Question: WHAT DO ASTRONAUTS LEARN TO DO? Answer: NUMBER ONE AND NUMBER TWO

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For as long as I can remember, I’ve been fascinated by space travel. 

I can still vividly recall being riveted to our old black and white Dumont TV watching Disney’s 1956 animated special “Man in Space” that envisioned what manned space travel would someday look like. The images turned out to be remarkably accurate and I think the show contained the first ever “3, 2, 1” countdown to blastoff.

What a gift we've been handed to be alive now and be allowed to be eyewitnesses to the birth of manned space travel and be among the first to peek at the almost daily new discoveries that will surely be important clues that will lead to the deciphering of the the secrets of the universe. Those who care can watch the evidence be unveiled on websites like NASA’s brilliant "Astronomy Picture of the Day." The site’s extensive archive of images is a virtual encyclopedia of mankind's ever-expanding knowledge of his universe. They are also more beautiful than anything he had previously imagined. 

But almost 50 years since man first reached outer space, we still know very little about how to live there. The topic fascinates me and it’s frustrating how little has been written about it. But that now appears to be changing, thanks to a generation of astronauts who have actually experienced living there and are now retired and free to speak about it. 

I’ve just read 20 pages – most of them hysterically funny – about how to difficult it is to go to the bathroom in space. Remember the detailed instructions on the wall of the zero-gravity toilet in Kubrick’s brilliant “2001: A Space Odyessy?” Well, reality is a lot more complicated than that. It’s so complicated that we’re not even close to solving the problem. 

Alright, you can stop laughing now – and thinking how hopelessly juvenile I am -- because it just so happens that having a bowel movement (BM) without the aid of gravity is a mysterious and very dangerous problem. Even after hundreds of hours of intensive training, it’s still damned hard to do it right. You don’t really want to know the consequences of even the slightest error. And there have been plenty of errors. 

Astronauts take this part of their space experience with spooky seriousness. The honest ones usually describe their moments spent going to the bathroom as the scariest part of their missions.

The zero gravity bowel movement has been a problem for as long as men have experienced weightlessness. The first Mercury astronauts didn’t worry about it much – and as a consequence, America’s first man in space, Alan Shepard, rode his Redstone rocket bathed in his own urine. After waiting hours sitting on his back in his space suit waiting for liftoff, he pleaded with his bosses for permission to relieve himself. His comment after he finally got the okay is kind of famous since it was first published in “The Right Stuff.” In his best Jose Jimenez impression (anyone too young to know what I’m talking about , watch the comedy classic bit on “You Tube”)  he said: “Well I’m a wetback now… Now let’s light this candle.”

The problem remained an afterthought through the Apollo moon missions. The worst experience was during the last Gemini flight. The mission had two astronauts spend two weeks living in a space the size of a phone booth. The quarters were so cramped that  the men could not get up from their seats -- even to take off their spacesuits. Normal bodily functions were almost impossible. At the end of the mission, their clothing, especially their underwear, literally disintegrated on their bodies and both crew members described the other’s smell with the vilest descriptions imaginable.

The history of space men with problems making sissy also goes back to the very beginnings of men leaving earth. Yuri Gagarin, the very first man to orbit the planet, realized he had "to go" when he reached the Soviet launch pad just before he was to get into the elevator to take him up to his capsule. So he did what he knew he had to do -- he turned his back to the photographers, pulled down his fly and pissed on the tire of the truck that carried him to the pad. Then he zipped himself up and made history.

The moment actually officially became part of the once-mighty Soviet space program. For decades – at least until Russian launches began to be televised live – it was tradition for male cosmonauts to relieve themselves just before they took that elevator trip. And no, I don’t know what female cosmonauts did.  I researched it, but as far as I know, that answer is still classified as “Top Secret” somewhere in the Kremlin archives. 

After all these years, I still find this,stuff -- all of it -- compelling. It speaks to how much we still have to learn about living in space. Those guys living in the International Space Station (ISS) for six months at a time -- trying to learn how to stay there for the three years its going to take to go to Mars and back -- are real heros to me. I can’t figure out why they’re not allowed to talk about the real human stuff – the interesting stuff to us regular earthlings because it's the stuff we can relate to..

It seems that being weightless while orbiting the earth makes the basic human processes of going to the bathroom extremely difficult. Almost everything people do: moving, eating, belching, farting, sleeping, having sex, giving birth – you get the point -- has to be relearned. Those early attempts resulted in hundreds of great anecdotal stories. Some of them are funny but some can be dangerous. Deadly dangerous. And after almost 50 years experience doing it, we haven't learned very much. (Fifty years after the Wright Brothers, aviation had advanced so rapidly that the sound barriers had been broken and  

Just to be part of the astronaut corps is the dream of millions of Americans of all ages  (most definitely including me, who once made the first cut to be the first journalist in space). But few realize that after they finally make the “astronaut candidate” list. the odds are still extremely slim that they will actually ever be chosen to rocket 50 miles up to earn the right to pin their gold astronauts wings (they still have to personally pay the $400 the wings cost) and claim the right to call themselves an astronaut. They spend most of their time waiting, studying hard, kissing up to the bureaucrats who ultimately make crew assignments  and praying for a flight assignment.

As far their bosses in NASA are concerned, the most important lesson they must learn is to avoid journalists. How many interviews have you read with astronauts that deliver a taste of what it's really like to be in space? NASA may be the most anal (no pun intended) government agency there is about controlling press coverage.. It's convinced that stories about astronauts doing things like taking a dump might upset American taxpayers enough to stop the flow of the billions of dollars needed to send human joy riders 200 miles up at 17,500 mph. So reporters are scarier to astronauts than the thought of riding rockets that tend to blow up at the worst possible times for the most preventable of reasons.

I was blessed to be a newspaper reporter covering the birth of space shuttle program in the 1980’s. (I went through an intensive selection process to land the job. One day I found myself next to the legendary Steve Dunleavy, the paper’s metropolitan editor, in the bathroom off the city room. Without really thinking, I impulsively blurted out: “Hey Steve, if you need someone to cover the space shuttle program, I’ll do it.”  Always one to obey men’s room etiquette, Steve stared straight ahead as he answered: “Okay mate, you got the job.”) It was a great assignment, after all, the shuttle was going to be the first manned space ship to fly without ever having a unmanned rehearsal.

