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Saruman’s ring is revealed in a rather startling way, as the Eagle-eyed Gandalf recounts at the Council of Elrond.Gandalf responded to a summons from Saruman, chief of his order. Since Gandalf knew the Nine were abroad and seeking the One Ring, the Grey Wizard decided to ride directly to see Saruman who, as he observed to the Council, “has long studied the arts of the Enemy himself.” He had long delved deeply into ringlore, attempting to learn the secrets of forging such a Ring for himself.We learned about Saruman’s having forged a Ring of Power for himself thanks to Gwaihir Windlord’s having rescued Gandalf from the Tower of Orthanc. One thing these two Powers of Middle-earth shared in common: keen observation.My opinion is that this very lore was the inducement Sauron used to convert Saruman; nothing less could have persuaded the White Wizard to betray a god, and a body of Valar, whom he had seen with his own eyes. But more on that presently.Upon his arrival at Isengard, Gandalf was admitted through a guarded gate.‘I rode to the foot of Orthanc, and came to the stair of Saruman; and there he met me and led me up to his high chamber. He wore a ring on his finger.' "So you have come, Gandalf," he said to me gravely; but in his eyes there seemed to be a white light, as if a cold laughter was in his heart.’Saruman, Gandalf quickly learns, has changed, and the changes are not small.“For I am Saruman the Wise,” the master of Orthanc declares grandly, “Saruman Ring-maker, Saruman of Many Colours!”He explains that the Power growing in Mordor will not be defeated, and so must be joined - at least in appearance.As the Power grows, its proved friends will also grow; and the Wise, such as you and I, may with patience come at last to direct its courses, to control it. We can bide our time, we can keep our thoughts in our hearts, deploring maybe evils done by the way, but approving the high and ultimate purpose: Knowledge, Rule, Order…. there would not be… any real change in our designs, only in our means.Ordinarily the detail that Saruman “wore a ring on his finger” wouldn’t have been worth mentioning. But since Saruman now named himself Ring-Maker, the glimpse of a ring on his finger took on a whole new and sinister aspect.And amazingly, that is the last mention of Saruman’s Ring.For crying out loud, hadn’t the professor ever read the first rule of drama, as articulated by the playwright Anton Chekov - if you bring a gun on stage, fire it!?!Evidently not. But we already know that a Ring doesn’t have to be mentioned to be present by its influence and actions; and this, I propose, is how we must evaluate Saruman’s new Ring.See Vilya, there on Elrond’s finger, with its gorgeous sapphire? Me neither. It’s invisible, or possibly on his other hand. It’s also absent from the Lord of the Rings, apart from its effects, which we can deduce upon reflection. Saruman’s Ring, I would argue, may also be known by its effects, of which there were quite a few.Rings of Power dance throughout the writings without being directly mentioned. The pages are awash with their influence. Elrond’s Elven Ring, Vilya, helps him keep Rivendell strong in the old ways, an outpost of far Elvenhome still alive and filled with strength through the passing of Ages. It almost certainly also aids in his well-known prowess as a healer. It was he, we know, who defeated the sorcery of the Witch-king by finding and removing the last shard of the Morgul-knife from Frodo, pulling the Hobbit fully back into the world only hours before he would have become a wraith forever.And yet to my knowledge Vilya is never mentioned at all in Lord of the Rings; you would only know about it from reading other writings of Tolkien. For the record, Vilya was the Ring of Air, the Blue Ring, a gold band set with a blue sapphire. And it was the mightiest of the Three.Galadriel feels the power immanent in Nenya, the White Ring, and is already imagining the wonderful ways it can help her protect her people and allow the garden wood of Lothlorien to flourish, for a time.Galadriel’s Elven Ring, Nenya, the Ring of Water, or the White Ring, was a mithril band set with a white gem of adamant (an archaic term for diamond). With it, she maintains Lothlorien against the decay of time, and helps guard and hide it from her enemies. Being a ring-bearer himself, Frodo is able to see the normally invisible Ring on her finger, and he becomes one of the few in Middle-earth who knows she wields it.Gandalf’s Elven Ring is present wherever Gandalf himself goes, bolstering flagging spirits and galvanising weakening wills into resistance against the Enemy, adding its fire to his own trademark powers of fire and light. Recall his easy facility with charmed fireworks; his words to the Balrog couching their battle in terms of two fires; his burning beams of the light of Anor that saved the defenders of Osgiliath from the airborne Nazgûl as they fell back upon Minas Tirith.And remember one of his most memorable feats of power, when facing down the Nine alone in the wilderness. He described the scene to the Council.'I galloped to Weathertop like a gale, and I reached it before sundown on my second day from Bree; and they were there before me. They drew away from me, for they felt the coming of my anger and they dared not face it while the Sun was in the sky. But they closed round at night, and I was besieged on the hill-top, in the old ring of Amon Sûl. I was hard put to it indeed: such light and flame cannot have been seen on Weathertop since the war-beacons of old.