TWO MOVIES

I know that I promised some rants but I’m going to deliver some raves. That’s life.

Marcia and I actually went to the movies this holiday weekday – twice!

We saw “Up in the Air” with George Clooney on Friday. Great movie and probably a multiple award winner and I think a leading candidate for best movie. It hit me especially hard because it’s about a guy who travels the country firing people for companies without the guts to do it themselves. In case you didn’t know, I got fired last week. Oh, I expected it. It’s very simple – I have a political job and my guy (for novices, he’s called your rabbi) lost. And even though the news of my pending unemployment was not a surprise, I wasn’t told about it for five days after it became official. I look at it as testimony to the courage of our political leaders.

But that’s only part of what “Up in the Air” is about. What it really goes after is a favorite rant of mine - the demise of American business and the suicide of capitalism. It’s about the belief by Americans who was educated in business but have never actually participated in it that companies can be run like a science. These misguided and over-educated schmucks think the key to success (profit) can be guaranteed by following mathematical equations, or algorithms, that can solve any business problem using numbers, therefore taking emotions, or human failures, out of the solution. Such things as pity, gratitude, sympathy, humanity, compassion and concern almost always screw with the bottom line and must be avoided at all costs.

This kind of thinking has made American business, once the greatest economic power on the planet, the laughing stock of the third world. Personally, it meant to my soon-to-be-former office was taken apart with explosives by a new political machine who never even gave anyone a change to speak of their ideas or fears and simply issued a blanket order to clear out in a fortnight – a few days after Christmas. But the sad part is that the new guy really believes he’s going to win his battle with the bureaucrats those tenured and protected civil servants who do the work and eventually devour every pol who tries to fight the real power in city hall. That’s how the new guy gets aligned with the over-educated schmucks and becomes one himself.

But let’s get back to the movies.

The other flick we saw was “Avatar” and we saw it in IMAX 3D. I've been pretty tough on new movies lately and had modest expectations for the over-hyped flick. I was wrong. Before we left for the theater, I told Marcia I was in the mood to have my socks knocked off. About half way through, I said to her: “I don’t even know where my socks are anymore.”

The movie is pure genius and a true milestone in entertainment history. The love (and money) put into the telling of this story is obvious from start to finish and steals every scene in between. Don't be put off by nit-picky reviewers like me who search for flaws. “Avatar” might very well have some flaws but my dropped jaw blocked my view of the list I was keeping, my tears blurred my 3D glasses at times and there were more than a few times I was so entranced in the action I simply forgot I wasn’t in the story myself. If there wasn’t any story at all, the movie would have floored me with just its visual appeal. It is really that good.

 This flick might have cost $500 million, but not a penny was wasted. “Avatar” is the reason to go back to the movies -- at least until they bring out an IMAX 3D home unit with 40,000 watts of surround sound. See it. See it again. I know I will until I find my damn socks."

FINALLY IN THE FLORIDA KEYS

With my health in the win column, I finally was able to give Marcia the mostly stress-free vacation she has deserved for so long and for the past week we’ve been staying a rented house in Marathon, our latest possible piece of Paradise. The weather has been hot and perfect and our companions, Norman and Elaine Lison have been great. Moe and Curly are well and also send their regards. More about the trip later, but I thought I could share these snapshots in the meantime. I know they’re the typical tourist shots of sunsets in Key West and a few personal favorites of a great biplane ride I took today, but they’ll do for a few days anyway. Enjoy.
  
Stay tuned for some rants I've been storing up. Unfortunitely, we'll be home in a few days. It's hard to believe it's been snowing there because it's been in the 80s here everyday.

MAX AND IMPORTANT THINGS

I know it’s been a long time since the last time I made contact with the mother ship, and I’ve got a lot to tell you about my continuing battle with modern medicine – but forgive me, this is more important. At this moment it’s much more important.

I’ve got to tell you about Max, the 14-year-old kid who hangs around here every other week, playing baseball, football and computer games while firing paintball and bee-bee guns that are more deadly (and expensive) then the weapons carried by 85 percent of the world’s armies. It’s an amazing thing to watch him eat enough food to allow his body to grow at a faster rate than a genetically engineered bamboo shoot.

It’s something he just did. And itt might not be a big deal to others, but it will always be one of the most magical moments in my life. Like most kids, I guess, Max falls in that giant group of his American peers who doom the newspaper industry I owe so much to. Kids don’t like to read -- unless it's about superheroes, teenage magicians and vampires and is accompanied by lots of pictures. (For some reason that clearly escapes me, they especially like vampires, who would hold majorities in both houses of Congress if they were the least bit politically inclined.)

