The geometry of cancer

Yes Virginia, you do need your geometry lessons. Geometry is an integral part of cancer treatment when using radiation because the doctors need to analyze the terrain (your body) and determine literal angles of attack.

In reality the universe has no geometry. --Kedar Joshi

Radiation exits the machine in the form of x-rays which are shot out in a perfectly straight line from point A to point B. They magically go right through almost anything. Hmmmmm...this seems a little suspect because they must not go through every substance in the universe or go on forever - otherwise the x-Ray somebody gets on the other side of the world would travel all away through the earth and zap you today while you're eating your tuna sub at Thundercloud Subs. I better look into this more since I obviously don't know what I'm talking about. 

Back to angles.

X-rays are straight. If the death rays were shot straight down at my breast from above, they'd hit and kill their target but then continue through my body and also zap my heart, lungs, bones, and other useful innards, thus extinguishing my me and negating the whole purpose. Let's just say - it'd kill ya. So they shoot the radiation in from the sides of the breast, trying as best as they can to have the killer rays go through the blob sitting on top of the ribcage...using geometry and art to get the rays to go as low low down to the rib as they can while still trying not to radiate any bone or lung or heart. 

There are several problems to be worked out geometrically mathematically emotionally mythically mentally psychologically though:

1. X-rays scatter a bit - they can be unruly preschoolers and a few may ricochet or freak out and ping pong around inside you willy nilly if they want to and no one knows if or where. So I will have some lung/heart/something else zapped - most likely. What if one x-ray bounces off a diamond chip somehow embedded in my breast and is sent shooting down at the speed of light internally inwardly through my body and it fries a little one celled organism in my gut - the one that was in charge of the probiotic army, the general, and then all the other troops die of depression and my guts explode with rot? Probably won't happen. But what will?

2. When the x-Ray thingy is on my right side trying to hit me at an angle across my cleavage down to exit around my underarm, the angle is so flat (obtuse?) that the rays go through the skin at an extreme angle (meaning MORE skin - imagine a highly diagonal bevel concept) AND they tend to "skitter" across the surface, so that this area gets much more irritated. I must confess, I was glad when the doctor explained this to me, because I was starting to wonder what in the world was wrong with my skin there because it looks dégoûtant as they say in French.

If they wanted textbook example of this they could take a picture of my chest. 

I'm showing you just a tiny bit of it in the picture I post here, I don't want to be too rated R for a blog, a family blog. Ha ha, what family reads this? And I don't want to scare you. The polite narrator.

There is still a difference between something and nothing, but it is purely geometrical and there is nothing behind the geometry. -- Martin Gardner

I have just completed my 15th radiation session. Five more to go. I'm getting to know the staff at my radiation clinic, and they are good people. Kimberly always smiles and has the grace to recall who I am every day when I walk through the door. I know I'm just one of hundreds or thousands of patients to go through the revolving door of her life, but to me, she is unique - a once in a lifetime (I hope) radiation oncology nurse. I wonder if she knows how important she is in the minds of the patients that she sees?  

Notes from inside the radiation room:

1. There are no windows in the radiation room. 

2. It is very fridgey cold in the radiation room. Is it part of the mystery of medicine to make the patients so cold and uncomfortable that they feel isolated, and are not warm enough to think very well or ask too many questions? This keeps the patients docile I think. Everywhere I go in this guise the room is out to freeze me. This room is no exception.

3. The door to the radiation room is about 15 or 18 inches thick, and it has scary danger signs on it. Warning warning, and I'm all like yeah.

4. After I have been set up and wiggled about and my bed raised up, like I'm a cheese toast being placed just so under a broiler, the technicians/magicians say to each other "925" in conspiratorial tones, and then they exit the room and close the door. 925 is my special number they say - part of the prescription, the recipe for just me - and relates to the distance between me and the machine. When I hear this I think of looking for a stamp on silver jewelry in 1978 in Mexico City, to prove that it was at least 92.5% real silver. Pure. I'm pure silver.

5. Once the techy people walk out it's lonely like outer space. I'm not to move, even my head, so I can't see around me. I feel very alone. At this point the roomness of the room recedes and I am in an ocean or a tomb or a womb or a spaceship. I am all alone in the casket of the radiation room which is down a long dark hallway in the building, which is in an ugly parking lot set off from the street, which is a long street on the east side of Austin. I'm way inside the Russian doll complex of complexities about to meet the machine. And I'm totally isolated, cold, silent.