“Gandalf gathered the huge pinecones from the branches of his tree. Then he set one alight with bright blue fire, and threw it whizzing down among the circle of the wolves. It struck one on the back, and immediately his shaggy coat caught fire, and he was leaping to and fro yelping horribly. Then another came and another, one in blue flames, one in red, another in green. They burst on the ground in the middle of the circle and went off in coloured sparks and smoke.” - The HobbitIt is by no accident that the magical energy of Gandalf, who wears the Ring of Fire, expresses itself on so many occasions in the guise of fire. But the Ring itself is mentioned only at the end of the trilogy; up to that point, we don’t know he has it. If we do from reading other sources, we are left to infer its existence and actions, as we are with the other two of the Three, because, as Elrond tells the Council, it is forbidden to speak of them.My point in all this is that Saruman’s Ring is not necessarily either inconsequential or without power just because it is unmentioned. Like Vilya, Nenya, and Narya, I believe it has effects that we may evaluate by evaluating the actions of its wielder.This, mind you, is only speculation. Still, let me propose one possible solution to “the Conundrum Of The Ring.”When I write about Saruman’s Ring, I give it the working name Nemenya, and the title Ring of Earth, until we discover some as-yet-unrevealed information from Tolkien himself.Why Nemenya? Why Ring of Earth? And what is the Ring’s significance?We know that after Saruman found out his nominal inferior Gandalf had been entrusted with one of the Three Elven Rings, he was extremely jealous. Indeed he rubbed elbows for centuries with all three of the wielders of the Elven Rings, and was himself the only one of the Council’s leaders whose fingers were bare.As for the Three, there was something very odd about them: they represented, curiously enough, only three of the four Elements. Consider those Elements and their correspondences:Element of Air - Vilya (blue stone)Element of Water - Nenya (white stone)Element of Fire - Narya (red stone)Element of Earth (“nemen”) - No ring.Saruman would have seen an advantage to completing the set of four Elements with his own ring; this would have the effect of elevating him (at least in his own mind) to the stature of Celebrimbor, architect of the Three.There are four Elements in ancient European cosmology: Earth, Air, Fire, and Water. It is odd that Celebrimbor chose to link his Rings with Elements but used only three of the four. Saruman would both be irritated by it, and would see in it an opportunity to elevate himself and his Ring in the eyes of his most vexing rivals: the wielders of the Three Elven rings. How? By completing the set.It would also seem to complete a natural set of Four, and put him (again, in his own mind) on a par with Elrond, Galadriel, and Gandalf as wielder of a Ring of Power. It would give both him and his Ring a context that would please his vanity.And if we associate Saruman with any Element, it may well be Earth. He was a technician and craftsman like the Dwarves, and Earth is the element we associate with the works of the Smith of the Valar, Aule, who was Saruman’s mentor in his youth.Oh, and what stone would he have put in his Ring? An Elfstone, naturally - a beryl, or emerald - in mockery of the Elves.But how was Saruman able to create a Ring in the first place? As far as we know, he lacked the knowledge to do so; he knew a lot about the process, but there were critical gaps in his knowledge. What changed? Where did the knowledge come from?In my opinion, from Sauron. Where else?It wouldn’t even be the first time Sauron had bargained with the precious information. Previously (in the Second Age), Sauron had seduced the Elves of Eregion with his ring-lore, a “gift” by which he gained access to their forges and techniques, knowledge that he secretly used to forge the One Ring. Sauron traded in power, and was subtle enough to realise that a few pages from his dusty workbooks could take the most powerful of the Istari out of the fight, and probably destroy the free kingdom of Rohan.He wasn’t about to leave that kind of power on the bookshelf.In their conversations over the Palantiri, Sauron interested Saruman with soft lies about rewards for his assistance; but this alone would not have been assurance enough for Saruman.Sauron would have to prove he was in earnest by giving Saruman something of true value, something none of the Wise possessed, and the thing Saruman most desired: The knowledge needed to create a Ring of Power.