Well, I'm going in. Today I reported to Vanderbilt for some lung tests- basically just like in The Right Stuff, but much wussier and much less dramatic. Tomorrow I have a full dance card at the hospital; appointments starting at 9am, but treatment does not start until 2:30pm. A heart test first thing in the morning, then a meeting with the doctor and NP, and then a little face time with the radiation oncologist who will be tasing me in the spring. Finally, the infusion- and remember, I have been promised Ritz-level accommodations during that. Really- the NP made it sound nice. We shall see. Caitlyn will come later, for what we are calling Meet and Greet those who Treat Pete.

Had a little hiccup with the Itraconazole antifungal treatment. Well, more like emesis- the hiccup's big and ugly brother (it means puking, emesis does). I'd been sailing along fine on the treatment that the docs confidently gave me for the condition they are pretty confident I had, when the nauseous side effects popped up. It's not a great story, but it has given me a little unwelcome reminder of what nausea is. For me it is sitting there with my head bowed and in my hands, doing my best not to move a muscle, using all of my energy on focusing on not emesising all over the coffee table. Luckily, a retired neighbor of mine had some medication on him, and he shared some with me. Even more luckily, it was the kind of medicine that makes music sound even better, so he turned up the jazz and we chilled on his couch for a while, and it was cool. Also, much love to our doctor friend for answering her phone at 5am and calling in an antiemitic prescription for me all the way from NYC- who knew they could do that?!

My mom sent me a cookbook today with the message "Fuck Cancer" on the enclosed Amazon card. I can picture her typing it in the Add Message field, maybe pausing for a moment to wonder whether you can write something like that in there, and then hitting continue.

Funniest thing said to me, in support of me, so far: "Um, do you want me to run a marathon for you?"
- Rebecca Childers

Caitlyn and I walked down to Star Bagel the other day for coffee and breakfast, and it was cold, but we sat outside because they discriminate against dogs. I was inside ordering when I ran into Bob Sillers, our across the street neighbor. I asked him to join us outside, and he brought his coffee and muffin out.

Bob is a great guy- he is retired, maybe 70 or so, and is part-owner of a little Italian restaurant in our neighborhood. He is tall with sparkling eyes and a white goatee and perpetually tanned skin- doubtless helped by the hours and hours he spends tending his jealousy-inspiring front yard. He is soft spoken, but there are flashes of intensity in there.

So the four of us sat outside in the chilly sunshine, talking about our plans for the day- Bob's included going to the flea market with a modest wad of cash to find some treasures. We talked a little bit about the AMP transit system that is a hot-button issue in our neck of Nashville. I wasn't sure whether Bob knew what was going on with me. I had sent out an email to a few neighbors, but Bob wasn't on the list.

Caitlyn went inside for something, leaving Bob and me alone on the Star Bagel deck. Whatever we were talking about trailed off. Bob put his hand on my leg, and I looked him in the eye.

"Pete- you are going to beat this thing." Bob's eyes bored into me. Everyone has said something about how I have a good attitude, or maybe that their friend had Hodgkins and he crushed it, but no one had made me look them in the eye and said that to me. My lip quivered and I reached up under my glasses to wipe the tears away.

"I know, " I sniffled, our Good Will Hunting moment being much shorter than the one in the movie. But this one was real, and it was something I needed to hear, in a way I needed to hear it- it just came form someplace unexpected.

You know, I love soup. I love it. Always have. When I was a kid, it was Campbell's all the way- chicken noodle, chicken with stars, chicken with rice. Beef with Barley. Maybe tomato, if none of the aforementioned were available. Cheddar Goldfish, maybe parmesan, were mandatory; I would drop them in by the handful, then skim them off the top and eat a spoonful of damp fish. When the bowl was overfished and the Cheddars were extinct, another handful would go in and get skimmed out and then get devoured. By the time I got to the sedimenty bottom of the bowl, I had probably ingested about a thousand calories worth of cheddar fish, in addition to the blood pressure-spiking sodium in the soup itself.

My mom always makes great turkey soup right after Thanksgiving, with rice and carrots and huge, sandwich-worthy flaps of turkey. And Caitlyn makes great soup- in fact, everything to her is a potential soup, and the bushels and pecks of leafy vegetables we get every week from our CSA keep us in good supply of soup fodder. There is a great cabbage and lentil soup in our fridge right now- I had two bowls today.

And now it's midnight, and I am having a chicken noodle soup, dotted with Sriracha and with a Cameron Hughes syrah. I have to eat something, because I have pills to take- itraconazole, to be specific, and antifungal that comes in one size, horse, and is filled with little 1mm balls that make a mesmerizing but fleeting sound when they go down the hatch. They dissolve better in an acidic environment, so you gotta take them after a meal, then chase them with something acidic. Soup, pills, syrah.

The only thing that keeps my current condition from being boilerplate is what's going on in my right lung. There are some cavitary lesions in there- little bubbles that are not supposed to be there. One of the reasons bronchoscopy wasn't conclusive is that the FNA probing of these babies showed no cancer- which I took as good news four weeks ago, even though that meant the scalpels were coming out. Anyway, the docs think these could be one of two things. The first, and worst, possibility:

It's a manifestation of the cancer, which, since it would constitute "organ involvement," would propel my diagnosis to Stage 4. No bueno. If that's the case, it would not alter my planned chemo/radiation treatment at all- we'd just roll on with what we have planned. The docs are pretty much unanimously in agreement that this is NOT the case- Hodgkins just does not tend to present that way. Its telltales are usually hard bumps or sinister, creeping neoplasms. I am not too worried about this, as I cannot imagine my own organs being involved in such activities.

