A big medical week

16 Dec

Yesterday the last in the current series of consultations confirmed the findings of last week's visits. I had the skin on my back checked for damage from the radiation. There were sensitivity, strength and capability tests around my legs and feet. With the lowered PSA, all the signs are that the cancer in my L5 vertebra has not put significant pressure on my spinal column.

We will no doubt be watching my regular PSA tests for indications of resurgence of my Gleason Grade 7 cancer. And if further radiation treatment seems to be required, we would prefer not to do that within a year. So, hopefully, I have a kind of warrant of fitness for a comfortable and medical-incident-free 2015. That's an outcome we didn't anticipate a year ago.

Thank you, Aragon and all the diagnostic benefits given to me In June and July while I was being considered for the for the ARN 509 Trial through North Shore Hospital. And Astra-Zeneca for quarterly implants of Zoladex. And the amazing NZ health care system which has spent an inordinate amount of money on this near-octogenarian over the last ten or twelve years. That's a lot to live up to, I guess. But I'm getting on with it. Life is so good.

11 Dec

Two consultations today… Ninety minutes’ drive into the city to meet again with the charming and ever-enthusiastic Frith (See 18 Sept). She was just back from an international prostate cancer experts’ junket in Portugal where there’s been interesting news of another drug trial with encouraging outcomes for men who receive chemo as the very first therapy after diagnosis. Well, that opportunity passed for me a dozen years ago.

But the good news is that the drop in my PSA during the last three months suggests that we will do nothing for another quarter. I am all in favour of doing as little as possible. We had a droll conversation about whether I should invest in much-needed glasses? (“Definitely!”), Do a $500 upgrade my video editing program? (“Why not?”) and go on a cruise? (“Well, perhaps not if you are going to take a couple of years to save up for it”). I forgot to ask about hearing aids and my ropey left knee prosthesis which is creaking ominously… But that was all pretty encouraging.

And so off to do a bit of windowshopping to fill in some time before Urology in the early afternoon at North Shore. I had nothing to complain of so there was nothing much to do there, either. We had another pleasant chat, collected a routine prescription or three, and said a final Goodbye. I won’t need to return there until, Madhu hinted a little mysteriously, I need a “bit of a plumbing job later on”. H’m… Well, if Frith is right, that won’t be for a while yet.

Considering the fairly vigorous nature of my cancer, and the absolutely regular rate of increase of my PSA for several years until October, that’s all a pretty good outcome. But we will still keep Monday’s appointment with Radiation Oncology…

8 Dec
I haven't started on this week of interviews yet but I have just now obtained my latest PSA result. It is about one-third down on the last quarterly one. 
Up until last June my PSA had been rising steadily at more than 50% increase per quarter for several years, and that's largely what prompted our move to the Village. So this is a significant trend, especially considering that we gave up bicalutamide nearly three months ago. It would seem that the targeted radiation on my spine has done some good.
I guess the discussions in the next few days will focus on whether we should start up an equivalent for the discarded bicalutamide. And no doubt some other options will be considered. But, all in all, if nothing else is done, this is an encouraging sign. It's some justification for all the time and professional skill and support lavished on us this year.

6 Dec
The other day I had my three-monthly Zoladex implant. That must be about the 40^th I’ve had since embarking on my prostate cancer journey. They cost several hundred dollars each so my bonus of extended life has come at some cost to the NZ taxpayer.

I also contributed more blood for a quarterly PSA test and some other tests which are going to be of interest this coming week. For I have appointments with three difference specialties in the next few days, each of them involving traveling into Auckland and traipsing all over the place trying to find the right offices. At least, with a bit of cajoling of the ever-sympathetic booking clerks, I have managed to get two of them on the same day – even if in different parts of the metro area.

So we will listen to the words of wisdom from another half-dozen people this week and, no doubt, have to make more decisions as to where we go with this journey from this point.

We have made one decision, pretty much unrelated. In January we are going on a two-week cruise around the bottom of New Zealand and across to Australia where we will have a further few days with family. 