(Only Sauron had to know that Saruman’s Ring could not possibly approach his own in power, either because he withheld some small but crucial bit of information, or because Saruman lacked a convenient volcano.)But Sauron did provide enough secrets to allow the Lord of Isengard to forge a Ring of true potency. And Saruman was convinced, because the new instructions he received dovetailed with all of the information Saruman had been able to amass or deduce on his own regarding the forging of the Rings.The logistics to breed and arm a host of 10,000 Uruk-hai would have been incalculable, and controlling and disciplining them would have been all but impossible - at least, absent some very powerful magic. We see Sauron exert this kind of magic; then he turns Saruman, and suddenly we see the solitary Wizard exerting the identical category of magic. To me, there’s little mystery about what coin Sauron used to purchase Saruman: he gave him the means to create a Ring of Power, albeit one an order of magnitude weaker than his own.So what would the particular powers of Nemenya have been?Before Saruman owned his own Ring, he had no army despite his craving for power. But once Saruman had a Ring of his own, an astonishing army was at his command - quite a change after 2,000 years as a solo act. I say that is evidence that his Ring had the powers of facilitating both the breeding, and the subsequent mental domination at a distance of those who were bred.These are hallmarks of Sauron’s own abilities, which were clearly built into the One Ring. Now, in lesser degree, they were built into Saruman’s Ring as well.And we already saw Saruman exercising highly potent domination of others at a distance in his manipulation of the Dunlendings and his possession of Theoden. These demonstrated abilities would be compatible with what we know of his control over his young army of 10,000 Orcish hybrids, the Uruk-hai.Further evidence may be the way Saruman’s army dissolved in mindless flight the morning of the third day at Helm’s Deep. They were as panicked as Sauron’s own legions would be before the Black Gate, the day the Ring was unmade and the Dark Lord’s own control evaporated. To me, this indicates that Saruman had exercised similar control but that Gandalf the White broke it when he arrived with Eomer and the Rohirrim.In summary, Saruman received something of great value to him for his betrayal of the Valar and the free peoples of the West. Nothing less would have moved an immortal being to such a consequential act of treachery.“Now you know that’s some mean pussy to make a man change gods.” - Benny Wilson (played by Redd Foxx, left), Harlem Nights, 1989.Through their negotiations,Saruman would get what he wanted: the ringlore he had long sought to forge his own Ring of Power, and as a result, build an army to command; andSauron would get what he wanted: an ally strong enough to injure his enemies, but still too weak to be a threat to his own power.Saruman would be a serious stone in the boot of the armies of Men, distracting them and preventing the Riders of Rohan to keeping the Oath of Eorl to come to the defence of beleaguered Gondor when Sauron unleashed the Morgul Army.And yet he would always be much weaker than Sauron; the Many-Coloured Wizard could be dealt with after the rest of Sauron’s enemies had fallen.I don’t for a moment believe that Sauron was taken in by Saruman’s protestations of loyalty. The Alliance of the Two Towers was strictly a marriage of convenience.And the wedding ring was right there, on Saruman’s finger.

It is a place where you have to train 18 year olds to run to the sound of gunfire and perform under fire and the threat of death.This act defies all "logic," goes against all human instinct, and takes one of the most intensive acts of psychological reprogramming to overcome.A few assumptions, however, have to be put down along with a few myths about boot camp and the experience.It is not about the skills you acquire. The shooting is an important part. Learning to march is somewhat important, though you aren't sure why. The swimming... well that is just awful. And if we think about it, we haven't fought in a non-desert in how long? The training is not about the skills. The tactics used in training are too extreme to train skills. In all honesty, most recruits are too stressed to actually learn. A much better environment would be a college or a school house. As I said though, boot camp is not about school.Recruits