The other option (well, not really an option)- the one that we're treating without really knowing- is that I have a fungal infection in addition to the Hodgkins. See, they did a "wash" when they did the bronchoscopy- squirted some saline around, collected it, then sent it down to the lab so the whitecoats down there could try and grow something from it. And guess what! Something's growing, but they don't know what it is yet. Something fungal. Maybe truffles. They don't know yet, and it might be a couple more weeks til they do. Might be histioplasmosis, which we're all exposed to in this part of the country, or maybe coccidiomyosis, which you find in CA and AZ and around there and has a bunch of names like "California Fever" and "Valley Fever" and also "Ol' Golden Coast dusty-lung." Well, I made the last one up, but you get the idea. My symptoms jibe pretty well with the coccidio symptoms, enough that they think that might be it, so they started me on the antifungals in kind of a shoot-first-and-ask-questions-later kind of move. I meet with an infectious diseases doctor on Thursday. And maybe the lab will call soon and tell me whether my wash is growing coccidio, or just mushrooms. We'll see.

Meaty confession, and Medical Updates

I am writing this for me, mostly, but also to give updates to the people that care. I could just write nuts-and-bolts updates, but I'm not. The medical updates are in here, but so is a lot of other stuff about what I am thinking, doing, and feeling. That's the part I am doing for me. It feels a little silly and/or narcissistic to broadcast it, but that's what I'm doing. Here's why I say this: if you want updates on me, but think the whole blog is silly and/or narcissistic, that's fine- just use your eyes and intellect to scan for pertinent information: the stuff you really want to know. That stuff, in this post, is probably like a thousand words down, at the bottom of the post.

 The bad thing about me not writing on Thursday, as I had intended to do, is that I didn't write. I did nothing that day. I woke up under a cloud that just got darker and darker as they day went on; the only sunny spot was a forty-minute visit from Elaine Wood, who came bearing homemade blue cheese dressing and clementines. We hung out and talked for a while in the mild early afternoon, then she left and it got dark again.

I went to work. I had worked on Wednesday, and that went fine- but Thursday was different. My mind was already in the dark place, and I couldn't shake it out. This was my first day after the surgeries that I had not taken a Percocet with breakfast, and I'm sure that did not help my mental state. My chest still ached, and I definitely could have- probably should have- taken a pill to dull that pain earlier in the day. But at work I wasn't feeling that bad, physically, and there came a point when I was fondling one little white pill, knowing that it would make my head hum pleasantly and make the world a little rosier, and all would be fine and it would be well worth the constipation (which, if we're being honest here, is probably the main reason I am not taking Percocet anymore). But, for better or for worse, I passed on the Percocet and wussed out on work, not having, psychically speaking, what it takes to do the whole song and dance required in the hospitality field. I drove home, where even walking the Lea felt like unbearable work.

The good thing about me not writing on Thursday is that you were spared having to read something so devoid of any positivity that it would have sucked the light out of the room you were sitting in. Up to that point I had taken in everybody's advice about good thoughts, listened to them tell me that they thought I had a great attitude (and I don't know whether I do or not- I am just matter-of-fact about it, I guess, sparing friends and family from having to hear why-mes). My response to all that, on Thursday at least, would have been "I know I'm supposed to stay positive, but this sucks, so fuck you." If I had written it, I would have meant it, but only in the moment.

Friday was better- I was looking forward to going to Vanderbilt and meeting Dr. Morgan, the oncologist that I had an appointment with that afternoon. I can't remember what I did that morning, but I met Caitlyn, Liane and Lee and Becca and L&L's minute baby Sylvia at Baja Burrito for lunch, which, for you non-Nashvillians, is the jewel of Nashville's casual food scene- a much less sterile (that's good) and less sanitary (that may not be so good) Chipotle. They make a seitan "chorizo" con papas burrito that I rarely deviate from, but I went with steak, which leads me to this aside: since I became a vegetarian in early 2010, I have fallen off the wagon from time to time- I have given in to cravings, and I have had meat at restaurants (Gary Danko, The Catbird Seat, The Hitching Post) where I felt that to avoid it would be to miss the full experience of the establishment. I fully admit to this. However, it is safe to say that, ever since I found out I was sick, I have abandoned vegetarianism like a teenage punk abandons a flaming fudge-bag on a neighbor's porch.

It started in Asheville the weekend after the wedding, where my carnivorous inhibitions were lowered by the celebratory occasion. A ribeye at The Admiral, bacon-wrapped and lamb sausage-stuffed rabbit saddle (morally probably the same as any meat, but definitely feels more evil) and a bottle of Puffeney Arbois at Table. I mean, table had a great Hen of the Woods pot pie, but surely I could not appreciate all these chefs could do by sticking to the vegetarian options on the menu.