I’ve spent the last 10 years watching young Americans lose the joy of learning. Living during a rare, wonderful moment in history when all the world’s knowledge can instantly be accessed by anyone on the planet with opposable thumbs, most kids frankly couldn’t give a shit. There are lots of reasons for what’s happened, but let’s face it, those clueless schmucks trapped by Jay Leno into taking and flunking ridiculously easy street quizzes are now the rule – not the exception. You know: Q: What's the Gettysburg Address? A: Main Street? Just appearing on TV has become the important part of life. It seems to mean they’re important. The fact that most animals blessed with backbones know more about the world they live in doesn't count.

Incidentally, I first noticed this terrifying phenomenon while Max’s older sister was attending a well-regarded, very expensive, Jewish private school up to the eighth grade. During all those years I never once saw a single kid in that school who ever looked like he or she was having fun. It was painful to see that the self-important jerks running those classes had sucked every last bit of the joy of learning from every one of those blank-eyed, smart phone-equipped "over-achievers" quietly marching (shuffling?) from class to class. I couldn’t imagine any one of them going home and Googling something just to find the answer to something they were curious about. (“Will this be covered on the final?”)

But back to Max. Remember Max? Out of nowhere earlier tonight he asked me to take a look at a spider web he had just watched being constructed on our front porch. Max has a lot of unexplained fears he’s acquired over the years and spiders are definitely high on that list – right between germs and not being like (and liked) everyone else. Almost every other time we’ve talked about arachnids before, its involved killing them and what would happen if you’re bitten by one of them.

But this time it was different. He literally dragged me outside to see it. He showed me the spider, the web it had built outside our front door and described how he had watched the spider weave his dew-covered home and set up house. It was a pretty decent web too and when Max showed me how the nice-sized spider sitting off to the side was patiently waiting for a meal. He didn't ask me "what would happen if? He told me he thought the web was beautiful. And it was.

I have had a fascination for spiders ever since my father brought home the Insects and Spiders edition that became one of my precious collection of the Golden Books of Animals– which I think I read until I was 35 years old. (I still remember my absolute favorite, "Reptiles and Amphibians" which me raise the countless snakes, newts, lizards and turtles I found wandering the streets of the Bronx where I grew up.)

I could actually feel Max's interest as I explained how there were two types of silk the spider spun and how one kind held the web together and fixed to nearby objects and the spider used the other kind to feel when a hapless future meal was struggling to escape from the spider's sticky trap. I told that even though spiders and eight eyes, they actually had very poor vision. I touched and broke one of the web’s supporting lines and we both watched with a boyish excitement (that I miss very much) as the spider suddenly dropped down one of his silk girders and quickly and efficiently repaired his work.

Max and I talked for a long time and it was great. He really wanted to learn and he asked excellent, probing questions. Five minutes after we said goodnight I went to his room to say:

“Ya know, when you watched that spider and showed it to me before … ah … ya know, that was one of the coolest things I’ve ever seen you do. I was prouder of you tonight for that than I was when I saw you hit that giant home run a few years ago.”

Sort of confused, he looked at me and said: “Really? Thanks, I guess.”

“No, thank you,” I said as I walked away.

“I just wanted to know stuff,” he said. I barely heard the remark. He whispered. But there were fireworks going off in my head.

"Yeah kid. That’s the point! It's okay to want to know stuff.

There is hope. Way to go Max. Don‘t take it the wrong way, but I love you pal.

Medical Update (don't miss video at end!)

I’m going back to the hospital tomorrow morning. I’m only visiting, but, after three solid months, it’s getting tiresome. It’s become a crappy routine. Arrive, check in, wait for a chair, try to get comfortable, have a needle inserted into your hand and then sit for five or six hours while some sort of drug is dripped into your bloodstream.

Tomorrow, it’s only my monthly dose of gamma globulin – antibodies harvested from thousands of donors meant to replace those that my body can’t produce anymore. In a couple of weeks, I’ll be back for another dose of Rituxan (a man-made genetically altered antibody that tags cancer cells in order to give my own immune system a fighting chance. That’s followed by an anti-nausea medication before I’m hooked up to the main event – a nice little concoction named bedamustine, trade-named Treanda.

It’s a nasty little chemical that comes in a plastic bag covered with another plastic bag thickly coated with a dark material to keep the light off it. Bedamustine has been used on cancer patients for about 60 years. It works by damaging the DNA of CLL cells triggering something called “programmed cell death.” It can work wonders, but unfortunately it not only kills cancer cells, it targets any cell that’s in the process of dividing – like skin cells, hair cells, the cells lining the digestive system and, here it comes, the cells of the immune system and those in the bone marrow that produce blood. My marrow is screwed up enough thank you. This year alone, I’ve needed eight blood transfusions to keep me alive.