do not go through hell together. After boot camp they will leave each other and go to different training and then on to other training for their actual military occupational specialty. Then 3 months to a year later after all their actual skills training is done they will join their real unit. This is the unit they will be a part of when they go on deployments and who will go through war with. You will likely see only a few of the guys you went to boot camp with a few more times in your life when you see one another at the PX on Mainside. You won't go through "Hell" together.Drill Instructors/Drill Sergeants don't physically touch recruits. They don't hit or physically assault recruits, ever. They come close as the picture above shows, but they never physically hurt or even touch recruits. Another thing that is important is that everything they do is for a purpose; a rehearsed, manufactured, and engineered purpose.It is about something else entirely.As for why bootcamp training tactics are so important, you need to imagine what is expected of someone who goes there. In modern warfare you have people too young to drink fighting the wars that we go through year after year. This has been the practice for centuries. The need for warriors and the nature for who has to fight hasn't evolved much and likely won't change in any near future. Drones, stealth, atomic warfare, and high tech weaponry won't change this. There will always be the need for young men who are willing and able to run to the sound of imminent danger and many, to their death. Nations need this. You need this. It is a horrible thing, but the sanctity and security of every nation on Earth requires young men and women capable of doing this.To do this, however, we need a form of psychological training that is able to forge individuals who can do this. That is why boot camp has evolved to become such a potent tool in today's military machine.Brigadier General S.L.A. Marshall in his book Men Against Fire described well the fundamental flaw which must be overcome by a warrior society which is itself, borne from a society in which violence is not understood and, in fact, looked down upon:" The army ... must reckon with the fact that he comes from a civilization in which aggression, connected with the taking of life, is prohibited and unacceptable. The teaching and ideals of that civilization are against killing, against taking advantage. The fear of aggression has been expressed to him so strongly and absorbed by him so deeply and pervadingly--practically with his mother's milk--that it is part of the normal man's emotional make up. This is his greatest handicap when he enters combat. It stays his trigger-finger even though he is hardly conscious that it is a restraint upon him."The most important single thing to know about boot camp is that it is 100% designed to reprogram children and civilians into warriors. It places within them a sense that they are expected to do important things, far more important things than could be expected from other 18 year olds. This is all happening during one of the most intensely stressful periods of your life where you are kept isolated from contact from your family and friends and taught that everything you were before entering the Marines was weak and lacking any real value until you too are a Marine. Cults are made this way too. I'm just saying. But in all seriousness, the psychological transformation of boot camp is a very intense and intentional effort by the Marine Corps to make warriors able to fight and kill out of kids who have just barely left high school. From the point that you graduate boot camp you will be different and have parts of the Marine Corps culture as part of your psyche.Some of the ways that this is done is through a series of extremely well planned and timed events that, by themselves, are meaningless, but when strategically combined together will change a person.1) ReceivingReceiving is a period before training. You arrive at boot camp, but for the first week or so you don't actually train. You are just doing paperwork to get into the federal documentation system. You will receive all your gear and start your initial process into "getting ready" for bootcamp. But it's the way you do it that is important. The entire time you are yelled at, screamed at, hurried and stressed. But there is more.From the first moment you arrive, you are now neck deep in terror. This is a video showing exactly what it is like for every recruit before they even get off the bus at the Recruit depot. Before you watch I want to make a few points.Everything the drill instructor does has purpose; everything. It may seem funny to you, but it is all crucial and instructional in some way.They are being yelled at before they ever set foot off the bus. You can hear this if you begin listening immediately.Within 5 minutes, 200+ individuals