The two weeks back in Nashville, before my first doctor's appointment, were veg. On Monday, October 29 though- the day I dragged myself to the doctor to look into my dypsnea (shortness of breath, to the lay person)- that Caitlyn and I were walking the dog, and I suggested we maybe go out and have a steak at Bob's Chop House, which had just opened and where my friend Michael Mathewes was now working. I had had the x-ray and the CT scan that day, didn't have any results yet, and was a little scared and looking to assuage my fears with wagyu. Caitlyn shot down my idea, more or less. Five minutes later, though, Dr. Sanders called with the news that I has a mass (her word) in my lung and she was referring me to a pulmonologist. I choked up as I shared that news with Caitlyn, and she suddenly felt like going out and spending $200 on a meal didn't seem like such a terrible idea, all things considered. We didn't go, but the latch to the meat locker had been lifted. Since then it has been pulled pork at work, the Green Eggs (walnut pesto) and Ham sandwich (Star Bagel), NY strip (J. Alexander's- twice), freshly-fried and moist chicken tenders (Publix deli- not too proud of that one), tender sirloin (cooked at home and enjoyed with the in-laws- Omaha Steaks delivery courtesy of the girls of 1409, who apparently were tipped off to my recidivism by Caitlyn ). I don't know if I am just being opportunistic about having an excuse to chow down on previously verboten foods, or whether I am physically craving the nutritional bounty of meat. Whatever.

But back to my day. I met Dr. Morgan at Vanderbilt, who told me he had read a lot about me before I got there, which, corny as it sounds, made me feel special and paid attention to. All my information had been forwarded from St. Thomas- they just had to take about 9 vials of blood from me, but they let me keep some. We had a long conversation, but here is the new information he gave me:

1- Hodgkins is not common- about 8,000 cases in the U.S. per year, compared with 90,000 cases of lung cancer. There you go- special again.

2- Hodgkins was also the first cancer to be cured by chemotherapy, and that was a long time ago. That is good information, as the treatments, though largely unchanged since the early days, have been refined.

3- I am most likely in stage 2, and with Hodgkins, stage 2 is divided up into Favorable and Unfavorable, and guess which one I have. Dr. Morgan assures me that, though Unfavorable is indeed the less favorable of the two, we're still talking stage 2 here, so let's keep some perspective.  For the uninitiated here, we're talking about a 4-stage scale. As Christopher Hitchens famously and darkly characterized his esophageal cancer, "I have stage 4, and there is no stage 5."

You can't be Stage 2 Favorable if you have a mass of more than 10cm, and apparently the mass I have in my mediastinum (the space between my lungs) is 12cm!!! Can you believe that? That's fucking huge! Shouldn't I feel much worse, having that thing in there? Wow. If you want to see the CT scan of that mass, you can click here. That's a horizontal shoulder-level cross-section of me. The black things are my lungs, and that thing in between 'em shouldn't be there- not at all.

In short, the doc is prescribing six months of chemo, plus some radiation to zap the interloping neoplasm in my chest. Then I should be good as new- really. The cure rate with the treatment is about 83%, and I like those odds.

Swell well-wishers

The flow of wedding presents had barely even slowed, let alone stopped, when the medical drama began, so these days we don't know whether the pastel envelope in the mailbox contains a message of nuptial congratulations or one of palliative sympathy. We don't know whether it will wish us an impossibly joyous and long life together, or humbly wish us the strength and positivity to get through the next six months. We don't know what we're getting into when we open those cards, but we are warmed by the sentiments inside, without fail. They are simple reminders that we have good people in our lives, all over.

Same thing with the gifts. Congratulatory bottles of wine have materialized: stately, patient wines to be laid down until they are called to duty on an appropriate anniversary. Alongside these gift bottles, other wines have appeared: restorative, medicinal wines ready for action; young whippersnappers that won't be allowed to lounge in the cellar. They are medicine, after all, and demand to be consumed with gusto and alacrity. For health, you see.

We already own a Vitamix, so no juicer found its way onto our wedding registry. However, some of our friends are steadfast believers that juice can't hurt in a situation like ours, so BOOM- juicer on the porch. Healing chocolate has appeared, as has prescription pancake mix. Mirth, in the form of The Onion's Book of Known Knowledge, found its way in the mailbox, assuring us that there will, if chocolate and wine and juice and pancakes somehow fail, always be laughter.

So thank you to everyone, whether you have send a card or a text or an email or a case of wine- it is nice to know that you are thinking of us. We think of you whenever we think of how lucky we are- which lately, perhaps surprisingly, has been a lot.

Much love,

PH

P.S. If you want to see photos of my three incisions, you can click here and here. You don't have to, but you might be a little curious. It's maybe a 3.5 on a 10-point grossness scale. NSFW.

No news is the news

It has been a wet, lazy Sunday around here, though not that much more lazy (for me) than the last few days. George and Kathy Gibbons got into town on the day of my surgery, and are shoving off tomorrow. During the visit they have cooked, cleaned, repaired, entertained, made cocktails, consumed cocktails, and have been all-around great houseguests and a huge help. I did a little cooking the other night, but I have not really had to lift a finger.

Dr. Gibson told me that the latest procedure would hurt more than the mediastinoscopy, and it was not a lie. In fact, I feel fine- not sick, not nauseated, energy is fine. It's just that my right upper chest area feels like it was slugged by a nine pound hammer, and that feeling is slow to go away. I was thinking of going back to work, maybe on Saturday, but it seemed kinda pointless- I would give myself a pass the weekend after surgery (full disclosure: the fact that it was a very consequential Saturday deep in the college football season was a check in the "stay home" column).