Meanwhile, we are enjoying our Barbershop Chorus as we sing our way through gig after gig in our Village community and local venues. One touching moment was for our male quartet to make a hospital call on a former member who is coming to the end of a cancer journey. I’d never met him before but I naturally felt a poignant affinity with him. It was great to be able to see him perk up as he tried to sing "Riverside" along with us.

Perhaps the rest of the quartet will come and do that for me some time. How will I handle that, I wonder? I hope I can give them back as much as Ron did yesterday.

End of Life Choice? - What choice?

Ian Lees-Galloway

So Labour Leader Andrew Little has "told" Ian Lees-Galloway that he is not to put his private member's End of Life Choice bill back into the parliamentary Ballot Box.

I was not unsympathetic to the decision made that the EOLC bill be withdrawn last year so that it did not become an election issue. That was understandable - to a degree. But I am now deeply disappointed that the party leader who is trying to convince the electorate that Labour is still "socially progressive" is not able to at least permit one of his members to give the draft bill a chance of gaining legislaters' attention.

It is reasonable that a private member's bill be given a certain amount of scrutiny by a party leader before the individual takes the plunge. It is understandable that promoting such a bill will draw off some of the energies of the member concerned. But the airy dismissal of this issue as a controversy that does not warrant consideration "at this time" because of Labour's political predicaments is frustrating for two reasons.

The EOLC Bill is already favoured in some form or other in opinion polls. And a huge amount of promotional work has been done and will continue to be done using energies outside of Mr Lees-Galloway's own resources. If the bill is put back into the ballot, and is actually drawn, there is no doubt that the issue will at least receive serious consideration.
Andrew Little apparently stated (disparagingly?) that this "stuff on euthanasia" is not timely for a progressive party.

In what I interpret as a dismissive and ill-considered decision I think he has made a profound misjudgment of both the issue and the mood of the electorate. Both deserve better from an aspiring Prime Minister. I suggest that the test for him now is whether or not he is able to reconsider this unfortunate and inappropriate decision.

The Christmas Story – “Once Upon a Time...... Lived Happily Ever After”

I had to cross my fingers behind my back a good deal in church this morning as we sang our way through the traditional Christmas carols. They are so full of concepts that are simply not true for me. My integrity is challenged in singing them. But I like singing, so perhaps crossing my fingers behind my back makes it OK to sing them. 

Of course it was mainly for the children that we acted out yet again the Christmas stories. Today’s service was entertainingly devised with symbolic Christmas presents brought forward for each element of the service. There was a lot of involvement of the congregation. Our curiosity was aroused as each parcel was unwrapped. And there were some whole-hearted laughs: after all, introducing the “Quirinius census” with an Inland Revenue Tax Return form was good for more than a bit of a giggle. And I can tell you the whole thing was a lot better than our recent Village Christmas service themed around a Partridge in a Pear Tree.

It’s OK to tell children stories that the adults understand are not “true”. There are usually elements of fantasy that are clues to help adults recognise fact from fiction. People can put imaginary quotation marks around these clues. But in the Christian stories the elements of fantasy or impossibility aren’t seen in that way by most people. Because they are found in the Bible, they seem to have become tests of our faith. Their acceptance has become a measure of our orthodoxy. No matter how improbable, unhistoric, or theologically unacceptable they seem, the fantasy elements of the Christian story have taken over the story.

I have no problem with re-presenting the story for the children at Christmas. But, let it be story. And when there are adults present let us be open and clear about what is most likely to be mythic. Maybe all we needed for the thinkers in the congregation this morning were one or two simple phrases. We could have been told that, "Of course, not all of us believe all these things actually took place like this..." or "We’re telling a story that was created by simpler minds in a world of different truth… and so on".

Such comment was not there today. For me, the story didn't end with living "happily ever after..." But perhaps I was the only person in 50 who felt a bit alienated because of it…  Also, what shall I say in ten days when I am invited to conduct the Christmas service in our former parish? How will I re-tell the story? 

A Good Funeral

I don’t go to many funerals these days —my cancer medication makes me excessively tearful and that is not a good look when it doesn’t reflect genuine emotion at a funeral—but yesterday we attended one that gladdened my heart.