I covered the shuttle program from the first flight to the horrible Challenger disaster. I’ve witnessed shuttles blasting off from Florida and shuttles landing in the California desert and back at KSC. I learned about the shuttle, its astronauts and ultimately that the multi-billion dollar program was basically ill-conceived and fatally flawed. 

[A momentary detour here for a brief explanation of the shuttle's economics, which eventually doomed the program. Originally, the system was supposed to provide a cheap, reliable method of sending cargo and crew into orbit aboard a mosly reusable spaceships. But NASA discovered the hard way that the numbers showed that the job was more efficiently accomplished with much less money by using reliable unmanned rockets to lift cargo and saving manned missions for a different system that incorporated all the necessary -- and expensive -- safety systems that are required to protect the lives of crews. But even that program was recently canceled by the White House as a budget buster. This means American crews will be taken to the ISS by Russian rockets for the foreseeable future while NASA privatizes the job and passes the effort over to American industry.] 

It wasn’t until I befriended astronauts that I finally learned a little about what living in space is really about. The hard-won knowledge made me – a least for a few years – the rightful self-proclaimed expert on the zero gravity toilet program. It also had something to do that there were no other reporters interested in the subject.

Luck had a big hand in getting those two sources. It happened when I, and about 20 other journalists covering the space program, was invited to the White House to meet President Ronald Reagan and listen to him make an important announcement about America’s future in space. I remember being briefed about Presidential etiquette (which is much stricter than the rules governing conduct in men’s rooms) before we were quickly ushered into the Oval Office for a few minutes with the man. I don’t remember anything about what the President announced but I will never forget what he looked like up close. His cheeks were very red, his hair didn’t have even a hint of grey and he looked more like a wax figure than a real person. I thought he looked just like Howdy Doody. (Younger readers can go back to You Tube.)

Then we were rushed out of the West Wing, put on buses and shuttled to the Smithsonian Air and Space museum for lunch and a sneak peak at an IMAX film taken aboard the latest shuttle mission at great cost. Lunch was magical -- we journalists sharing tables with real astronauts directly under the actual “Spirit of St. Louis,” the Wright Brothers’ heavier than air glider and other historic aircraft and space capsules. We got to touch real moon rocks – watched very closely by four uniformed guards. To the anger of hundreds of non-VIP visitors, the museum remained closed to the public until we were seated in the museum’s IMAX theater and the remains of our lunch were cleared away. 

I went in to watch the film with the two astronauts seated at my table, both of whom had been on board the mission where the pictures we were about to see was taken. It had been the first flight of the shuttle Discovery. 

By then I had started to figure out the two rules you need to follow to get an astronaut to ever speak to you. Number 1 was to absolutely swear on everything sacred to never quote him by name or ever use his name in a story. The second rule was never, but never, treat him as a hero. Every astronaut I have ever met considers what he does as “just his job.” They are just regular guys going to work. It’s what they do for a living. The possibility of a horrible death was “part of the job” to an astronaut. If you insisted otherwise, you got a quick goodbye. 

Astronaut Mike Mullane sat to my left as we watched the short film, which contained some breath-taking views of the earth and a lot of footage of astronauts floating through the shuttle’s cluttered compartments. Mullane kept up his own whispered commentary into my ear about the film as a NASA flak on stage explained what he could and told us that more film would have to be taken on a future mission – at a cost to IMAX of millions -- because the company’s camera had inexplicably jammed during Discovery mission, resulting in the scheduled film opportunities to be severely cut back. I tried to remember the best material Mullane was feeding me – it was too dark in the theater to take notes – but I was contantly distracted by someone sitting directly behind me who apparently had a terrible cold and was making the usual and unavoidable rude noises a nose makes under the circumstances. After a few minutes it was obvious Mullane was also annoyed by the sniffler

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When the lights came up, the first thing we both did was turn around to get a look at this virus-spreading joker. But the joke was on us. We both immediately realized that that the noisy nose belonged to Apollo 11 command capsule pilot Michael Collins. If Collins was major hero to me, he was a demi-god to Mullane.  Embarrassed, we quickly faced forward, smirked at each other and never said a word to the first man to circle the moon alone while his two crewmates frolicked on the surface and collected moon rocks -- and most of the glory.

The incident proved to be a big break for me. After the film, Mullane introduced me to his mission colleague, Judy Resnik. He wanted her to confirm the space secret he had just told me The story served as the punch line to a brief description of some of the problems plaguing the $50 million and growing zero-gravity toilet, a device that 25 years later still doesn’t work right.

Slightly annoyed, Resnik confirmed the payoff -- that the favorite time for shuttle crews happened every 90 minutes. That was when they all secretly left what they were doing and went to a window to see the moment that had been dubbed the shuttle “urine dump at sunrise.”

Mullane explained that NASA freeze-dries and saves astronaut solid waste matter (for further study?), but shoots their collected liquid urine into space for disposal. (In the new ISS, the urine is recycled and serves as drinking water.) It didn’t take long for crews to learn that once exposed to the zero-gravity vacuum of space, the urine broke up into micro-droplets, instantly froze into countless tiny perfect spheres which spread out in an equally-perfect circular pattern. Done with the spectacular backdrop of a sunrise seen from 200-mile high above the earth, the kaleidoscopic picture was so consistently beautiful that astronauts found it impossible to find the words that could adequately describe the scene.    

Mullane had two more shuttle missions before he retired from the program. His memoir, “Riding Rockets,” is one of the best accounts written by an astronaut I have ever come across. I highly recommend it. It’s highly informative -- as well as hysterically funny.

I bet you didn’t know that NASA’s training program for astronauts includes an multi-credit course on using the zero-gravity toilet? A large part of this program includes many hours of practice sitting on a mock up of the potty installed on all the shuttles. The practice commode isn’t a working model but instead has a TV camera planted inside on the bottom pointing up at the astronauts’ butts. Its purpose is to teach crew members how to position themselves directly over the spot where their waste matter is supposed to go. Any bit of feces that misses the bull’s eye ends up a disgusting mess so it’s very important to learn how to do this right because every astronaut is responsible for cleaning up anything of his that misses the target. 