Treanda, like all the chemo drugs in it’s class, is made from mustard gas, the favorite chemical warfare weapon of World War I. The chemo drug was invented by an Australian wool chemist who stumbled on it while trying to take the kinks out of wool fiber.

Compared to its cousins, bedamustine is pretty mild when it comes to side effects, or at least that’s what I’m told. My first experience with it was a disaster, but that’s another story (described with some detail in earlier posts here). A few weeks ago, I got a slightly reduced dose during round two a few weeks ago and didn’t feel a thing. The next round is during the first week in June and then I’ll have another dose before July 4^th.

The good part is that by all accounts, it’s working and working well.

Many of my swollen lymph nodes have disappeared entirely, including, apparently, the one that was blocking the lymphatic system in my left leg and preventing a infected wound from healing. Two months after beginning treatment, the wound is almost 80 percent healed.

That fact, plus all the other good news – 120 pounds lost, diabetes gone and the apparent successful battle against my blood cancer -- adds up to a healthier Marc than we’ve seen in some time. I should be very happy and confident.

So how come that’s not the case? Since my brush with death six weeks ago, I’ve been tense and anxious at times. I can’t seem to shake it. My psychiatrist says it’s normal considering what I’ve been through. But knowing that it’s normal doesn’t help.

I WANT MY MOJO BACK!

If my theory is correct, and it is, the proper attitude is absolutely necessary to successfully fighting cancer. I had it, but now I know that I’ve lost it. But I’m going to try hard to get it back. I need to laugh damn it! I need to not worry about catching the flu. I need to relax and lose this feeling that’s following me around like a dark cloud.

I appeal to my friends to let me know of any way of inducing smiles that I might have not dreamed up. In the meantime, I you spot someone walking down the street with a stupid fake smile on his face, it might just be me. Sorry.

In the meantime, here’s something I spotted on the web that did make me smile. It’s a promo that Ch. 2 made about Marcia that I’ve never seen before. As a matter of fact, when I showed it to Marcia, she had never seen it either. Enjoy!

To see the video click here.

Tahler, Meet your Grandmother

This just in ... By popular request, here the picture you all asked for -- Tahlia (I like that name a lot) Elkin and a real GIT. The newbe GIT (grandmother in training) is none other than Marc's sister Joan. He's known her all her life (no one else can say that with the same degree of truth) and he's never seen her happier and/or prouder. He thinks she deserves it. And he thinks (and prays) that Tahlia will be able to grow up to be spoiled rotten and still be a someone we will be proud to know.

Marc and Marcia simply want to sat to her: Have a great life kid. Enjoy the ride.

FYI: Joan can be reached her at: jckmoverman@aol.com.

Born Yesterday

Here are the first pictures of Tahlia Elkin, just-born daughter to Matt and Elizabeth Elkin. The young Miss Elkin is blessed with a full head of hair and reportedly weighed in at a healthy 9 lbs, 3 oz. Grandma Joan was quick to point out that Tahlia's weight was taken after her first b.m. (thereby proving she has some Kalech blood in her). Mother, daughter, father and grandparents are all said to be doing fine and Elizabeth is to be released from the hospital in Rhinebeck, NY, on Saturday. For the rest of her life, Tahlia will share her birthday -- albeit 60 years apart -- with proud grandfather Tom Movermen (shown here).

Best wishes to all!

The Winner

I'm gratified by all those who took the time to guess about the secret friendship expert but there was a clear winner. I don't how how she knew (unless she reads the Wall Street Journal's sports pages) but Dana Brecher (above left) got it right. Well done!

The quote came from Boston Celtic great Bill Russell. I always knew Russell (below left) is something of an intellectual Renaissance man, but that doesn't make the well-crafted truth he expressed so elegantly any less impressive. Oh yeah, he is one of the greatest hoop player who ever lived. One of a select group of athletes who forever changed the way his sport is played. Russell was talking about his friendship with his former coach and mentor Red Auerbach (right). Together, they helped the Celtics win 11 NBA championships in 13 years. For more information about the book Russell has just written about his life-long friend click here.

Next, watch this space for an updated and uplifting medical report.

Thanks again for reading.

On Friendship

I ran across this wonderful quote about the nature of friendship while reading the papers today. I'm sure that the author of this little nugget of truth will surprise you. Any guesses?

"Friendship is the most difficult of all relationships. You can't pick your friends. They just happen after you meet people. In most situations we tend to put our best foot forward, so that people we meet will like us. But in true friendship, you don't do anything to make your friends like you. And they don't do anything to make you like them, at least initially."

