Week 50: Clinic Update – On Track

A good week with my cough finally gone.

At my last clinic visit before my one year anniversary this week, I continue to do well in their eyes, confirmed by how I feel.

We are starting to make some of the changes related to being around the one year mark, a welcome transition.

Highlights:

  • Prednisone (the steroid) will be phased down from alternating between 10 and 5 mg each day to alternating between 10 and 0 mg for one month. This is to ‘kick’ the adrenal glands into producing cortisol. I may feel crummy for 3-4 days until this effect happens. After one month, this will further decrease to 5 and 0 mg. Should of course the crumminess continue, they may delay phase down. As of this morning, minimal crumminess, so I am lucky once again.
  • Septra (to reduce the risk of pneumonia) will end shortly, shortly after the one year mark or when Prednisone stops.
  • Acyclovir (to prevent shingles) will continue indefinitely given I have a drug plan. I cannot have a shingles vaccine as it is a live vaccine and my immunity cannot handle that.
  • I need to start taking vitamin B12 given that rebuilding my bone marrow has depleted my stores. Progress when I am prescribed only vitamins!
  • She also reviewed all the tests I have had over the last 6 months: CT scan, MRI, bone density test. All good. My pulmonary function test (PFT), the day after, confirmed what I knew: no issues given my walking and biking, and even a slight improvement.
  • Blood counts from last month were all good and stable. Hemaglobin remains slightly anemic which is natural post-transplant. My creatinine (kidney stress indicator) level was in the normal range, rare and good for me. Will have to see whether any post Europe bounce evident in the counts taken this week.

A good discussion on how I was feeling overall. I said, all things considered, very good. I was able to bike, walk, travel, be intellectually active, enjoy family milestones like our daughter’s graduation (with our son’s university graduation being the next milestone), and too busy to be depressed. She noted that it was very rewarding to her and others in the team to see patients doing as well as me, a real validation of their work and, of course, my family’s support. I noted that, of course, we are aware things can change, and that I tend to think in 3-6 month blocks, so as not to jinx things yet have a reasonable planning horizon.

I gave the Blood and Marrow Transplant team at the clinic as well as on 5 West (the hematology ward)  chocolate from our trip as a small thank you. Amazing how well this small gesture is received, but it truly is heartfelt by me and my family. I also mentioned my forthcoming book to her as I don’t want my medical team to be surprised if my marketing strategy works!

Another round of ‘re-vaccinations’ so sore shoulders and a new reaction, a rash on one that lasted a few days before going away. No more until next January then done.

While my book is being edited, I have been converting my Prezi into a video podcast. Like everything, the concept is simple, but Prezi does not have a simple ‘save as movie’ function, so yet another piece of software to learn (Screenflow). I have a renewed appreciation for post-production and the relative effort between the creative, fun part, and the necessary but less fun detailed ‘getting it out of the door’ part. Hopefully, will get this finished next week.

We of course watched the Olympics opening ceremony. While these all too often present an over-sanitized history, the British tradition of story telling was more refreshing, both for some of the quirkiness and wit but from the almost ‘subversive’ tone given current economic and social orthodoxy. A nostalgic portrayal of the former pastoral life, the grimness and inequities of the Industrial Revolution, the social struggles that followed, the importance of universal healthcare, and a celebration of modern, multicultural Britain (putting Canada to shame as Vancouver largely missed that opportunity).

Funny to see one British MP tweeted ‘multicultural leftie crap’ (and while Downing Street disowned these comments, the British Prime Minister last year had declared ‘multiculturalism is dead’). The MP in question, demoted earlier for attending a Nazi-themed stag party, may yet suffer another demotion – but expect others may have shared his views, if not publicly. Not quite Occupy Wall Street (with better production values!) but a reminder of the importance of equality, the social safety net, and multiculturalism for all those viewers worldwide.

A nice contrast from the absolute ‘on message’ approach of Beijing, and the value of democratic systems and their respect for artistic and institutional independence (Danny Boyle, the producer, confirmed this independence).