The pain has been miserable at times, but I won't pretend that I have suffered past few days; in fact, it has been fun. I am a little anxious to get out of the house and go back to work, but we have made the best of these circumstances by doing things around the house and enjoying great meals and drinks. It has been a mini-holiday.

I am being spared further medical procedures involving scalpels this week- I just have to go in for a PET scan on Tuesday, which will help the oncologists stage my illness, which will determine the best course of treatment. Right now there are a couple of unexplained nodules in my lungs, which are the only evidence of this not being standard-issue lymphoma- all other signs point to run-of-the-mill Hodgkin's. Because of this little question mark, Dr. Peacock is going to parade my films around some kind of lung convention that is going on this Monday. If those eggheads can't figure it out, then they'll call in Dr. House.

Friday I go to Vanderbilt for a second opinion, and that's my week.

An answer or two

Woke up bright and early on Wednesday not exactly pumped about the Wilt Chamberlain procedure, but ready to do the last final thing that would give us a diagnosis that we could really hang our hats on. We had a little cold snap here in Nashville- it snowed on Tuesday morning- and Wednesday morning was bright and sunny and about forty degrees. Lately my world has started and (mostly) stopped with doctors' appointments, but I can't expect everyone's to, so I excused Caitlyn from pre-op duties; they are boring, so I told her just to be there when I woke up from the 1 o'clock surgery. She drove to work and I walked the three miles down to the hospital and got there at about 10:15am. For better or worse, most of the admitting staff and nurses recognized me.

Caitlyn had had a long talk with Dr. Gibson the night before, grilling him about why it was necessary to go in yet again when we thought the previous procedure was supposed to clear everything up. Basically, they try and do as little as possible to get the information they need. They'll start with the minimally invasive bronch- not enough. Next up, mediastinoscopy- still not enough. And down the line. Hopefully this one would be the last stop on the road to being turned inside-out like a Bodyworlds cadaver.

Dr. Gibson texted Caitlyn in the morning, informing her that he'd be talking to me about doing a bone marrow biopsy in addition to the planned procedure. Of course I was hesitant to have another procedure tacked on, but Dr. Gibson made this simple and convincing point: If it is Lymphoma (which we think it is) we are going to have to do this eventually. After my cursory research confirmed that a bone marrow biopsy involves jamming a very sturdy needle through bone to get a sample of the marrow- and is usually done only with local anesthesia- my pain-avoiding instincts took over, and I told 'em to let it rip.

So I was in the anesthesia lounge, 2-for-1 coupon in hand, when a nurse casually asked about putting in a PortaCath. She told me that Dr. Peacock had ordered it, and my response was "I haven't even fucking met Dr. Peacock- why is she ordering anything done to me?" Turns out the PortaCath is something that, just like the bone marrow biopsy, would have to be done if lymphoma was the diagnosis, which the docs were banking on (The PortaCath is basically a valve they plant in your chest so they can give chemo treatment without punishing your veins with the toxic treatment- very thoughtful. If your chest is a basketball, and the PortaCath is the needle valve.).

So my 2-for-1 was now 3-for-1, and they wheeled me off to the OR. I breathed "oxygen," and then it was three hours later and Caitlyn was there. I didn't expect them to rush out with a diagnosis- I had an appointment with Dr. Peacock on Friday, and I expected to learn everything there- what I had, what stage it was in, and what we were going to do about it.

The Gibbonses fed me on Wednesday night, and we did not hesitate to tear into the generous vinous care package sent by Scott Uyeda via Ridge Vineyards (well, not until Thursday- something about general anesthetic and alcohol and depressed breathing and blah blah blah).

On Thursday evening Dr. Gibson called to tell me that the diagnosis was Hodgkin's lymphoma- not good news, but not unexpected bad news. And there was some good news attached- the lymphoma was not present in the bone marrow sample, so chances are the disease is not too advanced.

This morning I met with Dr. Peacock, who needs one more- just one more- scan to really say what stage this disease is in, but she is leaning Stage 2. My chest is bare and bruised and carved up a bit, but the surgeries are over for now, and I believe we are turning from figuring it out stage to figuring out what to do.

-oscopy vs. -otomy

A mediastinoscopy is when they make a half-moon shaped incision in between your collarbones. A mediastinotomy is when they cut your chest along the sternum,- through some muscle, if you've got any there. The -oscopy, you were told, would be definitive. The -otomy, you are told, will be definitive. The -oscopy hurt a little, the -otomy will hurt a little more. The -oscopy took 8-10 BB-sized pieces from your lymph nodes, and the -otomy will take a golf ball-sized chunk. The -otomy is also known as the Chamberlain procedure. The Chamberlain procedure is tomorrow at 1 pm.

Diagnosis: no bueno

So, I am 0-for-2, in terms of diagnosing myself with my own gut feelings. When the doctors first told me I had a mass in my chest, I was sure that I was one of the rare and unlucky non-smokers with lung cancer- and I was wrong, thankfully. And after the doctors told me that the bronchoscopy I had was inconclusive, but did not show any cancer cells, I was sure that my illness was just sarcoidosis: not something you want to run out and get, per se, but a lot better than the alternative.

