Saturday, February 25, 2006

West of Heaven - OCEANS OF LIGHT trilogy published


WEST OF HEAVEN is the title of the first book in the OCEANS OF LIGHT trilogy but is a self-contained novel in its own right, available for purchase now from

lulu.com/hughcook

What follows is a blurb plus a sample chapter, chapter ten, which gives something of the flavor of life in Chalakanesia.

As mentioned above, the storefront where WEST OF HEAVEN (and the other books in the OCEANS OF LIGHT trilogy) is on sale is:

lulu.com/hughcook

Unfortunately, while lulu.com would like to be a child-safe site, something like WEST OF HEAVEN is not child-safe content, so to see this otherwise invisible "mature" content you have to certify yourself as adult, as follows:-

To see the mature content (1) sign up to make a free log-in identity then log in; (2) go to "MY ACCOUNT"; (3) click on "manage content access level"; (4) assuming you are 17 or older, choose "Mature" as the consent level, and save that preference.

Returning to lulu.com/hughcook you discover that a number of books which were previously invisible are now visible, of which WEST OF HEAVEN is just one.

That said, here is a blurb for WEST OF HEAVEN.

This book focuses on Atlanta Ignalina Jubiladilia, an ambitious young female lawyer in a society which is not altogether friendly to her ambition.

As a lawyer, she finds herself, in the course of the book, grappling with three different issues.

One is a problem concerning her financially irresponsible friend Soba who may be forced into slavery by the man to whom she owes money, Gorkindachina.

Gorkindachina is pressuring Soba for the money she owes him because Atlanta's family is putting Gorkindachina under pressure to repay debts owed.

Can Atlanta save Soba and, if so, how?

Gorkindachina is, it seems, for his own purposes, threatening to unlawfully disclose the sealed court records of a trial involving a pedophile.

What, if anything, is Atlanta going to do about this?

The sex crimes committed against children disgust her but, on the other hand, the perpetrator was forced from political office and was compelled to spend twenty years in exile. The crimes were the crimes of his youth, and he, her grandfather Zinjanthrop, is an old man now.

Atlanta's third issue is a product safety issue.

Her family hires out living organisms known as adaptive skins which function as diving suits, melding their blood supply with that of normal human beings and so making it possible for normal human beings to, in effect, breathe underwater, this in a society where scuba equipment is not the norm.

Under certain conditions the adaptive skins can become dangerous, and Atlanta hears familiar rumors that there are problems with her family's skins.

The rumors are familiar, but could it be the case that the rumors are true? If the rumors are true and lives are being placed at hazard then where does her duty lie?

These events play out against the ongoing turbulence caused to daily life by the effects of the metapsychic faultline, which leads to, amongst other things, the formation of ghosts which often have physical substance.

And not just ghosts but, at times, doppelgangers, short-lived but fully-featured duplicates of human beings.

And not just doppelgangers but, at times, golems, which are massively heavier than normative humans, and are perilously dangerous.

What follows is the text of chapter ten of WEST OF HEAVEN.

Chapter Ten

Despite the battles she had been through, despite her torn and disheveled appearance, despite the fact that she was sodden to the skin, Atlanta was in no mood to go home.

Instead, on exiting from the Hari Mok, Atlanta headed for the Daffodil Burk, where she grabbed a coffee, borrowed a towel to dry her ice-white hair, then plumped her sodden bottom on a seat and ordered up some food.

She needed it.

The struggle beneath the water had automatically fired up Atlanta's metabolism, and her body was already demanding food, food, food, food. Had she still been underwater, hunger would not have made itself felt so swiftly, for those born to the sealines do not commonly feel hunger until they rest. But Atlanta was resting now, and so was ravenous.

Atlanta ate a loaf of bread, and a dozen rice crackers. She drank down a bowl of hot and salty miso soup, then — eating more slowly by now — finished off her meal with a bowl of cold rice served with a side dish of fish eggs.

The rice was imported from Sopwith Dromadex, since Islam Demaxus, with its uncertain rains and its periodic droughts, was no place for rice paddy. The roe, however, were local. The fish eggs were big, orange and popped in the mouth. They reminded Atlanta of the grapeskin-packaged goblets of wax which periodically oozed from the skin of Vignis Vo Gorkindachina. Still, this did not put her off. She took a seaweed-shaker, sprinkled her cold rice with a mix of sesame seeds and dried black shredded seaweed, then ate with gusto.

After food and coffee, Atlanta went next door to the Ul Den Ul, and went upstairs to her law office, intending to assuage her higher and her lower passions alike with a heavy dose of work. Certainly she was in no mood for sleep. She was either going to work or else she was going to go to Westport, root out Yulius from whatever funk-hole he was hiding in, and shake him till he shivered.

Before settling to her work, Atlanta changed her clothes. She shed her silks, angered at the damage which had been done to them. She had no idea if they could be salvaged. She knew almost nothing about clothes — she had always had a servant to take care of that, usually Baz, and, if not Baz, then another. Atlanta threw her silks into a corner, but was careful to stash her pearls in the same safe in which she kept her inkan.

She dried all traces of dampness with a hand towel, then changed into her law uniform. Her shirt was of soft grey cotton, high-collared and long-sleeved. It was accompanied by a matching pair of trousers, the ensemble being finished off with hard-wearing slippers of grey felt. The cut of both trousers and shirt was loose, these garments being made for comfort, rather than for fashion. There was a jacket of similar grey which could be worn for extra warmth, though Atlanta did not make use of it.

These clothes declared the nature of Chalakanesian justice. In its rhetoric, that justice claimed itself to be plain, sober, simple, direct, economical and practical. Unsurprisingly, that rhetoric hid complexities of power which it would take several encyclopaedias to explicate.

Having changed her clothes, Atlanta settled to her work. She lit no candle, but, rather, worked by the illumination of a vial of lightwine. Lightwine, that fluid which absorbs the essence of the sun by day then gives it off by night, generates a light somewhat like that of the gel-torches of Heaven and Hell, and Atlanta ever preferred it for nighttime work.

Atlanta Ignalina Jubiladilia was the only female lawyer in all of Chalakanesia, and it was her ambition to become the first-ever female judge of the courts of that archipelago. Though Atlanta did not know if she would ever fulfill these ambitions, she believed of a certainty that she had found a way to write herself into Chalakanesian legal history.

In the year Belta 2351, the senate of Jaz Diva had been privileged to elect a president for Chalakanesia. The person appointed had been Wolfganga Zenseneth Belch. His seven-year term of office had long since ended, but his decisions had yet to make their full impact on Chalakanesia.

Amongst other things, President Belch had signed into law an Ecology Act designed to protect Chalakanesia's forests, coastlines and wetlands. The citizens of Heaven and Hell, having grossly polluted their own lands, now urgently desired to do some Ecological Good, preferably in someone else's country at someone else's expense. Hence Heaven and Hell had coerced Wolfganga into passing the Ecology Act, which prevented Chalakanesians from reclaiming land from the sea.

But what exactly is the sea? Does it include the zones between high tide mark and low? Does it include river estuaries? When salt water flows up a river with the incoming tide, is every salty section of the river to be construed as being part of the sea? To address such questions, the Ecology Act had included a tortuous definition of the "sea", thus removing the legal definition of the word from the world of common sense to an arcane realm of legal abstraction.

As Atlanta read the Ecology Act, is seemed that the "sea" was now to be defined as that area demarcated as "sea" on the maps of the Chalakanesian Legal Survey. This was a new set of maps which was being prepared with the help of experts from Heaven and Hell. So far, Legal Survey maps had been issued for only half of Chalakanesia's waters.

Unless Atlanta was reading things wrongly, the sea was now no longer the sea unless a Legal Survey map said it was the sea. Only half the maps were finished, which meant that at least half of that wet salty stuff which was used for the floating of ships was no longer the sea at all. So what was it? It was a Realm of Limbo, as far as Atlanta could determine. Furthermore, the Legal Survey maps themselves did not become effective for the purposes of the Ecology Act until their existence had been advertised in the Chalakanesian Gazette, something which often did not happen until a year or so after a particular map had been published.

All this was of intense interest to Atlanta, whose clients were mostly fishermen whose boats and gear had been confiscated under the Fishing Quotas Act, which regulated the catching of fish from the sea. Under this Act, a fisherman could lose his boat and gear if he was caught with as few as half a dozen undersized fish on board, or if he caught just half a haul of fish more than he was licensed to catch.

So far, Atlanta had done her best for her fishermen by writing groveling pleas for mercy. She had usually managed to get at least partial satisfaction for her clients, since the penalties of the Fishing Quotas Act were so savage that the Court of Justice was reluctant to enforce them to the full.

Atlanta's clients were usually pathetically grateful, but she herself was sick to the back teeth of this business of groveling. She wanted to attack, attack, attack, and she thought she could see how to do it. Thanks to the Ecology Act of Belta 2351, large chunks of the sea were sea no longer, so the Fishing Quotas Act was surely inapplicable to such chunks. That meant that many of Atlanta's clients had been unjustly prosecuted, and could sue the Federation of Chalakanesia for wrongful prosecution.

Of course, if Atlanta brought any such case before Chalakanesia's Court of Justice, then it would be thrown out in short order. She would be laughed out of court. Alternatively, if the Court of Justice took her arguments seriously, Chalakanesia's current president would sign legislation making retrospective adjustments to the law. Chalakanesia was like that.

But, as Atlanta knew very well, Chalakanesia was negotiating with Heaven and Hell on the text of a proposed International Justice Treaty. This would enshrine a number of human rights, such as freedom from judicial caprice, and protection against retrospective legislation. Furthermore, it would allow Chalakanesians to go to the international Court of Conference to seek remedies for any Breach of Treaty.

Heaven and Hell wanted such a treaty because they expected that technological advances would soon allow their airships to fly to Chalakanesian territory. This would vastly increase the commercial intercourse between Chalakanesia and the Great Powers, so Heaven and Hell wanted legal guarantees which would protect the Big Money of the Great Powers when that Big Money went to work in Chalakanesia.