with no group training at all have been trained by drill instructions on how to: Listen and learn while at bootcamp, respond to instruction, stand in formation, and move as a unit. They have also all been read their rights and responsibilities as recruits and in single file moved to a different area. You will not appreciate the magnitude of this.Every word the drill instructor is saying is memorized.No recruit will be physically touched by a drill instructor. In fact, they won't be touched by one, ever. Surprised?This is a ceremony that has taken place every week for every new group of recruits for decades. It is very well rehearsed and very well engineered. As I said before, everything a drill instructor does has purpose.As I said, this is just the first 5 minutes. There are three more months of this.Later that night a recruit will do something else that is transformative in a rather impactful way.Why is the haircut so important? It is part of the erosion of individuality. What? Yes, the erosion of individuality. Why should a warrior lose his individuality? It is what makes him special and unique. It is what makes him valuable. Well that's the problem. Individuality makes them special and unique. It makes them feel that they might be above someone or something else. They are better than the orders they might receive. They are too good for something. Not at boot camp. From day one, everyone is the same. In fact, during my time, being called "an individual" was an insult as it meant that you were a person who couldn't put the needs of the unit first. Yes, individuality is repressed as they will spend the next three months dressed the same, act the same, and look the same.Now we move on to something else very important and why I say that it is "psychological" retraining. You go through the next few days running from place to place, doing this, that, this, that and you won't even realize... you haven't slept in three days. Yeah, you will go through about three days without sleep upon arrival. The whole time you are completely exhausted while running on adrenaline and hearing over and over, that you are inferior. Inferior to real Marines, which you aren't yet. You aren't thinking about it, but it is sinking in. You are completely tired and these things build up. Without realizing it, you start to believe that that which is being told to you is true, that there is a weakness in you and that you are less than perfect. In your current state you believe them and that you must change to be good enough. But there is something important you as the reader need to know.To be a Marine and to go to war, it is true.There are many habits that kids and civilians have that have to be unlearned. Like we said, they have to run into battle and that sense of self preservation is damaging to the mission. At this point we are still less than one week into bootcamp. The recruits are about to experience Training Day One, known as Black Friday. After receiving and from this point and over the next three months, the recruits will face exercising in endurance, arts of war, and learn to act and think as a unit. These are some of the more important things that are trained.I remember the first night that I was able to go to bed after what amounted to a few days of not getting to sleep. It was one of those, "What the hell am I doing here?" nights. I stayed awake and tried to write a letter home to Jennie. It was my first letter to her from boot camp. I remember another time I tried to sneak the chance to write home at night. We weren't allowed to write letters at night by the way, that time was for sleeping. I hadn't been able to write a letter for quite some time, so I wanted to this night. I was exhausted though. I wrote a few paragraphs and then started to drift off. You can actually see where I fell asleep while still writing. The writing becomes more and more illegible, slowly falls off the line and then turns into a streak across the page. I woke up suddenly and stuffed the letter in an envelope and sent it home. Jennie made fun of me for that one.2) The Arts of War:Marine recruits go through several different training cycles and will learn skills in Martial Arts, Small Unit Tactics, Hand-to-Hand Combat, Emergency First-Aid, and marksmanship. They will also receive nutritional training, maintenance of gear, and physical training. While I said that boot camp is not really about the skills, they are important and a necessary part of the training evolution. The uses of them in warfare are obvious and necessary for survival for some of the future warriors.All Marines will by the end of boot camp receive the first belt in the Marine Corps Martial Arts Program (MCMAP). This is a special form of combat martial arts designed by the Marine Corps.During the second phase of recruit training, more than two full weeks are dedicated to marksmanship. It is so important