The choice of Hey Jude to close was interesting. While written to console John Lennon’s son during Lennon’s divorce, it was also interpreted at the time as a drug song (The minute you let her under your skin, Then you begin to make it better), perhaps conscious or unconscious irony given Olympic history of performance enhancing drugs.

David Brooks also had an interesting piece on the Olympics (here), where he noted the contradictions between cooperative and competitive values, how the opening and closing celebrations represent the former, and the actual events the latter, and how such contradictions are part of human nature and our institutions.

He could have taken this further into social and economic factors. In one sense, the Olympics represent formal equality of opportunity (all athletes are equal with an equal chance to compete), a fundamental liberal concept. However, watching at the Parade of Nations, interspersed with all those commercials, one is also struck by the disparities in size and resources available to athletes, by country and sport. Social and economic support makes a difference in getting to the podium. Some professional leagues address this through revenue sharing with improved competitiveness among teams, others like the Olympics do not. While we appropriately focus on the dedication and commitment of the  athletes (and their families and friends who supported them get there), the Olympics does have an aspect that reflects and emphasizes today’s increased inequalities.

Enough editorializing for the week! I will continue to enjoy the summer weather and our usual walking and biking.

2 more weeks to go – almost there, and on to future milestones.

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Week 44: A Good Week

It has been a great Father’s Day weekend. Our daughter had her high school graduation, our son was here as well, so we were all able to celebrate together. The best gift a father could have, watching and helping one’s kids grow and develop.

And while these kinds of occasions always bring out the sentimental side in me, I am more sensitive to them now, given the double meaning of the milestone itself and my being around to witness it. So the emotions that wash over me are all that more intense. She made it, I made it, we all made it together.

And a number of fun events. A nice neighbourhood gathering to bid farewell to some long-standing residents of our street as they downsize, going to a new citizenship recognition event hosted by our Member of Parliament (who couldn’t be there given all night voting at the House – his wife hosted), and seeing the Van Gogh exhibit again, this time with less crowds so we were able to appreciate the work even more.

To my surprise, I received a Queen Elizabeth II Diamond Jubilee Medal for my contributions to government service. Particularly rewarding, as I was nominated and awarded this by my peers, along with a number of my colleagues. As I am well enough to go to the occasional ‘crowd scene’, it was good to see and reconnect with my former colleagues and catch up on their news. They were pleased to see me looking relatively well (my standard reply to how I am doing was, said with a smile, ‘I’m standing and I’m here’ – says it all). Funny how the simple word ‘here’ can have both its factual meaning and existential significance!

One of those relatively smaller things in life that nevertheless make one feel good (and keeping up the family ‘tradition’, my Father received a Silver Jubilee medal for his work in the arts).

I have also been re-discovering my creative side as I continue to work on new material for my lymphoma journey book. Part of it is in choosing photos to break up the major sections, which means looking through my old photos when I was in to photography, selecting and scanning them, and seeing how they fit in with the narrative (rather have beautiful photos than pictures of me in hospital ‘uniform’). The written content is largely down, apart from a few articles I have to finish for both Cancerwise and the book, and of course, subject to editing and some ‘trusted reader’ criticism.

Working on turning my Prezi into a video, with a set script and related touches, is another outlet.

And of course, with the benefits and risks that the technology and autonomy allow me to ‘do my own thing’; benefits in not having to worry about reporting relationships or permission, risks in that it may be too narcissistic and not critiqued enough to make it suitable for public distribution. Can’t have everything, and I am having fun with it.

I finally read Charles Taylor’s classic, Multiculturalism and the “Politics of Recognition”, where he straddles the fine balance between universalism and relativism, a good nuanced discussion. Quote:

There must be something midway between the inauthentic and homogenizing demand for recognition of equal worth, on the one hand, and the self-immurement within ethnocentric standards, on the other. There are other cultures, and we have to live together more and more, both on a world scale and commingled in each individual society.

Fighting off a bit of a sore throat this week – may be too much cycling early in the morning and the ‘crowd’ events but otherwise fine.