As soon as the International Justice Treaty had been signed and ratified, Atlanta would sue the Federation of Chalakanesia. She would bring a class action suit against the Federation on behalf of all the fishermen who had been unjustly prosecuted. And, when Chalakanesia's Court of Justice threw our her case, she would appeal to the international Court of Conference.

Win, lose or draw, she would at least make a major name for herself, and write herself into Chalakanesian legal history. But the amount of work required was immense. So she sat with her fishing files, with a stack of back-issues of the Chalakanesian Gazette, and with big books on international law as practiced before the Court of Conference.

As she worked, Atlanta entirely forgot about the events at the Haridjakarta Moskovola. She worked until she was so tired that her head felt full of cotton wool, then she went to sleep in her high-backed wooden hair. It was easy to drop off to sleep, because the light from her vial of lightwine had fallen so low that it had become hard to read and write.

Atlanta slept long, the vial of lightwine dying lower as the night went by. When the light of that vial was so low that it would scarcely have given competition to a cat's eyes reflecting fire, there came a scratching at the door.

Atlanta woke.

The room was almost dark, but Atlanta saw well in the darkness, in the manner of those born to the Merlines. She listened to the scratching, then roused herself from her high-backed wooden chair and stealthed through the dimness with not a single misstep to betray her onslaught.

At the door she paused, deciding between mercy and murder. The scratching paused, restarted. It was a very peculiar sound, that scratching, and it was accompanied by a whine like that of a wounded dog.

The hour was late, but -

It was the very lateness of the hour which at last convinced Atlanta to open the door. For, though her years were but twenty-six in number, she had nevertheless achieved a fairly broad experience of the world — enough at least to convince her that the greater part of the world's trouble occurs when the bars are closing.

In this, the deepest part of the night, the drunks had punched out their anger long ago. All whoring, gambling and fighting was done with, and so was all marauding, all midnight thieving and hot-haste rape. So Atlanta unlatched the door, and opened it, with no weapon to her hands but her own knuckles.
The door swung open — you must understand that it was a wooden door mounted on metal hinges, not one of the armored visor doors to which Heaven and Hell are accustomed — to reveal a man well known to Atlanta. Gorkindachina. His familiarity was fortunate, since it served to moderate the shock of his appearance. He was wet, bleeding, naked. His body had been scratched as if with thorns, lacerated as if with razors, torn as if by the talons of a tiger.

You know the tiger? Then, if so, you know it from the zoo. But in the wilder reaches of Chalakanesia, the tiger is alive and well; and it faintly occurred to Atlanta that just such an animal might (just conceivably) be on the loose in Lexis. It might, for example, be a returnee, spatially and temporally displaced from its past existence by one of the metapsychic storms of Islam Demaxus.

So thinking, Atlanta did her best to peer around Gorkindachina — a difficult feat, for his bulk was considerable -and to look both up and down the stairs for the shadow of a tiger. She looked too for any acquaintances, confederates or companions who might be leagued with Gorkindachina in mischief. Though she did not seriously suspect him of any delinquency, for he had power enough to do what he wanted without resorting to the stratagems of a juvenile gangster.

"Mah," said Gorkindachina, the nonsense syllable deep and throaty, guttural with the promise of blood. "Mah. Mah."

So saying, he wavered, and his eyes rolled up. Atlanta expected him to faint, but he steadied.

Just.

"Come in," said Atlanta, standing aside to let the man enter. Then, as he hesitated: "In!"

There was a touch of the whiplash to that last command.

Obediently, Gorkindachina shambled forward. He was lit by that phosphorescent light which sometimes accumulates around those who walk abroad at night in Chalakanesia. The light was color-bright, as the artists have it — sufficient for colors to be made out — and by that light Atlanta observed him clinically. He had a small pot; his buttocks were flaccid; there were small rolls of surplus flesh at his sides; but, all in all, his condition was not too bad for a man of fifty-four who had a considerable reputation for hard-living.

Only -

His back -

Atlanta glanced again at the stairs, checking for tigers or accomplices, then closed the door decisively and latched it. She took her time over the latching, slowing down deliberately as she felt her self-control wavering.

Gorkindachina was wavering too, teetering on his feet, which were flat. He was pallid in the manner of the people of the Gulf of Heaven. Lean and low against his skull lay a smattering of coarse brown hair, and stalks of a similar hair matted his back, their greatest thickness following the line of the spine. Despite those hairs, and despite the blood which was fluxing from his torn flesh, Atlanta could see that his entire back was covered with swollen pustules of yellow fat.

"Mah!" said Gorkindachina, a note of alarm entering that syllable.

It was an expression of dumb horror, of uncomprehending pain, of ignorance suffering.

Then he lifted his hands.

As if burst by that very action, the pustules on his back shocked open simultaneously. Swollen pellets of yellow fat sprayed through the air. Atlanta threw up a hand to shield her face -aghast at this onslaught. Gorkindachina flailed wildly, grasping for handholds in the air. Then down he crashed, carrying away a whole shelf of Atlanta's lawbooks. He crashed face-down in a shower of paper, then struggled to his feet.

The walls of Atlanta's office, generous with handholds, sustained Gorkindachina in his efforts as he began to claw his way round the room, crying out loudly as he fought his way from handhold to handhold.

"Mah!" cried Gorkindachina.

And down went Atlanta's prize jafogus cactus, displaced from its place of pride on the windowledge.

"Mah!" cried Gorkindachina.

And Atlanta's curtains ripped, torn down by his weight even as he staggered to his next place of purchase.

"Oh no you don't!" said Atlanta, seeing that her vial of lightwine looked likely to go next.

The vial was a large one, the size of your head, and when at its full strength it could flood an entire room with light. It was sitting atop a stand which was directly in Gorkindachina's path. Atlanta had only had it a couple of months, and it was not yet paid for, and was not insured.

"No!" said Atlanta, grabbing Gorkindachina and wrestling him away from his chosen course.

"Ga-mar!" he cried.

There was fury in that cry.

And with that shout, Gorkindachina turned on Atlanta, and did his best to rend her. He beat, clawed, savaged, tore. She fought back vigorously, tearing the flesh from his arms in long strips.

"God!" cried Atlanta, realizing what she had done.

In horror, she threw her assailant backwards.

Gorkindachina crashed back against the nearest wall. The impact shook the room. The stand bearing Atlanta's precious vial of lightwine swayed, and almost went over. Thus shaken, the lightwine flared up, filling the room with renewed radiance.
That flaring light lit every detail. Gorkindachina. His drowned man's eyes. His nostrils, wiry with hair, distended. His throat, huge with raucous breathing.

"Hold you there!" said Atlanta, with a commanding anger as large as Gorkindachina's breathing. "Hold you there, you thing!"

But the Gorkindachina-thing came shuffling forward like a drunken bear. The flesh yet remained to both its hands, and its left arm was sheathed in ragged meat as far as the elbow, but apart from that its arms were nothing but articulated bone.

"Hold!" said Atlanta.

But the thing came on.

Atlanta struck out. Her clenched fist struck roundhouse, the weight of her body packed behind it. Fist met jaw. The jaw cracked, tore. Then the Gorkindachina-thing was grappling with her, hard hands biting at her throat as it tried to strangle her. In fury, Atlanta rended the thing, her hands tearing away great globs of flesh. The meat was cold, was wet, was soft and dank. It felt like nothing so much as wet dishcloths.

But while Atlanta tore at the thing, its fingers kept pressuring her throat, trying — ineffectually, but even the attempt was frightening — to choke away her breath. So she windmilled as her combat instructor had taught her, putting the strength of her shoulders into her downswinging arms.

The Gorkindachina-thing's bones broke beneath that onslaught. Its shattered armbones crackled hideously as its shoulders rotated. It was still trying to attack her, though its jawbone was hanging loose, though its flesh was in shreds, though white bone showed where Atlanta had hit it.

"Back off!" said Atlanta, giving the thing one last warning.

It stood, teetering. Then its teeth began to fall out, one by one. As the teeth fell, the vial of lightwine began to flare erratically, lighting the room with soaring crescendos of blue-white light. Then, caught by a sudden rush of uncontrollable rage, Atlanta kicked the Gorkindachina-thing's feet from under it. Down it fell, crashing to the floor like a sack of rice.

Atlanta stepped back, hard-breathing. A shudder shook her milksilver elegance as the flesh of the Gorkindachina-thing began to fizz, to hiss, to bubble, to disintegrate. Blue-black smoke coiled around the collapsing flesh, filling the room with a very strong smell of over-ripe oranges.

As the last of flesh and bone sighed away to nothing, the vial of lightwine flared for one last time, then died down to a sullen red, a sunset red which indicated that it would shortly extinguish itself entirely.

By that bloodglow, Atlanta saw that a single souvenir of Gorkindachina's visitation as yet remained. Two teeth, joined each to each. She picked them up, expecting them to disintegrate. But they remained firm between her fingers, indenting her flesh when she squeezed their unyielding hardness. They were false teeth, two false front teeth set in a plate. Atlanta put them down on her desk, at which point her vial of lightwine died away to utter dark.

Within the darkness, Atlanta scrabbled through her assortment locker, finding a big fat beeswax candle as thick as her arm, a thin white taper, and an incensed nostraluminum candle of the kind designed to be burnt in front of a mirarilusistan for the gratification of the ancestors.

Atlanta lit all three candles — lit them with a box of Ak Cherish Five Virtues Firecracker matches imported from Barth Banchup Bakchakris, the kind which ignite with a small pop and a smell which the knowledgeable have compared to seared flesh roasting upon burning sulphur.

She lit three candles? If you wonder at her extravagance, then know that a candle gives but poor illumination. We in our modern cities, accustomed to switching entire ceilings from moon to sun at the touch of a button, seldom encounter the candle except in our more romantic restaurants. Yet we all of us know that our ancestors spent their evenings by such light, and on occasion used it to work out their income tax, and so we are apt to imagine a candle to be the equal of a glossamer or Cold Perpetual. But — as you will discover if you ever try to do your income tax in one of our more romantic restaurants — the candle is but a poor substitute for the sun.

Atlanta Ignalina Jubiladilia was given to clarity. She favored clearsighted precision, which was why she had gone into debt to buy the largest vial of clearbright lightwine which could be found in all of Lexis. Even three candles burning in hot competition made but a poor substitute for such piercing knowledge. But by the romance of that light, Atlanta surveyed the unromantic shambles of her room.