If there are no correct guesses, I'll reveal the author in the next post.

The Next Day (a medical update)

My doctor’s appointment this morning quickly turned into a classic Good News / Bad News situation.

The Good News:

• The chemo worked very well. Most of my swollen lymph nodes (tumors) that can be felt have disappeared entirely or shrunken so much they are probably not a factor in my health anymore.

• It appears Dr. A was right all along that a swollen node in my left groin was preventing my shin wound from healing because since the chemo the wound has begun to close at an amazing rate.

• As the nodes are metabolized by my body, I continue to lose weight. Fully clothed, I weighed in today at NYU at a trim 218.1 lbs. Our home scale said 211 balls naked, but it's on the payroll. I’ve just celebrated the fact that nothing fits anymore by binging on a pint of Cherry Garcia! That's a first for 2009. It made me sick. But it tasted sooo great it was worth it..

• I’ve been trying to take it easy and I feel pretty good considering ...

The Bad News:

• My blood numbers suck. Red cell count today was less than Monday’s numbers despite Tuesday’s transfusion of two units of red blood cells. I’ll get another two units of RBCs tomorrow at the hospital. White cell count is also down to "critical" levels. The working theory is it’s not caused by an auto-immune anemia reaction but rather the continued effects of the chemo. I've already beat AIA twice but it required a drug that will compromise my immune system even more than it is. Stay tuned for updates.

• Dr. A wants to strike while the iron is hot and doesn’t want to wait to resume chemo treatments. I’m now scheduled to get a second round Tuesday. But Treanda is now out of the mix – at least for now. We’ll go with a dose of Rituxin, the old standby monoclonal antibody that I know and trust. (We might even repeat the mega-doses I got in 2007 if it's needed down the road.) One step at a time.
  

Actually, it's not a bad trade-off . If all goes well – and it will – I’ll have successfully managed an incurable leukemia, cured my diabetes, left obesity in the dust and healed a seriously infected wound that was just hours from unnecessary surgery. All in just a few concentrated, crazy, weeks. All I have to do is to get my balking bone marrow in line so it starts manufacturing red and white blood cells again. Hell, I’ve done that before. (Maybe it needs some federal stimulus money.)

But I promise I’ll get by this even if it turns out to be AIA. It’s just a matter of time.

Keep those prayers and good wishes coming in. Let's get on with it!

Gratuitous advice: Before you criticize a man you should walk a mile in his shoes. That way you'll be a mile away from him -- and he won't have any shoes!

Dear Friends

The past few weeks have been a time that has tried my soul -- and, apparently the soul of my doctors. I admit I haven’t been the best patient, but patience is tough to come by when your life is concerned.

To get to the point, the main lesson I’ve learned so far this month has been that, when you’re fighting for your life, you cannot let down your guard for even a minute. I was so consumed with the battle with Dr. B to avoid surgery (see previous “My Birthday” blog post) that I let the dosing of my chemo slide. I didn’t ignore it, I was concerned enough to mention the issue to Dr. A, but I told him I would leave it to him and didn’t make an issue of it.

Historically, the problem with Treanda (bendamustine) has been dosing, too much and it’s very toxic and too little, it doesn’t do what it’s supposed to do. I got it in combination with Rituxan, the monoclonal antibody that I’ve responded to very well three times in the past. [See this website for an almost up-to-date article on chemos used in CLL by Dr. Terry Hamblin. It’s almost up-to-date because it doesn’t include a new, as yet unpublished, study where Treanda was combined with Rituxan for the first time. The first phase of the study was so successful that researchers skipped phase two and when directly to the third phase in hopes of securing a new market for the drug.]

I think history will show I got too much Treanda. A few hours after the second dose, it felt like a truck had hit me -- a big truck. It turned out the Treanda had worked too well too fast. It resulted in three outcomes:

• First, a condition called tumor lysis, where the drug breaks up the tumors so quickly it overwhelms the kidneys, the organ responsible with getting rid of the waste products of the cellular holocaust.

• But second, that meant the destruction of most of the tumors, including those, at least in theory, that were blocking the lymphatic system and preventing the healing of my leg.

• And last and least, all those swollen lymph nodes weighed something. So the silver lining in this cloud is that my weight is down. Officially, I weighed in at less than 100 kilos for the first time at Dr. A’s and my scale at home recorded 211.2 lbs yesterday. That’s down 121 lbs since my all-time heaviest and just 31 lbs away from my goal. The end of that project is in sight. I can now see the end, as well as my toes.