Next week I have a clinic visit. Nothing major to complain about so assume the next appointment will be at my one year mark in August (you may have noticed the ‘countdown’ widget that I am having fun with!). 8 weeks to go!

Happy Father’s Day to all you fathers our there, and thanks, as always, to our partners who make it all possible.

Week 40: All Well with Some Cognition Testing

A good clinic visit started off the week. The new routine seems to be that the nurse, then the haematologist, bound in, take a quick look at me, ask a few questions, and remark that I look well. Much better than the alternative, and kind of funny that with all the fancy equipment and tests available, the basic ‘look one over’ says all.

Some specific points:

  • My MRI was good, with no change. I asked for more detail about whether or not the leptomeninges had diminished or remained stable, he noted the report simply said no signs of lymphoma. However, he added, that the presence or absence of symptoms was a better indicator than a MRI, as the situation can change relatively quickly. The implication being that I should not count on the MRI, but still a better result than the opposite.
  • A radiologist friend provided more detail on my MRI. In essence, there has been a slight decrease in the leptomeninges damage seen earlier. As he explained, like any trauma, the healing process is slow, but it appears to be happening. Good news.
  • No plans to change my Prednisone dose (currently alternative between 5 and 10 g per day), to provide me with stability over the summer (at least until my SCT ‘birthday’ in August) and that side effects are not an issue at this low dose.
  • As noted earlier, my iron content in my liver is higher than normal (reflects the large number of blood transfusions). Unlikely that they will ‘bleed’ me to reduce the level as my overall haemoglobin level is not high enough and no major issues with it remaining high.
  • Asked about sun exposure, noting that I am careful with clothing and sunscreen, and whether I should be ‘prudent’ or ‘paranoid’ about sun exposure. His reply: ‘Never good to be paranoid’ but be careful.
  • I am also cleared for further travel and my next clinic appointment is scheduled before a possible trip this summer.
  • No blood work needed given I provided him with my results from my physical from a month ago.

I showed him my draft Prezi (link here to non-narrated version, comments welcome). His interest was more in how the technology worked, how he could use Prezi to liven up his presentations (with flexible navigation among ‘slides’ to make presentations more interactive), and how long and hard the learning curve is (he has a presentation coming up in a few weeks). He noted my draft Prezi was more of interest to support groups than doctors, where some of my slides may be helpful for people starting their own ‘journey’.

I underwent a cognition test, part of a study of the medium-term effects of stem-cell transplants (now at that stage I guess!). A range of tests ranging from simple reflex tests (pressing the space bar when one sees a shape), to more challenging working memory tests that invoke system 2 thinking, to invoke Kahneman’s terminology. Examples include remembering 15 words, 15 shapes, the stroop test (correlating shape and colour), and a sequence remembering test. Curious to see my results which I should get shortly.

In discussion with the pre-med student conducting the test, I noted my perception that I was not as ‘sharp’ as before, particularly with respect to short-term memory. She noted that people who have been in jobs requiring concentration, analysis and thinking often have this perception, as they notice any difference, even when formal testing shows it to be very small. We live our subjective reality – I certainly noted this effect when I returned to work in 2010 after my first stem cell transplant, and had to find ways to compensate for it.

While I seem to be able to function quite well now, the test illustrated some of my ongoing vulnerabilities. The intense concentration required to perform the tests left me somewhat exhausted; while I think I did well on the simpler aspects, the more complex tests of working memory were another matter. It is what is is.

One last bit of medical news. I received my file of hospital notes and checklists (yes, they use checklists in cancer care, so Atul Gawande will be pleased!), about 2 inches of paper, on my 2009 treatment. Much I do not need to keep – these are the medical equivalents of log books and notes – but it is somewhat reassuring to see the thoroughness of the methodology and documentation.

We watched The Weight of the Nation on HBO this week. A bit of a ponderous and heavy documentary and messaging (puns intended) but hard to dispute the overall message of an obesity epidemic (and this is not just an US issue. Some good tools on the site (link here) for things people can do on an individual level.