There were fresh bloody footprints on the floor. There was a horrendous mess of paperwork, much of it besmirched with blood and water. But apart from that, and apart from the two false teeth -they were still on her desk, she checked to be sure — there was no sign whatsoever of Gorkindachina. The man had disintegrated. Flesh, skin, bone and bowels — all gone.

In the realms of Hell, a woman thus assailed at night by a thing of disintegrating flesh and scarecrow bone would presume herself to have surely been the victim of an unlug lorgis, one of those adroit torturing machines which work by conjuring the subject's worst imaginings to life. And in Heaven? A woman of Heaven would have thought herself surely the victim of a nightmare.

But the unlug lorgis was unknown in Chalakanesia; and, even had such a device been covertly introduced into Lexis, it would not have worked, for the unlug lorgis is one of those subtle devices which are disabled by the metapsychic faultline. Furthermore, even had Atlanta Ignalina then been resident in Barth Banchup Bakchakris, she would hardly have thought herself the victim of her own worst imaginings, since her own worst imaginings involved a collar, a chain, the senate, and a plate of the whitest porcelain imaginable. As for nightmare — why, mere nightmare does not leave bloody footprints and souvenir teeth in its wake.

Therefore Atlanta knew she had been molested by a ghost.

A ghost so solid as to be in the possession of at least two perfectly serviceable and substantial false teeth would not be counted a ghost at all, at least not in Heaven or Hell.

In the Gulf of Heaven, as in the Chasms of Hell, when one talks of a ghost one talks of an ethereal spirit from the World Beyond, a thing which has a touch far fainter than that of any tendril of the night air, a thing which is silent in its charades as it walks through walls or levitates nicely through the air.

Well.

They do have such ghosts in Chalakanesia, gossamer-fine creations so short of substance that they can slip through walls or walk upon water. But even such gossamer ghosts are not things from the World Beyond but, rather, shadows of people who are alive and well in their living, breathing flesh.

Furthermore, the ghosts of Chalakanesia range through a full spectrum which begins with shadow and works through to substantial flesh. The most precise of these duplicates are fully-fleshed doppelgangers hard to distinguish from the real, original person. Many such doppelgangers are capable of carrying on an independent life for days, weeks, months — in some instances, even years -before disintegrating into a bubbling confusion of expiring horror.

It should also be said that the spectrum of ghosts, though it stretches from shadow to flesh, does not end there. From time to time, the peace of Chalakanesia is molested by things possessed of a fearsome bulk, weight and rigidity which are alien to the merely animal. There are golems heavier than iron; there are things with faces of stone and feet which crack the granite flagstones where they walk; there are things possessed of a rending strength which can tear your greatest hero limb from limb like so much wet paper.

But these, fortunately, are rare.

All such ghosts — the whole spectrum, from gossamer spirit through doppelganger to golem — are products of the metapsychic faultline, that zone of instability which runs through the islands of Chalakanesia, and which interacts with the human mind, giving rise to those many transient phenomena for which Chalakanesia is famous.

Fortunately, the phenomenon of ghosting is largely subject to voluntary control, else most of Chalakanesia's people would bleed off a continual stream of partial spirit-images of themselves. One learns the control of this phenomenon early, learns it along with toilet training.

Certain undisciplined people — like Atlanta's sister Panjalo — maintained a habit of uncontrolled ghosting long into adulthood. At the age of twenty-one, Panjalo still ghosted frequently (and, apparently, shamelessly). But, to her knowledge, Atlanta Ignalina Jubiladilia had never ghosted in her entire adult life.

Now she had properly recovered herself, Atlanta sat herself down at her desk and went to work by candlelight, writing a letter for Tilibel Ulibel Ul, the youngest daughter of the Family Ul, who came daily at dawn to clean Atlanta's chambers.

You might perhaps imagine Atlanta scratching out this letter with a quill-pen fashioned from one of the pinions of a bird of prey, and scratching it out, moreover, upon fresh parchment or a worn palimpsest. But she did not. She wrote in the conventional fashion using a self-inking stylus sourced from Chan Molest, and she wrote upon the finest acid-free rag paper imported direct from Idosolaris.

"I have not been raped, murdered or seriously discomposed," wrote Atlanta in conclusion. "I have merely been annoyed beyond measure, as you too will doubtless be annoyed when you survey the mess which awaits you. Please rest assured that I will compensate you for the extra effort."

Having thus concluded her letter, Atlanta imprinted it with her inkan, validating the imprint of her seal by countersigning it with her signature. Then, having weighted the letter with a handgrenade (a child's plastic toy, a souvenir of her brother Heineman's boyhood — and there is no telling how it came to infiltrate her law office), Atlanta pinched out the nostraluminum and its neighboring beeswax candle.

If there was one thing she couldn't stand, it was people who blew out candles. Such an act lacked economy. It smacked of posturing, of the theatrical excess which Atlanta ever associated with her sister Panjalo. And, besides, the smoke lingered afterwards, filling the air with the unpleasant smell of greasy wax-smoke.

She hesitated.

She needed no candle, but the comfort of the thin-burning taper was tempting. She had been shaking, badly shaken, more badly than she cared to admit, and the prospect of darkness was momentarily threatening.

"My name is Atlanta Ignalina Jubiladilia, and I exercise my talents in the service of justice, in accordance with the law of Chalakanesia."

So said Atlanta, using the familiar words as a mantra. Then she reached out deliberately and pinched out the flame of the taper — slowly, so slowly she almost burnt her fingers. Despite herself, she took a deep breath as the darkness claimed her. But she controlled herself, exhaled slowly, then stepped to the door, took the key from its hook, unlatched the door, then exited to the darkness of the stairs.

Atlanta locked the door — the cleaner Tilibel had her own key — then started to descend the stairs.

Then she heard it.

There was something below, and it was coming up the stairs.

From the very first, Atlanta knew the thing to be a golem, a doppelganger built heavier than any ordinary ghost. She knew it by the strength of its tread, that heavy-step tread which set the building shaking as it came stumping up the stairs. Heavier than stone. Heavier than iron. And strong, strong, strong enough to tear her apart like so much wet paper.

Atlanta turned, and fled upstairs toward the roof.

MRI Result is Ready

MRI RESULT IS READY

Do I really need a rock-solid Solitaire concept as part of my basic skill set? Well, probably not, but Friday evening, Friday 24 February, after I fired up the computer the first thing I did was click on the Solitaire icon on the desktop.

My Solitaire concept proved to be intact, at least for the moment, and the cards displayed on the 14-inch screen of my ThinkPad were workable, and will be in sharper focus once I have had a pair of spectacles made optimized for fine print, something I have schedule for next week.

I have enough time in hand to accommodate the occasional hand of Solitaire because my life is on hold for another week.

The magnetic resonance imaging scan which I underwent recently has apparently been interpreted, and I will get the result (radiation damage to my eyes or damage caused to my eyes by the return of brain cancer, those are the options) on Friday 3 March.

Oncology is evidently busy because, if I had been unable to make that appointment, the next time slot on offer would have been in April.

My crisis, then, if I can call it that, moves at about the speed of global warming.

Tuesday, February 21, 2006

THE SUCCUBUS AND OTHER STORIES collection published


Above, the cover of a fairly massive book of short stories, over 600 pages of fiction, THE SUCCUBUS AND OTHER STORIES.

On sale now from

lulu.com/hughcookj

Unfortunately, while lulu.com would like to be a child-safe site, something like THE SUCCUBUS AND OTHER STORIES is not child-safe content, so to see this otherwise invisible "mature" content you have to certify yourself as adult, as follows:-

To see the mature content (1) sign up to make a free log-in identity then log in; (2) go to "MY ACCOUNT"; (3) click on "manage content access level"; (4) assuming you are 17 or older, choose "Mature" as the consent level, and save that preference.

Returning to lulu.com/hughcook you discover that a number of books which were previously invisible are now visible, of which THE SUCCUBUS AND OTHER STORIES is just one.

Some of these stories can be read online at:

zenvirus.com/stories/stories.html

This is a book of SF, fantasy and weirdness, a really solid collection, something I am proud to have published. Date of publication is Tuesday the 21st of February 2006.

What follows is the TABLE OF CONTENTS:

Oh, and also, the dedication!



Dedication

This book is dedicated with gratitude to the various editors who accepted my work for their publications. For details, see the TABLE OF CONTENTS. Many thanks to all concerned for their encouragement when I was actively submitting work back in the closing years of the last century and the first years of this new one.


Table of Contents

Page 19 — Story One — THE SUCCUBUS. Story of sexual politics. Contains necrophilia. Saw an editor write, somewhere, "If you're going to write a scene in which someone has sex with a corspe, you'd better have a very good reason." I feel I have reason sufficient, and make no apologies for the story. That said, this is probably going to be yet another story which my mother is not going to like. But that is just too bad. TALEBONES liked it: thanks, guys. First published in TALEBONES in 1999 ed. Patrick and Honna Swenson. Note: Startel is a proprietary name and is used descriptively. A big slab of a story, about 8,250 words.

Page 48 — Story Two — HOWIE GLENST AND THE WOMAN MADE FROM GLASS. A story about sexual desire, cyberprostitution and the sexual delusions to which men are prone. First published in ALBEDO ONE in 1999, editorial responsibility attributed to a collective. A shorter story this time, about 2,580 words.

Page 58 — Story Three — CONSENTING ADULTS. Sex story of about 900 words. Very brief. If theft is the sincerest form of imitation, I should feel flattered that this story has been plagiarised online, word for word, at least twice that I know of, my work passed off as someone else's. In case you didn't know, that's one of the sins for which you burn in Hell. First published in KIMOTA back in 1988, ed. Graeme Hurry.

Page 61 — Story Four — IF YOUR BABY WILL NOT SLEEP. Everyone writes sex stories but baby stories are fewer on the ground. A micro fiction of 217 words written during the intensely stressful first few months of parenting. First appeared when published online in 2006. (Any story said to have been first published online first appeared when posted on the zenvirus.com site, which can also be accessed via hughcook.com.)

