The best clue may come from the Wang sisters. David Eisenberg in his book Encounters with Qi describes his remarkable encounter with these two young girls. They could describe in exquisite detail what was written on a piece of paper inside a closed box without previously having set eyes on the box or on the paper. They could even tell the color of the ink used on the paper. To Eisenberg’s amazement these seemingly ordinary girls were able to repeat this feat easily in front of Eisenberg and several other Western physicians. The girls could also “see the outline of internal organs simply by looking at a patient’s body . . . could determine the hair length and sex of an unborn fetus by inspecting the abdomen of a pregnant woman.”
These girls had not recognized the uniqueness of their talent until their father had mentioned over dinner a newspaper story about a Sichuan boy who had similar capabilities. They had assumed everyone could do what they could do; they took it for granted. Chinese historians and researchers who have looked at this phenomenon have come to believe that these “exceptional human body functions” are inborn in a rare child, perhaps one in several million. Fortunately for the rest of humanity, the Chinese have admired and cultivated these exceptional capabilities through Qi Gong and acupuncture rather than letting them wither and die.
How many one-in-a-million clairvoyants and telepathic superstars has the Western world failed to nurture, out of our own ignorance and arrogance?
The unseeable, the unknowable: The Wang sisters may have had a special power enabling them to manipulate electrical currents and energy, what the Chinese call Qi. We here in the West have focused almost exclusively on chemical manipulations, not electrical interventions. Better living through chemistry—not a bad way to go, given the power of antibiotics to resolve infections, the power of antidepressants to stabilize mood. Yes, nerve impulses are propagated by neurotransmitters, and we in the West have figured out how to manipulate serotonin and dopamine and adrenaline levels, all to enormous advantage.
But the yin needs the yang. A solo ride on the back of chemistry leaves out energy and electricity. How might our chemical manipulations alter our electrical impulses at the synaptic level? For example, how might our chemical interventions, our medications like the simple element or cation lithium manipulate and change energy levels in a disorder like manic-depressive illness that is as much an energy disturbance as it is a mood disturbance?
Is there a way to imagine a better living through electrical gradients?
Yes, indeed. The salamander remains my model—again, the only vertebrate that can regenerate its foreleg, its hind leg, eye, ear, as much as one-third of its brain, almost all of its digestive tract, and up to one half of its heart. Astounding—and even more astounding is the fact that the next animal up on the evolutionary scale, the frog, has lost this capacity for regeneration. We humans can regenerate bone after a fracture and skin after a cut—and that is our limit in restorative returns. For frogs and humans, fibrosis and scarring are the order of the day.
When we look at the electrical currents and voltages at the amputation sites of salamanders versus frogs, the difference is striking. The direction of current at the injury site is diametrically opposite in these two closely related species. In the salamander, the current of injury is negative, unlike the positive current of injury in the frog. Indeed the control system that starts and regulates and stops healing in living bodies is electrical, not just chemical.
A frog’s cells can be made regeneration-ready by simple exposure to astonishingly low levels of electricity measured in billionths of amperes. But even with this electrical manipulation, the frog is limited in its ability to regenerate by its small number of cells that can dedifferentiate, that can regress into primitive embryonic cells that can later differentiate into complex nerve and blood and muscle and bone cells.
Acupuncture may be one of the only human interventions that can create a negative polarity at a wound site. The insertion of a metal needle into the skin produces a tiny electrical current, and the miniscule injury from the needle entry is nevertheless large enough to create a local current of injury. A twisting of the needle may also produce a pulsing current at a low frequency.
Somehow, some wunderkinds not unlike the Wang sisters intuitively figured out these currents, these meridians and channels five thousand years ago.
I was determined to imagine a world in which there was better living through electrical currents and gradients. I realized I was no better off than the frog; I had a limited capacity to produce primitive dedifferentiated cells after the insults of surgery and radiation. All I could attempt to do was maximize the number of these cells and optimize the development of them—to see if they could evolve into highly differentiated nerve cells and blood vessel cells and muscle cells, and see if paralyzing fibrous scar tissue could turn into reasonably healthy and functioning neural and muscle tissue.
Little did I know at the time that this effort was going to take on a long and protracted course. No wonder Western medical practices have focused on chemical cures and modulating medications. The magic bullet works quickly and expeditiously. The alternative Eastern approach is a journey seemingly without end; the Western approach is a hurried destination.
Sisyphus was no longer a myth for me. He and his myth had become my reality.
CHAPTER 11
A Funny Thing Happened on the Way Back to Potency
“Comedy is simply tragedy plus time.”
Unknown (often Attributed to Mark Twain or Carol Burnett)
Cancer is a number of powers mightier than a wart.
My friends and colleagues started sending me journal articles with well-designed studies noting that visualization could help rid the body of warts and other minor viral maladies. Visualization techniques could also manipulate the extent of an inflammatory response after a cut or laceration. Through visualization we could, almost miraculously, either increase the inflammatory response or diminish it.
Ah, the powers of the human mind—a beautiful thing to contemplate. Let’s party, let’s celebrate, let’s rejoice at the wonders of the human spirit, let’s praise man’s capacity to recover and regenerate. Prostate cancer was beating a hasty retreat, and my mind was working wonders on my body.