We also watched Les neiges de Kilimanjaro (The Snows of Kilimanjaro), a French film  about a union leader who loses his job in a downsizing, along with other workers, is given money for a wedding anniversary trip to Kilimanjaro, but is robbed by a co-worker, and has to confront and question some of his past decisions, as well as his obligations to his co-worker even after he is charged. A bit slow, and a bit too much of a Hollywood ending for me.

I have been reading Disgrace, the book by South African writer J.M. Coetzee, 1999 Booker Prize winner. The main character, a disgraced professor, is thoroughly antipathique at first (a bit like in Bissoondath’s The Soul of All Great Designs) but one starts to have some sympathy for him at his hearing on harassment charges, as he, while fully admitting his guilt, refuses to play along. And then a different but parallel disgrace that happens to his daughter, which weighs down on him, and frames an end of life, as in living life, theme. Bleak, thoughtful, and very well written, and keeps one interest.

With the good weather, biking every day. No real improvement in my time but am certainly enjoying it.

Week 38: Uneventful equals good

Another uneventful week, all good. A bit too wet for biking but some good walks. While I can and do drive, given a choice, will walk instead, and seem to be averaging about 2 hours a day.

I had the usual charming jack hammer MRI and will get the results at my next clinic visit May 14. Funny that even if, as noted earlier, I do not expect any alarming news, lying in the ‘tube’ for 45 minutes is a sober reminder, and does bring back some worries. Hopefully, I will have confirmation at my next clinic visit in just over a week that my condition remains stable or, even better, that there has been some improvement. We shall see.

I am also looking forward to sharing my Prezi and related slides with my haematologist, to get his feedback and see how else he wants to challenge me. My other think pieces are either done (‘What we call ourselves’, or cancer terminology, will be posted this week) or in good shape (‘Letting go and accepting’). And I now have an ISBN for my forthcoming book and a workplace to complete it around the time of my one year anniversary this August. Now I just have to do it!

I continue to read Among the Believers, and have just finished his section on Pakistan. Reading his book 30 years later, and seeing some of the same issues repeat themselves, when so many other parts of the world have shown real progress. One of his milder quotes:

The Islamic ideal was the theme of a 1951 book, Pakistan as an Islamic State, which he (Nusrat) had brought as a gift for me. It would help me to understand Pakistan, he said. And the book showed me that thirty years before, the Islamic ideal had been as vague, as much a statement of impracticable intent and muddled history (with interim worldly corruption), as it was now. The Islamic state, I read, was like a high-flying kite, invisible in the mist. ‘I cannot see it, but something is tugging.’

April was a high readership month, perhaps because my posting frequency increased a bit. Here are the 5 most popular posts from April:

  1. Life, Interrupted: A Young Cancer Patient Faces Infertility – NYTimes.com
  2. Lessons
  3. Is The United States’ High Spending For Cancer Care Really Worth It?
  4. HealthcareNo, a Universal Cancer Vaccine Was Not Just Developed – The Atlantic, and Life and death battle with OHIP | Toronto Sun
  5. Dualities

I will be travelling and largely disconnected from our electronic world next week – good quiet time – so will not be able to respond to comments or ‘contact me’. I have scheduled a number of articles for next week so we will see how that works. Back to my usual schedule the following week.

Week 34: All well

Not much new to report – which is good. Good walking weather that I am taking advantage of, some nice get togethers with people, and the usual activities and projects that continue to fill my day.

As part of my turning my blog into a book and preparing a Prezi, have been working on some graphics to capture the different stages.

While these largely reflect ‘linear’ views to be used in the more ‘parallel’ Prezi, fun to develop these, and experiment with colour, grouping and ‘layering’ using Keynote. Without the normal corporate constraints (e.g., templates, culture of bullets), enjoying having the latitude to try more information rich approaches, and encapsulate a lot of information that was presented to me in a more organic and step-by-step process at the time.

For those interested, some examples (Allo SCT Decision, Allo SCT – Salvage Chemo, Allo SCT – Recovery – First Six Months, Allo SCT – Counts Bouncing Back, and Auto SCT – Treatment Protocol). Any comments or feedback on how these can be more useful appreciated.