But without gravity helping, it’s almost impossible to hit the right spot. Mullane’s theory is that crap never comes out straight but curves to one side making target practice a useless exercise. Another problem is that anything that does misses and doesn’t get stuck to the walls of the toilet is liable to escape containment and wind up floating in the cabin, eventually stinking to a piece of equipment or, even worse, a crewmate. The one place it doesn’t go is to the floor – remember, there’s no gravity to send it there. 

These unidentified floating turds happen all the time. The astronauts call them “floaters” and “streakers,” depending I guess on shape and consistency. The problem is so bad that astronauts strip naked whenever they attempt a BM because, as Mullane said, “It’s much easier to wipe  feces off your skin tham it is to get it off your clothes.” The astronaut said the bowel movement “is truly the most difficult part of any spaceflight.” What normally takes five minutes on earth takes at least a half hour in space, he says. 

It’s also the source for much humor. The best toilet humor was a legendary skit performed by astronaut Bill Shepherd during an 1984 flight. Shepherd sneaked a piece of breakfast sausage with him into the toilet during a BM.When he finished, he set the tube steak free to float through the cabin. “As panicked crewmembers ricocheted from wall to wall in a mad retreat from the offending planetoid,” Mullane says, “Bill chased after it with a piece of toilet tissue. He finally grabbed it and then, to the horror of all, he ate it.” Ah, “Caddy Shack Goes to Space.” Somewhere, Bill Murray is smiling. 

Astro urine is a whole other subject. The problem is at its worst when the Astros are dressed in their space suits. Male crewmembers deal with the problem with a form of “stadium buddy,” condom-like devices that fill up plastic collection bags strapped to legs. The condoms are sized but, well, you know, who’s ever going to ask for a small one? Therefore, “slippage” is a constant problem. Such an accident can have serious -- very serious -- consequences. Imagine if it happened during a space walk and an astronaut found himself covered with his piss. It’s actually happened and reportedly it wasn’t pretty, partly because mankind managed to learn a long time ago that you simply can’t take a shower in space. So we’re talking about the use of an enormous amount of wet naps. Enough said.

Anyway, I bet you also didn’t know that astronauts Neal Armstrong and Buzz Aldrin used urine collection devices (UCDs) when they walked on the moon. Actually, they each used two of them and then they left them there – on the moon, right under the famous plaque signed by Richard Nixon that famously stated: “They came in peace for all mankind.” They didn’t take them home and collect the deposit because the filled UCDs weighed too much and would have used too much fuel to get them back to earth. But the real point of this story is that two of the UCDs were size large and two were size small. To this day, which astronaut belonged to which size UCD remains a national secret. And that’s probably as it should be.

The human body is just not designed to live without gravity. The mysterious force effects almost everything humans do. We haven’t begun to scratch the surface of what we need to learn to successfully escape from our poor doomed planet. We had better get our asses in gear if we want to give our great-grand-children’s children a decent chance of surviving the coming end of the world 

Consider one of the basic requirements man needs to survive and perpetuate the species -- sex. It appears likely that no human couple has ever successfully become members of a 200-mile high club yet – despite a married Russian couple who spent six months together in the International Space Station. NASA actually has a rule that prohibites even attempting the act and claiming another historic first for America. Without getting too technical here, the reason probably has to do with Newton’s law that says every action has an equal and opposite reaction. Also, there is practically no privacy for crew members aboard shuttles and very little more on the much larger ISS.

NASA doctors dismiss the idea anyway. They maintain that the effects of zero gravity on the human blood supply make it impossible for the human penis to become erect. They never say how they know this but our friend Mike Mullane has first-hand knowledge that the space agency is all wet. His memoir describes waking up for the first time in space to a surprise. 

“My closest friend was alert and waiting,” he writes. “I had an erection so intense it was painful. I could have drilled through kryptonite.” On Mullane’s total three trips into space before he retired, he says that most of the time when he woke up after a sleep cycle, his “wooden puppet friend was there to greet me.” NASA did not respond to any of my phone calls and emails for comment.

When the shuttle toilet malfunctions, which has been disturbingly often, the crew reverts to their backup systems. For number one, they use small plastic bags. Sounds easy for men, doesn’t it. It’s not. You would think he would just open the bag, stick his business inside and let go. But it doesn’t work like that. First, there’s the splash factor, which makes it incredibly difficult to keep the undesirable liquid waste matter inside the bag. After all, even astronauts have only two hands to work with and this activity is not conducive to team efforts. Astronauts have learned to deal with the splash factor by placing a couple of wadded tissues in the bottom of the bag to blot up the stream of urine and stop comeback streams. This has been only moderately successful, according to NASA. 

The other problem with urine collection has been described as the “final shake factor.” The initial rushing stream from an astronaut is enough to overcome the lack of gravity. But, as every man knows, the final drops usually require a shake to fling them from the male appendage. This action doesn’t work in space and globules of urine just collect on the head of the space penis, so astronauts finish the job with an extra tissue to blot the final drops left over. Astronauts complain this seems excessively feminine and object to it. Besides, any paper products used during the activity must be disposed of in a special system which uses some suction to contain the paper inside yet another plastic bag. Even this method doesn’t always work and there’s very few things worse than coming up on a floating snow storm of urine and feces smeared wadded up balls of tissue paper.

Still want to be an astronaut?

I know this is getting tedious, so I’ll just briefly describe the backup system used for BMs when the toilet breaks. Briefly its just a platic bag with adhesive on the open end to stick the bag on the crewmember’s butt. They’ve been used since Gemini missions with very little change. You stick them on and then the fun part starts. With no gravity, how do you get the BM to drop neatly into the bag? Well, it can’t be done without help, so NASA has provided two finger holes on the collection bag that are used by the astronaut (one hopes) to “pinch off” his turd. It’s never nice and is rarely completed without incident.. Most astronauts drink very little and eat foods designed to result in as few BMs as possible.

