Monday, December 12, 2005

What is it here for?

The main purpose of this blog is to be a source of information for patients with chronic lymphocytic leukemia (CLL). In writing about this disease I shall let slip some things about myself. Can't be helped - and since it can't be helped I shall do it deliberately.

First: about the title. It is, of course, a play on the title of Wordsworth's famous poem "Intimations of Immortality". An early line from this long poem states, "The things which I have seen I now can see no more". This is a motive for writing. These days unless I write down what I think, I forget what I was thinking about. Whether it is worth remembering is for others to judge.

"Mutations" refers to the most significant piece of work I have done on CLL: the discovery that the mutational status of the immunoglobulin genes is the most important prognostic factor in this disease. But mutations are also changes, and changes are things that I will reflect on in this blog. One of Wordsworth's sonnets is entitled "Mutability" but his changes are all at the behest of the second law of thermodynamics: "entropy increases" or the housewife's version "things wear out". Change for Wordsworth is always an inability to sustain "the unimaginable touch of time". Are all changes for the worse? This we will discover as we read on.

Mortality comes to us all as long as (as they used to say) the Lord tarries. But not to CLL cells. A signal characteristic of the CLL cell is its immortality. Or in scientific-speak, its failure of apoptosis.

I used to joke that having CLL was a guarantee of immortality. What I meant was that by an large it is a disease of the old, and if you happen to have the mutated version the disease didn't kill you. Many of my patients were in their nineties and some were over a hundred. So perhaps it should be "Mutations of Immortality"? I experimented with this but I liked the alliteration and I wanted eventually to write about the problems of dying.

The word "leukemia" leaks terror in the staunchest chest. But this leukemia kills by stealth not strength. It hangs around for years and sometimes for decades. There is time to consider one's own mortality. And we have time.


Bill Percival said...

Dr. Hamblin,

I guess you needed something to do in your "spare Time" ;>)

Looks like a great start.

We have coresponded several times over the past two years. I was Dx'd Feb. 2004 CLL--Dx'd Mar. 2005 MCL--5 rounds RHCVAD, Auto SCT, Reinfused Yesterday, Dec. 12, 2005! Counts dropping as I write.

My hope is you continue your service to all the CLL'rs. I am hoping to be well enough to make a trip to England from my home here in Greenville, SC in late Spring, 2006. I will try to contact you as I would consider it an honour to meet you in person.

Chonette said...

An inspirational piece. Thanks for taking the time to write it down.

bernard adler said...

Dear Dr. Terry H.

I read your blog with great interest and am eagerly awaiting MORE from you.

I was dx with CLL in Dec 1993, still in w&w. I am now 80, feel good even though my platelets keep dropping(now 72).

I found the CLL List(Granny Barb)about the same time an Army Dr. told me I had leukemia and had about six months to live.

You are the greatest, and I pray that you live a very long,long time.

Bernard Adler
Major, U.S. Army, Retired

Ben Suntag said...

Dr Hamblin:

I received my first E mail from you and it has brightened my day!
Thank you for your concern about people and your knowledge on CLL.

It is indeed an honor for me to hear from you and I thank you very much for your kind words and encouraging news.

If I can do the same as you...that mankind in any way...I would be proud.

Ben Suntag (Gatnus)

Anonymous said...

Dr Hamblin...Thank you for all you do...If you can help save Wanda I promise to love Cricket and read every Chandler Novel.Further , I shall volunteer to serve as your batman,,not Batsman for every day you are here in california looking after her.