I have also been working on a piece trying to categorize the various terms people with cancer use to describe themselves: warrior, fighter, hero, survivor, student/intern/graduate, and victim.

Has been harder to put together than I thought, as it is more subjective, and changes throughout the cancer journey, than a technical and medical glossary. Forcing some good reflective thinking, helped by some friends, and hope to finalize this in the next few weeks. The intent is to have a piece that allows more reflection on why each of us gravitate to certain terms, and the possible implications of that choice.

Suggestions on any terms I have missed appreciated.

Finished the Ondaatje/Murch book The Conversations: Walter Murch and the Art of Editing Film. Really enjoyed it, and makes me want to re-see most of the movies mentioned as well as some that I haven’t seen (e.g., Orson Welles, A Touch of Evil, that Murch re-edited according to Welles’ wishes). Some favourite quotes:

I can think of no higher tribute to a film than … that you sense simultaneously that it’s crystalline and organic at the same time. Too crystalline and its lifeless, too organic and it’s spineless.

….

There’s that wonderful line of Rilke’s, “The point of life is to fail at greater and greater things.” Recognizing that all our achievements are doomed, in one sense – the earth will be consumed by the sun in a billion years or so – but in another sense the purpose of our journey is to go farther each time. …. I think we’re always failing, in Rilke’s sense – we know there’s more potential that we haven’t realized. But because we’re trying, we develop more and more talent, or muscles, or strategies to improve, each time.

When something is successful, everything that went into it, both the good and the bad, tends to get bundled up as the recipe for how to make a success. It becomes very difficult to separate out what was true and what was untrue, what was good and what was bad, what was superficial and what was profound.

….

The distortions of failure, of course, are the opposite: instead of having everything unjustly accepted, everything is rejected. Or that’s the risk, at any rate. Truly great lessons can be learned from work that fails, but failure is stamped on the product and there’s a tendency to think everything you did was wrong, and you vow not to go there again. You have to resist this impulse, just as you have to resist the syrupy entanglements of success. These are, almost, religious issues. What the world thinks is a success, what it rewards, has sometimes very little to do with the essential content of the work and how it relates to the author and his own development.

Helpful in my trying to develop some non-linear and more creative ways to tell stories and engage, as well as good reflections in themselves.

Not to mention a renewed appreciation for the importance of sound in movies, which juxtaposed with this short series of quotes on silence, from the book In Pursuit of Silence:

The Origin and Cultural Evolution of Silence

In watching A Dangerous Method, I found myself watching the editing more than usual, as the film itself did not really hold my attention (curious to know if the original play, A Talking Cure, worked better). Expect I will not watch movies quite the same way again, and now have a list of movies to watch again that Murch edited, to better understand some of the comments he made in the conversations.

Lastly, for those celebrating Easter or Passover, best wishes for this time of reflection and family.

Week 33: Life continues

Life continues and no major changes to report – all good.

As expected, back to normal seasonal temperatures so no cycling (apart from indoor) but lots of walks. And I treated myself to a good bike tune-up to be ready for the warm weather yet to come.

My hair was finally long enough – and mad professor enough (think Back to the Future) to get a haircut and I now have a more ‘corporate’ look.

 A great reader comment on my last weekly update:

Sounds like you’re doing great.  I always considered it a good sign when the oncologist started to let down “the wall” and treat me as if I was going to be around for a while!  I couldn’t blame him for keeping me at arm’s length in the beginning, but it sure encouraged me when he started being more personable and less business-like.

Delightful sense of black humour!

Over the past few weeks, have ventured out to more group events. Issue is no longer  immunity but just being very tired after having to focus my hearing in a group and concentrate more when other languages spoken. Bit of a proxy for meetings and clearly not there yet – I am better one-on-one or in quiet locations.

I have taken up the challenge of my haematologist with Prezi. It does require a more imaginative way of presenting than the linear Powerpoint/Keynote decks that we are all used to. I find I have to doodle and sketch out some ideas, rather than working directly on the screen. But very cool how the navigation possibilities – forward, backward, sideways – are better suited to capturing complexity and the somewhat fragmented and iterative structure of my treatment and my related personal journey.