And I’m not even going to deal with what, by far, is the most disgusting thing astronauts have to deal with – vomit. The sad fact is that everyone who goes into space gets sick and throws up, which is why the famous steak and eggs breakfast made famous by the early space program and still a tradition in the space program is NEVER eaten by crew members. If you think doing your number one and number twos in space is hard to master, wait until you try to contain a stream of you know what in the paper vomit bags provided in abundance. Every crew has their favorite stories describing the most disgusting moments of there mission. But you won’t hear any of them here. I admit that even I am getting a little queasy. 

The famous “Urine Dump at Sunrise” was finally stopped when it almost became deadly on one of Mullane’s missions. NASA had noticed that one returned shuttle showed an abnormal amount of damage to the all-important heat shield tiles around the nozzle used for the urine dump. So, a few days into the mission, they had Mullane’s crew use the TV camera on the shuttle’s robot arm to take a look at the suspect nozzle. Mullane reports they discovered a large “urine-sicle” attached to the outlet just waiting to break off during reentry and damage a lot of those tiles. So until the nozzle could be redesigned, they told the crew to use the arm to snap off the offending frozen pee and stop using the toilet for number 1 missions. 

Mullane’s description of male crew members using the toilet to leave their solid waste without letting any pee escape is classically funny. It’s written so well, I think you should buy the book and read it for yourself. Just one hint – they ran out of tissues to wad up and ended up usigng their dirty socks to piss on. Really.

The best break I ever got in reporting was when Mullane introduced me to Judy Resnik. Judy hated reporters – and just about everyone else who mightconsidered her a celebrity. And it was easy to see her that way because she was the first Jew to go into space as well as the second American woman to get launched. And she was beautiful -- and I mean she had been born breathtakingly, naturally beautiful. Mullane, who had a special relationship with her (she called him Tarzan and he called her JR) describes in some detail in his book how difficult it was to keep his marriage vows when he found himself alone with Judy during their training. Judy was also unmarried and a strict feminist who always insisted on being treated exactly the same as any male astronaut. It has long been rumored that that was the reason why Sally Ride got the nod to be the first woman and not Judy.

I learned to stay away from the dangerous subjects when I  spoke to her and we usually got along pretty well when he ran into each other, usually in Bernard’s Surf, a popular restaurant and bar in Coco Beach bar south of the space center. I never mentioned Judy or referred to anything she ever told me in any of the hundreds of stories I wrote about the shuttle program for The Post over the years. I had been told that there were subjects that really ticked her off -- like her Judaism. She would uneasily talk about what had happened in orbit -- usually giving short answer that always implied she was treated just like her male crew mates, but only up to a point. Once, after her second flight in space, I told her that I thought her new haircut looked great when she was weightless in space. After she saw pictures of herself taken during her first mission, she had cut her naturally dark curly hair so it formed a perfectly round bubble on her head when it wasn’t held down by gravity. She got mad at me over the remark.

It wasn't until very recently that the world learned a secret that Judy insisted her crew mates keep after her first mission -- that the reason that expensive IMAX camera had jammed was because her hair had got stuck in the mechanism. (Actually, she said something like "I'll cut your hearts out with a spoon" if anyone told the truth. Pure Judy. 

Judy was my favorite astronaut ever. I stopped covering the space program after the Challenger disaster. Judy was on that mission and covering the explosion and investigation was a constant reminder of how horrible her death had easily it could have been avoided.

A hour after what was lelf of the shuttle fell into the Atlantic, I was on a flight to the space center to cover the disaster. As I thought Judy’s last moments -- alive and conscious for over a minute and aware she was plunging toward certain death -- I saw I was holding onto both armrests so tightly that my knuckles had turned completely white. I was scared to death. It was the only time in my life that I’ve been afraid while I was flying.

Judy would never had said it to a reporter, but I’m sure she would have told her crew mates that at least she was glad she died doing what she truly loved to do. At least I hope so.

Rest in peace Judy. 

HEALTH INSURANCE

For the past eight months my health insurer has has made so many errors that it would take hours (maybe days) to put it all down here. In that short time, they have managed to twice send me two sudden but friendly notes that my coverage, and my family's, had been terminated. Imagine having incurable cancer and getting that note, which AETNA eventually admitted that, very simply, was their mistake.
Anyway, a few minutes ago, a message from AETNA appeared on my Email account. The message was very pretty - lots of blue color, balloons and smiling people. Ah,the world is good. And they actually had the electronic balls to ask me to take a survey about my last telephone call with them, which had happened Tuesday afternoon and also happened to be a disaster for both of us. If the truth hurts, AETNA is on lots of pain killers today. At the end of the survey they asked if I wanted to add anything. Oh boy! Here's what I wrote:

Service in the home office has steadily declined to the point today where it has become worse than useless. Over the past three months, I have been promised six call backs from supervisors "within 24 to 48 hours." NOT ONE CALL HAS BEEN RETURNED. Several months ago when you abruptly ended my coverage by mistake, I was eventually transferred to "a top supervisor" who told the error was made by one of AETNA's computer systems (yes, I know you have two, only one of which can be trusted with any degree of confidence by patients) and he said "no one at AETNA knows how to fix it." Finally, I have asked for a new RN to replace the wonderful woman that served me for almost a decade but who recently retired. But my repeated requests have been repeatedly ignored for six months. I could go on, but I know no human being will ever see it. AETNA has lost its way. Your MBAs have convinced you that your stockholders are your clients. You must remember that your patients' health is what you are responsible for. You have become a walking advertisement for the complete nationalization of health insurance. EVEN THE GOVERNMENT WOULD DO A BETTER JO B THAN YOU. How sad is that?"

As stupid as everything about this is, I'm pretty sure that if (when?) more people take a look at their health care coverage and their insurance, it will trigger something - like really meaningful change if we're lucky. But remember, after we're in charge, the insurance company executives get it right after the lawyers. Start making lists.

MEDICAL UPDATE AND A SUGGESTION

I’m sorry, but I have a brief medical bulletin.