that the drill instructors actually lighten-up to allow the recruits to focus. Marines are fanatical about marksmanship and that starts at boot camp.Physical training takes many forms, but generally centers on building instant obedience to orders over actual exercise. Most of the time it centers on listen and do what you are told, get through the exercise and get out of the situation before you are yelled at. This is really as much as a I want to get into the skills. Information on them is much more available on the internet and not pertinent to the question being asked.I remember that I was so anxious about shooting well on the range. I had just gotten married the week before shipping out to bootcamp and my new father-in-law was a gun nut. I just had to impress him. I had to make expert. On qual day I was so nervous. We did all of our shooting and got down to the 500 yard line. I was good at this, but I had to do well to make the score I needed. It came down to my last shot. I had to hit the black or I would be a sharpshooter. I made expert by one point and mailed home my badge the next chance I got to send home mail for Jennie to give my new father.3) Act and Think as a UnitThis is some of the most overlooked aspects of the Boot Camp process. This is refined groupthink where an entire unit of 80 men or women are able to act in perfect unison. They know the movements by heart and are always performed the same way and at the same speed. This is Drill. It is the reason for term "Drill Sergeant" and is both a time honored tradition and a valuable learning aide that's reasoning has been all but forgotten.Modern Drill was a tool first recorded being utilized by the Greeks to maneuver large armies in necessarily tight formations to fight in close quarters. It was necessary as far back as our Civil War. It still has relevance today in that it trains Marines to focus on the instructions of their leader and to gain unison in their actions. It teaches the importance of individual action in teamwork and is instrumental in training instant obedience to orders. This is a platoon of female recruits a few weeks from the end of their training.learned the maneuvers well, but still have a few more training sessions before they are perfected.Below is a platoon in what is called Final Drill. This is a performance review of their abilities to carry out drill as a unit. It is one of the most important training events as a platoon.Some things to note:Once again, these are 18 year old men fresh out of high school. There are 80 of them and they have learned to carry out actions involving several steps and intricate footwork... in perfect unison.Both the recruits and the drill instructor are being evaluated by the Marines carrying clipboards.There is a point in boot camp where a platoon "comes together". This is the moment where they stop acting as individuals and begin to truly become a team. For my platoon it was very hard. We were right in the middle of the summer and made up almost entirely of kids straight out of high school. We were young, selfish and immature. Individuals stood out and made life a bit more difficult for all of us. Towards the end though it happened. I think the first of it was on the parade deck. We were practicing for final drill. There are two orders you do called "Inspection Arms" followed by "Order Arms." You have to lock the weapon's bolt to the rear bring the weapon up to your face, inspect the barrel from chamber and return it to the Port Arms position. In order arms you send the bolt home and close the ejection port cover. This may all sound like jargon if you don't get what I am speaking about, but basically you have seven movements that need to be done exactly the same way at exactly the same time by 80 different people. Think about that... 80 different people doing exactly the same thing at exactly the same time. If done wrong it sounds like shaking a can of rocks, but if you do it right... If everyone can do it exactly together then it will make this harmonious echo throughout the parade deck, a small boom, a second sound that tells every single individual that they did perfect. It took every single one of them to be perfect and because they all were able to they were perfect. If a platoon can do it it is a special moment. We did it the week before Final Drill. It was awesome. We talked about it that night. I really think that was the moment we came together.After that I would say it might have been when the drill instructor started the nightly quarterdecking. You would get quarterdecked if you screwed up really bad that day. It is the most intense barrage of physical exercise that one can endure. It was awful. A funny thing happened though on one of our last nights. A few people were being quarterdecked. Then one guy went over and volunteered... WTH? He started to go over and just being quarterdecked with everyone