Page 62 — Story Five — DADDY'S LITTLE GIRL — A longer story, about 3.000 words, which first appeared online in 2004. This story has a science fiction idea at the core, something human which is genetically new, which changes social reality. The story flows, emotionally, from the rage and frustration which I experienced during the first months of fatherhood. A child is one thing, but a baby, this red-faced thing which screams mercilessly, with no stopping it, that is another thing altgoether. To the parents of young babies everywhere, my sympathies. (And you, if you don't like my attitude, you can go write your own happy story starting "The baby cried endlessly, and the more it cried the happier the perfect mother got.")


Page 72 — Story Six — POGY BOBS AND THE HYENA OF DEATH. From sex the natural segue is to violence, or, better still, sex and violence. Unfortunately we took a double deviation into procreation, touching first on motherhood then on fatherhood. But now we're back on track again with a serial killer sex slaughter story complete with the hyena of death. Put that "horror" label on the cover, got to have at least one serial killer story in the collection. It's a rule. First published in HARPUR PALATE in 2001 ed. Toiya Kristen Finley, and made BEST OF THE REST 3 in 2002, ed. Brian Youmans. A reasonably substantial story at about 6,300 words.


Page 93 — Story Seven — HONEYMOON. And, having started down the horror road, let's go further. Much further. This is as about as dark as dark gets. A short 778 words, first published online 2004. Republished in THIRTEEN in 2004, ed. Andrew Hannon.


Page 97 — Story Eight — SUICIDE HOTEL. I spent seven years living in the Tokyo-Yokohama area, where, every year, hundreds of people inconvenience fellow citizens by jumping in front of trains. What every society needs is specialized hotel facilities where people can take care of that kind of self-destruction without inconveniencing their fellow citizens. 931 words, first published online in 2004.


Page 109 — Story Nine — THE SUICIDE BOMBER. A story about the motiveless malignancy of the suicide bomber, the malignant death freak we do not, cannot, will never understand. 1,697 words, first published online 2003.


Page 115 — Story Ten — THE RAT. From suicide to murder. The rat, which is not trying to commit suicide, dies. 524 words, first published online 2003.


Page 117 — Story Eleven — THE KIDNEY BEAN DIET. From one extremely unpleasant murder to another. A story of 1,850 words first published in ALBEDO ONE in 1998.


Page 124 — Story Twelve — GOLF COURSE. And once you're dead, what then? One option is given here. 2,739 words. First published in 1999 in SACKCLOTH AND ASHES, ed. Andrew Busby.


Page 134 — Story Thirteen — OTHER LIVES. Meanwhile, back on planet Earth, murder yet again, this time with demonic complications. First published in the winter 2000/2001 issue of BLACK PETALS, edited by Kenneth James Crist and John Gollihar.


Page 145 — Story Fourteen — HER MINT-GREEN BREATH. Moving on from murder to murder, here is a science fiction tale about murder in a mode of corporate wetwork. First published in TALEBONES in 1999, ed. Patrick and Honna Swenson.


Page 169 — Story Fifteen — HARRIET'S ARMPIT. Harriet gets started with one murder, that of her husband, but it most certainly does not stop there. 1,704 words. First published online 2003.

Page 175 — Story Sixteen — HOT CARDBOARD. Hard-boiled story of city life complete with a drive-by shooting, a box cutter rape and a male hearthlessly abandoning a female on the grounds that she has been despoiled. (No fault of hers. She's the innocent virgin who got slashed up big time by the box cutter.) The big hard city does not come any harder than this. 1,609 words, first published online 2004.

Page 181 — Story Seventeen — SANTA CLAUS, SEX CRIMINAL. Your friendly local pedophile endures the damnation of his afterlife, forced to commit a series of acts of giving, a series of selfless acts of light. You with your left leg blown off, got a box of chocolates here for you, too! A story of redemption and of spiritual hope. 919 words. First published online 2004.

Page 184 — Story Eighteen — SWEETNESS AND LIGHT. From one form of purity to another. Literature gets cleaned up. All that nasty stuff? It goes. (Not a new idea. Historically, Thomas Bowdler, a "let's clean up Shakespeare for the family" editor, was hard at work on this some time during his own lifetime, 1754-1825.) 3,462 words. First published in PSYCHOTROPE in 2000, ed. Mark Beech.

Page 196 — Story Nineteen — JORGELVACE. A science fiction story about reality mutating around you. The game has changed, obviously, how how exactly? And how are you going to handle it? 88 words, first published as part of an e-mail newsletter in 2004.

Page 209 — Story Twenty — THAT NIGHTMARE KNOWN AS LIFE. So your eyes open and you are awake, but who are you and where are you? In which nation is this mountain? And what are you doing on the mountain? And how are you ever going to get home again? 9,250 words. First published in CHALLENGING DESTINY in 2001, ed. David M. Switzer.

Page 243 — Story Twenty-One — THE TRIAL OF EDGAR ALLAN POE. This underage sex stuff, can't let the guy get away with that. Would set a truly terrible precedent. SF story of 7,393 words first published in CHALLENGING DESTINY in 2002, ed. David M. Switzer.

Page 269 — Story Twenty-Two — SHOTGUN AL'S LAST PICNIC. A classic science fiction scenario: the multi-generational spaceship heading out into the hard vacuum, away from the sun. Sounded like a good idea to the scientists who got on board it. But Al, he wasn't consulted about this. So there are consequences. 6,559 words. First published PREMONITIONS in 2004, ed. Tony Lee.

Page 290 — Story Twenty-Three — HEROES OF THE THIRD MILLENIUM. And from one classic science fiction scenario to another: the time machine. Have time travel machine, can travel. Where? To New York. A story which, having visited New York, I wrote and sold to a New York editor, Gorden val Gelder of FANTASY AND SCIENCE FICTION, in the pages of which this story first appeared back in 1998. A reasonably substantial story at 5,017 words.

Page 307 — Story Twenty-Four — BAD SEX. Continuing with classic science fiction themes, a clone story. 5,285 words, first published online 20003.

Page 326 — Story Twenty-Five — NIGHT ON BEAR MOUNTAIN. A virtual reality story of 7,903 words first published in CHALLENGING DESTINY in 1999, ed David M. Switzer.

Page 351 — Story Twenty-Six — HUNTING ANDREW. An SF story of 3,705 words first published in ALBEDO ONE in 2001, editorial reponsibility attributed to a collective. Published again in BLACK PETALS in 2002, ed. Kenneth James Crist and John Gollihar.

Page 364 — Story Twenty-Seven — HOUSE HUNTING. This story of 3,479 words also came out in BLACK PETALS, thanks to the same editors, appearing in 2003, in the Halloween issue. Reality starts to get a little atlernative. A story about the nightmarish process of looking for a house to buy.

Page 376 — Story Twenty-Eight — HIS NAME WAS MAC. Reality continues to get alternative as we take a fresh look at the homeless person problem. A story of 1,889 words was first published online in 2003.

Page 386 — Story Twenty-Nine — BOXES. One editor rejected this saying it was too obvious right from the start exactly what was happening. Another rejected it because he read it through three times and quite simply could not understand what was going on. Can't please everyone. The editor who accepted it was Graeme Hurry who published it in KIMOTA in 2000. A story of 1,314 words about a man in an extremely alienated situation.

Page 391 — Story Thirty — LIFE ON PLANET EARTH. Reality gets totally alternative. An SF story about the consequences of an alien invasion of our planet. A story of 3,386 words first published online in 2003. In 2004 this story was published for a second time in THIRTEEN, ed. Andrew Hannon.

Page 404 — Story Thirty-One — LIVE ON CHANNEL 10. A horror story about a fire, a little piece of realistic horror fiction. A story of 1,064 words first published online in 2003.

Page 408 — Story Thirty-Two — THE TRANSFER OF PATIENT TWENTY-SEVEN. Still in a mode of realism, a sombre lunatic asylum story, a story of words first published online in 2003.

Page 414 — Story Thirty-Three — VIEWS OF TEXAS — A brief literary excursion into mainstream fiction, a take on old age. Mine, yours. That of your parents. A story of 691 words first published in BARBARIC YAWP in 2002, ed. John and Nancy Berbrich.

Page 417 — Story Thirty-Four — CONSEQUENCES. If you desecrate the sacred temple, there are consequences. A story set in Thailand, Nepal and India. A story of 4,591 words first published in 1998 in TALEBONES, ed. Patrick and Honna Swenson.

Page 432 — Story Thirty-Five — AN ALIEN IN JAPAN. A story about an alien living in Japan. Married to a Japanese woman. Japan is a pretty strange place. These things called dogs, for example. This story of 3,440 words was first published in 1999 in SACKCLOTH AND ASHES, ed. Andrew Busby.


Page 444 — Story Thirty-Six — THE EARTH IS FLAT is a story of 4,326 words first published in CHALLENGING DESTINY in 1999, ed. David M. Switzer and Robert P. Switzer. It is a high school story which introduces us to Ida Brahma, who conclusively demonstrates that, yes, the planet on which we live is flat.

Page 458 — Story Thirty-Seven — LOST IN THE MOID. In this story of 7,314 words also first published in CHALLENGING DESTINY. In this tale we pick up the tale of Ida Brahma at a time when she is lost in the moid, an artificial environment which contains gateways opening onto a variety of planets, some more hostile than others. A science fiction survival story. Ida Brahma, young adult, must face her reality and master it. The alternative is to die trying.

Page 482 — Story Thirty-Eight — VORN THE GLADIATOR. A story including torture, a story of 4,364 words first published in VAMPIRE DAN'S STORY EMPORIUM in 2000, ed. Daniel Medici, then published in LEGEND in 2001, ed. Trevor Denyer.

Page 496 — Story Thirty-Nine — INVASION OF THE CHICKENS. The heroic gladiator, Vorn, faces his greatest challenge, the invasion of the chickens. A story of 3,730 words first published in CHALLENGINE DESTINY in 1999, ed. David M. Switzer and Robert P. Switzer; published again in LEGEND in 2002, ed. Trevor Denyer.

