Big Bird, Small World

Artists around here put together an annual event called the Art Loop, in which potential patrons are encouraged to make a circuit of the studios of participating painters, sculptors, weavers, potters etc..

So we got in the car several weeks ago and headed for Lincoln, a wide spot in the road that used to be the county seat but is now best known as the stomping grounds and last jailbreak site of Billy the Kid.

Just outside town, we located the studio of Susan Weir Ancker, who specializes in ceramic sculpture and decorative pottery. Between her house and studio was a tall plinth, on which rested a handsome life-sized ceramic raven like the one above. I noticed it almost as soon as I got out of the car.

There's hardly a moment when ravens aren't circling or roosting in the woods around our place in Ruidoso, and their cawing and quorking are an almost continuous part of our soundtrack. It struck me that a raven would make a fine totem to mount on one of the tall stumps left behind after we had some of our dead ponderosas removed, victims of drought, bugs or both.

It turned out that Susan had another raven in her workshop. Less than an hour later, we were on our way with the bird wrapped in paper and packed inside an Apple computer box for the trip home. Susan said she liked to visit her works in their new homes and asked us to call her when we had it placed.

This week I borrowed a neighbor's extension ladder to mount it, a near-death experience requiring two trips to the top of the 15-foot stump, first to drive a spike into the top with a small sledge hammer and then to place the hollow but very heavy bird over it.

On Susan's advice, we sprayed the void inside with insulation foam, which would then expand and harden to grip the spike and secure the sculpture against the many windy storms that blow down from Sierra Blanca in all seasons.

I carried it up the ladder in a big canvas tote. But when I got to the top I realized I needed both hands to extract the heavy object from the bag and then lean precariously back to lift it onto its new home, not knowing how far back I could afford to bend before being forced to choose between dropping the prize or breaking my own neck.

"I don't like this, I don't like this," I whined to Pam, spotting me below and struggling against the impulse to needle me as she usually does for expressing my anxieties, since for once they were justified by circumstances.

But there's the result in the photo above, and Pam alone is not left to tell the tale.

Susan and her husband Leif came to lunch yesterday to admire it. And we were mutually astonished to learn that Leif's daughter Jessica is the wife of John Affleck, a senior editor at AP with whom I worked more than once on legal issues before I retired.

If I'd dropped the raven or lost my footing, we might never have discovered this astonishing connection, so I'm very glad I didn't.

They Picked, We Grinned

We decided to go trailer camping in the mountains a couple of hours southeast of here over the weekend. It's a beautiful drive over terrain that gets high enough that the ponderosa pines we're accustomed to give way to massive spruce and some gorgeous aspen.

Still, I always wonder why I should tax myself with the arduous, unfamiliar and aggravating rigamarole of hitching and hauling our elderly Airstream to some place where the views are no better and the amenities far worse than they are at home.

The answer is that I shouldn't without some additional incentive, but in this case we had some.

Tiny Weed, NM, has been host for the past 18 years to an annual bluegrass festival, so we looked online for an RV park near there. Pam found one about four miles away that promised a fishable trout stream where Elizabeth could try out her Barbie rod and reel.

But when we got there, the place looked like an abandoned goat farm. There were hookups, but only a few spots were occupied by a handful of dilapidated and clearly unoccupied trailers. The stream was nearly dry in spite of recent rains, and there appeared to be nobody home in the forlorn little house nearby.

We circled around and headed back toward Weed. Halfway there we came to even tinier Sacramento, where we happened upon a Methodist conference center with an adjacent RV park located next to a scary "challenge course" that looked like a place where you could train special forces or scare delinquent teenagers straight.

Near the office was a wonderful little playground and a well-stocked fishing pond. It was perfect, so I attacked the hitch again, which is just as unpleasant as getting under way, but in reverse. Each site offers unique ways of soaking or injuring me, but after 45 minutes of muttered curses we had electricity for the lights and fridge, gas for the stove, and hot and cold running water. The puddle in front of our door wasn't my fault. I threw our astroturf doormat over it.

Pam cooked some tasty burgers and we laid down for a night of what I would call zombie sleep.

