Daniel Menaker

“Are You Still…?”

Thursday, June 28, 2012

Dear Dan,

How can one respond effectively to the question “Are you still writing?” without some tone or other creeping in?

Meanwhile, I am happy to keep track of you via this blog, and I am eagerly waiting for My Mistake.

Best,
Katharine

Dear Katharine,

Nice to take time out from oncology for a few minutes, and very good to hear from an old friend and excellent writer, Katharine Weber.

Well, are you? People want to know!

Seriously, the problem with this question, and, potentially, any question that starts with “Are you still …” (perhaps most famously, this variant:  “Are you still beating your wife?”) is that it may, in the voice of the asker and/or in the ear of the hearer, contain an accusatory or critical undertone.  As in “Are you still writing [or have you finally given up this folly]?”  Or “Are you still writing [or have you finally realized that you’re not very talented]?” Or “Are you still going to the gym [or do you realize that your case is hopeless]?” Or “Are you still friends with Jack [or have you finally realized what a bad guy he is]?”

It may be a legitimate question, unfreighted with insult or indictment. In fact, even though I share your sensitivity about this matter, I’ve come to believe that most of the time it actually is an innocent question and could even be a hopeful one.  But if we, as writers (or gym-goers or friends of Jack) are having problems ourselves, like writer’s block or a rejected manuscript or a poor sales track or being fired, then we’ll often hear some kind of negative note in that question.  So before we attribute an unpleasant motive or boorishness to the asker, we should probably look at our own psychological state about what we’re doing or not doing–writing or not, using the elliptical or not, going to Jack’s picnic or not.

But if you don’t have the time or temperament for this kind of self-assessment, here are three possible and foolproof answers to the question:

Yes.
No.
Not at the moment.

“Ask Dan” was a public online Q&A series that ran on this site from 2010 to 2012.

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Onconversations XXXV

Monday, June 11, 2012

FRIEND (At dinner. He has had so-far-successful surgery for a sarcoma):   So, what’s going on?
ME:  Well, I have another follow-up CT scan in mid-July, which should say if and how well the radiation treatment worked.
FRIEND: You just had one in April.
ME: Yeah, my radiation oncologist guy does them every three months. Can you believe he has an M.D. degree, a Ph.D. in Physics, a Ph.D. in Radiology, and a Ph.D. in Radiological Oncology. And he looks like he can’t be more than thirty-five. Half my age. A fucking sprat.
FRIEND: That’s amazing. But why so soon–every three months?
ME: Well, that’s just how he does it, I guess. Don’t they do follow-ups with you?
FRIEND: They did, but I stopped having them after two years.
ME: Really?
FRIEND: Yes–they wanted me in every three months and then six months and then I just said no.
ME: Really! Well, do you think that’s a good idea?
FRIEND: Well, obviously.  I think everyone tests too much all the time.
ME: But isn’t a routine test how they diagnosed you in the first place?
FRIEND: Yes, and I have been lucky. But after a couple of years of negative results, thank God, I’ve had enough testing.
ME: ________
FRIEND:  I couldn’t stand the anxiety of those tests. Leading up to them, waiting for the results, going back so soon.  Unless I have symptoms, I’m not sure when I’ll have another follow-up examination.
ME: That seems pretty risky to me.
FRIEND: Life is risky.
ME: But let’s say you did the follow-ups and they found an early recurrence. Wouldn’t that give you  a better chance of survival or at least remission?
FRIEND: Maybe. But I just couldn’t live with that shadow coming back over me from a few months in the future. It takes over your life, and you live from one scan to another. I’ll take my chances.
ME:  Well, it’s true that I was surprised that it keeps on being every three months for a while.  I thought someone said three months and then six months.
FRIEND: See? It preys on your mind.
ME: Then the doctor said, “I like to do it every three months for a while.”
FRIEND: See what I mean? He likes to do it. Is he gathering data or taking care of his patient, do you think?
ME: You know, I almost said, “Let’s make it six months–what do you say?”
FRIEND: You should have.  Listen–everyone is testing too much all the time. Haven’t you noticed all the stories about pulling back on annual checkups and EKGs and PSA tests and so on? It has to do with money, charges, a whole industry. It’s not even statistically related to patients’ health.
ME: Well, all I know is that if I hadn’t had routine follow-up chest X-rays after the lobectomy, to say nothing of the chest X-ray that found the first tumor, the recurrence would have been found probably at a much later and less treatable stage. Don’t forget you’ve had two years of NED.
FRIEND: Ned?
ME: Yes, NED. Haven’t you met him. Wait–you have met him, for two whole years, and that’s what we’re talking about, and that’s the difference between you and me.
FRIEND: Who is Ned?
ME: I’m astonished you don’t know NED, especially, knock wood, since that’s what you have.
FRIEND: What?
ME: No Evidence of Disease. NED. May he continue to be your best friend and may I get to know him a little better in mid-July.