So I didn't exactly skip and whistle into last Thursday's surgery, but I went in pretty damn sure that the more-invasive but much-more-definitive mediastinoscopy, which involves an incision in the throat and the removal of all or some of a lymph node, would clear lymphoma's name. Sarcoidosis, the pulmonologist told me, is pretty much diagnosed by elimination; you go in, and when you don't find anything else, you are pretty safe assuming that what is there is sarcoidosis. The doctors told me that they would not have a full pathology report for a few days, but they would have a preliminary diagnosis (i.e. sarcoidosis or lymphoma) the day of the surgery. So, as the anesthetic was wearing off, as I was drinking my second Coke (they were out of Sprite), and as my mood was brightening, the doc came in to check on me. I said, with the positive intonation of a guy who's sure that he's about to receive the less-bad news, "so, you think you'll have some kind of diagnosis this afternoon?" The doctor didn't exactly do the index-finger-trying-to-loosen-a-too-tight-collar thing, but I'm pretty sure his answer started with "um, yeah, about that..."  The thing is, they had run off, node in hand, to a microscope immediately after the procedure, and had seen as much as they had to see. Diagnosis: no bueno. Lymphoma.

(Side note, and the only thing so far that has made me raise an eyebrow at the medical-industrial complex: Going into the bronchoscopy, the doctors were quite confident it was either sarcoidosis or lymphoma. There was a slim chance it was one of several lung infections, but those usually occur in spelunkers and bat-tenders and those who travel to steamy, exotic, dung-laden locales, so my likely options were more pat. An inconclusive bronch (which is what happened- remember, sarcoid is the diagnosis of exclusion) would necessitate the mediastinoscopy. A conclusive bronch (i.e. lymphoma) would require a mediastinoscopy for a more specific diagnosis, as well as to "stage" the cancer. In other words, I was getting the mediastinoscopy, regardless of the results of the bronchoscopy. I mean, I'm not saying I got ripped off- I just feel like I got my tires rotated when they knew they were gonna replace 'em anyway.)

And now it's Tuesday, and that's still all we know; we don't know whether it is Hodgkin's lymphoma, non-Hodgkin's lymphoma, or Bob Hoskins' lymphoma. Apparently the pathology lab is taking their sweet time ( I don't really know that- maybe they're just very busy) and my doctors don't have enough suction with them to hustle it along. Maybe they'll call me today or tomorrow- I don't know. Next step is for me to meet with the oncologist, Dr. Peacock, on Friday- in the conservatory, with the candlestick.

So I decided to blow two years' worth of dust off of this blog instead of emailing updates- you can follow it if you want. I did not change the "blogger profile" that I wrote a few years ago- most of it is still true. I did notice, however, that I listed "rarely going to the doctor" as an "interest." Ah, what a brash, young, healthy, smug little fuck, that would write that. That was true, at the time, and it was a perfectly reasonable thing for a fit vegetarian with a healthy love of wine to write- I had cracked the code on health.

Ha! Not. So. Fast.

PH

Bad Guys Win

A few months ago, my lawyer buddy Sam and I were talking about the case of Snyder v. Phelps going to the Supreme Court. I told him I knew how I felt about the case- my position regarding the vituperative homophobes of the Westboro Baptist Church and their brainwashed sign-bearing children is unambiguous- I was just trying to figure out why their vile funeral protests should not be protected by the First Amendment. I was struggling with how to be for the First Amendment and also be for the WBC having to sell all their holdings to pay damages to the Snyder family. I knew where I wanted the line to be; I just hadn’t found the convoluted logic to draw it.

This was the no-brainer case that found rednecks, gays, average Joes, suburban moms, military families and veterans all standing on the same side- against a group as broadly detestable as any Marvel villain. No matter who you are, chances are there is something the WBC does, says, or stands for that turns your stomach, and the reasonable public was rightly rooting against them. But if only making them shut up were as easy as wishing them harm. If only justifying banning their right to expression were as easy as reviling them, this case would have been open-and-shut.

So in my heart, I was sorry to see that the Supreme Court nearly unanimously ruled in favor of the the Phelpses and their deluded flock- because the guys nobody wanted to see win, won. There was not happy denouement. There is nothing heartwarming in the Court’s denying satisfaction to the grieving and seemingly star-crossed family of a dead soldier.

But my greater feeling, or maybe the feeling that I have no choice but to be left with, is that this is our periodic reminder that we are not to be governed by the visceral or ruled by collective public outrage, but by principles much more detached and steadfast- a reminder of why we have an objective Constitution that we go back to over and over again. Of why we don’t just make it up as we go. Because when we feel acute pain, we flinch, and we just want to make the hurting stop. Times like these are why we rely on core values that can’t feel pain- that never flinch.

It’s easy to cheerlead for the First Amendment when it concerns uptight moralists railing against smarmy smut peddlers or clownish devil-worshipping metal bands-these are relative Milquetoasts. But fighters don’t prove themselves against meek challengers- they have to knock out fierce and worthy opponents before we know they’re for real. And this decision is one for the ages: a reminder that the First Amendment is a heavyweight, whether it makes you stand and cheer or cringe and look away.

What's the outrage du jour? It's today's outrage.