The next morning we drove over to Weed, a cluster of small buildings that included a school, cafe, a few houses and the community center where we could hear the music as we pulled into the parking lot, already jammed with bulbous, mud-spattered crew-cab pickup trucks. Inside, the crowd demographic was almost entirely western geezer -- straw Stetsons, boots, belts and suspenders on the men, polyester prints and white velcro Reeboks on the women.

On stage was a family from Artesia, NM, who called themselves Blue Sky Country. To be honest, they were a little too solemn even for bluegrass, and not that great musically. But they gave their cute little daughter several turns at the microphone, which scored points with both Pam and me. Later on they came and sat near us, and the little girl carefully plaited a friend's hair while Elizabeth watched enchanted.

When the next act, Bost Family Traditions from Bisbee, AZ, opened up, they were so good it brought tears to my eyes. And they sang about people and places in Cochise County, which regular readers might recall is where Pam's granddad was sheriff. They were worth the trip.

After a late lunch of barbecue and homemade pie in the cafe, we picked up our trailer and headed home. We arrived just ahead of a thunderstorm and I managed to back Streamie onto her parking pad before the first squall hit.

My standard of success for trailering ventures is pretty low: no property damage or severe bodily injury. We did considerably better than that on this outing, so Mission Accomplished.

Schwing!!

I'd like to say I put this thing together myself, but if you know me at all you wouldn't believe me even if I actually did. Which to be clear I didn't.

No, I knew the project was well outside the scope of my meager skills as soon as the thing arrived and it took one of those little portable forklifts to get it off the truck that brought it to us.

Even the forklift was intimidated by this project. The operator got the blades under the pallet, got it raised, got it turned to an empty spot in the yard, and then dropped the load from about the height of the flatbed. "Oops," said the operator.

I told him if gravity was going to handle most of the job, we could have done the rest with a couple of crowbars and saved him and his fancy powerlifter a lot of trouble. A smart mouth is all I bring to this kind of work.

He drove away and I broke open the box to locate the assembly instructions. Soon to be a major motion picture, it runs to 48 pages of dense text and schematics, not counting the parts list. We called the multi-skilled Jerry, our go-to Home Improvement helper.

Sometimes here in the woods, where every real man has a crew-cab pickup truck and a leather tool belt, I feel abashed when I engage somebody else to do a household chore I might at one time at least have tried to do myself.

Not this time.

Jerry showed up last Saturday morning, examined the box and the documentation, and let out a soft sigh. He admitted later he wished at that moment he had told us he was too busy to do this. But now he was stuck, so he pulled out his cell and called for reinforcements.

The pants-on-fire manual said it should take two adults between six and 10 hours to turn the three cartons of lumber and hardware into a playground. They didn't even pre-drill the wood.

Jerry had three helpers for the first couple of hours. After that it was just him and another fellow, a former electrical contractor who now freelances as a home builder and driver of earth moving equipment.

Even between them and their buttload of power tools, they used up the whole 10 hours, and we still don't have the monkey bar extension and the handhold/footholds on the climbing wall.

But Elizabeth is already enchanted. When she gets up in the morning, the first thing she asks for is permission to go out for a swing and a quick slide in her PJs. Breakfast can wait. After playschool, she heads straight from the car to the sandbox. (Which we did manage to create ourselves. We hung the swings too!)

I wondered as I watched the two-tiered structure go up whether I was supposed to get a building permit, a zoning variance, file an environmental impact statement. Bringing in Jerry raised the all-in cost by 50 percent. There's not much left of our tiny yard.

But it was worth it. Even though all I did was hold my tongue when Pam placed the whopping order and write checks to make it happen, I'm enjoying a few moments of feeling like the world's greatest dad.

Gratitude and Grief

Both of us woke up around 3 a.m. this morning and listened appreciatively to the sound of a hard soaking rain falling on our thirsty pines, handicapped by drought in their mortal struggle against the continental infestation of bark beetles.

Some have already lost, like the casualty above. It's one of a half dozen or so we told Jerry, who looks after things around here for us, to take down while we were traveling. We asked him to leave the stumps high, thinking we might mount a carving of some kind on one or more of them.

So the property looked a little forlorn when we returned from New York and got our first look at how much shade the bugs have stolen from us. Worse yet, we noticed that another smallish tree has turned brown at the top and will have to go.

