Soi Dogs

Surgery done

Back home. This will be a short post--I ache, and typing just isn't something I have the discretionary energy or will for. Short story: I'm okay, all visible cancer has been removed, my spleen has been taken out (just in case), the cancer is likely to come back (but I may be lucky), more treatment options will follow.

Longer post to follow.

Last post for a while

I'm getting ready to go into the hospital now--gathering clothes and pyjamas etc., plus (most important) books to read while I'm laid up. I'm due in the hospital at 2.30; the operation is sometime tomorrow. The physiotherapist said they'll discharge me when I can walk down the main hospital corridor unaided--which hopefully will take around a week or so. (Maybe a little longer.) Until then, I'll be electronically incommunicado.

Just trying something out . . .

Surgery soon

I went into the Royal Marsden hospital Wednesday. All set now for the surgery on Tuesday. I'll be in for around 7-10 days.

Things going downhill in Thailand

Rumors about the state of H.M. the King's health have been circulating for some time, but the government are now going to some rather worrying lengths to stop people talking about it. Have a look here, here, and here.

Not good. Indeed. Notthenation also has some rather less serious things to say: here, here, and here.

Back in Thailand

Back in Thailand for ten days (about a week left now), trying to sort out visas and passports. All the kids have UK passports now (well, the application is in; we just have to collect them) as well as Thai passports. Just need to get the settlement visa for the wife sorted out. This involves quite a lot of paperwork. I took a photo of the immigration official handling my wife's application:

Tally ho!

Going under the knife

I went in again to the Royal Marsden on Thursday. They gave me another CT scan--results negative again--and then I spoke with the oncologist who is treating me: Professor Thomas, a most intimidating man. His comments this time can be summed up as: Situation grim. Major surgery. Small chance of death during procedure. Large scar, through the tattoo on your belly unfortunately. Will try to match up edges when sewing you up. Ten days in hospital. One month to recover.

He also said that my presentation was very unusual for melanoma. It's possible that the lump in my abdomen is not melanoma. It "should be" (his words), but it's very odd for melanoma to spread in this way. So . . . it might be something benign. Which would be very good. That would put me on Stage III rather than Stage IV, which makes a very large difference in prognosis.

On the other hand, and somewhat less reassuringly, he also said that if it *is* melanoma, then it's possible my disease is quite aggressive, as it's also not usual to get melanoma in three different places at once (primary tumor, metastasis to lymph node, and then distant metastasis).

The only way he can know, of course, is by chopping out the whatsit and looking at it. He also doesn't know what it's attached to, so it's possible I may lose my spleen, and/or a section of my bowel. Still, I can live without my spleen, and I'm certain a small chunk of bowel won't be missed. We do seem to have rather a lot of it, after all.

The operation is set for November 24th, but that might change if there aren't enough beds in the hospital for me.

I have to spend the month before the op getting things in motion for something else. I'll post about it later.

Oh, and I had two rejections for short stories. They both arrived today, which kind of made the morning email check a bit sucky.

Posted story, reviews

My short story "The Hand of Afaz" is up. You can find it here: http://www.heroicfantasyquarterly.com/?p=284

And you can find reviews of it here:http://jameslecky.blogspot.com/2009/10/heroic-fantasy-quarterly.html and here: http://matthewwuertz.blogspot.com/2009/10/heroic-fantasy-quarterly-issue-2.html and here: http://adventuresinfiction.blogspot.com/2009/10/review-of-hfqs-second-issue-and-very.html

(This is being typed on a borrowed Mac, and for some reason Safari doesn't want to format URLs. If anyone knows the reason for this, or the reason why Safari won't let me paste URLs into Typepad's dialog boxes, I would greatly appreciate it if you could let me know what I'm doing wrong.)

And my story in Year's Best Horror' ('Harry and the Monkey', in case you forgot) has also been reviewed. They liked it: http://charles-tan.blogspot.com/2009/10/bookmagazine-review-best-horror-of-year.html

More referrals

The past couple of weeks have just been getting moved from one doctor to another, but it looks like I'm with the best lot now. I had some trouble registering for a GP. For a while, the NHS trust refused to offer me treatment, as I'd been living outside the UK for so long, but fortunately my aunt works with the trust and went in and bent some ears and got it sorted. 

