered that losing my voice was due to catching a cold. Flitney has meanwhile had his red card rescinded, which only serves to prove the referee's onanist tendencies.

I have issues with...

• work
• patience
• excess
• discipline
• walls

Any surprises there? similarminds.com can tell you what you have issues with.

Getting from A to B

Business education, in an attempt to convince itself that it is a serious discipline rather than vocational training, has long incorporated aspects of psychology into its courses. At its most basic, this involves proto-Jungian psychometric profiling between types A and B. Type A people are characterised by their competitive need to achieve, a sense of urgency and a general hostility to others and to the world. Conversely, type B personalities are more relaxed, probably seeking a more spiritual path through life.
In my view, type A's aggressive attitude may be ascribed to an underlying dissatisfaction. This type, by its competitive nature, expects external recognition for what it achieves. Type B personalities may be more secure and self-satisfied. The irony is that despite type A's disdain for world, this personality requires an approbation that it should know it will not value, leading to frustration and seeking out more challenges in a spiral of dissatisfaction that tends to terminate in a coronary.
While this typology is highly simplistic, it is easy for me to identify myself with those in type A. Although my aggression is usually confined to sport, commuters and this blog, I always try to do more than one activity at a time (hence my PDA dependency). This is not a healthy position to be in. Can a type A ever be satisfied or even accept satisfaction as a good thing?
It is possible to get from A to B. A striking example is Heinrich Harrer, author of Seven Years in Tibet, a book that I read much of from my mountains-obsessed father's shelves when I was nine or ten years old, though it held no meaning for me then. Harrer was an archetypal type A, a hugely competitive and successful sportsman living the Aryan dream in 1930s Austria. In 1939 he headed to India in an attempt to climb a mountain that had defied numerous expeditions; he failed. War broke out, he was imprisoned by the British, but escaped to Tibet where he was eventually allowed to live. While there he met with the young Dalai Lama, through whose friendship he achieved a sense of calm and compassion he had previously struggled to understand. He returned to Austria after the war, just as the Chinese took over Tibet.
It was a Saul of Tarsus-like conversion, one to bewilder a type A atheist. How does one move from A to B? Do you need to find a god three miles high? Do you need to abandon the twice-daily rush hour for a hippy kibbutz? Or tell a type A world to forget about deliverables and milestones and just relax?

Management posturing

I've been contemplating visting some chiropractic quack recently as I'm sure my posture at work isn't what it should be: huddling over a laptop then leaning right to gaze at my burgeoning screen of resource planning can't be good for the spinal column. Then I realised that these exertions on my suppleness were not the cause of my woes, but that these are endemic to my position:

The Calgon effect

Washing machines, we have been told, live longer with Calgon: it prevents limescale accumulating on filaments that heat water. Of course it's practically impossible to tell the impact that Calgon is having as the filament is hidden from view and you have no idea what would have happened if you'd never used the product. And so it is with cancer.
Cancer patients live longer with vitamin supplements. I've been taking A, C, E and selenium since I was able to eat again and I'm significantly ahead of the pancreatic tumour mortality index. Whether these antioxidant supplements have anything to do with this is anyone's guess, but I'm not prepared to take the risk of stopping. And when there is spread, interferon will be the new Calgon. It's frustrating knowing that there's limescale building in the machine, but short of pouring a vinegar of chemotherapy into the drum there's little else you can do.

Speedy recoveries

Researchers at the University of Birmingham have shown how ecstasy and other amphetamines can prevent the spread of cancer, according to BBC news. If I'd known this before, speed may have become a drug of choice. Maybe my oncologist will prescribe some kind of dopamene / ecstasy hybrid, which would make the daily grind of work a touch more interesting.

Waiting...

What's it like waiting in an oncology clinic? Many of you will find out. Today was an interesting one. 3½ hours of waiting because prints from some of my scans went awol. And I knew it wouldn't be good, so there was a lingering sense of doom.
This wasn't helped by having to sit next to some fuckwit with "worry" beads -- those Greek wooden beads on a string that men play with between their fingers -- who was rattling said device very slowly and in perpetuity... His selfish success in attempting to relieve his own concerns succeeded in pissing off everyone else, but somehow made the impending appointment less intolerable. It was a relief to get away from him into the conversation about the hole my oncologist wants surgeons to drill into my jugular.
It wasn't that bad I suppose. I knew I'd have spread at some point and it appears on the face of it that this is possibly the least bad metastatic disease might be. So I now have to wait up to six weeks while they debate whether it's feasible to conduct a biopsy on some lymph nodes that are half a centimetre across and then they'll probably stick me on some inteferon therapy.
So more waiting then, but at least that twat with the beads isn't there.

Individual biologies

As I learn to live with cancer -- there are some tough lessons on this syllabus -- it becomes increasingly clear that for all I discover about tumours and treatments, this objective approach will tell me little about how my own cancer might be cured. Because when you're looking for a cure, it's not about a given percentage success rate for a particular therapy or trial (especially for so rare a form of tumour as mine); the individual biology of your cancer is what counts.
My oncologist characterizes the idea that if 70% of treatments work then you have that chance of success as a neanderthal approach, and I can see his point. For example, it's no use putting patients through the most effective radiotherapy if they have lots of small metastases: it would take years to target all these mini tumours, during which period there would be further spread. The reason why people are put through mass courses of chemotherapy is not because the oncologist knows that it will work for those patients, but because it's statistically successful. Oncologists need more time with each patient to determine the correct solution: therapy shouldn't be a mass market but a heavily tailored solution.

Having kittens over allergies?

I'm not an animal lover (that's probably the French in me) but I do know that some people who like pets suffer from the disgusting bugs they carry around with them unless they're cooked to rare at gas mark 6. Fear not, oh hypersensitive Brits, for soon you will be able to acquire a hypo-allergenic cat to soothe your ills.