#4: Update on Jonathan

Jonathan has made great strides in the past two days — needing less and less pain meds, up and walking laps through the hospital hallways, and fully able to bathe himself and dress. He’s no longer on any IVs, and has had his feeding tube removed, which is a relief. Interestingly at Montreal General, you eat by ordering room service. I literally pick up the phone in his hospital room, and order from a menu of food options that include several vegetarian choices. Amazing. I can’t tell you how tasty it is. Jon is just happy to be eating on his own, so it all probably tastes good. Everything he eats has to be thickened, so his apple juice is like pudding. Mmmm…..

We thought Jon might get a smaller tracheostomy tube today, but it sounds now like he’ll get a smaller one on Tuesday, with the idea that he will no longer need any tracheostomy by Friday the 26th. We are hopeful that this will be the case. With a smaller tube he’ll do more breathing through his nose and mouth, and be able to move more air through his vocal chords, enabling him to speak.

All in all, he’s doing remarkably well. Will make another update in a day or two!

–Carrie

#3: Update on Jonathan

Jon got his own hospital room on Tuesday and is no longer a nomad in Montreal General Hospital. He’s becoming more and more self sufficient, and is going for walks down the hallways of the hospital–not running any races, mind you, but able to ambulate on his own. On Friday his surgeon extraordinaire, Dr. Richard Payne, will be visiting to see how his left vocal chord is doing. He’s scheduled to be in hospital until at least next Thursday, Feb. 25th. On Wednesday the 24th, he’s scheduled to get a smaller (thinner) trach tube, which should enable him to swallow more easily and begin to talk a bit. He needs to have that smaller tube to leave the hospital, and must be able to swallow. He’s making great strides each day.

I’ll have another update Friday, after we talk to Dr. Payne.

–Carrie

Monday Night Update on Jonathan (Update #2)

Hello friends, family and colleagues:

Thanks so much for all of the well wishes you have sent to Jon and I in the past few days. I wanted to write with a brief update to tell you how he’s been doing since his surgery Friday.

Jon spent the weekend in the post-op recovery room, because there wasn’t a bed for him in ICU. The care he received there was fantastic, nonetheless. To every last person, the nursing staff at Montreal General Hospital is simply incredible. Last night, Jon was able to be moved to ICU, where it’s a bit more peaceful. And this morning he was extubated (the tube that enabled him to breathe was removed). After his surgeon took a look at his vocal chords and throat, he determined that there was a lot of swelling, so much that he didn’t think Jon would be able to adequately breathe on his own without a tracheostomy, so they put one in. A tracheostomy is a breathing tube that is surgically implanted into your windpipe via your neck/throat. It looks a little bit like Jon has a “spout.” Sounds unpleasant, I know – and from the look on Jon’s face, it isn’t very comfortable for him right now. But he’s managing. He’s not speaking right now – the tube is very large, and in the next couple of days he should have a smaller one that makes it more possible for him to speak. We do know that he can speak, because he did one time, when his doctor showed him how with the trach.

The surgeon tells us that his tracheostomy will be temporary. It might be in for 4-6 weeks. Each week they will switch to smaller tubes, toward the goal of permanently removing the tube. Over this time, the remaining vocal nerve in his neck should have the time it needs to heal. Basically, all of this will happen in, and only in, its due time.

Muriel and I are spending lots of time with Jonathan—as much as we can—-reading him the newspaper and having light conversation and otherwise just being there – he doesn’t talk, but occasionally writes us and the nurses notes.

Jon cannot have any other company except us yet until he is moved out of the ICU into his own room. He’s eager for company, so when he’s able to receive visitors, I’ll get the word out. Even now, with pain meds and under various states of sedation, he’s the uber-social man we all know him to be.

All my best,

Carrie

Update on Jonathan’s Surgery

Jonathan got out of surgery this afternoon at 4pm and is now resting in the recovery room at Montreal General Hospital. He’ll be in recovery tonight and will move to the ICU for the weekend. Following Jonathan’s lead, I too will tell you exactly how it is, without overwhelming you with too too much detail.

Jon’s surgery took almost all day, from 9:30am-4pm, a long haul that culminated in the surgeon successfully removing the rest of his thyroid and 30+ cancerous lymph nodes in his neck. The vocal nerve on his left side that was at-risk due to the surgery is intact and working, though at present it is not working well enough for him to breathe on his own. The nerve is “stunned,” as the surgeons said, which is likely a result of the physical trauma of the surgery itself. One surgeon said the nerve had been stretched. As a result of the nerve being stunned/stretched, Jon will be intubated (have a tube down his throat and be hooked up to a breathing machine) from now until Monday afternoon, at which point one of his surgeons will check to see whether the vocal chord is fully working, thereby enabling him to breathe on his own. The surgeons decided to keep him intubated over the weekend to see whether the nerve just needs a few days to recover. While I cannot fully explain the relationship between the vocal chords and our ability to breathe, I know that there’s an intimate relationship between them and our ability to control the esophagus/windpipe interface. What I know is that he needs that left vocal chord to be able to breathe and swallow properly without outside intervention.