After getting registered with a GP, I got referred to Mount Vernon oncology center at the end of the first week. At Mt. Vernon they gave me a PET scan and the basic prognosis. The PET scan showed nothing further--so it's not spread to my lungs or brain, which is, you know, nice. However, the consultant was pretty blunt; he said that it's very rare to eliminate cancer completely once it's spread, and that especially holds true for melanoma. He also said that there's a 90% chance that the cancer has spread to other parts in my body, but it doesn't show on the PET scan as the scan can only pick up tumors around 1cm or larger. He also said that the NHS doesn't offer chemo for melanoma as it doesn't actually affect survival time--it just lengthens the time to recurrence, and the side effects are horrendous (thus reducing hardiness for surgery, which is the only real solution). So . . . pretty much what I'd read about the non effects of chemo. Kind of surprising that the NHS doesn't offer it, but it doesn't make any difference in overall survival. On the bright side, he said that it looks as if I may be one of the few people for whom surgery is an option--seeing as I only have resolvable tumors in three places. He thinks the tumor in my abdomen is probably attached to either my bowel or the mesentery--the abdominal wall. He also said that the surgeon is going to need to take a look before any surgery--and if the surgeon sees numerous minor tumors (smaller than 1 cm), then they're not going to operate, as it wouldn't really do much good. He then referred me to a surgical oncology unit--the Royal Marsden in Kensington.

Thursday last week I went down to the Royal Marsden. I got seen by an oncologist and a surgical oncologist. They took another biopsy (and my leg wouldn't stop bleeding for about forty minutes, which kind of sucked), and booked me in for another appointment next Thursday.

Basically, I think the procedure will be: 1) exploratory surgery to see it the tumor is resectable. 2) If it is, then resection of all tumors. This will lay me out for about two weeks I think, following the surgery. There's no chemo afterward, but I'll have to go back for check ups every three months or so. If the tumor is not resectable, then they'll have to think about what they want to do next.

I'll write more when I know more.

PET scan

PET scan today at the Mount Vernon hospital. Nowhere near as uncomfortable as the CAT scan--no poking things up my bottom, which was a VAST improvement, let me tell you. In fact, I fell asleep during the scan, which just goes to show how astonishingly dull it was.

No results yet of course. Appointment with the oncologist tomorrow.

Back in Blighty

Landed yesterday at 7.00 a.m., whisked through customs and immigration in seconds--then spent twenty minutes waiting for the baggage. Typical. :-)

I'm now registered with my local GP, after a lot of faffing about trying to prove residency, and have been referred to an oncologist. PET scan tomorrow--after which I'm going to be radioactive for eight hours (hopefully I will develop some form of super power that will allow me to correctly predict lottery numbers). And then an appointment with an oncologist the day after.

By coincidence, my aunt is friends with someone who works with melanoma patients, so I was given the names of 'the people to see' and managed to get myself referred to them. Nice result. The top people in melanoma in the UK (recommended to me independently by melanoma specialists in Oz) are the people I'm going to be seeing. And both hospitals are close to where I live. Surgery will probably be done in London, but the chemo etc. will be at Mt. Vernon, which is about twenty minutes away from where I live. So at least something's going well.

Really bad news

Diagnosis came on Saturday. I have metastatic melanoma. CT scan shows a tumor in one lymph node in the groin, possible smaller tumors in the abdominal lymph nodes, and a large mass attached to my spleen. The doctors said it's impossible to tell whether the splenic mass is a metastasis or not, but it's likely. If it isn't, then I either have concurrent lymphoma (which would frankly suck), or there's a small chance it could be benign. (It's kind of big--5cm by 8cm by 8cm--and melanoma metastases to the spleen are rare, 5% of total.) But, even if it's benign, it still needs to come out.

What looks likely is immediate surgery (block removal of lymph nodes in groin, removal of primary tumor on my hip, splenectomy, possible removal of lymph nodes in my abdomen) and then adjuvant chemotherapy and radiation. Chemo will suck, but at least I can take consolation in the fact that I'm already bald, so losing my hair won't be a biggie.

I may stay in Thailand for treatment. If so, I'll be getting treated at Sirirat hospital--which is the one they send the King to, so it's good. But . . . I'm not sure yet how much experience they have with melanoma. It's kind of rare in dark-skinned people (like most Thais). At present, though, I'm negotiating the maze of insurance. Which is really not much fun.

The other option is traveling back to the UK. But the really advanced melanoma treatment is in the US and Australia, so I'm not sure how much advantage being in the UK would give me. I'm also trying to find out about treatment in Australia. (But I suspect the cost will be brutal.)

Bad news

Looks like the pathologist may have made a mistake. I have a tumor in my thigh in a lymph node. Fine needle aspiration done already, CT scan tomorrow. Results from both on Saturday next week.

Possibilities (in decreasing order of likelihood):

1. Metastatic melanoma

2. Lymphoma

3. Metastasis of the Spitz Nevus (unlikely)

4. TB (very unlikely)

5. Viral infection/some other random disease (extremely unlikely)

Edited to add:

When they told me about the CT scan, a smiling nurse gave me two bottles of orange colored gunk, along with the times when I had to drink them (5.00 p.m. today and 8.00 p.m. today). She told me it was 'yaa rabai'.

I've just worked out why it's called that. 'Rabai tor' in Thai means 'clean out the drains'. Yaa rabai does the same thing, only to your insides.

Yup. I'm feeling pretty damn well cleaned out, I can tell you. I must have lost a good three kilos or so. Quick! To the scales! And then claim a sudden weight loss victory!

Questions. How I hate them. (My precious.)