Page 508 — Story Forty — MACHINE READABLE. Ever have nasty fantasies? Suppose the government had a way to sniff them out. And that they were against the law. SF story of 3,150 words first published in THE DREAM ZONE in 1999 ed. Paul Bradshaw.

Page 519 — Story Forty-One — PORTRAIT OF A WOMAN WITH HER HAIR ON FIRE. An interesting case. SF or fantasy, you be the judge, a story of 4,042 wrods first published in ALTAIR in 2000, ed. Robert Stephenson.

Page 533 — Story Forty-Two — THE INVENTION OF STONES. Culturally, what is it, exactly, which drives these delinquent kids to do these crazy things? A story of 1,419 words first published in CHALLENGING DESTINY in 2000.

Page 538 — Story Forty-Three — KILLED BY A GHOST. A ghost story, obviously. 1,732 words; first published in 2004 in OMEGA 3, ed. Alexander Hawksville.

Page 545 — Story Forty-Four — A GORILLA IN VIETNAM. Fantasy story of 4,072 words first published in SPACE AND TIME in 2005, ed. Gordon Linzner.

Page 560 — Story Forty-Five — MEETING MY AGENT. A war on terror story. First published online in 2003. Became my Hungarian breakthrough story when published in Hungarian translation in GALAKTIKA, ed. Nemeth Atilla. A spectacular science fictional cover on the magazine and my own story in a language totally unknown to me: Hungarian publication was, for me, my own very happy science fictional experience.

Page 562 — Story Forty-Six — SAINT GEORGE AND IBRAHIM. A crusade in action. Horror story of 208 words first published online 2003.

Page 563 — Story Forty-Seven — MAKING AN ATOM BOMB. 72 words; first published online in 2003.

Page 564 — Story Forty-Eight — ESCAPE FROM HELL. Out of the frying pan and into the fire. A war story of 1,505 words first published online in 2004.

Page 569 — Story Forty-Nine — YOU'RE IN MY BODY. And I would like you to leave. Now. Fantasy story of 516 words first published online in 2004.

Page 571 — Story Fifty — A SUBWAY RIDE. And what happened during the ride. 544 words; first published in 2003 in THE FROGMORE PAPERS, ed. Jeremy Page.

Page 573 — Story Fifty-One — THE TRIUMPH OF JAPANESE ENGLISH. A true-to-life insight into how some of the English which comes out of Japan originates. 380 words; first published online 2003.

Page 575 — Story Fifty-Two. MOUNTAINEERING COMPLEX. Satirical vignette of 741 words first published in BARBARIG YAWP in 1999, ed. John and Nancy Berbrich.

Page 578 — Story Fifty-Three. WET LEAVES ON THE TRACK. Normality as weirdness. 668 words; first published in EM THREE in 2001, ed. Karl Sinfield.

Page 581 — Story Fifty-Four. A TOTALLY ORDINARY YOUNG WOMAN. Just sitting on the bus then! 736 words; first published in KIMOTA in 2001, ed. Graeme Hurry.

Page 584 — Story Fifty-Five. THE INTERVIEW. Realistic interview story, loss of temper story. 419 words; first published online in 2003.
The A-F stories below form a group, GRANT OF POWERS, stories about getting a grant of power, not necessarily to your advantage. All pretty brief. I call this length compact fiction: a little longer than flash fiction but a bit not much. A-F all first published online in 2006.

Page 587 — Story Fifty-Six — AARDVARK GETS NOTICED. We all want celebrity, right?

Page 589 — Story Fifty-Seven — BERTRAND GETS KISSED. Want to be indelibly grossed out? No? Then don't read this story.

Page 591 — Story Fifty-Eight — CASPAR PLAYS DOCTOR. You can buy the parchment online. But what if your sister now decides that it's for real?

Page 594 — Story Fifty-Nine — DAVID STARTS A CULT. Let's get weird. See how far we can push it.

Page 596 — Story Sixty — EVANS EATS GARLIC. A vomit story, if you're up for it.

Page 598 — Story Sixty-One — FABIAN GETS EXCITED. First published online in 2006.

Page 600 — Story Sixty-Two. THE THERAPY OF THE GREAT GOD MULCHAGOLA. A story about therapy first published online in 2004; 930 words.

Page 604 – Story Sixty-Three. BURNING LOUTY. Extreme stress produces an extreme reaction. A fantasy story of 931 words first published online in 2004.

Page 607 — Story Sixty-Four. LOST IN HIS BEDROOM. A realistic brain damage story. Autobiographically, before my own brain cancer was diagnosed and treated, I got lost three times at night. Not in my bedroom but on the darkened streets going home. Freaky experiences do not come any freakier than getting lost on the familiar road home.

Page 610 — Story Sixty-Five. METASTASIS. Fantasy horror. Cancer, personified, arrives and inflicts. 1,263 words. Fiction, but first published in 2005 in the non-fiction medical memoir CANCER PATIENT.

Saturday, February 18, 2006

WITCHLORD WEAPONMASTER second edition now on sale


Book ended up being a standard paperback size, 6 inches x 9 inches; 8.5 x 11 inch description is wrong ... sorry ...

Above, the cover of a new edition of THE WITCHLORD AND THE WEAPONMASTER, the tenth and final volume in my CHRONICLES OF AN AGE OF DARKNESS series. It has been out of print for some years, but now a new edition is on sale.

The book can be bought at:

lulu.com/hughcook

lulu.com/hughcook

Unfortunately, while lulu.com would like to be a child-safe site, something like THE WITCHLORD AND THE WEAPONMASTER or the suicide bomber novel TO FIND AND WAKE THE DREAMER is not a child-safe book, so to see this "mature" content you have to certify yourself as adult, as follows:-

To see the mature content (1) sign up to make a free log-in identity then log in; (2) go to "MY ACCOUNT"; (3) click on "manage content access level"; (4) assuming you are 17 or older, choose "Mature" as the consent level, and save that preference.

Returning to lulu.com/hughcook you discover that a number of books which were previously invisible are now visible.

For those who are not familiar with THE WITCHLORD AND THE WEAPONMASTER, I have written a blurb, which is below. Note that, though this is the tenth volume of a series, it constitutes a self-contained novel in its own right, and can be read independently without any reference to any other book in the CHRONICLES OF AN AGE OF DARKNESS series.

Blurb

This massive novel of 57 chapters and about 250,000 words is the story of a barbarian named Guest Gulkan. He, the self-styled Weaponmaster, is the son of an emperor known as the Witchlord. The story concerns, amongst other things, the struggle for the control of the empire, and the sweep of the action encompasses battles, wars, the invention of air travel and the first-ever airwreck. (Actually, to use the parlance of the wizard Sken-Pitilkin, they didn't get air-wrecked. Rather, they crashed.)

Before Guest is done, he had learnt an enormous amount about geography by fighting battles on various bits and pieces of it, by adventuring through it and by being airwrecked on it. He survives a duel in Enskandalon Square, sword against sword in fair combat against the Rovac warrior Thodric Jarl, and survives, also, an encounter with the Great Mink.

Survival is not painless, as the following excerpt suggests:

"For Guest Gulkan, arms and legs both shredded by the mauling strength of the Great Mink, there was no blessed darkness."

Will Guest Gulkan survive being savaged by the Great Mink? And how will he fare against the quokka when he eventually encounters it in the Stench Caves of Logthok Norgos? The key issue in politics, as one of the wise has said, is "who whom". That is, who has the power to do what to whom? When Guess Gulkan comes face-to-face with the quokka, who will be hung and who will do the hanging? And who, ultimately, will rule the empire?

In this sprawling saga, a tale of combat, torture, power struggles and (on occasion) encounters with the irregular verbs (and more, much, much more) the tale of Guest Gulkan unfolds in a self-contained novel which is complete in itself. No prior knowledge of Guest Gulkan or his world is required. Eat well, pack lightly, make sure your boots have plenty of road-wear left in them, then begin, if you dare, this, the ultimate saga adventure.

Blurb ends.

My publishing plans for 1996 include new editions of two other books which are out of print, THE WORDSMITHS AND THE WARGUILD and THE WORSHIPPERS AND THE WAY.

With those two miising books also published, all ten books will be in print, as Colin Smythe of Colin Smythe Ltd is still selling stocks of the original Corgi paperback versions of the remaining seven books in the ten-book series.

Transworld Publishers, owners of the Corgi Books imprint, remaindered the Corgi paperbacks some years ago, but Colin bought the stocks and rebadged them with new ISBN numbers, therefore these books can be purchased from amazon.com.

Also on sale at the lulu.com/hughcook storefornt are the three books of the OCEANS OF LIGHT trilogy, a fantasy trilogy set in the archipelago of Chalaknesia. The three books are WEST OF HEAVEN, EAST OF HELL and NORTH OF PARADISE.

Special Language for Talking to Children

SPECIAL LANGUAGE FOR TALKING TO BABIES

I read a book called BABY TALK which recommends that you teach your baby your native language only, not some other language. Why? Because, as a native speaker of your language, you know the special talking-to-babies variatne of that language, which you will automatically deploy without conscious effort.

Reading this, I was intensely sceptical, despite having been impressed by the book as a whole. A special language for talking to babies? Not me! I'm a baby zero, know nothing about them except that you put wet stuff in at one end and take it away at the other.

Or so I thought, until, on a day very early in my daughter's life, it was stime for her to wake, and I said, quite without thinking:

"Wakey wakey!"

And my Japanese wife, whose English is easily good enough to read the newspaper, asked: what is this wakey-wakey business? No kind of English that she knew.

And I realized that, yes, it was the special language for talking to babies, and that I had been programmed with it at a very deep level, to the point where it was automated, unthinking, a situational imperative commanding me without conscious thought.

Culturally, then, as a native speaker of English, I've been programmed to speak to babies.

Later, turning this over in my mind, I wondered where, if you were going to do a thesis on this, you would find written materials, something to quote and cite.

Well, recently, thanks to a very welcome gift made to a member of my household, I got access to a starting text, something you could quote and cite.

Not that I'm ever going to write this thesis, but someone might, some day.

The book in question, which fascinated me, is A WAS ONCE AN APPLE PIE by Edward Lear, a book which is a product of the Victorian age, the age of the twelve-child family. An alphabet book, one poem per letter.

