Acne

After a week of family time in Kansas, I was back up in Boston on Thursday for Cycle 1, Day 8 of a clinical trial of a new combination of drugs that will target, I hope, a particular genetic vulnerability in my cancer cells. That's the hope. All that the good people at Dana-Farber can promise is that my participation in the trial will expand the boundaries of scientific knowledge and perhaps help future generations of patients. And the downside? For fans of TV drug commercials, a few of the potential side effects:

Fatigue; Increased risk of infection, which may be serious or life threatening; Bleeding and bruising, which may be serious or life threatening and may require a blood transfusion; Tiredness and shortness of breath, which may require a blood transfusion; Abnormal heart rhythm or irregular heartbeat; Nausea; Vomiting; Diarrhea; Constipation; Joint pains; Fever; Dizziness; Hot flashes; Blurry vision; Hair loss; Headache; Bloody nose; Muscle spasm; Dry mouth; Abdominal discomfort; Indigestion; Flatulence; Pain; Chills; Shortness of breath; Cough; Runny nose; Mouth/throat pain; Back pain; Muscle weakness; Muscle pain; Itchy skin; Night sweats; Taste changes which may affect the way foods normally taste; Decreased sense of touch or sensation; Decreased weight; Difficulty sleeping; Heart palpitations; Jaundice; Acne; Confusion; Bowel perforation that could result in a serious, life-threatening infection and may require surgery.

The only change I've noted so far is acne, way down the list and fortunately above that bowel perforation. I don't know how one realizes that one has a perforated bowel, although I suspect that it's no mystery when it happens and that it's best it not happen far from an ambulance. But if I spend too much time dwelling on the potential side effects, I'd have less time to fret about the real one.

This is not of course my first bout with acne. I had it two years ago in another clinical trial, and before that, decades ago in the trial of 13, 14, 15, 16, 17, 18... It is different this time. The anti-acne drugs are better, and I do not need to worry about getting a prom date; my loving wife will accept my invitation for dinner and say nice things regardless of my complexion. Even so, acne is ugly, uncomfortable, and somehow manages to make me look both juvenile and old at the same time. I do have other disfigurements, most notably an array of scars and a hernia as a souvenir of two abdominal surgeries. But for those, at least. I can wear a shirt. Facial acne is kind of out there.

However, I shall not obsess about any of this. It is too easy to get caught up in worrying about all the things that might go wrong, or the superficial things that certainly will, and forget the big picture, what really matters in life now: the Nationals are 19 games over .500, 6 games up in the National League East, and playing some baseball that at its best looks like last year's Royals. And here let us spare a moment for the beat-up and scuffling Royals, who shined in the All Star Game and still have half a season to overcome the pretenders in the American League Central. It's the middle of the best season of the year, the Dodgers are coming to town, and my bowel is not perforated. Life is just fine.

The crew in Kansas.