If on Monday he is unable to breathe by himself, the surgeon will give Jon a tracheostomy – making a hole in his windpipe (covered by a valve) bypassing the vocal chords so that he can breathe. Most likely this would be temporary. Everyone involved with the surgery indicated to me and Muriel (Jon’s mom), that they think the nerve will become fully functional. The issue at present is whether it will be fully functional by Monday afternoon, when the tube will be removed.

Muriel and I are hanging in there. We are a bit exhausted from the anxious waiting we did today. We will see Jon tomorrow morning. I do not expect him to really be that aware of us when we do see him, since being intubated requires that he be sedated (being intubated is apparently very unpleasant if you’re not sedated; it induces a gag reflex). He won’t be able to talk while that tube is down his throat, but I’m sure he will appreciate our being there. From his two surgeons’ estimates, it is sounding like Jon will be in hospital for at least 6-9 days.

We are grateful to you all for your support and concern. As things progress, I will send make additional posts.

–Carrie

Oops

Well, I’d planned to blog a whole lot more but the last couple weeks have been surprisingly busy, which is good, since it’s not much fun to contemplate the countdown to surgery. More musings, possibly deranged (but don’t get your hopes up), will be forthcoming when I get home from tomorrow’s surgery. Carrie will post an update in this space when there is one.

In the meantime, I have become quite concerned about the lack of visibility of thyroid cancer in the stuffed animal world. As you may know, breast cancer has an enduring association with teddy bears. So, in the interest of promoting thyroid cancer stuffed animal awareness, I give you the thyroid cancer hedgehog.

On Diagnosis (Attitude Part 1)

I get a lot of questions about my attitude toward having cancer. I don’t actually feel as though I am exercising an act of will, or being stoic, or heroic, or brave or anything else. These are clichés, as well illustrated by the Onion article “Loved Ones Recall Local Man’s Cowardly Battle With Cancer”:

“Most people, when they find out they’ve got something terrible like this, dig deep down inside and tap into some tremendous well of courage and strength they never knew they had,” said Judith Kunkel, Russ’ wife of 11 years. “Not Russ. The moment he found out he had cancer, he curled up into a fetal ball and sobbed uncontrollably for three straight weeks.”

That’s the thing, it actually takes more effort to run around screaming “oh shit oh shit oh shit!” than to simply, well, deal with it. (Though I guess I’ve never tried the running around screaming part, so I will have to defer to those who have more experience than I do).

So let’s start with the diagnosis. A cancer diagnosis, even a thyroid cancer diagnosis, is supposed to be devastating. To me, it was a relief.

I don’t know how cancer diagnoses work in other medical systems, but the medical culture here is that one does a test and either schedules a follow-up a few weeks later or gets a “we’ll call you by X date if there’s anything to worry about.” I had a biopsy in September and I had an appointment 3 weeks after the biopsy. Maybe 8 days after the biopsy, I get a phone call asking me to come in at 8:30 the following morning. You don’t need a PhD to figure that one out–they weren’t calling me in urgently to tell me it’s benign. So in a way, the phone call tells you.

Carrie and I spent that night worrying but we couldn’t really do anything, and there is still reasonable doubt since nobody has actually said the words “you have cancer” to me. I imagine that is one of the crappiest parts of the medical profession. I’ve had to dole out my share of bad news as professor and chair but it’s not life-and-death bad news. I remember the appointment only in pieces, and in fact could not tell you how I was told. But I do remember in vivid detail the surgeon going over the risks of surgery and its necessity. That’s where I first learned about the anatomy of my neck–the parathyroids, the thyroid lobes, and the recurrent laryngeal nerves (you’d think I would have come across that one in all that physiology reading for the Audible Past but since they weren’t ear-related, I more or less tuned it out).

In my case, the diagnosis turned out to be a relief, especially in retrospection. I had been feeling like crap for months, with a diffuse set of symptoms that were hard to explain and impossible to attribute to a cause. Some were outright bizarre. For instance, I had become incredibly sensitive to pressure changes. Some old farmers can predict the weather from their knees. I was able to predict the weather from my neck, and pressure changes made me feel pretty sick. Once the right lobe came out and the surgeon looked inside, it was clear that one of my major causes was that the tumor was essentially strangling me. If cancer had not been found and if the surgery would not have been performed, it might have eventually killed me. Though probably my diffuse symptoms would have become more and more acute and I would simply have wound up in a hospital in much more unfavorable conditions. Instead, I can no longer predict the weather. That’s what the internet is for, anyway.

With a thyroid cancer diagnosis, anyway, I went from not knowing what was wrong with me to understanding exactly what was wrong, and what it would take to make it right. Yet, cancer itself is incredibly abstract. In its advanced stages, it is intensely painful. But it is not causing me any physical pain. Nevertheless, I know it has to go.