Last week, after a few days of living in a fog, I was taken by ambulance from the NYU Cancer Clinic to the NYU Tisch Medical Center a few blocks away. A blood test had revealed my blood levels had gotten way out of hand and Dr. A used the opportunity to get me in a confined situation to 1) see what was happening to my blood (2) get a infection expert to take a look at my leg wound and (3) get a complete workup on me.

I fought the idea as hard as I could but I knew it was necessary. As it turned out, my worst fears about hospitalization would be nothing compared to the actual experience. As I said, I wasn’t the best of patients. But despite the best efforts of many dedicated professionals, the hospital nearly claimed a victory.

I don’t want to dwell on the nightmare of hospitalization right now, but I do have to thank those who helped me escape as quickly as I did. First of all, my sister Joan, who was there every day. And the Tisch family, who came to my aid and got me a private room in their hospital. But most of all, I need to thank my beautiful, wonderful wife. Marcia made the call to Mrs. Tisch and she was at my side as much as was humanly possible, bringing me edible food and a touch of sanity. But mostly, she gave me her love, which was something, everything, I needed to live.

I also now realize how much I’ve come to depend on some of the medical professionals in my life. First, my NYUCCC nurse Tara, who cared enough to send her husband, an NYU doctor, to visit me the first night in the hospital and make sure I was alright. And Dr. K, who visited me in the hospital when she didn’t have to. And Dr. S, who called me everyday. And Dr. A’s nurse, the amazing Bridget, who visited me on her DAY OFF and ended up changing my dressing when the wound specialist didn’t show up. And Dr. A’s receptionist Ellen, who calmed me down so often (too often) and found him in minutes when I needed him. And Dr. A himself, who has learned to listen to me and who finally agreed with me that as a patient, I was “a pain in the ass.”

Well, I’m home now after the closest scrape I’ve ever had with the great beyond. My blood chemistry still screwed up and I’ve had to have two additional units of blood to replenish my red blood cells (in addition to two units of whole blood I got in the hospital) and find out tomorrow morning if I need more. But it’s obvious now that I’m going to be around for awhile longer and will have lots of opportunities to make a general pain in the ass of myself. But I’m a lot lighter and more maneuverable now, so watch your step.

One more thing, during my first chemo session, I got a phone call from Dr. B (see the same earlier “My Birthday” posting). He called to apologize for “what you had to go through.” He said because of my letter, he realized he had to “make a lot of changes” to his practice which, he said “has gotten away from me” and forced him “to take a look at how we operate from top to bottom.”

Amazing!

FUN WITH NUMBERS. (Really!)

The following is adapted from a website suggested by the remarkable Dr. Hamblin. Just go with it and enjoy the magic.

Arithmetic Relating to the Number 432

or

The Secret of Nine

The number 432 appears in various catagories and forms (432,000, etc.) in different cultures throughout history.The following is a composition of various aspects and forms the number 432 takes, and the effects it has in our everyday lives.

***

Some interesting arithmetic related to the number 432:

4+3+2=9

9x9=81

1/81 = 12345678

8/81= 98765432

98765432 x 9 = 888888888

12345678 x 9 = 111111111

432x432=186624 (close to the accepted universal constant speed of light)

186624 /9 /9 /9 /9 /9 = 3.16 (similar to the value of pi)

In the so-called "magic number" sequence of the periodic table of elements - 2,8,20,28,50,82,126 = sum = 316 (see immediately above).

12 x 360 = 4320 (link between the number 12 and 432, degrees in a circle, etc.)

Diameters Of The Sun And Moon

The diameter of the sun is 864,000 miles (2 x 432). The diameter of the moon is 2160 miles (432 / 2).

Comment - These ratios and numbers, combined with the cycle of the Precession of the Equinoxes of the Earth at 25,920 years (60x432), form an astounding coincidence, at the very least. Despite popular opinion that there may be billions and billions of worlds in the Universe, the odds are billions and billions to one that any such ratios prevail anywhere else.

Heart Beat

A healthy, athletic adult at rest has a heart rate of 60 beats to the minute. 60 X 60 minutes X 24 hours = 86,400 beats per day.

Comment - This may be one of the reasons why the number 60 is so common in metrology. It also gives humans a special relationship to the cosmos, in the sense that it links a fundamental physiological property of the human species to the cosmic geometry symbolized by the number 432.

Latitude of Stonehenge

Stonehenge is located at 51 degrees, 10 minutes, 42.35294118 seconds North latitude, and 51 x 10 x 42.3529 = 21,600, i.e. (432 / 2).