else. The drill instructor yelled at him to go back, but he wouldn't. He did the push ups and the side straddle hops and everything else and wouldn't leave. And then another guy went up there too, and then another and another. Now a funny thing is that we noticed that they never had more than 10 of us on the quarterdeck at any given time. We kind of believed that they limited the number on purpose because of abuse rules or something else. This time, however, the drill instructor had collected before he knew what do half the platoon quarterdecking themselves. It was the oddest sort of rebellion really. In a way it was hilarious. Did I take part? Hell no. I was kept cleaning my weapon. I wish I had though. It was a fun moment. A graduation of sorts I suppose. No one ever got quarterdecked again though.4) Endurance trainingAmong the many training elements that recruits must endure, the largest obstacle they all must face is one of immense magnitude and endurance. It is aptly named "The Crucible". This is the final of several training hikes, and it is a three day march totaling at around 60 miles with little sleep, little food and numerous stops to do obstacle course workouts, carrying a huge amount of extra gear and equipment and a climactic day-long final march up a mountain, called "The Reaper" and 10 miles downhill before returning to their barracks. By this time the recruits are all physically in shape enough for the exercise, but the mental aspect is what is being pushed here. The entire ordeal is also made all the worse by carrying massive packs with all the recruit's gear and supplies, along with body armor. In total the recruit will be carrying around 70 extra pounds with him on this journey. It will not be easy, but when they reach the top of the mountain, they will have completed the most important major obstacle and last right of passage to becoming a Marine.By enduring long hikes like this, recruits are trained to overcome obstacles like pain or fatigue if given proper motivation. I for one learned that, even under these conditions, you can still run carrying all this equipment for more than a few hundred yards with a cramp in your leg. The pain doesn't actually stop your body from working, you just keep running and somehow the pain will go away just as fast as if you stopped and cried about it. This mental training is necessary as it will give them the strength to survive much harder and longer training once they reach the fleet, and missions that will test them physically and mentally.I think the Reaper was one of my proudest moments in life. I had done well throughout the Crucible and now we had this last hike up the mountain. I pushed through and kept pace. I had a friend Lobo who wasn't doing so well. I told him that he could hold on to my pack and I would pull him up. I was fine doing it for Lobo, he was my first rack-mate at boot camp and one of my friends. Still though, after a few miles of assisting him it started to get really hard to pull both of us. I looked behind me and saw that not only was Lobo holding on to my pack, but someone was holding on to his, and someone to his! I was the engine of a four person train. The last guy wasn't even in our platoon! I got mad and told and told them all to get off. It was pretty cool to think about that I was able to do that though.On the way down it was much harder than we expected. We had been told as much by the recruits who went before us, so it wasn't really a surprise. People were exhausted. I was just looking forward to the Warrior's Breakfast and kept telling myself just a few more steps. I actually had a lot of energy for most of us. I think I just had the right body type back then for that sort of thing. As we got about half way down members of my platoon started to falter. The drill instructors would yell at them to keep up. I started to yell at them too. I was angry. What excuse did they have to tire out? I am pretty sure that was when one of the Drill Instructors stopped hating me. He had hated me for most of boot camp, but that day I was a bit of an asshole who wasn't weak. You know what's funny? By Drill Instructor terms he was nice to me after that day.After the Crucible and the Reaper Hike came the warrior's breakfast. It was the most awesome thing in the world. You get to eat as much as you could and celebrate the awesomeness of what you and the rest of the company had achieved. Eggs, waffles with peanut-butter, cereal, fruit, and a doughnut. Seriously we had hiked 53 miles over 3 days, full packs almost no sleep and two meals. You have no idea how good a bowl of Fruit Loops can taste. You really don't. We ate like kings. Oh how grand it was.After that though a few of us were sent on a working party to clean up after the Warrior's Breakfast. My thoughts were, "What the friggin' hell? After all that I have to go back and do a working party?" When the ten or so of us arrived we were directed to stand over on the side of the building until we were called for. This was normal so we did it. About half an hour went by and we were wondering what was going on and why no one had come for us. We thought we were supposed to be doing work or something. Oh well. About an hour later our Drill Instructor came back and took us back to the platoon. That was really strange. Then we got back to the squad bay and everyone else looked sick as dogs. I asked my rack mate Kruger what had happened. He said that the DIs made them drink water... 