It was October 1989, five exact years since diagnosis and initial surgical treatment. I was feeling damned good. The surgeons kept reminding me that they had gotten it all, and for good measure we had killed any wayward cancer cells with 6600 rads of radiation. No signs of recurrence. Plus, I had managed to defy the laws of nature by re-establishing some modicum of potency and sexual functioning, with the promise of more to come.
I was continuing with regular acupuncture, having learned to administer the needles myself, with the help of Jing Wu. Monkey see, monkey do—needles into the scar tissue of the lower abdomen and pelvis to help break up that scar tissue. Magnificent visualizations of my magenta, my pink and my purple immune cells grabbing and dismantling any black and yellow fly-like cancer cells in my Venus flytrap apparatus. Magnificent visualizations of the hardened brown scar tissue becoming pink and pliable and perfused. Magnificent experiences of sex with Helen, my libido and lust as strong as ever.
W. H. Auden again: “Lust is less a physical need than a way of forgetting time and death.” I had forgotten time and death. I was in the moment, and moment after moment was magnificent.
My swagger was back. Prowess and pluck and pride were words I became reacquainted with. I left the University of Maryland to become associate director of the newly redesigned Georgetown University Counseling and Psychiatric Service, and I reassured my new colleagues and employers that I was healthy, having recovered from my “bout” with prostate cancer. My cancer had not been a secret. I had written about it in the newly established health section of the Washington Post, and Helen and I had been the subject of a profile on the “sandwich generation” in the local glossy Washingtonian magazine a few months prior—with reflections on our aging parents and our young children an
d my own health problems.
Everything seemed to be in sync.
Except, there were some flies in the ointment. The Venus flytrap had not been able to catch all the flies.
In December 1989, the surgeon in Manhattan called me a few weeks after our regular yearly follow-up appointment.
“Your PSA is rising,” he soberly told me.
“What the hell is a PSA?”
“This is a new test, the prostate-specific antigen, something we can detect in the bloodstream. We’ve been experimenting with its use here. We didn’t tell you at the time, but we’ve been measuring your PSA for the past two years. In December 1987, two years ago, your PSA was undetectable. Last December it had risen to 0.6, a borderline figure that could possibly have represented a recurrence. But since the test is so new, we didn’t know how to interpret it, and I didn’t want to scare you unnecessarily. But now the PSA is 2.1. Since you have no prostate, you shouldn’t have any prostate activity anywhere in your body.”
He could have added, but he did not, “So, now it’s time to scare you.”
“Isn’t it possible that these are normal prostate cancer cells that have come back to life?” I asked, hopeful, thinking all too bizarrely and optimistically that my visualizations and acupuncture created some immaculate conceptions. Denial is a beautiful thing. In this case it did not last for long.
“No. No chance of that.”
When these surgeons said they got it all, doubt never entered the picture—even when they did not get it all.
“I want you to come up to New York. We’ll put you under general anesthesia and look in the area where the prostate used to be and see if we can find any palpable evidence of the cancer. We can always re-treat if we find the cancer cells in the prostate bed.” Little did he or I know at the time that a PSA of 2.1 generally meant microscopic cancer disease, not something that would be visible in a surgical observation. Again, in 1989, no one seemed to have a clue on how to interpret the PSA.
He insisted, based on the scientific literature that early intervention for metastatic prostate cancer was crucial.
Yeah, early intervention—a euphemism for surgical castration—the cutting off of my balls. All that effort to save my potency, to save my pelvis, to save my life as a man—all down the drain.
I knew enough from medical school to recognize that the only treatment available for metastatic prostate cancer that has spread systemically to lymph nodes and bones and into the bloodstream and beyond the prostate, was castration. In 1941 Charles Huggins and Clarence V. Hodges discovered that prostate cancer growth could be slowed or in some cases eliminated by the removal of testosterone. Male hormones, otherwise known as androgens, were a crucial growth factor for prostate cancer. Androgen deprivation could stop prostate cancer in its tracks, at least temporarily. Huggins and Hodges had won a Nobel Prize in medicine and physiology in 1966 for their discovery.
Without the presence of testosterone, most prostate cancer cells shrivel up and die. But eventually they will find another growth factor to help them propagate and proliferate. These cancer cells have a mind of their own, the same desperate desire to survive and reproduce that I had. A formidable opponent.
Eunuchs – young boys in various cultures who have been castrated in order to make them into couriers and servants and guardians of women and high-pitched singers – never develop prostate cancer. They are immune because of their inability to produce testosterone in their castrated state. I on the other hand was facing the worst of all worlds—being a eunuch and having prostate cancer.