Comment - This is either an extraordinary coincidence; or the originators of Stonehenge knew a lot more about astronomy, geophysics, and geometry than they've been given credit for. It was the Greek astronomer Hipparchos (ca. 190 - 125 B.C.) who is credited with covering the sphere of the earth with meridians and parallels. Following the Babylonian method of dividing circles and angles according to the sexagesimal system he created a grid of 360 lines running from the North to the South Pole and 180 lines running parallel to the equator. All this was done, however, thousands of years after the building of Stonehenge.

---

Precession of the Equinoxes

The Earth's axis is inclined at 23.5 degrees to the plane of its elliptical orbit around the sun. As the Earth rotates it experiences precession, like the wobbling of a top. This wobble causes the direction of the north celestial pole to change in a circular path over time. This motion is called precession of the equinoxes and occurs in a full cycle every 25,920 years (60 x 432).

Speed of Sound in Granite

The speed of sound through granite rock at room temperature (about 72 degrees) is 12,960 feet per second.

Comment - Sound waves need some type of matter as a carrier. Their speed is affected by the density and temperature of the substance through which they travel. At higher temperatures the speed of sound increases. This particular measurement (3 x 432), ties a primary property of stone to the cosmic geometry symbolized by the number 432. Coupled with the known power of acoustics to modify the physical properties of substances, this measurement suggests intriguing links between sound, stones, and the number 432. ,

Square Root of the Speed of Light

Einstein's famous equation of energy and matter - E=mc2 - leads to one of the most profound instances of the occurrence of the number 432. In the equation, E= energy, m = matter, and c = the universal constant speed of light. The speed of light is generally accepted to be 186,291 miles per second in a vacuum. However, the square of the number 432 is 186,624. If the universal constant speed of light were in fact 186,624, then the number 432 would be the square root of the speed of light. The deviation is small enough be be accounted for by several possibilities:
(1) Variation in our understanding of the length of the "mile", i.e. 5280 feet.

(2) Known anomalies in the theory of general relativity.

The Egyptian sacred pyramid inch is .0011 inches longer than our inch. 186,291 (accepted speed of light) x 1.0011 = 186496 or 99.931429 percent of 186,624. The speed of light, if calculated using the slightly longer sacred pyramid inch, is extraordinarily close to the square of 432.

Comment - Presume for a moment that you do not know the speed of light, but are aware of the equation E=mc2. An intuitive scientist who substituted the number 432 for "c" in the equation would be very close, if not precise, in the determination of this universal constant, that is, E=m(432)4. This illustrates the important concept of "reverse engineering" to find unknown quantities and constants by use of the cosmic number 432 and its multiples and divisors.

Got it?

MY BIRTHDAY

Today is my birthday and I want to thank all of my good friends who have taken the time over the past few days to send me their good wishes. And also my thanks to all of you who have followed these chronicles of my 61st year. Best wishes to you all!

Just for the record, as the BW likes to say, here’s an up-to-date medical update.

My weight: In the wake of my lap-band surgery on May 31, I’ve lost a total of 105 pounds. From my top weight of 332, I now tip the scales at a much more manageable 228. It’s like not having to carry around a 100-pound person 24 hours every day.

My blood pressure was 110/75 last Friday.

My cholesterol was under 100 the last time I checked.

My diabetes has gone away. Although I have stopped taking all insulin and other diabetes drugs, my blood sugar levels remain perfect for a non-diabetic person. (A1C = 6.5)

I look and feel pretty good, I think. But I have to admit that there were moments during the past few weeks that I thought I might not make it to my birthday.

My leukemia has returned. But that was expected. I know CLL remissions aren’t forever. The disease is still incurable. But it can be managed for a long time with the proper care and attitude. And I’m very lucky to have a lot of both. Leukemia is easy. It’s the small infections – and bad medical advice that worry me at times.

I still have a chronic wound on my left shin that just refuses to heal or be diagnosed. At least that was true until last week. I now think we’ve turned the corner on this and it has begun to heal. I’ll be concentrating on that during the next few weeks.

Perhaps the following letter I sent to the administrator of the NYU’s Joint Disease Hospital will tell you what happened and save me regurgitating the whole episode again. (The actual names of the doctors have been removed for real and imagined legal reasons.)

March 16, 2009

Mr. David Dibner
Senior VP, NYUHJD Hospital Operations
301 East 17th Street
New York, NY 10003

Dear Mr. Dibner,

This note is being sent as an addendum to the Outpatient Programs Survey sent to Indiana. But I’d like to tell you about my experiences at NYUHJD during the past few weeks.