I went to the clinic today for a long-overdue checkup and examination. Frankly, I’ve been stressed about this upcoming visit for a few weeks. As the date neared, the stress got to me and I began to amplified some suspicious (okay, maybe imagined) symptoms and somehow brewed myself a major cancer scare. I went as far as take a car service to the clinic because I really thought the odds were decent that would be hospitalized and I didn’t want the BW to worry about retrieving my car.

I’ve been told by fellow survivors that simmering stress syndrome is more or less part of the cancer game and the best tactic is to try to get used to it because you’re stuck with it for the rest of your life. My friend and colleague in the Comptroller’s office, Andy Joseph, passed this advice to me after practicing it for more than 35 years before he finally lost his battle with lymphoma a few years ago. Not long before he passed, he told me he still suffered with it. Andy was one of those few people you meet in life who managed to get through this world without bullshitting. I often miss him.

I still predicted disaster on the way to the clinic. I was surprised at the warm welcome I got. I hadn’t been to the clinic – my “second home” for much of the past five years – since last April and was surprised by the warm greetings I got from many familiar faces. I felt better for a while, but the dread returned after they took my blood and I watched them zoom to the lab via pneumatic tube.

Upstairs, I waited just a few minutes before I was called in to the torture area where the doctors and nurses hang out. Bridget spotted me right away – and if you don’t know who Bridget is, you haven’t been reading this blog. “Your blood work is back already,” she said without preface.

“Oh no,” I said. “How bad is it?” (By now, I was sure I was a goner.)
Never one to kid around, my Bridget turned stern. She crossly said to me: “It’s not bad. You’re such a faker. It’s great!”

And it was.

There wasn’t a single sign of the big C. Dr. A, my big C expert, even used the word “perfect” to describe the blood workup and searched but failed to find a single enlarged lymph node. He pronounced me healthy and said I should immediately be given a flu shot and go to the fifth floor to have a $25,000 liter of harvested gamma globulin infused into my veins for 2½ hours.
But the news is good. I’m healthy. Really.

That makes it official - I’m an idiot. I’m pretty sure they’re going to suspend my medical license and this pisses me off because I’ll be less of a doctor than my surgeon friend Dr. Epstein, and I know that 50 years ago, when we were stupid teenage boys in Queens, Ep was at least as stupid as me. Maybe more stupid.

But read on – I actually had an idea. A good one. At least the two doctors and three nurses I proposed it to didn’t blow it off, which is something that medics love to do when a patient proposes a better – or even different – way of doing things. Ready? Try to follow this:

When I was first diagnosed, it was thought that my leukemia (chronic lymphocytic leukemia or CLL) was caused when cancerous lymphatic white blood cells became “super cells” and never died. (Normal lymphocytes live about three months.) That crowded the healthy blood cells out of the system. Not good.

But a few years ago, they found that wasn’t what was happening. They discovered they do – but they live much longer, about three times, or 9 months, longer. This little tidbit changed just about everything in CLL research land. Okay? Keep following.

Normal chemo treatments (protocols) last six months (basically two doses of poison given closely together one week, wait three or four and then start the cycle over again). The treatments have gotten more and more successful in killing CLL cells but almost always leave a few survivors. And the CLL cells have become better and better at hiding and avoiding the poison aimed at them. And if they do survive, they continue to divide and perpetuate the cancer. This where we are now. Chemo sharply reduces the extent of the cancer, but it usually comes back to be treated by another round of chemo that produces the same results – but usually less effectively. In other words, we can maintain CLL but not cure it. Curiously, despite these and other advances, typical survival rates have not increased. But they might be about to.

All right, get ready, here it comes:

A new study has just proved that CLL cells are especially vulnerable to chemo’s poisonous effects when they are dividing, which any rocket scientist will tell you they do at the end of their lives.

Therefore, here it is: Isn’t it logical to extend the CLL chemo protocol to nine months (at least as a start with low dosing)? Statistically, wouldn’t that give you a better chance percentagewise to get all the little bastards when they’re at their most vulnerable and cure this fucking blight of a disease? Doesn’t it make sense? Of course it does. Make it so.

Anyway, it’s my theory and I’m sticking to it. Wouldn’t it be a pisser if it turned out to be the answer?

THE SECOND TIME I MARRIED MARCIA

Exactly 30 years ago today, Rabbi Michael Williams was conducting Friday night services in his beautiful synagogue in Paris. He was leading hundreds of worshippers crowded into Union Libérale Israélite de France on the eve of Simchai Torah.

The shul serves the rich elite of the Parisian Jewish community. Its entrance is inconspicuous from the stores and residences lining both sides of the narrow rue Copernic, one of many small streets in an ancient tony section of Paris between the Arc de Triomphe and the Eiffel Tower. But inside two sets of doors, polished wooden pews upholstered with red velvet seats surround a simple but imposing bimah. But the most magnificent part of the sanctuary is overhead, where the ceiling is dominated by a giant Star of David made of brilliant blue and white stained glass. Somehow, the ceiling is illuminated from above. You could easily believe that the light comes from heaven.

Rabbi Williams says his head was bowed in prayer when he first noticed something different was happening that evening. “I remember thinking: ‘Well, that’s strange. It’s raining in the synagogue.’ ”

The “rain” was shards of glass. Part of the glass ceiling -- already replaced after it was destroyed by the occupying Nazis 40 years before -- was being torn apart again. And once again, the motivation was hate.

A powerful bomb strapped to the side of a motor scooter had gone off. But the thick doors of the synagogue had kept out the noise of the explosion – until those doors were blown open.

The rabbi remembers: “At the beginning we thought we’d carry on the service. You know how one has this kind of heroic pseudo-reaction. The hazzan [a lay person who leads the congregation in prayer] was an ex-Auschwitz man, and I’m a pretty combative Englishman, so we thought, ‘fuck that, we’re going to carry on.’ ” he said.

“But about two minutes later we saw the flames and we saw people injured, so we left the synagogue.” There, through the dust and smoke, they saw broken shop windows, twisted overturned cars, bloodied survivors and four bodies – three non-Jewish Frenchmen and a visiting Israeli woman walking to the grocery with her grandchild.
Already arriving at the scene were Parisian emergency squads and, of course, the press. As ambulance sirens screamed, reporters surrounded the rabbi. Most of them wanted an answer to the one stupid question newspeople always seem to ask in almost any situation: “How do you feel?” The following day the New York Times reported on its front page that the rabbi paused for a moment and, before turning to walk inside and continue his service, left a simple message to the world: “We are not afraid.”

