29 January 2001:
I was wondering today about the effects of radiotherapy after having learnt that the high energy x-ray radiation they use on me is basically 100 times more powerful than a simple x-ray. That sounds a lot, but to me it becomes even more powerful when taking into account that one session radiotherapy lasts about 60 sec., which is certainly much more time than is used to produce a x-ray. In addition, radiotherapy is repeated 4 times a week. I conclude that I get a big pack of radiation which must have quite a few effects beyond the sterilization of cancer cells. Which are these effects?

The literature is not very specific about those effects. It basically states that each individual develops a specific response to radiotherapy. That's a bit surprising to me as I assume that massive radiotherapy must have some massive effects on human cells. And that these effects may impact on other areas of human well-being.

Can x-rays be controlled in terms of the area they affect, i.e. do x-rays not spread beyond the areas defined for radiotherapy? In other words: is it possible to direct x-rays to a clearly defined area of the body and that this does not result in radiation beyond this area?

31 January 2001:
Finally, we've got some rain in my little town. After weeks of dry weather, it's a relief to see it rain again. Down here, I love the rain because Mother Earth needs it more than anywhere else I have lived before. It takes a few hours after the rain and the plants are of the greenest color you can imagine. Even better than any Kodak advertisement.

Last night I dropped into a chamber concert by the Canadian singer-songwriter Suzanne Vega. What I am saying is that she played with three or four other musicians an acoustic set of her music. I like her voice and some of her songs are simply great. One of my favorites is called "Tired of sleeping", and here are two verses:

Oh Mom, the bird on the string is hanging
Her bones are twisting and dancing
She's fighting for her small life

Oh Mom, I wonder when I'll be waking
It's just that there's so much to do
And I'm tired of sleeping

© by Suzanne Vega, 1990

Isn't it ironic that I'm getting "tired of sleeping"? Well, I'm not sure whether that's really true but when I listened to the song I recalled that there are a few things I want to do, before I lose interest entirely.

This disease management system won't fascinate me until the end of my days. It's getting boring already, now that it has lost all its glamor and credibility. Why the hell should I want to study something any further which is rotten in its fundament to such a degree that those studies would turn out to be studies in necrology. Sorry, that's not my favorite domain.

I received a few e-mails, in which I was assured that the disease management system is in bad shape all over the place. Some of the mails sounded like an attempt to comfort me like, "hey man, it's not only bad in your little town, it's also bad over here ..." Well, that doesn't comfort me at all. Just because the shit has hit thousands of fans doesn't mean that there's less shit for everyone. It's still shit, people, and it needs to be called that way.

It's also no comfort to learn that the Germans will copy some aspects of the Australian disease management system. Gee, that's a threat indeed. Just because they copy it, doesn't mean it's good.

1 February 2001:
When I have the weekly visit with "the doctor", my mood gets better. It's the time to check out some things and give feedback regarding their performance as well as receive some information about my condition.

Today was the day and so I brought up two proposals which I had received from a friend in the USA. She's a nurse and she also seems to know quite a bit when it comes to deal with the disease management system.

Her proposals concerned oral health during radiotherapy and "the doctor" was pleased with the idea though he hadn't heard of it before. But he knew all of the ingredients and he felt, that I should give it a try to ease some of the difficulties regarding swallowing food. OK, so here we go an try out something different. Perhaps it helps a bit.

Discussions about the generation of phlegm in the esophagus were less successful. "The doctor" felt that not much can be done. But then he browsed through his drug directory and found a nice little piece which he prescribed with the comment that it may help reduce phlegm production a little bit, however I should be aware of potential side-effects on my heart rhythms. Wow, I thought, don't wanna kill myself because of phlegm. Wouldn't be a nice death, would it? Public health lecturer dies of heart attack while attempting improvement of food swallowing - nay, that's not a good headline.

So, and what about my performance? "The doctor" is pleased, very pleased indeed, he said. Finally, I am even able to please a medical doctor. I ain't a bad man, mum, they start to like me.

2 February 2001:
We've got the new drugs today, and the "Magical Mouthwash" is probably the best product so far. It operates as a local anaesthetic thereby allowing me to swallow food for about 30-45 min. That's the time-slot for the weeks to come.

It really has become a nuisance not to be able to eat properly. Yesterday was the first day that I felt hungry, and feeling hungry combined with the effects of radiotherapy doesn't make me a happy person at all.

I tried to sleep as much as I could if only to forget that I was hungry. It worked rather well, but it certainly is not what I am looking for. I am not losing weight, by the way, because the liquid food is so nutritious that I can keep my body functioning rather well.

The other drug needs to be cleared by "the doctor" because the pharmacist was not sure whether "the doctor" was aware of different strengths of the drug. We have been waiting now for more than 5 hours to get this clearance via telephone. Looks like we have to call back again and find out what's going on.