My family, including me, likes to eat, and my mother's favorite in the collection is this one:

C was once a little cake,
Caky,
Baky,
Maky
Caky
Takey caky
Little cake.

Culturally, this book could almost be today. There are, however, a few Victorian era markers: U is for Urn, and P is for Pump, as in the familiar local hand pump which you use to pump ground water up into your bucket.

And Z? I expected "zoo", but, no, it's "zinc", a metal the Victorians used, I think, for a bunch of purposes for which we would use plastic: a zinc bath, for instance, rather than a plastic bath.

I think our image of the Victorians is not that of the progressive child educators, but A WAS ONCE AN APPLE PIE is quite simply genius at work, playfulness on the loose in a mode of uninhibited generosity.

The edition which has made it as far as my household is illustrate very nicely by one Julie Lacome. If your house lacks its collection of Victorian urns, the picture economically communicates the concept.

At first blush, the word "urn" does not look poetically promising, but Lear, limbered up and in an effortlessly recombinative mood, the master at work, goes to work on it, and produces this:

U was once a little urn.
Urny
Burny
Turny
Urny
Bubly burny
Little urn.

A totally proportioate genius.

Urn, zinc and pump apart, not much has changed. The text dates from two centuries back, but we still have dolls for D, and, in Japan, if I ever get there, vine for V is part of the living reality of the expaded matchbox which I refer to grandly as "the lawn".

Speakig of Japan, a teaching note: having taught at elementary school in Japan, I think these poems would go down pretty well with ages six and seven, being suitably declamatory. The one hundred and fifty kids in a gym situation, and what are you going to do with them? Well, BAA BAA BLACK SHEEP and THE LITTLE TEAPOT song took me a long way, but, if elementaqry school is ever again to be a part of my doom, then I reckon I'll have Lear in my backpack along with all the other stuff.

Brain Damage

BRAIN DAMAGE

The immediate consequences of brain damage, right now, are blurred vision, a loss of central vision in the right eye and a generalized haziness in both eyes, together with a loss of the visual field in the upper left quadrant of each eye.

Getting no worse, as far as I can tell, and, although it is impossible to judge accurately from my own subjective position, it is possible that the visual field defect may be in the process of gradually clearing up.

There are three explanations for this obvious damage: (a) an irreversible but self-limiting damage process to the nerves inflicted by last year's theoretically therapeutic radiation; (b) pressure put on nerves by a return of brain cancer; or (c) logically, a possible combination of both (a) and (b).

My doctor told me (a) and (b) but logic necessarily forced (c) into the play of my considerations.

To find out what is going on, I needed a magnetic resonance imaging scan, which the public system, presumably prodded hard by the oncologist who heads the team dealing with my case, finally delivered one, in a reasonably timely fashion, on Wednesday 15 February 2006.

It would have been possible to go private and get an MRI done a few days faster, but my eye surgeon had counseled me to do no such thing, saying that the key point would be not obtaining the MRI scan but interpreting it. Locally, it seems, genius in interpretation lies with the experts working for the public health system.

They work in pairs, it seems, and, if memory serves, it takes a team of two a couple of hours to work through a set of brain images and to figure out what has happened.

They will be comparing my new scan with one or more of my old scans, all available in computerized form, but, given that the brain has not only been damaged in various ways but is also, in the aftermath of radiation, in a never-ending state of dynamic changes, always and inevitably changing from one scan to the next, arriving at a diagnosis is not going to be easy.

But I am assured that it will be done.

If it's only radiation damage, then I will be back to Japan. If so (and even if not so, in fact) I will be making another trip to the optometrist to get a third pair of spectacles.

My first pair was a set of progressive lenses which were a poor and partial solution, engineered as a kind of rational compromise for an eye incapable of adjusting to different distances, and, therefore, optimized for none.

For computer work, a pair of spectacles adjusted precisely to the computer-working distance -- I took my computer to the optician to be sure of getting it right -- has proved entirely satisfactory for my private purposes.

But, at the distance of my outstretched arms, it is impossible to sharpen up the image to pull the smallest fonts into focus, so I still need a magnifying glass to read the details of some pull-down menus which cannot be adjusted.

This is fine for me, but not really acceptable in a corporate environment.

Also, although I can pick my way through a newspaper without the magnifying glass, it is a slow and difficult task.

So I figure that my next step is going to be a pair of spectacles optimized to sharpen up fine pint at whatever distance that is best done, probably where a book would sit if I held it in front of me to read it.

Then, if I ended up working at a computer in some glossy corporate environment in Japan, a land where appearances are important, I could simply wear my computer spectacles and have my up-sharp-and-close spectacles sitting on the desk, and swap to these, and lean forward to study the screen, when I needed to capture fine detail from the screen.

So, if all I am looking at is nerve damage, then, given that I have been told that this damage has probably gone as far as it will, and given that my eyesight is still workable, I could be on a plane back to Japan as early as next month.

If the cancer is back, non-Hodgkin's lymphoma of the large B-cell variety, the one treatment option (which may, for technical reasons, not be available, something my oncologist would have to research) seems to be a specialized B-cell killer drug, a drug which goes through and wipes out all B-cells, good or bad: a drug called rituximab, promoted on the pharmaceutical industry website rituxan.com.

The "return of cancer" option is alive and well at this stage, but it is a possibility, not a definite given.

The ongoing expression of brain damage, however, is inevitable, part of the background of my life.

I have been told that the "moderate" shrinkage of my brain which was caused by methotrexate is similar to the shrinkage of the brain which is experienced in old age. In effect, then, the aging process has already been accelerated, and my brain is, in effect, years older than its biological age.

I have also been told that the radiation will, in the coming years, produce accelerated aging, with the result that effects that could have been expected thirty years in the future cutting in sooner.

How sooner nobody can tell, but the brain will continue to change for at least ten years, maybe fifteen, with consequences.

Some of those effects may already be with me, but it is hard to differentiate brain damage from fatigue, pure and simple.

At the moment, I am stable but largely sleepless on a dose of eight milligrams of dexamethasone a day. I have no sleep pattern left. I move forward in shark mode, feeling low-key and businesslike, until exhaustion cuts in. Then I go to sleep. And, after a while, maybe as little as ninety minutes, on occasion as two, four or even six hours, I am awake again, further sleep no longer either necessary or possible.

The good point about this is that, as a lifelong insomniac, I find nothing odd about being up and awake when everyone else is asleep. The bad point is that if this goes on for too many months, as it did last year, then I will eventually enter a zone of extreme irritation, the result of the cumulative effects of sleep deprivation.

Last year, I got thoroughly tired of being eternally driven forward by the drug, never able to blob out and relax.

Anyway, for practical purposes, I find myself, currently, in a zone of productivity, with writing projects of one kind or another stacked up waiting to be done, and with the hours of darkness, good for no other purpose, pushing ahead with my work.

The writing skills are solid.

Other things, not.

I was cleaning up unused icons on my desktop the other day and found the Solitaire icon, never used, and clicked on it. The Solitaire game opened up on the screen and I was disconcerted to find that my Solitaire concept had been deleted.

Experimentally, I pushed a king to the top of the screen. It jumped back, rejected. No, kings do not go to the top. But what does? How do you play this game?

I gave up, closed it down. Opened it up again the next day. This time, remembered. Aces go to the top.

A day had been sufficient time for my brain to recover its Solitaire concept from wherever the concept was hiding. But, initially, the concept had been deleted, which was disconcerting.

I once read a newspaper article about a navy diver who, over the years, had suffered brain damage as a consequence of imperfect decompression. The result was that he ended up with navigation problems and could not find his way home.

In Japan, back in the closing months of 2004, I had the extremely scary experience of getting lost while going home on darkened roads at night. This happened three times, the brain cancer, as yet undiagnosed, being in the process of shutting down the brain, pressure building up and squeezing nerves.

Now, in 2006, I find that my night navigation is definitely shot.

In the light, getting from A to B is no problem. But, if I am in the dark, trying to get from A to B, then I cannot match my mental map to the reality which I am trying to navigate through.

I was on my way to the kitchen, moving through the darkened house, and was convinced that I had arrived at the kitchen sink. But it was not steel but porcelain. Unaccountably, I had navigated my way into the bathroom, remote from the kitchen. I had gotten completely lost and disoriented in the darkness of what is, really, a very small and compact house.

The simple answer to this problem is to switch on the lights when moving around the house at night, which is what I now do.

But it is clear to me that I have identified the first significant identifiable outcome of brain damage: my night navigation facility has been deleted.

On top of that, my night vision itself is shot. I cannot see well in dimly-lit shops.

With optimized spectacles not yet available to me, reading for pleasure is not really an option, unless I restrict myself to large-print books. So recently I've been having my computer read to me.

I have been checking through the texts of some of my own writings by using OpenOffice 2.0 (a free office suite, roughly equivalent to Microsoft's Office suite) which can effortlessly convert a file to PDF format (FILE throws up an EXPORT AS PDF option).

Adobe Reader 7.0 can read a PDF format in a computer synthesized speech which sounds pretty close to someone reading naturally, with a surprisingly close approximation to natural intonation.

(VIEW -> READ OUT LOUD).

There are a few speaking books on CD at the library, but nothing i particularly want to listen to.

It occurred to me, suddenly, that I can make my own speaking books very easily.

Just get a plain text of a book, and there are thousands available online from Project Gutenberg, open it up with OpenOffice 2.0, export is as a PDF file, and, voila! My own speaking book, done in less than five minutes.

It is also possible to get files for a range of free books from other sources. A few years back, Baen Books was offering various read-free science fiction books, for example.

I had been thinking of possibly getting an iPod, but have rejected the idea, at least for the moment, since I'm usually working with my computer on my lap, and so can just plug earphones into the computer.

Plus, an iPod cannot read PDF documents aloud, at least not yet, as far as I know.

It occurs to me that maybe Apple or someone might give us a hand-held reader for PDF documents, a gadget into which you could load your Adobe Reader / Adobe Acrobat public document format documents, and have them played to you.

So far, I have been able to have Adobe Reader read a whole text through to me, stopping it and starting it by the simple process of closing the lid of my computer whenever I wanted a break.