Interestingly, while my haematologist wanted me to apply this to some of the treatment slides, I am finding it more useful to integrate the personal and the medical. And finding the right balance between the linear and parallel modes of thinking – I need some of both – is proving a challenge, but a fair amount of fun.

To help me visualize this, and recognizing that a good use of Prezi has more in common with film making than a deck in many ways, have started to read Michael Ondaatje’s,  The Conversations: Walter Murch and the Art of Editing Film (Murch was the editor of The English Patient as well as Apocalypse Now and many other films by Coppola and others).

Helps me understand some of the possibilities of going back and forth, yet within a coherent storyline, as well as being a great read on the creative process. I once did a report with lots of strong graphics and my boss at the time reminded me, wisely, to be ruthless on the cutting floor. Not quite there yet – still in the creative phase of getting all the ideas out.

A few sample quotes from Murch to give the flavour:

Somebody once asked W.H. Auden, “Is it true that you can write only what you know?” And he said, “Yes it is. But you don’t know what you know until you write it. Writing is a process of discovery of what you really do know. You can’t limit yourself in advance to what you know, because you don’t know everything you know.

…..

Yes, that’s what I call the “Tragedy-of-Job moments” (referring to the cutting out of what initially appear to be key scenes). They are like the good man Job, who does everything – and more – that God requests of him, but God perversely afflicts him and not the bad person who is Job’s neighbour. Why me? Job asks. Well, it’s because God can see the whole that Job cannot see, and in some mysterious way these afflictions are for the good of the whole, in a way that is invisible to the person.

And lastly, my month stats on the most popular posts, apart from my weekly updates and views of my home page:

  1. The women behind ideological debates about abortion
  2. Why I Won’t Get a Colonoscopy | Scientific American Blog
  3. A Story About Care – YouTube
  4. A doctor’s letter to a patient with newly diagnosed cancer
  5. Faith

Some nice get togethers next week to reconnect. Looking forward to these, as well as my usual routine and projects.

Week 32: Rebirth and Renewal

Spring: rebirth, renewal, regeneration.

Particularly poignant for me given that last year, at this time, I was confronted with my relapse of lymphoma, the prospect of uncertain and risky treatment, and the reality that my hopes for normal life were dashed yet once again.

At the clinic this week, with the same senior haematologist who gave me the bad news last year, the story was different:

  • no signs of lymphoma
  • my blood marrow was working well and blood counts strong
  • no significant GvHD
  • and, looking and feeling well.

While the more conclusive assessment will be at the year mark, my progress is good and ‘directionally correct’. Some other bits of good news included:

  • no need to worry about Hepatitis C from my donor – test came back negative
  • MRI on May 4th will give sense of any activity – or not – within the brain and spinal cord
  • have progressed from a two-week to two-month recall – another graduation as it were, and suddenly all those free Monday afternoons to look forward to!
  • and no issues with biking, yard work or vacuuming, so I can enjoy this spring and summer while being more useful around the house.
I will continue to phase down Prednisone but at a gradual rate of alternating 2 tablets per day (10 mg) with 1 (5 mg) until my appointment in May.

I came out of the clinic with a mixture of giddy euphoria (‘This may really work’) and more sober realism (‘been here before’). Combined with the wonderful – and unseasonable – warm spring weather, I have had strange mixed feelings all week between these two extremes, normal for what I have experienced but nevertheless so much better than the bleakness of last year. And of course the same feeling of awe and wonder about having been given this second chance at life.

I also showed him some of the graphics and tables I have been preparing for my lymphoma book. Fun discussion. He started off by saying that I was obviously feeling well with enough time to start producing these things and then started a deeper discussion, based in part on his experience in teaching.

He is not a great fan of Powerpoint (‘deadly’, he put it), noting that its main weakness is that it presents things in a linear fashion, when the reality that he and his colleagues is more complex. He then challenged me to try Prezi, which can capture this complexity more, asking me to try thinking in ‘parallel’ rather than serially, and use my creative side more.