A new kind of castration anxiety. A literal castration terror. Sigmund Freud coined the term, castration anxiety, as a metaphor for the struggles every adult male and female, gay or straight, feels in an ongoing relationship—the struggles in being able to combine a sense of grounding with a genuine sharing of passions in a steadfast relationship. Many of us can have one or the other, but we can feel swallowed up in a relationship—we lose ourselves, we lose our solid sense of identity—when we try to establish both facets in a relationship. It is what’s called the classic Madonna-whore complex, except it occurs just as readily for women as for men, just as readily for gays as for straights. Some of us turn to our partners for grounding and support and nurturing. Others of us turn to our partners for the relief of unbearable sexual urges. Often the twain never meet—or at least do not meet in the same partner. We turn to one partner for grounding and support and to another for the sharing of passions—a phenomenon we can observe in presidents of the United States, in governors of New York, a ubiquitous phenomenon.
Freud’s choice of words was unfortunate. Being swallowed up, losing one’s sense of self, being overwhelmed by the demands of a relationship: None of these are akin to castration, especially for women.
Let’s deal with the real deal, not the metaphor. No metaphors using the notion of castration are allowed in the late twentieth and early twenty-first centuries. Huggins and Hodges with their Nobel Prize-winning research in 1944 made sure of that. Now prostate cancer and real castration go hand in hand.
The surgeon in Manhattan made that case stridently. After poking and prodding and prying around in the soft tissue around my anus (I was under general anesthesia), he later told me that castration was absolutely essential.
“Even though we haven’t found any clear-cut cancer cells, it doesn’t mean the cancer isn’t there. All the literature indicates that the sooner you get castrated the better. Waiting will only lead to your dying sooner.”
He handed me some journal articles from the New England Journal of Medicine, which I looked over halfheartedly. I got the gist: In one way or another I would be dying very, very soon—either a metaphorical death by a literal castration or a literal death via metastatic prostate cancer.
“You have two choices—a chemical castration using medication to shut down your hypothalamus and pituitary and by extension your testicles, or a surgical castration. I can arrange to do the surgical castration here at the hospital. Just say the word.”
I was speechless.
Eventually, I simply said, “Let me get back to DC as soon as possible. I’ll talk to Helen, I’ll think it over, and I’ll let you know. Don’t schedule the surgical castration quite yet.”
All I knew was that I was fucked. The classic Hobbesian choice: I will not be able to fuck if alive, or the prostate cancer gods are really fucking with life itself.
“I’m taking some time off from work,” I told my colleagues at Georgetown University. “It could be a few days, a few weeks, I don’t know how long it will be.” They all seemed to be okay with it. I had told them about some “major complications” with my prostate cancer.
I gathered around my closest friends, along with Helen, and explained my dilemma: “It seems like surgical castration or chemical castration is inevitable—sooner rather than later according to everyone I’ve spoken to so far.” We were sitting in my downstairs office at home, trying to troubleshoot. We all knew the trouble, but none of us had any bullets to shoot with.
Finally, in the midst of a despairing silence, one of my friends piped up, “You’ve gotten to this point by talking to the best minds in the medical business. You’ve never failed to get alternative viewpoints and recommendations. This is not a good time to drop that approach.”
This idea broke the impasse. Speaking to someone, an expert, anyone, had to be better than sitting there in a helpless castration-panic mode.
I got on the horn trying to figure out how to reach Gerald Murphy, who along with his colleagues had developed the prostate-specific antigen, the PSA, a few years before in a lab in a hospital in Buffalo, New York. If anyone might know how to interpret the PSA of 2.1 and what to do about it, he would be the man.
It took me about forty minutes to track him down—remember, this was long before the Internet and search engines. Murphy, it turned out, moved from Buffalo to Atlanta and was now working at the Center for Disease Control (CDC). Amazingly, I was able to reach
him on my first try.
My voice quivering, my speech pressured—with my cascading terror I barely had had any sleep for several days—I summarized my story and current predicament, with my rising PSA and a normal bone scan.
I heard giggling on the other end. Is this guy some imperious and insensitive jerk who thinks he is a gift from the gods to our lowly planet?
Boy, were my initial impressions wrong. I never had the pleasure of meeting Gerald Murphy in person before he passed away eleven years later from a heart attack while attending a conference in Israel, yet at that very moment, Murphy actually saved my life. He saved the basic fabric of my life—my work life, my family life, my marriage, my life as a man. He gave me a reprieve from castration, from the testicular guillotine.
“Listen, I’m only laughing because of the unnecessary panic in you and your doctors. Relax, go back to work. Go back to your office and help some people who truly need some help, unlike yourself. You’re fine. You’ll have a nice decent life. There is absolutely no need to panic.
“Here’s the thing: The PSA is a relatively new test as you know, and practitioners have not figured out how to use it and interpret it. I’ve had a number of post-prostatectomy patients whom I’ve followed for several years with experimental PSAs, before the PSA became a commercially available screening test. Some patients have had their PSAs rise to 18 or 20 without any evidence of palpable or visible disease. Your PSA will probably rise slowly over the next few years. The PSA of 2.l, without much doubt, reflects some existing disease, but the disease load is small and inconsequential. In a few years when the cancer becomes more consequential, you can consider some interventions.
“And, who knows?” he reminded me. “We might have some more benign treatments than castration in a few years.” I wanted to tell him I could barely imagine any treatment being less benign than castration.
A Salamander's Tale Page 8