I like to be in the loop, and I like to fit in, so I need to know: Is this whole airport body-scanner/pat-down thing the thing we are caring about this week? I mean, this thing got pretty big leading up to Thanksgiving: folks talkin' bout voicing their displeasure by opting out of the intrusive and personally humiliating scanner screening, and opting into what I've heard is an even more intrusive and horrifying full law-enforcement pat-down. Why opt for the worse option? Well, because it is slower, and (ostensibly) a bigger pain in the ass for the TSA, thereby causing huge delays, thereby embarrassing them (the TSA) and really getting the message across. Really, though, it seems like it's a bigger pain in the ass for the people behind you in line that just want to get where they're going, which seems to be the reason why the protest kind of fizzled. Rightfully so- I think it would have punished the TSA much in the way that refusing to do your homework and failing that class punished the teacher you hated so much. I just don't think it makes the person you want to make pay, pay.

So, Thanksgiving disaster averted, but Christmas looms.

Quick catch-up, if you need it: New scanners show ghosted nude image of traveller to some officer at remote screen in on-site closed room. Images are not stored, nor are they capable of being transmitted (says TSA). Don't wanna play that game? You gotta get frisked like Chevy Chase in Fletch. Oh, and there's a little radiation involved in first method, but not much. Less than in a McRib. Third option is driving to your holiday destination.

The reason people are opting out of the scan is not the radiation, but the thought of a stranger seeing a naked image of them. Also, people don't like the possibility of the image being associated with their true identity and being leaked on the internet, I guess. Knowing what I know about diminishing returns, I imagine that the screeners checked out the genitals on maybe the first five images, then got bored (or worse) and started doing their job.

As for the leaking of images, who would do that? and why? unless Scarlett Johansson and hubby Ryan Reynolds are travelling together. Disputed, though, is how much of a nude "picture" the picture is. I propose this test: send the aforementioned couple through a scanner monitored by male 40 y.o. screener. If image of Johansson (straight screener) or Reynolds (gay) provokes erection, then images are probably intrusively detailed.

I bet if I thought about it- I mean really read up on it and put some serious cognitive energy behind it, I might be outraged, too. I might think it is un-American and a violation of the Constitution, which is so in right now. But my gut instinct? Well, I guess I don't care that much. I doubt I would like the pat-down, but I doubt it would ever come to that, because I doubt I would ever care enough to opt out of the body scan. I've had one. I mean, I have dealt with airport security for years, and I just accept it now as a pain in the ass; but I get the point. Sure, I'd like to walk onto a plane as nonchalantly as one gets on a bus or train, but that ain't happening. Had the terrorists roadjacked the overnight 'Hound from Columbus to Memphis and crashed it into a Waffle House, then maybe the whole thing would be reversed, and flying wouldn't be the hassle it is.

But they didn't, so it's not, so it is. Hey, I don't like the metal detector. I don't like worrying about if I have a wine-opener in my bag, or my keys in my pocket, and now I have to take off my fucking shoes. What I really hate is when they go through your bag- that bothers me more than a thorough pat-down would, but maybe that's because I am in pretty good shape but am a very messy packer.

But, like I said, I guess I just don't think about it that much. Or hadn't until now, when I heard voices out of this tinny uproar telling me how much I should care about this violation of my rights. How I should be outraged too, and if I'm not, then I'm a part of the complacent problem.

My response to that is this: I think about what they are doing to me in the airport as much as we collectively think about the implications of gassing up our cars. Or as much as we think about whether or not we should eat meat. Or downloading music illegally. Or maybe as much as we think about shopping online to get the cheapest whatever from wherever while our neighbors' businesses go belly-up. Or maybe about as much as flinging an empty water bottle into the trash.

See, because pretending to care takes nothing, and really caring is an energy- and sometimes joy-sucking slippery slope. It takes thought. It is infinitely harder to actually care, because that requires self-awareness and action, and meaningful action hurts.

THANKS FOR THE BIRTHDAY WISHES!!! I LOVE YOU ALL SO MUCH!! YAY! updates the birthday girl on Facebook. I wonder what meant more: the hundreds of Happy Birthday!s from acquaintances who were reminded of her birthday by a machine, or the hand-written and stamped card from Grandma that got there two days early. Who showed that they cared?

The United States has been illegally wiretapping its own citizens regularly since 9-11. This is old news. Tax dollars subsidizing companies whose executives make in a day what most of those taxpayers make in a year? Common knowledge. We fought a war in Iraq based on false pretenses, and thousands of people have died there. Scores of thousands, really, if you count Iraqis as people.

So if you don't like all this airport stuff, fine. I respect that. But if you want to care, I hope you started earlier, and you better not stop now. Because every day things happen to be enraged about, to care about, and to cry about, and we just look silly when we don't notice until a strange hand grazes the underwire of our own personal bra.

Wealth Imitates Taste

Wealth imitates taste.

I spent a couple of pretty happy years working at Craft, chef celebre Tom Colicchio’s westernmost outpost, in Los Angeles. We worked hard and were rewarded, thanks to the restaurant’s location in the shadow of the Creative Artists Agency building, with myriad celebrity sightings, ranging from the silly to the sublime. I and my barmates served a cheap Australian blend to Rupert Murdoch (really) and a cranberry juice and soda, sans Jack, to Slash (REALLY!). We had true gourmands and camera-happy Top Chef-bred food fetishizers. Reality stars and filthy-rich nobodies whose trophy brides had trophy breasts hoisting trophy baubles. It was not just a job: it was a spectacle.

One time I was talking wine with an Everyman guest (not the same, generally, as the kind of Everyman you find outside of Craft, btw). As I swirled my glass and he polished his monocle (ok, not really), I asked him what kind of wines he preferred. His reply was curt and dismissive: “Cult cabernets.”