So here's a question for you: What is a question?

Surface syntax says, either SV inversion or a WH- word with SV inversion or VS tag at the end of a declarative. For example:

Is he coming?

Why is he coming?

He is coming, isn't he?

Okay, so what about:

Your name is Smith?

You attend Northwestern University?

Rising intonation for a declarative turns it into a question. Also works for phrases, too:

Elephants?

Alex?

People perceive intonated declaratives, phrases, and words as questions. So the syntactic definition of 'question' is not the same as the pragmatic definition of 'question'.

So what's the pragmatic definition of a question?

I've been reading papers that frame it in terms of 'request for information.' Seeing as 'request' and 'command' have the same illocutionary force, I guess we could define a question as 'I direct you to tell me a piece of information that I lack,' which would make them directives in Searle's speech act framework.

But this also has problems. Have a look at this:

92. A: I think Thai heh to be honest more . because like . when we were eights um ei oh no . =
93. A: sixteen you can go to nightclub or anything like that . and they dance like . really different
94. B:           [where?]
95. B: can you go to a nightclub when you're sixteen? .     Where? =
96. A:                                                                                        [yes heh]  in New York but like =
97. B: you can? . °wha?              you can?     [  Aren't   ] you supposed to be twenty one?
98. A:                                  I can            .          cause it's

This is an excerpt from my thesis. 'A' is an interviewee. 'B' is the interviewer. Have a look at the questions that B is asking. Do they look like requests for information? Maybe the first one--but how about on line 97? Serious requests for information? I don't think so. At this point in the interview (you'll have to take my word for it as I can't post video data due to loss of anonymity and all that), the interviewee and the interviewer have obviously hit it off (body language is clear). Look at the way the interviewer plays off the interviewee's responses. Even if the question is ultimately about information that the interviwer wants to know, I think it's clear it's not the primary purpose of the question.

And if that doesn't convince you, how about this:

129. A: °okay I . when when you leave . today . you need to . uh look at the catalog =
130. A: and you can do some of this online . or maybe go to the library and you need to =
131. A: look at the:: tourism major . and you need to look at the business major . because =
132. A: some of the requirements for courses are different . so: when you change =
133. A: programs . or you change first of all when you change universities . you'll =
134. A: lose some credit . you'll have done some things in Canada that you won't =
135. A: get credit for . and even within the same university when you change academic =
136. A: programs . you could lose credit . because there may be some courses that are =
137. A: required for business majors that are not required for um . er tourism majors . =
138. A: so . you need to look at the two programs . you need to be sure which one you =
139. A: want to be in and then you need to look at your . transcript what you've done =
140. A: . and what you want to transfer it because . once they transfer the credit it =
141. A: it becomes com- complicated if you want to change it for example the Math =
142. A: class required for business . is different from TIM . once they exempt one =
143. A: it's very difficult to go back and try to exempt another one . so you need to take =
144. A: a day or two . and really figure out what you want to do with the the college . . =
145. A: and if it's TIM . you should . be admitted or or apply as a TIM or once you're =
146. A: admitted you should change your major so that you have a TIM advisor instead =
147. A: of a business advisor . . okay?

A long chunk of information given in the interview, and then an 'okay?' at the end--to which the interviewee doesn't respond. It's intonated as a question, but is it a request for information? Well . . .  possibly, if you phrase it something like 'do you understand what I said?'--but if that's the case, then why doesn't the lack of response bother the interviewer. In fact he/she doesn't even wait for a response.

So. Questions are not always about filling in gaps in information, and they're not always syntactically questions either. So maybe we could define a question as something that the hearer feels compelled to answer. I need to think about this more, but basically it would mean that a question is a question when it's seen as a question. In other words, there may not be anything in the question itself that marks it as a question; rather, the determination of whether an utterance is a question depends on the hearer's interpretation of it.

Yeah. I know. Messy. Needs clearing up, but I think the basic idea is sound. So what about this:

95. A: do you have any uh . idol business person in your °mind?
96. B: °mm . °no °heh
97. . . . . .
98. B: I . I just gave my cause there's only two . grades like final ones but I did go for many others . the others are at my . teacher(?) house °because °I °just °got °them °today . cause =

A = interviewer, B = interviewee

See that? A five second pause in the interview followed by the interviewee answering a question that hasn't been asked. In the video, you can see the interviewers looking at her final exam grades in her application packet. So the interviewee is responding to a question--only it's not even been verbally asked at all.

This is what I'm wrestling with in the second chapter of my thesis--and of course, as I'm examining questions in interviews, I can't move any further until I've defined the object of investigation.

Interesting though.

Short fiction: Sale

I sold The Hand of Afaz to Heroic Fantasy Quarterly. It's not a pro-market, but judging from how much care they took over the submission, I'm guessing they'll get a good rep. once they've settled into their groove. The first issue is up for free at their website, so do bimble on over and have a look. My story will be up, I guess, next issue.