Kimberly said she read my blog yesterday and that it was interesting to see the patient's point of view. I told her I was going to revolutionize radiation oncology -  probably not true - but I do have a few ideas. How about if doctors and clinicians took off their shirts and laid bare chested on a table for about 10 minutes while both gendered stranger people walked around and arranged pillowcases on them, and moved their bodies up and down in a freezing cold room while trying to match up little dots tattooed on their floppy non sexual bodies to X-shaped red laser lights that are shooting at them from the walls and the ceiling? That would provide another angle. Maybe they all already do this and I don't know. 

I don't know.

Kimberly has something that many people I've encountered along this way, the cancer way, do not have: the human touch. The last thing she does before she leaves the room to seal me in the submarine death ray chamber, is to put her hand firmly on me - my shoulder or my leg - and say something in a calm kind voice. This is more reassuring than anything. Doctors could learn from her.

I am now starting to not love radiation. 

My friend had 33 sessions of radiation. I ask her about it, as I do my other co-breast-cancer friends. I don't know why some of us have more radiation sessions than others, I think it has to do with the dosage. I may be getting the same dosage in fewer sessions, but I'm not sure. Anyway she said that for the last week or so of her radiation she literally had to wear no clothing on her chest, she had to go topless, so she didn't really go anywhere. Like out. Her skin was actually coming off. It was too painful to wear anything so she lived topless at home, and would just drape something strategically around her neck to cover her chest when she would get a ride to radiation. I am nowhere near that bad yet, but I can see that it might be coming. My left nipple looks like it's melting off of me. And the skin on my mid chest area is horrible. I saw the doctor the other day and she says this has to do with the perpendicularity of the rays.

Geometry.

A figure with curves always offers a lot of interesting angles. -- Wesley Ruggles

This same friend who also had similar chemo as I did, is in physical therapy cuz she had a mastectomy and she noticed that she could barely run without feeling dreadful so they measured her oxygen level on a treadmill and noticed she could not get the oxygen over 96 (should be 99-100). The PT said she should be careful about aerobic exercise because her lungs and heart don't work as well as they used to apparently - and the therapist said "Oh yes we see this after chemo all the time." And she was athletic. Is athletic.

In other words - it's hard to know what all after effects anyone will have from chemo, or when they'll show up, or how long they'll stay. Or from radiation. Or four surgeries. What weirdo effects will I have, what do I already have? What chemical time bomb is ticking or not? What radiated particle will mutate later in a bad way? Or not? Right now I'm so tired it's hard to sit up - is that from chemo? Radiation? Dull laziness? Menopause? Depression? Is it fake? And why is that pleurisy thing popping up? It keeps coming back every few days and I swat it away with other chemistry and tonic. Am I permanently altered? Or looking for excuses for my sloth? All.

Am I obtuse or acute? How do I measure the time of this? How far is the arc?

My Dog Practices Geometry

BY CATHRYN ESSINGER

I do not understand the poets who tell me

that I should not personify. Every morning

the willow auditions for a new role

outside my bedroom window—today she is

Clytemnestra; yesterday a Southern Belle,

lost in her own melodrama, sinking on her skirts.

Nor do I like the mathematicians who tell me

I cannot say, "The zinnias are counting on their

fingers," or "The dog is practicing her geometry,"

even though every day I watch her using

the yard's big maple as the apex of a triangle

from which she bisects the circumference

of the lawn until she finds the place where

the rabbit has escaped, or the squirrel upped

the ante by climbing into a new Euclidian plane.

She stumbles across the lawn, eyes pulling

her feet along, gaze fixed on a rodent working

the maze of the oak as if it were his own invention,

her feet tangling in the roots of trees, and tripping,

yes, even over themselves, until I go out to assist,

by pointing at the squirrel, and repeating, "There!

There!" But instead of following my outstretched

arm to the crown of the tree, where the animal is

now lounging under a canopy of leaves,

catching its breath, charting its next escape,

she looks to my mouth, eager to read my lips,

confident that I—who can bring her home

from across the field with a word, who

can speak for the willow and the zinnia—

can surely charm a squirrel down from a tree.