But to become a proper reading technology there really has to be the capacity to rewind a little and listen again, and so forth.

At the moment, being uncertain of what the future holds, I want to push ahead with my list of writing projects as fast as possible, aiming to optimize my use of my time. But, some time, I hope to take another look at what is out there on the Internet in terms of texts.

Some years ago I downloaded quite a few books, which I still have on CD-ROM somewhere in Japan, but I never read a single one of them. Like most of the rest of the world, I don't find reading a book on a computer screen to be satisfactory. In comparison, having the computer read a book to me is a more satisfactory solution. Though, as indicated, the technology for reading PDF files is at its most primitive "works but a bit clunky" stage.

What we consumers want, I think, is a kind of iPod-sized device with PDF-reading facility with rewind capacity, easy pause-and-restart controls, speed control (from BBC ponderous to race track commentator gabble speed) and a range of reader's voices (male, female, young, old, and not just American English but other accent options also).

Meantime, I can make my own reading library, when I have time. Five minutes a book. No problem.

Magnetic Resonance Imaging Scan

MAGNETIC RESONANCE IMAGING SCAN


There is no induction process.
I am the expert,
The many times,
And they know it from their records.
The machine
Transports me into the tunnel,
Ready for my launch.
Gabrupting on,
The magnets mining for data,
Sharp drillbits of sound
Ferreting my psyche,
Discovering
The astigmatism of my ethic,
The skewed oblong of my soul.
Invasive gopera,
Gorthic with discord,
Flangelating the brain.
Tronstop! Tronstop!
Coherencies of code,
Impositions of certainty.
Noise garrotes and abrupts,
Gamhandling,
Onhocking,
Degolstigating.
Drilling the universe for my data.
Encrypted insertions,
Mega attacks of the alien armies,
Incursions
From the outer galaxies,
Serrated hammers,
Jagged stars,
Triumphant,
Suzerain,
Sound dominant.
Lordship rules the world.
The machine owns me.
Carelessly
Transgressive of aesthetics.
Conquering the universe.
In the background,
The steam piston,
Archaic powerhouse
At the heart of the universe,
A cryptic treadle hissing,
Gastumption! Gastumption!
And, over its underlay,
Silences, pauses,
Meditations of aggression,
Then the sounds again,
Jaculations,
Scarab extravaganza,
Inverted pyramids of annihilation,
Erratic in onslaught,
Emphatic in assault.
Bizarre beyond orchestras.
Music
Self-invented.
And so the MRI proceeds.
Out of the hurtling of expectations,
There will be an outcome.
These messed-up eyes of mine:
Damage from radiation?
Or cancer back and death?
We will get an answer
Teased from the puzzle palace
Of my mobile disaster,
That melt-down called my brain.
Half way.
Withdrawn from the machine,
I am injected.
A dye for contrast.
The drug
At the pulse of panic
Spurtles to the brain.
An instant smell,
Alien,
Fluid in the blood
Made olfactory:
The rare earth, gadolinium,
Conspiring with my neurons to create
An imagined odor.
I am breathing Betelgeuse.
Back in the machine then done.
The machine
Disgorges me.
Meat on the rack,
Extruding.
Out of the tunnel, headphones off,
Reclaiming shoes.
The woman,
She's been watching.
The acquisition not unobserved.
"I can see you've had brain surgery."
My infolds have no privacy.
That said, my nakedness is still a mystery,
The revealed brain
A hodgepodge of deconstruction,
Scarred by surgery,
Skeletal with tapered tumors,
Shrunken by methotrexate,
Cooked, and cooking still,
By radiation,
Its arc of change projected
To run for en years easy and chase fifteen.
If I live.
Some interpretation required here, obviously.
Next step: shopping.
Clothes.
Eighty dollars at the dirt and cheap.
Three T-shirts,
Seven pairs of underpants,
And ten pairs of socks,
Black,
Identical.
If I get out of here alive,
If I get back to Japan,
There will be a massacre of the geriatric socks,
Their mismatched jumblage
A holocaust
Promised and yearned for.
Okay, we got the scan
And we triumphed
In the realms of haberdashery.
We're on track.

Informed Consent for Death

INFORMED CONSENT PROCEDURE FOR DEATH

I know this is tiresome for both of us
But we do have this procedure.
It's a legal requirement,
And we cannot proceed
Without a signature.
As part of the protocol,
There are certain side effects
Which I must necessarily draw your attention to.
Your eyeglance, earglance and postural profile
Will not be human-normal.
Your social life will cease.
Additionally, psychologically,
Regret is not unheard of.
Telepathy?
I don't believe we promised that.
Are you quite sure you're in the right room?
Let's check.
Room 40-K?
That's us.
But, sorry to be a niggle worm,
Just to be sure,
Just to be on the safe side,
Could I see your Surcease Number, please?
Thank you.
Any questions?
Yes, the donuts do have jam in them, as promised.
When?
Why, as soon as we're done.
How many?
As many as you want.
You're not rationed.
Just one more thing, before we do get done:
You do understand, of course,
That we do not offer refunds.
Good.
Any final questions?
Pardon?
Can you say that again?
Yes, that's true.
You have been correctly informed.
There will be no, absolutely no, requirement to pay taxes.
Yes, I agree:
It's a big happy.
Sign here, please.

Sunday, February 12, 2006

Informed Consent Procedures are Broken

Informed consent procedures are broken.

I've been thinking of this on and off for some time now, having been through quite a number of informed consent procedures, both in New Zealand and Japan, and they have all been broken in exactly the same way: there is no concept check.

No feedback loop.

No "what is your understanding of what you have just been told?"

Maybe a "Did you understand that?", but, as a trained English teacher, I can tell you straight off that this is the world's most useless question. Does someone understand? Well, if they can explain it to you in their own words, then, yes. Otherwise all you know is that you heard the word "yes".

A broken procedure, then.

Nobody asks you "What do you think you've just been told?" There's no student-teacher relationship here, even though, in practice, the patient is the student, studying to understand.

Got no money for that. Got no time. If there's any formal teaching of the notion of becoming a patient as being some kind of induction procedure through which the patient should be guided and assisted, I've never seen any evidence of it.

Done as it is, on the quick and on the cheap, look at this and sign here, informed consent procedures, as they currently exist, are, in my considered opinion, not very far removed from the realms of the farcical.

As a rule, the whole thing becomes reduces to a legal formality, often with the "we have a legal requirement to do this" message being explicitly communicated to the patient in as many words, sometimes by someone who doesn't hide the fact that they don't entirely buy into the concept.

So the hospital runs in accordance with the law, with what the legislators had in mind. Sort of. Sometimes.

The informed consent form I signed on behalf of my wife when she was struggling in labor in a Japanese hospital and needed drugs, that was just floated into my field of vision for a legally required sign-off, the woman being in no state to sign anything for herself. No explanation, no nothing.

The informed consent procedure which I did to have intravenous iodine injected for a CT scan, well, the Japanese doctor explained, in English, the key points of the Japanese-language documentation I was going to sign.

But skipped part of it.

The part that I could read very easily, my reading level in the Japanese language at least adequate for this part, the part which says, okay, and, one more thing, sometimes, on occasion, this stuff kills you stone dead.

(The risk, from memory, was something like one in twenty thousand.)

The doctor chose to skate over that one in untranslated silence.

So, as a patient, you're at the mercy of staff who, often, see informed consent procedures as just one more paperwork hassle, or doctors who really do not want to level with you about the ugly downside of what might possibly happen to you.

But the informed consent procedure is the point at where you are, or should be, consolidating your idea of exactly what you are getting into?

And if you feel you were misinformed then the downside may be quite big.

And, as I have said, there is no feedback loop. The message was given to you, you signed to acknowledge receipt of the message, as the law requires, then it was over, done.

A broken procedure because nobody ever checked that the message was received.

Messages signed for are not necessarily messages that have been heard, interpreted and completely understood.

My thoughts on this matter were sharpened up by an informed consent procedure I went through before a cataract operation last year.

It looked bulletproof.

This place, they give you the documentation to take away, and it's about four pages of stuff, all the horrible things that can go wrong with cataract surgery, which, while it generally has a good outcome, is not risk-free surgery.

Off the top of my head, the negative outcomes that I can remember at this point, some months after reading and signing, are:

1. A cataract operation on one eye may, in rare cases, cause infection in both eyes, with permanent blindness the result.

2. The intraocular lens implanted to replace the natural lens (which is removed when the cataract is removed) may decenter, causing subsequent visual problems. (I don't think they go back and operate again to try to put it right. The eye is not the kind of organ on which you want to do repeat operations if you can possibly avoid it.)

3. You may be disappointed by the result, because successful cataract surgery may reveal a problem at the back of the eye, a problem which was masked by the cataract: macular degeneration, a downgrading of a light-sensitive area at the back of the eye known as the macula. Cataract surgery is typically for the old - my maternal grandmother, for example, had cataract surgery on both eyes at age 94 - and, as you get older, your risk of having macular degeneration increases. Surgery was a success but, sorry, your outcome is disappointing.

At this stage, I do not remember if the informed consent procedure made it clear that cataract surgery messes up the production of tear film, so you end up using eye drops after the operation until the natural production of tear film recovers.

The bottom line, though, which emerged very clearly from the informed consent procedure documentation, which was thorough, honest and up-front about the risks, was that cataract surgery does have a potential downside, and you should be ready for this.

Thinking this was, at last, one informed consent procedure which had the level of clarity, honesty, thoroughness and detail that I thought was appropriate, I signed the informed consent form and mailed it back to the place which was going to do the operation.

Bulletproof for me.

But not for my parents' friend who had her surgery at the same place.

Same place, same form, same procedure.

And the friend went into surgery totally ignorant of the risks for one simple reason: she could not see well enough to read the informed consent procedure.

Given that she's over eighty years of age, you would have thought that, as a fully grown adult, she would have done the logical thing and would have asked someone to read the form to her. But she never did. And nobody eve checked. There was never any feedback loop. No "what is your concept of your medical outcomes?" question. No student-teacher interaction.

The law was satisfied. She got the information and she signed to acknowledge receipt. But she went into her operation minus the key concept: the outcome may be negative.

