Cancer 20: normal is really not an option

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Cancer 20: normal is really not an option

Paul Brasington 2023
Published by Paul Brasington in Good health · Friday 29 Oct 2021
Tags: Cancer
It’s 2.15 in the morning. I’ve been trying to sleep for the last four hours, without success. Thanks to the steroids I have to take to help my body cope with the poisonous elements of the chemotherapy four hours’ sleep is about the total I’ve had over the last three nights, apparently soon to be joined by a fourth night fully awake. I am exhausted, but I still can’t sleep. My mind won’t stop. It’s disconcerting because for the most part we tend to think of “mind” and self” as more or less synonymous, and yet here I am beyond self-control, manipulated by the modified balance of chemicals in my brain.  

The grim steroids
I’m nearing the end of the first week of my third cycle of chemotherapy, the penultimate cycle. The second cycle was slightly worse than the first, and this one is closely following that pattern. Because I only have to take the steroids for the first three days after the Oxaliplatin infusion I have some reason to hope that after tonight the insomniac effects will fade, and my heart goes out to those who suffer insomnia as a matter of routine without any hope of an end. It’s a horrible debilitating condition, and one I’m finding all the harder to cope with because sleep has always been one of my superpowers: I am by inclination or nature a night owl, but I’ve generally been able to go to bed when I needed to, shut my eyes and pass out for seven hours, then immediately be awake and ready for the day.

I am well aware that in the bigger scale of discomfort that chemotherapy can bring I’m still getting off lightly. I’m not complaining. I’m just trying to cope.
The end of the treatment is in sight now, with just one more cycle after this to endure. In the middle of that cycle I’m booked to have another CT scan, to check that all is well. And then I can look forward to something like a normal life, except that this statement is becoming meaningless.

The next normal
Normal is not really an option on a personal level, because much as though I can and will push the prospect of a cancer recurrence to the back of my mind, it will lurk there, and influence my outlook. But perhaps this isn’t a bad thing. I got married last weekend, an unplanned gesture of defiance to the interruption of illness, and a marked step away from a difficult decade for me. It was necessarily a modestly-scaled event, at least when set against the commonly ridiculous social rituals of contemporary marriage ceremonies, but it was a deliriously happy event. I’d like to think I now have cemented a new better framework for whatever life remains left to me (and my wife).

We have to live within our personal frameworks, but it’s hard (and wrong) to ignore the bigger context, and by glaring contrast this is the week in which our government yet again underlined their staggering ignorance, incompetence, acting as if after the extraordinary events of the last five years some reassuring return to “normal” was possible or even desirable. It is not.

The limits of government?
I do understand the value of trying to create a sense of positive possibility for the future. No one is going to vote for a politician who can only speak of doom. But there are realistic visions of what could be done to make things better, and then there’s the retreat to a fictional past where things seemed better, which drove the Brexit vote and is still distorting the judgements of a government desperate to prove they haven’t made a catastrophic mistake (though they quite clearly have).

There are plenty of other sources, from across the political spectrum, if you want to know why this is a truly terrible budget for the future. But there is a more fundamental issue. Towards the end of his speech Sunak asked this question.“But now, we have a choice. Do we want to live in a country where the response to every question is: ‘what is the government going to do about it?’ Or do we choose to recognise that government has limits, that government should have limits?”

The distortions of dead dogma
This is a moronic false opposition. The necessary question is: we have many problems and how can we best solve them?

The answer is likely to include both public and private sectors, because that is the world we live in, and injecting an always misplaced dogma from the outset is not going to help find an optimal answer. I don’t believe Sunak is simply playing politics here (though he is, trying to corral support from the stupidest Thatcherite wings of the Tory party): it’s apparent that he speaks from the heart, taking sides in an ideological battle that has been distorting any real understanding of what we’re dealing with for at least the last 50 years.

Instead of talking about government limits Sunak and his pals need to start thinking a lot harder about what government can do, and its inescapable responsibilities. Ironically Johnson does seem to have an inkling of this, though he appears too lazy intellectually to think through what it could mean.

Private enterprise alone cannot begin to tackle the problems of climate change: it can only work within the context of inter-governmental action (and sadly, too often has only done the minimum within that context). In this week before the COP26 conference it beggars belief that Sunak is still talking in this way, and that his budget seems to have nothing to say about it (meanwhile encouraging internal flights and easing car use).