And worst of all, the two largest pines we have, which have been looking paler and paler with each passing season, are now past the point of denial. We can't put off the inevitable much longer, Jerry says. When there's no more juice, the beetles will jump merrily to the nearest healthy tree and party on.

This is the start of what locals call the monsoon season, when thunderheads catch their feet on the tops of nearby Sierra Blanca and the rest of the Sacramento's and spill daily deluges. But for the past several years, the rains have been increasingly meager, and the forecast for this summer and the foreseeable future is for more of the same.

Ruidoso and surrounding Lincoln County exist in a state of painful ambivalence about rainfall. On the one hand we need as much as we can get for the sake of our trees and also to replenish our own water supplies. Runoff after last year's Little Bear fire ruined several important reservoirs.

On the other hand, a heavy storm over one or more of those burned out watersheds could trigger dangerous flooding and more damage, to say nothing of the possibility of a lightning strike like the one that started Little Bear.

That doomsday scenario has raised the stakes still further on prompt removal of dead trees and brush from around homes and other structures, which will be easier to defend if there's less fuel.

Last night's rain came without thunder and seemed like the kind we could accept thankfully without any mixed feelings. We lay in the dark, enjoying the steady drum on the roof and the deck and feeling quietly happy.

Then Pam reached for her phone as she often does in the wee hours if sleep isn't coming, and there at the top of her news alerts was word that 19 firefighters were dead in a wildfire northwest of Phoenix, overtaken by some kind of catastrophic flareup or change of direction that overwhelmed their emergency shelter equipment.

Notwithstanding our comforting bit of rain, we're living in a vast region that some experts say is in the early stages of a 30-year drought. We're all betting that the lives and livelihoods we enjoy today will be the same tomorrow, but the odds are getting slowly longer and the dice are rolling daily.

After my health misadventures of recent weeks, I scarcely needed a reminder that everything you know and love can turn on a dime in a dark direction. But life has a way of sending such reminders anyway, whether you need them or not.

Um . . . Never mind.

I read on the Internet last week that one of the treatments for a benign schwannoma is to do nothing but track it to make sure it doesn't turn into something more sinister.

When we saw Dr. Singer on Thursday he confirmed this, explaining that our options were either to just watch the tumor, or to schedule surgery and take it out.

So it didn't surprise us this morning when the neurosurgeon on my case, Dr. Mark Bilsky, started his presentation with a description of the laissez faire approach. We'd heard it before and presumed the doc was just clearing his throat before he got serious about my particular case.

It was several minutes before it dawned on us that he was recommending we actually pick Door #1, the door leading to a summer free of any further medical attention whatsoever.

We had never thought this option was open to us -- and apparently Dr. Singer hadn't either -- because my schwannoma shows up on the CT scans as invading bone and grasping for major nerve conduits and blood vessels in and around the spine.

But for Dr. Bilsky, the single most significant fact of my case is that I have no symptoms whatsoever. No numbness. No loss of strength or function in my lower back, legs or feet. Most important, no pain when going to bed or waking up in the morning.

He reasons that a slow-growing tumor as big as mine which hasn't yet interfered with life as I know it may not do so for years. It's been with me, he said, "forever," meaning at least 20 and maybe as long as 30 years. An old friend.

"It may never have to come out," he said, a sentence I repeated back to him slowly, to make sure I had heard it right.

If I go ahead with surgery now, he said, I will undergo all the risks of the operating room, the pain and discomfort of getting back on my feet, and the inconvenience of months during which I wouldn't be able to do anything remotely strenuous, not even so much as putting Elizabeth in her carseat. At the end of all that, I can count on being less strong or nimble than I am now.

The only reason to accept that grim certainty, he said, is if I think I'm bound to have the surgery anyway and it would be better to have it now while I'm relatively young and strong.

But Dr. Bilsky said the odds of avoiding it entirely are actually pretty good. And even if symptoms appear months, or years, down the road and he has to operate after all, the delay won't cost me much. The spinal repair I'd require would be no greater than it would be today, and any other neurological damage inflicted between now and then can be repaired.

"I'm sorry to have to tell you this," he said. "I love to operate, and I've got kids about to go to college."