Now, jump ahead exactly 19 years and two days. Rabbi Williams stood on the same bimah, under the repaired stained glass ceiling and married Marc to Marcia before God and whoever He invited. Three witnesses joined us in the otherwise empty synagogue.

The rabbi performed a beautiful 45-minute service. A tallis held aloft by the witnesses served as our chuppah. I placed the wedding ring on the middle finger of Marcia’s right hand and she walked around me seven times. The rabbi sang a beautiful Hebrew love song, delivered a heart-felt sermon about marriage and gave us the traditional blessings.

It was all very traditional because the rabbi played by the book. Jewish tradition mandates that a rabbi cannot marry a couple he has never met. So we visited him in his office early in the afternoon, walked to a small café on Avenue Victor Hugo, had a few glasses of Champagne and returned to him a few hours later. We returned to the same café after the ceremony. It was wonderful.

It was not until we left the shul for the last time that I noticed the bronze plaque of remembrance honoring those killed and injured in the 1980 blast – and the scars in the wall that have been left unrepaired.
But it almost didn’t happen. It seemed like almost everyone and everything had tried to stop the ceremony.
Our first wedding took place December 15, 1996. I was Managing Editor of the New York Post at the time. The ceremony was simple and hastily arranged. Post gossip columnist Cindy Adams was my best man and about 40 guests, mostly business associates and close family, watched as New York State Chief Justice Judith Kaye recited the vows in the backroom of Le Perigord Restaurant on East 51st Street in Manhattan. The restaurant’s owner, Georges, had opened his usually sedate restaurant on that Sunday morning just for us. The Champagne was good and there was plenty of it and the same for the food. Cindy’s husband, the late comedian Joey Adams, told a joke. (I will repeat the joke when requested, which happens very, very rarely.)

The next day, still aglow with wedded bliss fueled by true love, we left for a honeymoon in Paris. It was as close to perfect as a honeymoon could be.
But I always thought my wife wanted to be married by a rabbi. Frankly, I think I wanted it more than she did. Nevertheless, when I suggested to Marcia that it might be “fun” to get married by a rabbi in Paris, she immediately thought it was a good idea.

So I decided to let her have it.

What I could not have known at the time was the heartaches and nightmares such a mission of love would set off. Getting a French rabbi to seal the deal turned out to be one of the most fascinating, educational, frustrating and time-consuming experiences of my life. It took more than four months of planning, testimony, negotiations and compromises to get it done. And even so, on the morning of the planned ceremony, it came within an hour of being called off completely amid an atmosphere of old-testament laws and Talmudic pronouncements.

It started easily enough. Since we were already booked to spend a week at the end of September touring the French Champagne region floating down the Marne River on a barge, we already knew the dates we would be in Paris. My first move was to call the only person I knew who might be able to advise me how to set up a Jewish wedding in France.

The man was Uri Dan. Based in Tel Aviv, Uri was The Post’s Mideast correspondent and had become one of our closest friends. [Unfortunately, Uri died in December 2006. My tribute to him can be found in the December 2006 post earlier in this blog.]

I was accustomed to Uri surprising me by his wide-flung resources, but even so, the voice on the line from half around the globe floored me. “Ah Marc, my friend, this is wonderful news! Don’t worry about a thing. I will take care of everything. I will be back in touch shortly.” Then he hung up.

A few days later he called to say “everything is being taken care of” but that was followed by another call the following week describing a “slight problem.” It seems the French rabbis in charge could not understand why two American Jews would fly all the way to France to be married in a synagogue. They suspected some sort of scam and needed proof that we were Jewish.

Marcia already had all the necessary documents. But my Jewish life was much more informal. And the rabbi who presided over my bar mitzvah was long dead. I had to collect notarized letters attesting to my Jewishness from as many upstanding New York rabbis as possible. It took weeks. Some quizzed me on Jewish history and rituals. I anticipated some of these tests and studied – but there were some pop quizes. They were tougher.

But I managed to pass them and proved to their satisfaction that my intentions were pure. There was a debate whether a Jew’s tribe was inherited from his mother or father [the correct answer is the father]. Finally, after a few months, everything seemed to be in order. But it was a false finish.

Uri called a few weeks before we were to leave. He explained that the Jewish community in France was controlled by ultra-orthodox elderly rabbis from north Africa who were very paranoid – although it’s not hard to figure out why, considering what they had seen during their lives. The latest problem was solved by my visit to the New York Beth Din. I admit the Beth Din is an institution that I had never heard of. But there I was taking the subway to Beth Din headquarters in Chelsea where I was stunned by the huge bureaucracy behind the doors. I was shuttled among various offices, questioned by numerous authorities and finally, after two days, handed a very official-looking piece of paper certifying my Jewishness. The parchment was laminated, had several embossed stamps and, on top, a color photograph of me. The picture had some more stamps on the corners to make sure it could not be replaced with someone else.

The certificate, along with a stack of other necessary papers, were over-nighted to Uri who profusely apologized and assured me we were now cleared for marriage.

So we flew to Paris. We had a day before the barge tour left, so we checked into our favorite hotel on the left bank, where we would leave most of our luggage until we returned from the tour. Early the next morning, the phone rang. It was Uri. After everything we had gone through, the chief rabbi of Paris refused to allow the ceremony. “The reason is not clear,” he said. “But don’t worry, my friend, I will figure something out by the time of your return to Paris.”

As usual, Uri was true to his word. The first morning we were back on the left bank, Uri called with instructions. We were to meet the rabbi at 2 PM in his office in the Synagogue on Copernic Street. As if he was apologizing, Uri explained that he was forced to bypass the roadblock set up by the orthodox rabbis by moving the ceremony to a “liberal” synagogue, explaining that in France, liberal congregations fall between American orthodox and conservative. In short, the service was in Hebrew but men sat with women. We could not have been happier.