I like to think of myself as an informed patient who has learned to manage his own treatment during the past decade. Since I was diagnosed with type 2 Diabetes (1998) and Chronic Lymphocytic Leukemia (2003), I have chosen doctors affiliated with NYUMC to facilitate my treatment. Choosing Dr. K (endocrinology) and Dr. A (hematology / oncology) has been very satisfying to my family and me. This relationship was important to me in choosing Dr. F to perform gastric lap band surgery on me in May, 2008. Today I am 105 lbs lighter and free from diabetes thanks to my NYU experience.

Imagine how happy I was when, while researching doctors to treat a chronic wound on my left shin, I discovered that Dr. B, an expert in treating these wounds, was now affiliated with NYU. Imagine how disappointed I am after what happened next.

Even before I met Dr. B (at 3 pm on Feb. 20, 2009), my first experience with the doctor was to overhear him talk with an associate about an “operating room mortality” while standing outside the examination room where I waited. “I know you have to expect mortalities,” he said, “but …”

He walked into the room, took a quick look at my wound and quickly told me there was a “deep infection” that would have to be “abraded” during the first of a series of surgeries that might last six months to a year. He said there was a good chance the bone was involved in the infection. His Physician’s Assistant informed me the immediate therapy was to apply iodine soaked patches on the wound. As the first patch was being applied by an orderly, Dr. B reappeared and told me the iodine might “tingle or pop for a little while.” He then handed me his card, told me to call him on the phone at the hospital on Sunday “to talk,” and left.

Although everything I had read about chronic wounds said caregivers should quickly make sure to treat the patient’s pain to assure he would cooperate in treatments, none of my complaints about constant pain were addressed during my visit, and the doctor’s “tingle and pop” remark was the medical understatement of my year.

Our “talk” on Sunday was very short. Most of it involved the doctor trying to remember who I was. I asked him to call my endocrinologist and oncologist to tell them what was he was considering. He said he would.

All during the weekend, I felt uneasy about Dr. B’s proposed treatment. I called many of my friends in the medical profession and they all confessed to not understanding his approach. I even asked Dr. K, who I would -- and do -- trust with my life, to call Dr. B and tell me what her impressions were.

The pain from the iodine pads was considerable but I went ahead and applied the pads all week. The following Friday I visited the doctor again. Again, the receptionists and especially the orderlies all performed heroically. The RN who saw me prescribed Lidocaine patches to help with the pain from the iodine (“Put them on the wound for 12 hours, take them off and apply the iodine patch,” she said.)

Then a smiling Dr. B made a brief appearance. “Are we all happy here?” he asked.

I told him I was not happy, mainly because he had never returned Dr. K’s repeated calls during the week. “What’s her number?” he asked, pulling out his cell phone. I gave him her cell number, immediately got her on the phone and disappeared. About 45 minutes later, he told me he had spoken to her for a long time and had a much better idea of my medical “history” and my oft-stated desire to stay out of the hospital if at all possible.

“Two or three days -- two days, tops,” he promised about the surgery now suddenly scheduled for March 9. “He ordered me to get an MRI and pre-op tests during the week and said he would see me before the operation.

I still had my doubts and a nagging feeling something wasn’t right. “Can I ask you something?” I said. “Why haven’t you cultured the wound and started me on a wide-spectrum antibiotic?”

He said he needed a “deep biopsy” to get an accurate reading and somehow equated that with trying to avoid “indiscriminate use of antibiotics.”

I’ve spent half my life living that belief, long before it was accepted in the medical mainstream, I said, protesting: “But I’m infected now!” It didn’t make sense to me to wait trying antibiotics to control the infection. But before I could gather my thoughts, Dr. B had left.

Dr. Katz reported on her phone conversation with Dr. B. She said she understood my reluctance but didn’t think I had “any other options” but to go ahead with the surgery despite still feeling very uneasy.

I had the MRI Wednesday evening, March 4. The following day, I spoke to Dr. A who said he didn’t like the idea of starting such a surgical process because I was due for another round of chemotherapy to control my CLL. I asked him to speak to Dr. B, who still hadn’t contacted him. I then called Dr. B’s office and asked that they tell the doctor to return Dr. A’s calls. (I also had asked the RN to call me because the Lidocaine patches are not helping. When she called two days later she told me the directions she had given me were wrong and I should not put the patch directly over the wound.)

Dr. B and Dr. A finally talked late in the afternoon and Dr. A called me to report that Dr. B “was very insistent on going ahead with the surgery.” The MRI results still hadn’t been posted. Asked what I should do, Dr. A said I should postpone my pre-op physical and see him in the morning. The results were finally put into the computer system at 5:51 am on Friday. I saw Dr. A and he showed me the report. No bone involvement! Superficial cellulitis! No signs of any deep infections. Dr. A prescribed Levaquin and took a tissue sample to culture. Anticipating a round of chemotherapy, we scheduled a CAT-scan session for the following week.

