Pulmonologist says what?

Amy and I met with the pulmonologist for a consultation yesterday morning, primarily about the biopsy of the nodules in my lungs. Dr. Taylor is going to be the surgeon for this procedure which is scheduled for Thursday. The procedure is outpatient, and relatively low risk. Fast in the morning, get there at 11, do some more CT scans, get put on general anesthesia. Dr. Taylor will go in through the trachea with a robotic surgical tool, grab biopsies from the nodules, and be done. From there, I wake up, and Amy drives me home. Then I eat and probably watch TV the rest of the day, in a funk. Results will come back in 2 to 5 business days.  

We learned about different types of lung nodules, and that I have two that would qualify as "suspicious", both in my right lung. "Suspicious" was Dr. Taylor's word, and he was clear that it's not definitive that they are cancerous. The largest of the two is 3x4 centimeters. Everything sounds bigger in centimeters, but picture a large grape or a walnut. The other one is about half that size. It's a good sign that there aren't more, and it's just in one lung. The larger one has a couple of bumps on it that are visible in the CT scan, which isn't ideal. Dr. Taylor was careful not to give a percent likelihood based on what he's seen. I'm a data guy, at least with stuff like this, so I'd much rather deal in probabilities to get my mind around it. Based on the tone of the discussion, I've inferred that they are probably evidence that the cancer has metastasized in the lungs, but probably in the sense that France will probably win the World Cup. Or more like France will probably beat Morocco. 

I've picked Morocco as my dark horse team to win the World Cup. 

Possible side effects of the biopsy primarily fall into two areas. The most likely is coughing up some blood after the procedure.  In most cases, it will be spotty and heal on its own. More significant cases are also very treatable and would just require a return trip to the doctor. The second most likely side effect would be a collapsed lung which happens in less than 2% of cases. Apparently this just sounds worse than it is. It would probably just mean an extra day in the hospital while it heals. All okay and no anxiety about the procedure itself.

More answers will wait until (1) a consultation on Monday with my primary oncologist, Dr. Yorio, and (2) Dr. Yorio's review of the biopsy results, which will likely come a couple of days after Monday's meeting. So, sometime next week. 

How I’m feeling

Mostly good. I made it into the office today for the first time since getting the news. I'm going out to lunch with a team member, Ethan, who is leaving the business with his last day on Friday. He got a role in Nashville which is closer to where he grew up. Good guy, and sorry to see him go.  

What I'm thankful for

I've got a great group of friends that I've known since elementary school. Brendan, Dave, Carl, and Josh. We keep in touch, mostly via text these days on a group chat, but every time I see them, the connection is the same as it was in high school, college, and in our 20s. We've all gone on to do different things, live in different places, some with kids some without. But we always get the same jokes, can make fun of each other, and pick up right where we left off. Also, they're the smartest group of guys I know, each in their own ways. Dave's the funniest, Brendan's the most analytical and business minded and likeliest to break into song on a golf course, Carl has a photographic memory and deep and varied base of knowledge he can tap into to make sick references, and Josh is uniquely gifted both in writing and in music. I'd say that I'm an amalgam of the four of them, and almost certainly because of the four of them. In many ways, they are the most influential people in how I became who I am. Like me or not.

One of those friends is dealing with some pretty serious stuff as well. I don't mean to be cryptic, but he's keeping it confidential within our group. Big day for him today and sending good vibes his way. 

A Memory

I was an English Lit major at Penn State in college. My buddy Josh went to NYU, which meant a lot of fun weekends in Greenwich Village where I earned the moniker of "King of New York". We were both into creative writing at the time and would periodically send each other random shit in the mail. I still have some of it. We would often write these ridiculous plays – short, just a couple of pages, filled with inside jokes and random famous people. They were funny, but probably just to us. It was determined that if you couldn't figure out a sensible way for something to end, it was appropriate to have Alex Trebek randomly enter a scene and spontaneously combust. Again, funny, but probably just to us. 