When we met the rabbi for the first time, he was seated under a picture of him with Queen Elizabeth. He explained that as the former liaison between the British royalty and the Jewish community, he was known as the “Queen’s Rabbi.” We talked for awhile about the big issue for the conservative Jewish Community raging at the time in back home – how to stop intermarriage with non-Jews. He turned serious and had extremely emotional thoughts on the subject. “I’m against any program to stop intermarriage,” he said. “How can you possibly stop two people in love from getting married.”

He’s the guy to do the job, I thought. And he was.

That’s the story. If you’re wondering if the terrorist was ever brought to justice, a suspect, an Arab associate professor, was arrested in Canada in 2008 by the Royal Canadian Mounted Police acting on a warrant issued by French authorities. Rabbi Williams said at the time that the arrest “was better late than never” but it came as something of a surprise to him because French police never entered his shul until after the suspect was arrested 28 years later. The French police said the evidence came from German intelligence sources.

As of October 2010, the suspect is still in Canada, fighting extradition.

Rabbi Williams has recalled two things about the aftermath of the attack on his shul. He remembers the French Foreign Minister telling the world the bomber’s actual victims were mostly innocent Frenchmen -- carefully separating them from the French Jews praying inside.

And he also remembers a visit to the hospital to visit some of those wounded by the blast. He said a group of French doctors and medics surrounded him, insisting that French Jews should build their synagogues on the outskirts of town instead of in the more crowded inner city where innocent people might be involved.

Ah, the French.

One Night in Equador

Check out this amazing video. As the Milky Way drifts by, watch various satellites streak by and, near the end of the 98 sec. clip, the lights of mountain climbers on the mile-high Cotopaxi Volcano. As usual, the clip is from the wonderful APOD Astronomy Picture of the Day web site. I'm there everyday. Bookmark it here.

Don't Forget Your Sunscreen!

EXPLANATION FROM THE EDITORS OF ASTRONOMY PICTURE OF THE DAY: Sometimes part of the Sun can just explode into space. These explosions might occur as powerful solar flares, coronal mass ejections, or comparatively tame eruptive solar prominences. Pictured above is one of the largest solar prominence eruptions yet observed, one associated with a subsequent coronal mass ejection. The prominence erupted last month and was recorded by several Sun-sensing instruments, including the recently launched Solar Dynamics Observatory (SDO). The above time lapse sequence was captured by SDO and occurred over a few hours. In recent months, our Sun has becoming increasingly active, following a few years of an unusually dormant solar minimum. Over the next few years our Sun is expected to reach solar maximum and exhibit a dramatic increase in sunspots and all types of solar explosions.

HEALTH BULLETIN

I made the decision about two years ago -- scroll back here if you need to remember. Making the decision to stay alive was easy considering the alternative. Starting the process was just a bit harder but accumulating the momentum to sustain the effort to successfully reach my set goals was slower, harder and more complicated than I thought it would be. When the process began, I knew it was going to be the most important battle of my life.

At the time:

§  I was taking 26 different medicines every day – eight of which were labeled as controlled substances.

§  I weighed 332 pounds, making me severely morbidly obese.

§  My borderline case of type II diabetes had definitely crossed the border and I had to give myself two or three injections of insulin each day to stay conscious.

§  Carrying around all that fat 24/7 also spiked my blood pressure, which doctors fought by adding more blood pressure medicines and doubling the doses of meds I already was taking.

§  A few chronic wounds on my lower legs got better and then got worse on a constant, frustrating basis. Then several painful wounds on my left leg merged, were infected, became very painful and were the focus of some frenzied debates on how to treat it – reaching the point of how long it would be before part of the leg would be amputated.

§  Then it became clear that my leukemia was out-of-control. I had huge tumors growing throughout my body, my immune system was practically non-existent and my blood chemistry looked more like wastewater than blood.

Therefore, I decided to get a gastric lap band installed and undergo innovative chemotherapy to stop the cancer.

A year ago next week, I was taken from my doctor’s office by ambulance to a hospital isolation room. One specialist looked at the results of my latest blood test and told me that it appeared I was getting “ready to check out.”

Earlier today (Wednesday, March 24, 2010), I had a new blood test. If you have never seen the results of one printed out, they consist of three columns. On the far right is the range of numbers that would be considered “normal results. On far left are the actual results of your test that fall in that “normal” range. And the middle column consists of all the results that might be a problem. Let’s cut to the chase: For the first time that I can remember, there were no results in that middle column.

I was at the hospital to receive my usual dose of gamma globulin (cells harvested from healthy donors of antibodies that my own compromised immune system can’t produce anymore) and used the opportunity to visit my oncologist. He liked the blood test results. He liked my weight. He liked my color. He liked the fact that there is absolutely no sign that there were ever any wounds on my legs. And, after a very probing search for them, he liked the fact that he could not find a single swollen lymph node on my body.

So here’s my latest medical report:

§  I’ve lost 120 pounds

§  I have no sign of diabetes

§  My leg wounds are all completely healed.

§  They don’t call it that anymore, but if they did, they would say my cancer is “CR” -- or in complete remission, which definitely sounds better than the politically correct phrase “progression-free survival.”

Nuff said. Thanks to all responsible. You know who you are.  

ANOTHER STORM, ANOTHER BIRTHDAY, ANOTHER TRY TO REFORM HEALTH CARE

 
The storm hit Friday and got worse through the night. By midday Saturday the electricity waved goodbye. That's when we decided to take the big SUV and tour the neighborhood. The first thing we noticed is the 100+ year old tree that had always stood near the NW corner of our house was now a lot closer to our neighbor's home. As a matter of fact, it had come to a stop about two inches from their roof. (Six gardeners spent all day today chopping it up but they will have to come back tomorrow to finish the job).
 

The rest of the neighborhood was a lot worse and for almost two days we were literally trapped in our immediate area by streets closed by downed trees and arcing power lines. Incidentally, the sight of arcing electrons lighting up a storm at night is pretty awe-inspiring. The rest of the story: the power was restored after about 55 hours (remarkable really) but the cable didn't return full-time until Thursday afternoon. And keep in mind Cablevision also supplies our hard-wired telephone service as well as our broadband.

