I see that another half a year has passed since I reported on my health. The following describes my current state: I go in to see my doctors at NIH for a relatively infrequent (for me) checkup at NIH, and they say 'David, you are looking very good... Really, David, you are looking great... I really mean it, David, you are looking great!'

When I last wrote I was about to start my fourth round of radiation. I was treated with 'tomotherapy:' the X-ray beam is first run at low intensity to align the patient before the energy is jacked up for the actual treatment. The patient is moved in and out of a tunnel around which the X-ray emitter revolves. By revolving around the patient the emitter performs a CT scan when run at low power and converging beam therapy when run at high power. By using beams that converge on the tumor, the therapy delivers a high dose to the tumor and a low dose to the healthy tissue. The steriotactic therapy used for my brain tumor used the same principle of converging beams.

Thus for four weeks over the summer I stopped at NIH every morning on the way to work. With my 'extended visitor' badge and vehicle pass I sailed past the guards like an NIH employee, and as a patient I had valet parking. The nurses, doctors and medical physicists in radiation oncology were very happy to see me again, not out of sadism, but because I could return for treatment. I would lie down on the table; the technicians would tug on the sheet under me to shift me a millimeter this way, a millimeter that way to align me with the lasers that crisscross the room; the table would slide me in and out of the tunnel for the CT to refine my alignment; and then, after the staff scampers out of the room and the massive door closes, I was treated. And what was the treatment like? I could hear the X-ray emitting device revolving around me with a whoosh and a clicking like a rat running through a metal airduct. The clicking was actually little tungsten windows opening and closing to shape the X-ray beam so it would hit just the tumor.

Of course, I had a cook's tour of my treatment from the medical physicists. This mixing of my roles as patient and fellow physicist was particularly strong on the last day of my therapy. The last treatment was delayed by a few days because the machine broke. Not that this was a reason to be concerned; the machine had so many safeguards that it was temperamental on the side of protecting the patient from an incorrect treatment. After waiting for two or three days, I received a call mid-afternoon that the machine would be fixed in a few minutes, so I could come in the next morning. What about that afternoon, I asked (wanted to finish the treatment). Of course, when I arrived the machine was not quite ready, and I spent the next three hours on and off the table, sliding in and out of the tunnel (and I spent half-an-hour in the 'relaxation room' playing with the chair that massages and vibrates and shakes and otherwise tortures you in the name of relaxation). While waiting I chatted with the technician from Tomotherapy (the maker of the machine), the technicians and the medical physicists about the software and how the machine works; it was as if I were a colleague looking over their shoulder (not that I could make any constructive suggestions).

As for side effects, I may have a little fatigue, but after a year of chemo, who knows which treatment is causing me to be a bit tired. I still have neuropathy: my feet burn at the end of the day, with chairs that press the underside of my thighs exacerbating the burning. I am still numb, with no loss of sensation, below the waist. These effects have been a constant for so long that I can't say whether they are worse or different.

Over the summer I was going into NIH for treatments, or MRIs, or followup appointments with physicians, nearly every day. Some days I would be in twice, in the morning for a blood test (to check my kidney function before an MRI) and in the evening for an MRI.

And then it stopped. The radiation treatments ended. The MRIs showed no change, and I don't have my next set of MRIs until December. No blood tests every few days. I could go to work every day without a stop at NIH. The normalcy is surreal.

At the end of the summer my parents put Debbie and me on a plane for St. Thomas, and yes, I drove on the left-hand side of the road dodging the rum-besotted natives. A month ago we flew to Buffalo and drove to Toronto for a family Bar Mitzvah. I just returned from a conference. At work the guest investigator program I am running had a deadline, and we are planning for the review. I had a paper accepted. The normalcy is surreal.

I have been back at NIH for followups. The doctors tell me that I look really good. And in the middle of a discussion of proton therapy vs. X-ray treatments with converging beams, and the economics of radiation therapy, the head of radiation oncology tells me matter-of-fact that I will be back. I am not surprised, but for now I am coasting through this surreal normalcy.