More Than a Few Words on the Form of Music

This week I received a CD from Owen Chapman, my colleague at Concordia. Entitled Calling the Voice-O-Graph, it is an album of sample-based music though he also plays some of the parts himself. If you click the link to the online part of the project, you’ll see the idea behind it is pretty interesting: free music in exchange for dialogue, or more accurately, commentary. That works well when you don’t have to sell your wares to get by. Owen’s attitude toward the record is like my attitude toward the articles in the “text” section of Sterneworks. We’re both more concerned about an audience than about revenue since we both draw a salary by other means (thank you, Canadian taxpayers). I read it as a slight escalation of the process you can see at places like bandcamp, where you have to give your email address to the band. In fact, there’s a great deal of free stuff available online in exchange for your email address and the implied right to promote to you.

Allowing for their differences, in both Owen’s case and the bandcamp case, there is a slightly coercive exchange dimension to replace the economic relationship with music that comes when you buy a record. The music isn’t truly “free” because you’ve got to give something to get something. Even if you are downloading music of bitTorrent or listening to a swooshy myspace track, you’re paying your ISP (and the hits no doubt generate some kind of “value” for myspace as well). Music is never really totally “free”–though what these new strategies do (bandcamp, Owen, but also Radiohead and Saul Williams, among others) is force the relationship into one between audience and performer, even if it’s just giving up your email address to allow some for some more marketing news to flow through email, the sewer of the internet.

The last chapter of MP3: The Meaning of a Format is called “Is Music a Thing?” and is an extended rumination both on the economic form of music and a debate that has ravaged music studies for at least a century. Stated roughly, one side argues that the primary “ontology” of music is artifactual–music is a “thing” that exists in scores, records or some metaphysical notion of “the work” itself. The other side argues that music only exists relationally, in process, and inbetween people. Of course there are many shades inbetween. The position you take on this debate subtends arguments about both what we should do about the music industry and what a better future for music might look like. If you are a historian of sound recording, it also shapes your understanding of what recording does. Here’s one of my favorite quotes in the chapter, from Evan Eisenberg (with some text around it from me). You’ll see Eisenberg was writing in the 1980s:

Eisenberg writes, “when I buy a record, the musician is eclipsed by the disk. And I am eclipsed by my money–not only from the musician’s view but my own. When a ten-dollar bill leaves my right hand and a bagged record enters my left, it is the climax. The shudder and ring of the register is the true music; later I will play the record, but that will be redundant. My money has already heard it.” Eisenberg’s argument is a pretty straight-up variation on Georg Lukacs’ account of reification, where relationships among people become relations among things. In Eisenberg’s world, relations that once existed between musicians and audiences are transformed into relations among cash and records.

I’m not entirely sure I believe this account since it assumes a prior relationship between musician and audience that is somehow less “damaged” by commerce. Let us not forget that before recording, many 19th century relationships among performers and audiences were mediated by money in other ways–whether we are talking about paying audiences in concert halls, cellists playing “middle music” in the back rooms of bars, or middle class women serving as home entertainment systems at the family piano. But let’s go with Eisenberg for now since there is also some bit of truth in his quote. If Eisenberg’s account is true, what happens when there is no cash and there are no records? My physical copy of Calling the Voice-O-Graph is a short run CD-R. The art on it is really nice, but it doesn’t even have a jacket. As far as I can tell, it is a “promotional” copy. But promotion for what? Promotion for the website and the project, of course.

I’m thinking about this not just as a scholar but as someone who makes music. I’ve now got two “music” projects in two states of incompletion, and one of my therapies during all this cancer crap has been composing soundscapes (and increasingly, beats) that will no doubt turn into some kind of recording as well. Then there are a couple random recording projects sitting around that I guess I would call capital S A Sound Art though I wish there were a better term (here’s an old one). I enjoy making the stuff (a lot) more than I think I enjoy the getting out and promoting it (not at all). And with bandcamp and other resources, I’d started to think of abandoning physical copies altogether. There is plenty of great music I’ve discovered online (for those who enjoy abstract electronica, try track 2 here for this week’s discovery). And yet, a physical record does something. I’m Facebook friends with Owen and no doubt got the invite to the release party for Voice-O-Graph. But I get so many invitations to so many things on Facebook that I don’t even remember getting it. And I might well not have been able to go anyway, since the whole out-in-loud-public-places thing isn’t working that well for me right now. (I also don’t really like the promotional culture of social-networking sites, and therefore don’t pay a lot of attention to it. It’s probably an age thing more than anything else.)

Conversely, I dutifully put on the CD this morning, a few days after receiving it, and then went and checked out the site. And here I am writing this post now (Owen, this is your comment!). In fact, the only times anymore that I put on a CD are when I buy them or receive them. Then they’re in the computer and I go back to them, or not as the case may be.

I won’t end this with any grand claims about how the materiality of music still matters. After all, it is a lie to call digital music immaterial (this is also a major theme in the mp3 book). And consumption patterns are intensely generational. I’m not in a position to judge the affective investments of people a whole lot younger than me, and I know that many people my age and older still populate their musical lives with recordings that live as artifacts, whether as CDs or records. That’s also the pattern I grew up with and so my reactions to a CD vs. a link are themselves second nature. So I guess I will be making some hard copies after all.

As for the mp3 book, I have yet to see (at least for me) a viable e-reader for something so thick as a scholarly book. I’m sure it will come someday. In the meantime, I’m going artifact all the way.