 I turned 62 in the midst of all this and, wonder of wonders, never got so many birthday greetings in my life. Thank you all who took the time to send your kind notes via e-mail, facebook and even USPS. Your messages really moved me and I will try to answer all individually.

It's too early to know yet the final grade of the proposed health reform bill. But, despite some personal reservations like research funding and what it's going to cost my family, it looks like an overall winner. It's not perfect, that's for sure, but it's better than what we got now. More poor Americans will get better care than they would have and I fail to see how that's bad, But it doesn't yet address the real problem - caring for the elderly. We will see. But it will be fun to watch the Republicans break new records of hypocrisy and stupidity while the Democrats desperately look for a way to fuck it up. They always do. My prediction: both sides will prove how hopelessly hopeless they are. By the looks of it, I don't think Curly is happy with the fine print (or is it the flamingo?).

APOLOGY UPDATE

Now hear this! We've just been informed that our domain troubles have been fixed -- but the fix won't take effect until 12:01 am on March 3. That's Wednesday, we think. The short form: until then, our URL will be www.kalechblog.blogspot.com. After that, our addesses will be www.marckalech.com OR www.marciakramer.com.  That is all.

GLOBAL WARMING?

WE'RE SORRY

Due to some still-unexplained administrative fubar,  the www.marckalech.com URL didn't end up here (www.kalechblog.blogspot.com) for most of last week. 

Hopefully, it's fixed by now. We apologize for any inconvenience.

(Above) White Plains about midway through this week's three-day snow storm.
(BelowL Don't worry, that's not foam on Curly's mouth - he just likes the way snow tastes while it's still white..

A LOOK AT THE FUTURE OF HEALTH CARE?

On Monday, I spent most of the day in the hospital for a chemo treatment. After more than six years, it’s a trip accompanied by low levels of anxiety -- especially when the drug I’m scheduled to get is as benign as gamma globulin.

This week’s visit was going pretty well. Tara, my regular gentle chemo nurse who knows every available vein on my body, painlessly inserted the catheter and the crystal-clear liter of globulin began dripping into my body right on schedule.

I need periodic infusions of this stuff because my cancer-ravaged blood manufacturing system doesn’t produce antibodies in sufficient numbers and that compromises my immune system – which, of course, is not a good thing. So every six to eight weeks, I get a load of the immunoglobulins collected from thousands of blood donors to boost my immune system and keep me alive.

I’m very thankful of this process and consider myself extraordinarily lucky to have it available to me. I know that fluid in that little bottle hanging upside-down next to my chair is very expensive. Like $25,000 expensive. Lucky for me the good people at Aetna HealthCare have agreed to pay for infusions of the stuff for a year at a time. I think this is the third or fourth year they’ve approved this treatment. And I thank them. I know how important it is to keep the folks at Aetna on my side.

That’s why what happened a little later in the afternoon scared the shit out of me.

It was about half-way through the slow four-hour drip process and I was feeling pretty good from the great neck and shoulder massage I got from the therapist at the NYU Clinical Cancer Center. (This is a wonderful little perk given to chemo patients at NYUCCC that deserves to continue and be financially supported. More about this program later.) The therapist who gave me my massage today was especially effective and I had a pretty good buzz going. When it wore off, I restarted the movie on my laptop and watched the last few minutes of “Doubt,” the Meryl Streep movie I was sort of enjoying as the last of the harvested antibodies made their way into my capillaries.

Then the phone rang.

I have to explain some things here. First, my life has undergone a little change lately – mainly due to my sudden lack of employment. And since this was my first visit to the hospital in 2010, I had to undergo the dreaded yearly checkup in the hospital’s infamous “payments receivable” office. This is never a good way to start your day of getting healthy. For one thing, NYU always manages to schedule these visits so there are two or three administrators available to screen at least 20 anxious patients. These officials all move like they are receiving massive doses of Xanax. It’s not a speedy process.

I’m no longer intimidated by this detour. I expect it after the first of the year -- and I have my own Xanax prescription. This year, I knew there was going to be red flags put up when I told my interrogator that I was no longer employed by New York City. But apparently she had heard this from other people recently and just pressed something on her keyboard and told me to go upstairs to my treatment.

But now she was back on the phone and she sounded panicked -- telling me that I had lost my health insurance when I lost my job. But I’m not stupid and I know that had not happened. Knowing how important health insurance is to me, I took pains to perfectly follow the rules of how to extend my health coverage using for the Consolidated Omnibus Budget Reconciliation Act (COBRA), which gives workers who lose their health benefits the right to choose to continue them. But the bottom line was that I wasn’t insured. What did NYU want me to do, I asked her. Did they want me to give back the immunoglobulins that I had absorbed into my bloodstream?

Fighting back panic, I got on phone. Still hooked up to intravenous tubes, I called my secret weapon. I’ve written many times before that the back office people in the health care system actually, in many instances, control the system. In my case, the registered nurse Aetna assigned to assist me over five years ago has been invaluable through the years in keeping me alive. In Hartford, Nurse Rebecca Valenti listened to my problem -and did what she does best – keeping me insured and alive.

Within 30 minutes, Becky tracked down the trouble, put me in touch with the right person and got me covered again. When I spoke to the NYU biller and told her I had straightened out the problem, she just said she would check Tuesday and “we’ll see.” I haven’t heard from anyone at NYU so I guess they did see.

But the real story here is what actually happened and what it means for the present and for the future. It was an inexcusable mistake that I hope I managed to fix for the hundreds of NYC employees who followed the same instructions I did and mailed their COBRA applications to the wrong address. I was lucky to have my laptop with me in the hospital and had available the name and address of the person I had directed my application to. This gave Becky the information she needed to get to the bottom of it. It also gave her the location where she could go to find my application and deliver it to the right place. Hopefully, the other misaddressed applications also found their way there.

I was going to make some calls today to make sure that happened but decided to leave things as they were because any calls might only serve to screw things up again since it is so easy to screw up. Just imagine what will happen as the government starts taking over more of the health care system.

But I’ve decided to add another rule to my survival list: Never panic!