By Sunday morning the pain was completely gone and the wound was making huge strides in healing itself. The culture came back as containing three different infectious organisms – enterobacter cloacae, paeudomonas aeruginosa and staphylococcus aureus – but all were responding to the Levaquin.

As you know, one thing all three germs have in common is that all are usually spread in hospitals. Whenever I think of how close I was to dangerous and needless surgery, I tense up.

One postscript: On Wednesday, Dr. B’s office called and asked if I wanted to reschedule the pre-ops and surgery. I asked if the doctor had seen the MRI report. “No, we don’t have it yet,” the secretary said.

“Let me get this clear,” I said. “The report was posted at 5:51 am last Friday and doctor still hasn’t seen it?”

“I guess I should print it out and fax it to him,” she said.

I guess so.

I am sorry this has gone on so long but I think it’s a cautionary story worth telling. I know how hard doctors work and how difficult their jobs are today and I am still proud to be an NYU patient and intend to be one for as long as possible.

If you do have any questions, please feel free to contact me. Thank you.

Yours truly,
Marc Kalech

I think all of this goes to prove what I said here a long time ago:

• Don't go in the hospital unless you absolutely have to.
• Learn about your disease and how to manage it -- even if it scares you.
• Take charge of your own care and treatment.
• Remember, you know as much -- or more -- than your doctor.
• Always! Always! Always, get a second -- or third -- opinion.
• Follow your instincts. Your informed, intelligent body probably knows more than anyone lese about what's wrong with you.

Happy Birthday. (And, please, many more.

WEEKEND AT BERNIES

Just got this photo and we've only glanced at the website that created it. It's a cool way to get traffic to a sales site. But the Mafia Nickname Generator is much cooler. It dubbed me Marc "The Squealer" Kalech.

THE PERSON I LOVE

First, some full disclosure: In New York, WCBS-TV’s (Ch. 2), chief political reporter, Marcia Kramer, does not use her real name, which is actually, legally, Marcia Kramer-Kalech. Marcia is married to me, Marc Kalech.

I’m still not sure how this happened – but I do know that sometime, somewhere I did something right to deserve the company of this woman.

Professionally, Marcia is an anachronism. In any sense of the word, she’s beautiful, which is a priority in today’s market. But she also the last of a breed – she knows how to do her job. She has actual sources, actually comes up with stories, gets them right, meets deadlines and does it all with a personal style that’s makes viewers believe what she says.

My father once described her perfectly – and said so before he even knew I had ever met her. “She’s a beautiful woman with a real head on her shoulders,” he admiredly said. As an aside, when I told my parents I was going to marry Marcia they said “Who?” I told them to turn to Ch. 2 where she was on the air. They didn’t believe me and they didn’t until I took her home with me and produced her body.

As competing street reporters on the 5 pm to midnight shift in Manhattan, we saw eachother often. I had such a crush. But I always thought Marcia was out of my league. An obscenely long time ago, I remember covering a Bar Assn. dinner in Terrace on the Park in Queens. Marcia was there, on the arm to a guy I took to be a retired judge. I still remember what she looked like, what she wore and the smile she gave me when she saw me. The result – she seemed to move even further away on my imaginary league scale.

I say today that Marcia is better looking than ever. TV news executives, ruled by ratings, cannot get past the studies they paid squillions of dollars for that concluded viewers make up their mind about on-air reporters in about half a second. And their decision is based almost entirely on their gut reaction to the reporter’s face.

But before she went into TV, Marcia was a very successful newspaper reporter. Print editors – at least old-fashioned ones – still hire journalists based on whether they’re persistant and clever enough to get their resumes noticed. The late Jerry Nachman (who once called New York Post reporters “the crash test dummies of American journalism”) also declared that newspaper reporting was the only profession that rewarded personality defects. A master of the sound bite, Jerry wasn’t right about everything, but he nailed those two.

Anyway, I’m hoping all this will convince her how much I love her. She is the reason I live. I love her more everyday. She makes me a better person. And I swear that I’ve happily devoted my life to making her’s better – and happier.

I admit it doesn’t hurt a bit that she’s a knockout. In full TV makeup, she’s stunning. But without any makeup at all – and with just an unstressed smile – she’s unforgettable. That's the way she will live in my heart forever -- and I want her to know that I will devote my life to making those smiles last forever. With the a great belief in the power of the web, I pray these words will live for all time.

I love you Marcia.