Cult cabernets.

Period.

Those were his favorite wines. No specific vintages, no producers; no real properties that he preferred. Just “cult.” Whereas one statement of preference or taste usually begets another, prolonging and enhancing the discussion, his was haughty and superior: a real conversation-ender.

The “cult” term is thrown about pretty liberally these days in the wine world, but it refers to wines that, due to high ratings or extraordinary quality or low production or mystique or maybe all of these, are in such demand that they are all but impossible to get. Wines whose attraction lies much more in their rarity than their quality (I’m not saying that these are not good wines, mind you, but once you reach that status, you sell out no matter what, and people say you’re great no matter what). What this man was telling me was that his taste in wine is not based on the actual taste of the wine, or how good it is, but on how rare it is. I mean, you don’t sniff or sip wine and pick up notes of cult. What he really loved about it was that you can’t have it. He spoke about it like he knew what he was talking about, but all he really knew was that he could manage to plunk down a few Benjamins per bottle. At the time, I didn't know that I had grazed the tip of a peculiar cultural iceberg. In fact, at the time, I may have even been a little bit impressed.

But wealth imitates taste, and this guy was a first-class jerkoff.

Wealth imitates taste. I read this pithy statement somewhere; I think it was in Jonathan Nossiter’s Liquid Memory.

What does it mean? It means that wealth is too often (ab)used to affect taste. To fake taste.

What is taste?

That’s tough, but I would say that taste is a learned, earned, and educated preference for certain things. For anything. Wine, fast food burgers, guitars, sailboats, whatever. You name it, you can have taste in it.

But here’s the thing: you gotta earn it.

Wealth imitates taste, and it is everywhere.

It is in the suburbs of San Francisco, where doughy venture capitalists’ $3000 bicycles see more mileage secured to the back of their Porsche Cayennes than on their own (the bikes’) lightweight rims.

In Belle Meade, TN, where gaudy monogrammed handbags inspire great envy.

On Mount Everest right now, where teams of Sherpas practically carry rich tourist-“adventurers” up the daunting (for the Sherpas, at least) mountain.

On Nantucket, where flush “sailors” hoist their mains and slack their jibs with the push of a button, instead of with their milky hands.

Now let’s be clear: There is nothing wrong with wealth. Wealth is fine and dandy. Who doesn’t aspire to, or enjoy, financial comfort?

Let’s also be clear about this: Wealth does not indicate a dearth of taste. In fact, it can be quite the opposite, as wealth can be a great enabler of taste. The wealthy wine lover does not have to dip into Junior’s Ivy League fund to buy a bottle of Brunello, and that’s a good thing. The wealthy sailor may be inconvenienced, but is not grounded for long, by a broken rudder, and that’s a good thing. But there is no wisdom in wealth alone: it can only be an ally of taste, not a substitute for it.

Because taste- true taste- is earned. It comes when you don’t expect it, because you aren’t looking for it. You don’t set out to “get” taste in something. Know why? You are too busy doing, enjoying, struggling with, or even cursing whatever it is that you have a passion for. You don’t set out to become a sailing enthusiast: you are too busy sailing enthusiastically. You are too busy drinking wine, riding your bike, writing or surfing. You are too busy reading or playing guitar or painting or backpacking. And when it comes time to spend on the tools of your trade, you spend with thought and prudence.

The wannabe with more money than passion or patience just spends, and the world’s salesmen salivate. He gets the biggest and baddest _________ because it’s the best- because the salesman told him so. The boldest and priciest wine, the glitziest boat. The wannabe autophile goes straight for the Lambo. The sailor with more cash than experience goes for the flashiest automated behemoth he can get his hands on (on second thought, maybe we should count “automated” as a virtue w/r/t crashable things). He is the fish in the commercial barrel, for he has not taken the time to swirl and spit or strum or sail. He wants the cred and he wants it now. Bells and whistles? She of true taste knows which bells she will ring, and which she can do without. Leave the superfluous whistles to the rich sucker- let him blow them.

On the subject of bells and whistles, have you heard of the Fender “Relic” series of guitars? It’s like the guitar version of distressed jeans. You get a Strat or Tele (and maybe other models) built to the specifications of a long bygone year, its color sometimes even determined by some famous rocker’s iconic axe. They’re brand-new, except that the paint on the body is chipped and faded in strategic places, the neck is practically worn bare, and it’s all done at the factory for you. Oh yeah, they'll cost you some dough for sure- AT LEAST a couple thousand bucks: more than a regular old new one. It’s cool- they make it look like it has been played for years, and you don't even have to rock out on it; you just have to shell out for it. The hope, I guess, is that when your friends come over and see it, they say "Hey man, have you been secretly touring with a rock band for the last twenty years?" It is the shortcut incarnate. It is the musical equivalent, as one blogger deftly pointed out, as a 4X4 truck with spray-on mud: a towering monument to missing the point.

Because real taste grows by millimeters, not miles. It can be baffling and peculiar. It can be fickle, but when it is true, the one thing it can’t be is wrong. Sure, it can be argued, but it is not swayed by the breeze. It might budge a little from time to time, but that’s because he who has it is curious and hungry for more.

Feigned taste is all wrong. It is directionless and vain, show-offy and vulgar. It is baseless and desperate. It changes with the latest trends and rumors. It blows in the breeze. And where true taste is steadfast, ersatz taste is shrill.