Giddy as we were starting to feel, this struck us as a real knee slapper. He wasn't done. When I said I had many well-wishers who might feel a sense of anticlimax when they heard the news, he told me not to worry.

"Oh, we can keep it going," he assure me. "We can milk it. Tell them we said the tumor is inoperable. Tell them you went to Sloan-Kettering and we couldn't take it out."

All levity aside, flying home with nothing to show for the past several weeks of psychodrama but frayed nerves and a prescription for a fresh CAT scan in four months does leave me feeling a little sheepish alongside my deep satisfaction and happiness. I know it shouldn't, but it does.

I'll get over it.

I think my friend Nancy in Albuquerque probably wrote the best epitaph for this whole affair.

"Okay, we've ridden all the rides. That was fun. Now it's time to go home. Whew."

There's No Place Like Home

I figured that with my appointment coming up this morning, Dr. Singer wouldn't bother giving me a preview of my biopsy results over the phone yesterday.

So my phone was turned off last evening and I was unaware of his call until I woke up today and saw that he'd left voicemail, with staggering news. The pathologist reported that my tumor is a benign schwannoma.

We rushed to our iPads and learned that a schwannoma originates in tissue that sheaths the nerves, grows slowly, is nearly always non-malignant, but can invade and destroy bone. It is often misdiagnosed as a soft-tissue sarcoma.

A benign schwannoma is best treated by surgically removing it, though if the surgeon doesn't get the whole tumor it may grow back. I even found a report on a Brazilian case much like mine, in which the intruder lounged in its victim's belly while gnawing away at the lumbar spine.

Surgeons in that case braced the weakened vertebrae with titanium mesh and a couple of long screws. In the X-ray illustrations the hardware looked like a kit you could buy at Home Depot.

Dr. Singer ended his brief recorded message by saying that the pathology report was "good news." It certainly felt that way to us, although you know you've accepted a new normal when learning that you need five hours of highly invasive abdominal surgery to remove a grapefruit-size tumor and reconstruct your damaged spine feels like good news.

What made it look good to us was not only that a benign tumor would not spread cancer throughout my body but also that treatment generally doesn't seem to include radiation or chemotherapy. It seemed I might be able to have my surgery and perhaps go home a few weeks later. No need for costly and uncomfortable months in New York.

We headed downtown for my 11 a.m. appointment with Dr. Singer in a state of cautious optimism. It all seemed too good to be true.

And then, suddenly, it looked as if perhaps that's exactly what it was.

I had promised Dr. Gerald Rosen at NYU that in exchange for his courtesy in seeing me informally and evaluating my scans, I would let him know what my biopsy results were. I called him from a Starbucks as we paused to caffeinate before seeing Dr. Singer.

"Hold on. Hold on," Dr. Rosen said. "I think we may have what we call a sampling error. What kind of biopsy was it?"

When I told him the biopsy was a needle or "core" procedure, he said the amount of tissue removed from the tumor was too small for a reliable conclusion on its malignancy.

"That tumor is just too big and its invasion of the spine is too aggressive for it to be benign," he said. "I think we need to get you in for a PETscan and then biopsy any area that shows rapid metabolism."

We ditched our lattes and trudged to my appointment like the rainy day parade we had just turned into. Neither of us had much appetite for further weeks of scans, tests and conflicting opinions before actually starting any treatment.

Dr. Singer began badly when we asked him to comment on Dr. Rosen's concerns. He rolled his eyes slightly and suggested that Dr. Rosen's view should be discounted since it came from "a medical oncologist," meaning, I suppose, that he's neither a surgeon nor a pathologist.

Maybe Dr. Singer guessed from something in my expression that I didn't appreciate his intramural scorn any more than I had Dr. Rosen's on Tuesday. In any event, he quickly came up with some actual responsive arguments:

1.    The pathologist says the tumor appears homogenous and it's highly unlikely that it contains any malignancy.

2.    If there is a malignant segment, neither a PETscan nor additional biopsies would have any better chance of picking it up than the first one did.

3.    A malignant nerve sheath tumor that large would almost certainly have revealed itself with chemical traces in my bloodstream which have not appeared.

4.    Even if we knew the tumor contained malignancy, nerve sheath tumors respond poorly to efforts to shrink them with radiation or chemo before operating. Surgery might still be the best option.