Sunak also made the claim that he believed debt is immoral, as if this is self-evident. It is again the remark of an unthoughtful man.

Morality and debt
As it happens I’ve been reading the anthropologist David Graeber’s book on the history of debt over the last 5000 years. It’s a long and detailed book, but there are some clear and clarifying ideas that emerge, which demolish Sunak’s fatuous moralising.

Graeber’s starting point is that classical economics talks casually about the nature of money, markets and debt without paying any attention to how these concepts have evolved through history, and what this could mean. He is irrefutably right about this, and it’s small wonder that the “science” of classical economics continues to fail, lacking as it does any true empirical rigour.
The alternative ideas of Modern Monetary Theory are rapidly gaining traction, not least because they have the virtue of paying real attention to how government finance interacts with national economies. I’d like to know more about MMT before endorsing it fully, but at the very least I understand it makes it clear that public and private debt are very different, and it’s also evident that public borrowing now does not automatically load debt onto future generations (the root of Sunak’s claim that it is “immoral”).

It could as easily be said that a failure to “borrow” and invest now (MMT argues that governments can indeed create money effectively out of nothing, just as banks have also been given the legal framework to do just that) will cost future generations far more, especially in the face of catastrophic climate change.  

Then Graeber has a great deal more to say about the morality of debt. He notes the ways different societies from the ancient world to the present have viewed debt, observing its often complex and contradictory relationship to essentially theological ideas about what might or might not be owed to us as human beings (the phenomena of slavery and serfdom play important parts in his survey).

Power and nature
Crucial too is the empirical observation that money, debt and markets are not ineluctable natural phenomena, much as though classical economics tends to treat them that way, as if they were like gravity. They are functions of power and status, and concepts of debt have been manipulated in pursuit of power and status.

It’s why the notion of free markets is a chimera: markets are created and maintained by human rules, paying some regard to basic notions of equity and justice, but those basic notions quickly come under strain when you introduce the idea of interest (let alone compound interest).

You can’t talk about the morality of debt without considering the morality of these power games, or indeed the immoralities of usury, or by extension the demands of the finance sector for counter-productive returns on capital, or indeed of rentier investment and behaviour. Since Sunak is part of a class that believes it has some kind of natural right to enjoy the benefits of these assets and behaviours I suppose it’s not surprising that he should have a narrow view of what might and might not be immoral in finance.

Graeber to his credit is content to use his historical survey to note how things have been, and not to try to extrapolate how in themselves they could show what we need to do next. His argument is rather that we need to understand the historical contingency of our ideas about debt, about how those ideas have changed and been influenced by other social factors. The point then is that our economic assumptions are not laws of nature, and that in the face of global catastrophe we can and have to be open to new ways of organising our national and international institutions, and financial structures, in order to address better the frankly terrifying multi-level crises that sit in front of us.

The same exhausted old games
I am exhausted, but even I can understand this much, in depressing contrast to our Chancellor of the Exchequer. He continues to play the same old political games, when we no longer have time for games. Of course he’s not alone among national leaders, and no one is pretending that there are easy answers. Well, actually they are, because that’s where most of our politicians have got stuck, pandering to the assumption that their publics can only deal with easy answers.

I don’t believe this is true. The polling evidence is contradictory. Of course if you ask people whether they want to change their lives they will tend to say no. But it’s also apparent that they are looking for “something to be done” and understand on some level that it’s going to come with pain (because pain is coming whether we like it or not).

For whatever reasons it is our tragedy that we lack the political intelligence (and I’m afraid to say this is true across left and right) to think beyond the assumptions of the last fifty or two hundred and fifty years. I believe electors will be drawn by a practical and radical vision of how we could move forward, not backwards, because most people outside government already understand that the past is no longer an option. We desperately need a practical vision of the future to emerge from the COP26 summit, a vision with detail about how it’s going to work.

Instead we’re apparently locked in arguments about fishing “rights”. In this world of unexamined assumptions, I’m curious to understand how it is that anyone has come to an exclusive claim on freely moving fish. It’s little wonder I can’t sleep.

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