The outcome was negative: intolerable glare to the point where she cannot watch TV.

In my case, some months after cataract surgery on both eyes, I still find the world a bit glaring, to the point where, for preference, I will wear sunglasses outside, but this woman has the glare very bad.

Finally she sat down with the top guy at this place and he was, it seems, reassuring. Improvement can be expected, I gather. The operation was a success, and I believe it's been indicated to her that her long-term outcome will be satisfactory.

But the point, no feedback loop, that's the key point. The procedure is broken.

Of course, truly informing the patient is a source of friction for the system.

To do it properly would mean the patient becoming seen as a student, the provider-patient relationship a teacher-student relationship.

But that is what you become, when you become a patient, if you take on the role seriously. You become, to a lesser or greater extent, a student of your own condition.

I think the pharmaceutical industry understands this.

Back in Japan, I taught at a regular basis for a couple of years at a pharmaceutical research laboratory, teaching English to high-level research scientists, the people who work on developing the new drugs that may one day save my life. Or yours.

The pharmaceutical industry has, and, on the grounds of historical misbehavior, deserves, a bad image. It's an industry which, from time to time, has catastrophically misbehaved, and, giving the pressures of the marketing environment, may reasonably be expected to misbehave again in the future.

That said, despite the kind of sinful behavior which has been documented in the past and will continue to surface in the future, having seen this industry from the inside, and having got to know some of the people working inside it, having met them as human beings, my own take on the industry is essentially positive.

Yes, people do mess up, particularly on the marketing side, hiding things they should not, and playing fast and loose with the truth.

But, that said, having acknowledged the fact that a pharma essentially exists to make a buck, my take on the pharmaceutical industry as a whole is that it is, essentially, an ethical industry, most definitely so at the level where the researchers are at work.

I came to the classroom in Japan one afternoon, late afternoon, the sun sinking over the gritty urban environment visible from the seventh-floor window, and my students had something to show me. It was a photo, and they were very happy to be showing it to me.

The photo was of a British woman, a bit overweight, red-faced, homely, smiling, looking happy.

She was looking happy for her child, who was too young to understand what was going to happen, who was too young to have the concept of death, far less to understand that the mother had an entirely incurable cancer for which there was no treatment, no hope, no cure.

So this entirely ordinary British woman was facing her death, and her way of facing it was to leave, for her child, her smile.

And why were my students so happy?

Well, because the woman lived. She got a new drug invented by the very corporation for which my students worked, and it saved her life. And they were radiant.

All these years of work amongst the molecules, the work of their lifetimes, the work to which they have dedicated the supremacies of their intelligence, the work which they do day by day, week by week, year by year, infinitely patient, giving their lives to this: it paid off.

I don't want to sound hokey, but the mood in that room was radiant. There is no other word for it.

So, though the bad pharma is a reality, and though the bad pharma shenanigans which feature in the currently playing movie, THE CONSTANT GARDENER, do have a basis in real life, my concept of the industry, written from having seen it from the inside, is that it remains, nevertheless, an essentially ethical enterprise.

And it's an enterprise which, when it interacts with the public via drug information websites, takes on the teaching role, takes it seriously and does a good job.

Of course, the websites are skewed in the direction of happy smiles. The side effect warnings may be clear and up front, but you're going to be seeing them on a site which is, typically, going to have its fair share of entirely irrelevant calendar-type photography: smiling couple on beach, smiling couple with dog on beach ... the beach doesn't really have anything to do with the drug, but your visual residue, after visiting the site, is going to be, in part, that of having had a day at the beach.

The best "happy couple with a dog on a beach" was on a site promoting a drug which, while useful, could cause serious heavy-duty psychological side effects. The effects were documented, reasonably prominently, but the romping dog on the beach was the star of the site.

I've recently been clicking around a site which may end up being of direct relevance to me, rituxan.com, a promo site for a drug called rituximab.

First thing you see, top left, is a photo of a beach with two people standing on it, looking, to my eye, as if they are signaling to some kind of hallelujah in the sky.

On the right, a lone figure in a landscape, arms outstreched in a kind of "embracing a universe of joy" gesture.

So the photos, here, are doing the selling.

Perched up above the photos, a very clear "what's this?" message, telling you this site is "has information you need about non-Hodgkin's lymphoma and treatment with Rixutan," this Rixutan being another name for rituximab.

The site is divided into two slices, left side for the general public, right side for health professionals.

Right on the front page, on the left, in the part for the general reader, making no effort to hide it, they put the big possible negative: death.

"Fatal Infusion Reactions: Deaths within 24 hours of RITUXAN infusion have been reported. These fatal reactions followed an infusion reaction complex which included hypoxia, pulmonary infiltrates, acute respiratory distress syndrome, myocardial infarction, ventricular fibrillation or cardiogenic shock. Approximately 80% of fatal infusion reactions occurred in association with the first infusion."

So there it is.

What I'd call a standard pharmaceutical drug information site.

Basically, the concept, regardless of the corporation, seems to be the same.

I would break it down like this:

1. Really mellow photographs, the kind of thing you would have on your calendar in the kitchen, beach almost compulsory, dog optional, sky is nice and a lot of sky is better than a little. People should, of course, be smiling. Hand-in-hand is nice, and two people in a photo is probably better than one.

2. The big bad downside is featured somewhere reasonably prominently, if only because you're on public display, so you have the motivation to come clean and be honest. Your doctor might skip over the fact that this stuff can and does kill people, but if you are the Good Pharma (either the real thing or just faking it, makes no difference) you have to do a "let me level with you, buddy" thing up front.

3. For people who want to go into the technical details, a typical pharmaceutic industry site will have, somewhere, at least some data relating to stuff like clinical trials, the stuff that a doctor might be interested in. Quite possibly tagged with some kind of warning that you're not entitled to access this documentation unless you are in fact a medical health professional, but you can still click and read.

Obviously these sites are biased in the direction of optimism. The real stories we see with real faces attached, they're the faces of the survivors, the ones who are (genuinely, I believe) keen to share their experiences because, hey, it worked for them.

If you drill down to the actual clinical trials data and start looking at the statistical outcomes, you may find a landscape where the beaches do not look quite so pretty, where the dog is not in a good mood.

In summary, then, any pharmaceutical industry site designed to promote a drug is going to be engineered in the direction of glossy, designed to give you a feel-good feeling after having visited it, and your dominant visual residues are going to be of beaches, big skies, smiles or something similar. Nothing medical, certainly.

That said, having seen a whole bunch of these sites, I have to say I've never yet seen a bad one. Every single one has been well-designed and, if you choose to drill down deep, as informative as you could reasonably expect.

So, for the patient who is ready to take on the role of student, one way to get around the informed consent problem - the problem of actually being informed about what you're theoretically consenting to - would be to study up in advance of the procedure.

And then, ideally, in a face-to-face setting with your qualified medical services provider, you would concept-check your understanding of the consequences of the drug you are consenting to take.

For example:

"Excuse me, but do I am I right in understanding that this drug sometimes kills people outright?"

Your doctor or nurse may not be keen on exploring the death, disaster and downside issues as fully as you would like to. May not want to go there. But your friendly pharmaceutical industry site, whatever your concept of the industry is, Good Pharma or Bad Pharma, they will lay it out on the line for you.

Obviously I'm stressing the importance of interaction. There's no point in forming a concept of your treatment unless you go check it with someone who is qualified to confirm, refute or refine your concept.

A website can't check the concept that you form by studying that. For concept-checking, the face-to-face is necessary, the doctor or nurse functioning, effectively, as the teacher, the student coming in with homework to be checked.

But, as a starting point, a drug information site is, in my view, the place to begin, if you have serious questions about a drug which may be really important in your life. Because, while the calendar graphics are trying to sell you a feel-good message (and are succeeding, since nobody was ever made unhappy by looking at a photo of a sunny beach) the information on these sites is solid.

Side Effects Include Death

Side effects may include death. They're pretty up front about this at rituxan.com, the pharmaceutical industry site I ended up at, seeking information about rituximab, a drug I may possibly end up taking if in fact my lymphoma has come back.

In the "safety profile" it says "Death related to Rituxan therapy has been rare. In general, most deaths have occurred after the first administration. Other rare causes of death have been kidney failure following rapid killing of tumor cells".

The drug seems to be a standard treatment for what I may have, which is B-cell non-Hodgkin's lymphoma (NHL).

The site says "Rituxan is for people who have relapsed or refractory low-grade or follicular, CD20+, B-cell non-Hodgkin's lymphoma," and that may quite possibly be me.

So how come my oncologist put "highly experimental" in my head?

Maybe treating central nervous system lymphoma with this drug in combination with an Omaya reservoir is "highly experimental".

Anyway, it exists. A possible cure. Sometimes does cure. Sometimes also kills you stone dead.

While stressing that everyone's case is unique, the site tells various stories, including one man's story of lymphoma coming back at him again and again over a period of nine years.

A well-designed site which includes a downloadable information organizer (telephone numbers, medications etc) that some people would doubtlessly benefit from printing out and filling in, and a long list of questions and answers, standard questions that a web site can answer as efficiently as a doctor.

But the big question, kill or cure, how long? That one is answered in a way that says it is unanswerable, since "every patient is different".

Your own case is your own one-off experiment in the arena of life and death, and the statistics of yesterday's games do not necessarily have any relevance whatsoever to yours.


The website, then, is every bit as non-committal as my oncologist.

A specialized B-cell killer, this drug, a selective ninja rather than a chemotherapy bulldozer steaming through in a mode of massacre. Has worked for some people but, of course, "No cancer treatment works for every person."

Nature, operating in a mode of political correctness, gives us our uniqueness, so what I'm really looking for, a sense of what might be considered "normative" in this situation, quite simply isn't there to be found.

In amongst the information for health professionals on a clinical trial, this:

"The overall response (OR) rate was 48% (80/166) with a 6% (10/166) complete response (CR) rate and a 42% (70/166) partial response (PR) rate. The median time to onset of response was 50 days, and the median duration of response (DR) was 11.2 months."

Not being sure of the definition of "complete response", I read or misread this as meaning that your chances of a long-term solution are in the range of six percent.