We wanted to be persuaded, and we were.

So the plan is that Dr. Singer will remove my little suicide bomber on July 15, stopping where it enters my backbone. At his side will be Dr. Mark Bilsky, a neurosurgeon, whose job will be to scoop out the rest and repair my damaged vertebrae with cement.

We won't be borrowing our friends' apartment into which we had planned to move tomorrow, nor will we be renting our other friend's apartment next month for the summer and fall. Instead we'll fly gratefully back to New Mexico next week to regroup, then return by car for the surgery. A post-op week in hospital. Another in a hotel room before I can travel.

If things go smoothly, I could be convalescing in the comfort and safety of my own home by the first week of August.

Of course, many a good monster movie ends with a chilling scene that leaves you wondering if the beast really died.

In this story, that would be my surgeon carrying the loathsome contents of his operating room waste bin through the door to pathology for a cell-by-cell examination.

So Many Docs, So Little Time

In her 15 years of selling Manhattan apartments to wealthy clients, Pam met a lot of smart, successful people. Some of them became good friends, and a few of those were doctors.

That's how I found myself on the phone a couple of nights ago with Glenn Agoliati, an oncologist who retired several years ago but still likes thinking about tough cancer cases. That would include mine, judging from his eager questions about what my doctors and radiology reports have told me so far.

"Could be a lymphoma," he said, echoing speculation we first heard in our second opinion, from Dr. Singer. "But it sounds to me like it might also be a plasmacytoma. That would be my first guess."

I had no idea what to make of that. In my anxiety and ignorance, I hear the bell tolling for me in any word that ends in "oma." Glenn hadn't even seen my scans, and I had no real idea how brightly his star had shone in the medical firmament. So I googled plasmacytoma to see if it looked like a death sentence, and when it didn't I put it out of my mind.

But it came back to me this morning as I sat in the small office of Dr. Gerald Rosen, professor and director of the medical oncology sarcoma program at NYU. I got his name from Elizabeth's cousin Jennifer, an NYU researcher herself.

I'm starting to understand why the author of Talking With Doctors kept trolling so obsessively for medical consultations on his brain tumor. The pace of cancer diagnosis is glacial, so you have a lot of time on your hands. Anything beats staring helplessly at the abyss.

I was only going to drop off my CD's today and ask Dr. Rosen's assistant for an appointment next week, but I got very lucky and caught the doctor himself with a few minutes to spare.  He stuck my disc in his drive and began thinking out loud about what he was seeing as he scrolled through the images.

A sarcoma? Maybe, but soft tissue sarcomas don't generally attack bone. Could the tumor have started in the bone and pushed out? Probably not, judging from its size and the way it appears to be invading the vertebrae. Lymphoma? Highly plausible, because my spleen is enlarged, often a calling card of lymphoma.

"Any pain? No? See how it's right next to that nerve? What about numbness or swelling in your legs?"

He had me stand up and come around his desk so he could look at my ankles and give my abdomen a couple of speculative pokes. "That hurt? No?"

Like me, Dr. Rosen was now very interested in seeing the pathology report and slides from my biopsy. He had his assistant call a friend in the radiology office at Sloan-Kettering to try to spring them. When that didn't work, I tried Dr. Singer's office. No luck there either, not till Thursday when Singer discusses the results with us himself.

On one point, Dr. Rosen lined up squarely with Dr. Singer. Surgery right now would be nuts and in the end might not even be necessary at all, depending on what kind of tumor I'm hosting.

"I guess they're finally starting to learn something over there," he said with a wry little grin. I smiled uncomfortably at the insider humor, not wanting to think of my Sloan-Kettering team as a bunch of quick-knife guys who only just got house trained.

"A friend of ours is a retired oncologist," I said. "He told me he thought it could be a plasmacytoma."

Dr. Rosen went silent for several long moments.

"That's a very interesting idea," he finally said. "I hadn't thought of that, but it very well could be. We really need that pathology report."

Would plasmacytoma be good news? It might be, according to Dr. Rosen, since it's often associated with cancers that can sometimes be treated with relatively mild drugs.

Glenn's star was burning quite a bit brighter in my personal firmament as I walked out the door. We're planning dinner with him and his wife this weekend. I will beat him to the check.