Wealth imitates taste. You know it when you see it.

Just don’t be it.

So go do whatever it is you are passionate about. Go get wealthy, if you want, and go spend that wealth on the objects of your passion. And if the thing that you are passionate about makes you rich, then all the better.

But for heaven’s sake, have some taste.

PH

The Matter of Age

If you're like me, when you hear about someone doing something you want to do, notching an accomplishment you dream of notching, you think about age.

Your age.

Then their age.

Then your age again.

And you also wonder if you, at your age, are hopeless. If you're like me, there is a steadfast part of you that knows that you are not, but there is also a quivering, insecure part that is always thinking that maybe you really are just as (or, God forbid, even more) pathetic than you fear; that you really do have nothing to say, nothing to contribute, and nothing to offer the world but sad envy of those that have more to offer the world than just sad envy. This part of you is so consistently quivery and insecure that it rivals the confident part of you in its steadfastness.

I just turned 33 and, like I have done around other birthdays, I wondered. This year, though, I wondered and I looked- I did a little superficial research on folks that popped into my mind: some that I admire, some that I know (I didn't have to do research on them, I guess), and some that lease a little space in my head for whatever reason. I ran a cursory check, leaning heavily on Wikipedia, on what they were doing when they were my age or thereabouts, or about how old they were when they did some of the stuff for which I admire them.

David Foster Wallace, my favorite writer and once-living proof that God loves the English language, was at my age busy wrapping up Infinite Jest, his chef d'oeuvre and a dizzyingly complex and compassionate novel. Of course, one assumes that he didn't just dash off his nearly 1100-page doorstopper that year; the man was hard at work on what is a true work of genius during his late twenties. If you've read it, you get it. If you haven't, just think of how much work it would be to mindlessly type 1100 pages of nonsense. I mean, a lot people haven't even read 1100 pages since leaving school. DFW was 35 when he received a MacArthur Fellowship, and 46 when he hanged himself.

Tom Waits, who I consider to be (perhaps) the greatest songwriter ever, could not possbily have growled out the weary wisdom of Closing Time or painted the vibrant and dismal dreams of Small Change before age 35, could he have? He could have, and he did. Small Change, Waits's gravelly, lewd and lurid masterpiece, was done two or three years before he hit 30; Closing Time, The Heart of Saturday Night, and Nighthawks at the Diner years before that. Bob Dylan's youthful creations are the stuff of legend, but a lot of those early tunes are dreamy and vague enough to be something that you, frankly, could picture coming from one in his early twenties. But "Invitation to the Blues"... at 27 or so? This is stuff so artful and painfully real that it makes Waits seem more medium than musician.

I've always assumed, since I learned the song at least, that Nashville hitmaker Phil Vassar wrote the smash "My Next Thirty Years" on his thirtieth birthday, which he may have, but he was 36 when Tim McGraw took it to number one. McGraw's first number one, "Don't Take the Girl," came the month he (McGraw, not Vassar) turned 27.

Cormac McCarthy was 32 when he published The Orchard Keeper, his first novel. At that same age, Sarah Palin was elected to the city council of now world-famous Wasilla, AK.

David Cross was well on his way to making mainstream comedy look even dumber with his and Bob Odenkirk's too-beautiful-to-live Mr. Show, which started when he was 31. Roger Federer at 28 had won 16 of tennis's Grand Slam tournaments, each of the four at least once. In fact, anything Federer has done, he has done by 28. My brother Andy was almost 33 when he completed his first (and, um, last) Iron-distance triathlon. My sister-in-law Diane was just 30, and her uncooperative ankles were 96.

If procrastination and lack of focus are the Nazi gunners on the Omaha Beach of your creative life, then think of Steven Pressfield's The War of Art as your BAR, your Colt 1911 sidearm, and your pack of Luckies. Pressfield slugged it out as a screenwriter through his thirties and forties, and was over fifty when he published The Legend of Bagger Vance, his first novel. He was nearly 60 when he bestowed The War of Art on us.

Andrew Ross Sorkin, the NY Times mergers and acquisitions writer who wrote Too Big to Fail and looks like he's 26? That guy is like 33.

I remember reading at the van Gogh museum in Amsterdam that Vincent did not even decide to fully dedicate himself to being an artist until age thirty. I was approaching that age at the time, and I found that heartening. He painted The Potato Eaters, widely considered to be his first great work, at 32.

Oprah was given (or earned) "The Oprah Winfrey Show" at 32, and soon had Phil Donahue on the run. Quite an accomplishment. That was the same age, approximately, at which George W. Bush accomplished a DUI at Kennebunkport.

That girl from California that attempted to sail around the world solo? Well, she's only sixteen, but she flopped big time. Reinhold Messner didn't flop, though, when he summited (which is not a real verb, BTW) Mount Everest WITHOUT SUPPLEMENTAL OXYGEN at age 34. This may just be the most impressive feat by anyone, ever. He basically hiked to the cruising altitude of your average commercial airliner, just breathing whatever God left up there. To put this in perspective, just think about how you feel after walking up some stairs. Like up 2 flights of stairs. Wow, right?

If you're like me, you know you haven't climbed your Everest. You know you haven't written your Infinite Jest, or painted your Starry Night. But how about your Potato Eaters? Have you finished that yet?

Have you even started?

PH