Of course the occasion was imbued with the Christian faith of the lady and her contemporaries. The things read and sung were her choice and well chosen. But, in these days of lengthy funeral contributions from all manner of relations and friends and even ordinary attention-seekers, what struck me was that her adult children declined to offer their individual spoken thoughts. 

Rather, they crafted a comprehensive written tribute which was read by the celebrant just as they wrote it. It was lucidly informative and touchingly intimate. The only other contributions, prepared carefully by a family member and her congregation were significantly distinctive and memorable. Her life was adequately and beautifully reflected in this celebratory part of the funeral service.

Then, after something like a committal, the celebrant turned to the family and spoke specifically to their need to deal with the gap left in their lives. They would, he said, be moving through “deep waters”. He urged them to “take it easy” and suggested that grieving may be expressed in love. But he warned that anger might be expected and would be best met with compassion and understanding. He seemed to be urging them to be accepting of their different levels and timing of acceptance of their loss. Caring for each other they could “allow loving to heal” them.

I wish that I could recall all the significant phrases that lit up this short section to the service. But whatever they were, there was communicated a profound awareness of the reality that seems to be so often missing in funeral celebrations: someone has died and a great hole is left in the lives of the bereaved. A good funeral can set the stage in which that huge loss can begin to be explored and dealt with. And the celebrant can then genuinely give an assurance that “One day, you will think and talk about your loved one without pain.” Any funeral celebration should include this dimension.

Thank you, Russell; it was well done.

What, no Conference Video?

The NZ Methodist Conference apparently entered a new age this month with the use of large screen images of the ordination service so that everyone could see what was going on in the very large venue.  It obviously made a good impression. But, we have been told today, nobody ran the final program mix into any kind of video recorder, so there is no archive copy of the event.

Back in 1986, when "prosumer video" was an unknown term, the Video Connexion Volunteers produced a three-camera, field-produced record of all the major events of the Conference. Not only that, but they handed out ten-minute professionally-edited videos for members to buy as they left the venue.  Many people used these for their "back-home" reports in church the following Sunday. In 1990, this report video was recognised as an international first for religious communication.

The Administration Division contributed the cost of transporting the equipment for a few Conferences. It amounted to a generous subsidy for each video purchased at $15. But when that assistance was no longer forthcoming the volunteers were not able to meet that cost as well as provide their time and skills. So the Conference video programme died.

The Church has a Communications Endowment, conceived by the outgoing Prince Albert College Trustees to develop a national strategy for Connexional communications. An indirect product of three major Commissions on Communication in earlier decades - most of which foundered on the the question of where the money would come from! - the advent of this endowment has failed us in the area of audiovisuals and has not been over-generous in support of the church's newspaper. What was to be a Connexional resource continues to be frittered away on parish projects like hymnbooks, computers and projectors.

And in the technology-rich environment of Conference a few days ago, we apparently had no strategy for how to get the best out of it. How could that have happened?

Methodist Conference in Changing Times

The NZ Methodist Liberal Society is thinking through what its members saw of the 2014 national Conference just concluded. Some are uncomfortable with the ebullient presence of Pasifika members whose passion and commitment is so evident in the on-line photos. This, together with the failing mission and increasing age of the dwindling Papalagi congregations is radically changing the theological and ethnic balance of the Church’s makeup. 

This change is particularly reflected in the Conference, but it has not been so noticeable everywhere, of course. In the Far North where I have been for 23 years there are relatively few Pasifika people. The Methodist Church’s impact after 40 years of ecumenical administration has been only by way of over-bearing, insensitive and ill-considered decision-making. 

Naturally, the denomination is not what it was when some of us became involved. It is OK for us to feel a little nostalgic about that. But we should be grateful that we don’t have the endless debates where only a handful of persuasive speakers dominated the rostrum, that Maori have been given long-overdue recognition, that other ethnic groups and their vigorous church life are much better served, that social issues have resulted in practical outcomes over a sustained period, that sometimes business doesn’t totally dominate our national get-together.

We who feel the impact of a denomination with which we are no longer familiar might also be grateful that the old-timers who were scared stiff about what some of us young up-starts were doing with “their” church in the 1970s did not drag us all back into a past that they were more comfortable with.