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Onconversations XXXIV

Friday, June 01, 2012

(A friend of mine–a person of great and wide-ranging intelligence–and I have an ongoing argument about the philosophical subject of Free Will. He kinda sorta believes in it, and I more or less don’t, though we now seem to have entered common upon ground. [See Oncoversations XXXIII.] The following is a redacted email exchange between him and me about this subject and, at least at the beginning,  how it’s related to my medical situation.)

FRIEND: … I love having opinions, as you know.

ME:  You are the person whose opinion I value most highly–often more highly than my own, as in this case, and as in the case where you may have helped to give me years of good quality of life with your brilliant skepticism about surgery for my lung nodules.

FRIEND: I can’t believe you’re giving me credit for that. I’m touched—and how wonderful if it were true. But man, that one’s on you.

ME: I certainly give you credit–which you must accept–for helping me by talking and thinking those things through with so much reason and logic.  If not for those conversations, I might well have made a different–and probably less intelligent–decision. Yes, the decision was on me, but you have to take credit for helping me toward it. And even if it turns out to be the wrong decision (which it actually can’t, since it’s the decision I made and we can’t know what would have happened if I’d made the other one), I will be grateful and give you credit for helping me think it through in new and different ways.  Now on the other hand, if you try to turn this conversation into some kind of exemplum of of free will, as I’m sure you must be tempted to do, I can tell you in advance that, genuine gratitude and credit notwithstanding, it won’t work.

FRIEND: You say, “Now on the other hand, if you try to turn this conversation into some kind of exemplum of of free will, as I’m sure you must be tempted to do, I can tell you in advance that, genuine gratitude and credit notwithstanding, it won’t work.”  How much of an a_____e would I have to be, to use your gracious words against you, to score some sort of cheap debating point? Besides, I think we had reached agreement.
It occurs to me—— and by the way, isn’t this a nice expression in English? “It occurs to me …” From your point of view, it reflects the fact that the conscious self is not very much in charge of its thoughts or anything else. The idea needs no help from the likes of us. I see this is an old expression, per the OED:  “1568  (1505)    R. Henryson Fables 886 in Poems (1906):  “I sall rehers a pairt of ewery kynd /Als far as now occurris to my mynd.”   From my point of view, what occurs to people’s minds is the meme, avant la lettre. Anyway, as I was about to say …
It occurs to me that one is more willing to credit the fact that other people can affect one’s decisions than the possibility that one’s conscious self can do that. Perhaps you noticed that I started emphasizing issues of persuasion as our debate marched on. In the case of other people, we don’t need to reach the question of what their conscious selves are up to. We can conveniently treat the other people (the persuaders) as integrated wholes; or as black boxes.
(Nice word, exemplum. It should be a fruit.)

ME: I was just skittering away from my own feelings–that’s all. I didn’t really think you would pick up my gratitude as a free-will cudgel.
I agree about “it occurs to me.”  About six times in the last 24 hours alone, I have tried to remember something–a name, a year something happened, etc. I failed, until the answer occurred to me. I could say that I thought about and finally came up with the answer, but that isn’t what it felt like. It felt like the name came out of nowhere (sort of a la Julian Jaynes). I just thought of one example. I was talking to_______ about New Yorker writers who were sort of created by the magazine, meaning that they couldn’t write at all but the “machine” sort of smoothed them out and made them presentable. I couldn’t think of the main example–the writer who we all thought didn’t actually exist but was kind of manufactured in the office. I couldn’t think of it and I couldn’t think of it, and then, BAM! there it was, in my mind. Joseph Wechsberg. The answer really did feel as though it had happened to me, not that I had generated it consciously.
I don’t understand “the meme, avant la lettre.”
About other people’s influence on decision-making: agree.
The answer really did feel as though it had happened to me, not that I had generated it consciously.

FRIEND: Sure. I agree that it did happen to you and that you did not generate it consciously.

ME: I don’t understand “the meme, avant la lettre.”

FRIEND:  From a book: “Ideas have retained some of the properties of organisms. Like them, they tend to perpetuate their structure and to breed; they too can fuse, recombine, segregate their content; indeed they too can evolve, and in this evolution selection must surely play an important role…. Ideas cause ideas and help evolve new ideas. They interact with each other and with other mental forces in the same brain, in neighboring brains, and thanks to global communication, in far distant, foreign brains…. Who’s in charge, according to this vision—we or our memes?”

ME: I remember reading the [wonderful] meme stuff (now), but “avant la lettre“?

FRIEND:  Ah. My favorite pretentious expression. Not that I have ever used it except in email. But I’m always looking for excuses.  You could look it up, but no one will ever explain it better—or produce better examples—than our friend Roy: “Means ‘before there was a name for [some quality or category].’ As in ‘My great uncle Llewelyn was a flower child avant la lettre….’ Or, to be really literal, ‘Snakes were making the s sound avant la lettre.’ ”

ME: But who is Roy?

FRIEND: Roy Blount, Jr.

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