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.