Josh is the guy who stuck with his creative outlets, left NYU, moved to Memphis, moved to New Orleans, DJs a lot, teaches, and started a couple of bands, which he still plays in to this day. All for good reason, because amongst our group of friends, he's uniquely creatively talented. I would've liked to have seen him lean into writing more than music, but Josh sets his own path, and I admire him for that.

What I'm looking forward to

Getting a trip with this group of guys on the books. Somewhere where we can all be together, eat, drink, get outdoors, and pick up where we left off.

Something I recommend

Pancakes, for the table. Look, as adults, ordering pancakes as your primary breakfast is the sign of a maniac. It's pure carbs, covered in fatty butter and sugar. Here's 2000 empty calories, prepare to feel like shit. You're going to crash in 2 hours, and hope that you're near a toilet and that there is something good to watch on TV. And right, you decided to get a side of bacon too. Good for you. 

But pancakes for the table? That's just genius. Everyone would like to have a couple of bites of pancakes. This solves that. You share in the experience, and break bread with the group. From there, you can order your benedict or your omelet and all can be right with this world. 

What I ate

Last night I cooked up Three Cup Chicken for Amy and I. It's a Taiwanese recipe that is a garlic and ginger bomb with a good bit of spice. It's the second time I've made it, though the first turned out better. I had to debone and remove the skin from the chicken thighs, and ultimately got my chicken to garlic and ginger ratio off. Amy got me an amazing left handed chicken carving knife that made that relatively simple. Super flavorful and will go back to it again. Relatively easy, if you have a good wok. We used a ton of fresh Thai basil from our garden. https://cooking.nytimes.com/recipes/1017456-three-cup-chicken

Random thought

Money, fundamentally, is not real. It's this collective mass delusion that is dependent on this delusion to drive productivity.  Delusion might not be the right word, but it's this construct that we've all agreed upon to trade perceived value that we've either contributed or amassed. 

That doesn't mean that it's bad, good, right, or wrong. We need some sort of system to trade stuff, incentivize labor and innovation, and build amusement parks, restaurants, hospitals, and popcorn machines. But it's all a form of collective psychosis.

I find that it's important to think about it in this way when we think about things like government spending, taxes, social security, and the national debt. It's not as easy as just saying, well we can just print more. But it's not that far off. Yes, printing more requires faith and belief in the value of the more that's being printed, but that's just managing faith and belief.  In God We Trust.

Even when money was tied to raw materials like gold and silver it was just faith and belief. It's messed up that Spain was so focused on mining the New World's silver mines in Bolivia and Peru that it led to massive sustained inflation. The silver didn't add any actual value. People were enslaved, massive fleets, armories, and infrastructure were put in place to protect the silver and transport it back to Spain. Wars needed to be funded to support the continued protection of the silver mining.  But what could you do with silver? You could trade it for things that weren't silver because the people that you traded it to could trade it for other things that weren't silver, ad nauseum.

So when it comes to government spending, a general concept of good government spending would be, "How many times can we spend that dollar that we print?”. If we spend it to make a bomb that we drop somewhere, the people that make the bomb get to spend some money on groceries, furniture, a new house, etc. Which enables the people that sell the groceries, and the farmers that supply them, and the people that make the house, and the etc…to do the same. It flows through the economy. One dollar gets spent several times.

Now bombs might not be the best example. Schools, hospitals, and roads? Probably better. They do the same thing – the teachers get to spend the dollar that flows through all the same economic levers as the bomb maker, but also educates a student, who can then figure out how to add value in other ways. The Hospital funds the doctor and the nurse and the custodian to enable them to spend their money, and on and on. Roads help people get from place to place which helps the economy, while the road worker gets to save money for vacation.   

So, we can always print more so long as we maintain the delusion, and spending it enables others to spend it. 

It's possible this line of thinking isn't ready for release yet….