Given my natural disposition is more linear, analytic thinking, quite a challenge, and I have a few months to do my ‘homework’. The recent post on medical history (Visualize This: An e-Patient’s Medical Life History) provides some additional inspiration.

Impressive to see another side of my haematologist, particularly the teaching side, which he is very passionate about. Some great asides of some of the students’ penchant for looking up everything and correcting their professors – and quite often, on the minor details (e.g, he will say my white blood cell count is 8.6 and someone will look it up and say, ‘no, it is 8.5’).

Looking forward to showing him my homework on my iPad (he was adamant that it should be on the iPad) in a few months.

With the warm weather, I started biking again. Wonderful being outside with the sense of freedom that only biking provides, dating back from my childhood. But in terms of finding the balance between the prudent and paranoid, now am equipped with SPF clothing, covering up as much skin as possible. Not quite like biking in a biohazard suit, but the combination of a SPF cap and a helmet is far from elegant.

Some of you may recall that before my transplant, I did some baseline of my biking times. My first times this week were horrible, but started to come down after a few days. Still about 10-15 percent slower than before, a measure of how much the treatment has taken out of me.

Not trying to compete with Lance Armstrong (some of his tweets about 80 km bike rides I find less inspiring than irritating, but then again I expect some find my little victories equally irritating!) but more with myself, to have a better sense of the before and after, and what will be my new normal.

I have been reading Neil Bissoondath’s critique, Selling Illusions: The Cult of Multiculturalism in Canada. He perceptively notes some of the absurdities of extreme multiculturalism, the complexity of culture, identity and ethnicity, and the paradoxes for creativity, again when taken to the extreme. One of the better quotes on the complexity of ethnicity and its relation to individuals:

My point is simple, but it is one usually ignored by multiculturalism and its purveyors – for to recognize the complexity of ethnicity, to acknowledge the wild variance within ethnic groups, would be to render itself and its aims absurd. The individuals who form a group the “ethnics” who create a community, are frequently people of vastly varying composition. Shared ethnicity does not entail unanimity of vision. If the individual is not to be betrayed, a larger humanity must prevail over the narrowness of ethnicity.

To preserve, enhance and promote the “multicultural heritage” of Canada, multiculturalism must work against forces more insistent than any government policy. If a larger humanity does not at first prevail, time and circumstance will inevitably ensure that it does.

He may overstate the effects of time and circumstance in today’s age of cheap travel,  free communications, and increased targeted segmentation. But even within the frame of multiculturalism, he does not acknowledge that Canadian multiculturalism always had a strong integrative intent (dating from Book IV of the Bi and Bi Commission), in contrast to Europe, where immigration policies (guest workers), lack of immigration culture and identity, and greater traditional ethnic identification with nationality, had a vision more of communities living side-by-side, as well as overstating the difference between the US and Canada, where the ‘melting pot’ and ‘cultural mosaic’ labels are overstated.

And if the price of any public policy is the risk of extremism, likely better to have the Canadian variant, leaning to over accommodation, than the European variant, leaning to intolerance at best, racism and discrimination at worst.

For a more nuanced view, Review of Pax Ethnica by Will Kymlicka, which notes that success in multiculturalism is not tolerance and the absence of violence, but  more positive integration, at the group as well as at the individual level:

At their best, these cases go beyond mere tolerance or bare co-existence to include positive elements of inter-group solidarity, and this is what makes them harbingers of a better society. The various groups are committed to living together in justice, and to sharing fairly economic opportunities, political representation and cultural recognition.

As is normal, I received the annual invitation to participate in the Light the Night Walk for blood cancers. Although the Leukemia and Lymphoma Society does good work, I did my usual due diligence on the portion of funds that are spent on management and fundraising, compared to program spending. 47.5 percent, of which 37 percent is fundraising. Hard for me to support a charity when 1 out of every 2 dollars goes to overhead. My hospital has a better ratio (only about 1 in every 5 dollars).

The weather is back to seasonal norms, and the brief taste of what is to come remains just that. Nothing major planned for the week ahead, but I seem to have enough activities and projects to keep me busy and engaged.