However, at the end of the day, Conference is not really what the Church is about. A little note that used to be above my desk when I was Fieldworker in Ministry for the denomination in the 1980s, said: If the Church isn’t local, it isn’t real. 

I think that’s still the challenge to any Conference.

My Two Bits' Worth

Somewhere in my distant past life with Family Budgeting and general social services I entertained the concept of delivery of supplementary financial support via something like a present-day debit card. 

Anyone could apply for such a card and it would have the capacity to divert the cost of a specific percentage of any sale of certain items to the public purse. Each individual’s percentages would be related to their normal income and their tax rate as recorded by the IRD.

It could apply equally well to everyone from low-wage earners to full-time beneficiaries. The retailer would receive the full amount of payment and would not know how much of any sale was met by the state.  

A system of this kind could be much more flexible around the edges of bands of entitlement than supplementary assistance. It could also smooth the very difficult transition from benefit dependence into work. Indeed, if a political choice were made, it could easily limit the large amount of financial support given to some of us who do not have so great a need of it in our older age.

In the 1970s it was a pretty impossible strategy. The country couldn’t agree to personalised cards at all, even just for personal identification, and certainly not for delivering credit rather than cash. But the concept is not so unrealistic in these high-tech days.  The Community Services Card could probably provide a vehicle for the distribution of realistic financial assistance via credit rather than cash. 

I'll send that to the dreamers in Treasury ...

How to better fund our poor

It's interesting to note that Treasury is doing some "crowd sourcing"  for proposals to improve outcomes for those in need - as well as for taxpayers... An interesting idea, even if the time frame is pathetically short.

Did they get a nudge from minister Paula Bennett before he news release a few days ago? Or did she pick up a bit of political capital from being aware that they were exploring the issues?

At least the Treasury invitation seems to leave fewer questions answered before they are actually asked. And it is clear that interested people and groups may make submissions.  I hope that there will be a flood of creative and compassionate suggestions.

I guess a bottom line for me is that the basic level of benefits, reduced so dramatically over twenty years ago, is simply not adequate for the huge majority of those who depend on them these days.

Well done Mr Qain!

Store owner Kanmin Qain sought a relocation of a liquor licence for his Vege Oasis shop. Neither local officials nor the Police were inclined to object. 

But in the context of the large number of licences already active in South Auckland community members made strong submissions. Mr Qain listened to their stories of alcohol abuse and withdrew his application. He says the welfare of the community is more important than money in his pocket.

"As a businessman you have to make a contribution as well. It's not just about the money." He invites other businesses to follow suit.

The recent empowering of Community Boards to make representation on behalf of their communities could have worked better in this instance. But it is heartening that the applicant himself became more aware of the issues and took a bold and costly step on his own initiative. 

Well done...

Methodists "Face to Face"

When I was stepping out of a nine year term on the staff of the Theological College I declined to be available for a regular parish appointment. One reason was that having spent fifteen years working in alternative congregational life and ministry I was not willing to participate in what I called the conspiracy between congregations and their clergy to maintain the status quo. At its most crude, I considered this was that the “members would raise the funds and the presbyter would deliver ministry”…

 

My other hesitation was because of conviction that the “face to face” gathering recently brought into the Methodists stationing procedure was un-Methodist, un-discerning, unnecessarily stressful and generally not in the least helpful. I believed I should put myself in the hands of Conference and trust it to make a good match. The face to face procedure cut across what it meant for me to be in “Full Connexion” with the Conference.

The irony was that when I offered to pick up a part-time “supply” position I was put through the face to face process anyway. And it was pretty much what I expected and brought out only the huge difference in expectations between myself and many of the members. It set some of us up for differences that endured for the next two decades.

Yesterday we attended another face to face gathering - this time as members of the congregation. There was plenty of affirmation. But the most discerning questions could not be answered at this stage of negotiations. And the absence of any negative comments led the Chairperson to declare a consensus in favour. In this case, that was probably right. Though perhaps a lot of us were just ready to go home after a long morning in church.

A consensus that is achieved when the uncertain and the objectors remain silent is hardly a consensus. Even worse is a recent Presbyterian Assembly decision where, apparently,  the objectors left the chamber in protest and vote was taken without them.