8 canteens worth of water. He said that everyone in the platoon basically vomited the entire Warrior's breakfast out. Perhaps it justifiable in that they helped them get re-hydrated. All I could think was how lucky I was that I was at a working party. Years later I thought about that working party and I realized what it was. The Drill Instructors were protecting us. For some reason the few of us had been selected to not be punished that day. I thought about how cool that was and learned an interesting lesson from that day. Sometimes in life you should be happy if your only reward is a lack of punishment.5) Isolation from the OutsideWhat you may not know is that in some branches of the military, the Marines for example, communication lines are completely severed from friends and family during boot camp. There is no internet, no phone, no distractions. The only thing you really get is hand written letters once a week during your only "me time" for four hours on Sunday morning once a week. Does it seem cruel? Well, I had just been married one week before boot camp so I think I am best to answer this. There are no distractions. All the aspects I told you about are never interrupted by distractions from the outside world. It helps to engross new recruits in the mentality that they are being absorbed into, but for a few months it completely shuts them out from their friends, families, and the outside world. For a few months, the Marine Corps is your entire world.One thing that happens for everyone is that immediately upon arriving at boot camp you get to call home. It isn't a real call. You have a short script where you basically say that you're there and you're alive. That is all. A few weeks in though, our Senior Drill Instructor found out that we didn't get ours. About a month in he made sure that we got ours. As a platoon we got to go down to the phone center and speak with our families. I remember the day. It was July 7th, my birthday. I called my wife's phone. Oddly my Mom answered. That's a whole other story. We talked for a few minutes and then I asked to speak to Jennie. It was great. I told her that I would have to leave soon and that we just get cut off and that would be it. We needed to use the time as best we could. I think I got about 10 minutes to speak with them. It was really a blessing. After a month of boot camp it was good to hear her voice again. I think of her as rain when I walk through the desert. As I knew it would our time ran out. The line went dead. I was prepared for it, but still for a moment your heart breaks again. Still I was happy. There were a few tears that rolled down my face as I returned to the platoon. I know a few of them noticed. I was the only married recruit in the platoon and I think they all knew how hard it was for me. No one ever said a thing to me about the tears. I was happy. It was my best birthday present ever.On the other end of the line it was a completely different story. The phone cut out abruptly as we knew it would, but Jennie thought she had somehow hung up on me. She was already crying a bit, but then tells the story that she completely broke down. "I hung up on him! I hung up on my baby! I only get to talk to him once in a whole month and I hung up on him! And on his birthday!" The way she tells the story she was completely irrational. My mom was trying to console her and remind her that we had just ran out of time, but Jennie knew that she had hung up on me. She even tried to call back the number, obviously to no avail. Now that I know we laugh about that all the time, but that was not a good moment for Jennie.6) The YellingI am pretty sure this is what brought on the question in the first place. In the Marines, bootcamp instructors are actually trained on how to manipulate their voices so that they can yell for extremely long periods of time without damaging their vocal cords. This is known as the "Frog Voice" and it is as real as the weapons we use. The fact is that once you enter the military, people are literally screaming at you all the time and you adapt. Eventually you will be a leader and screaming will be part of your job too. This video actually shows a great deal of things that are important. It is a video of a charity golf tournament where some Marines were invited to give a show for some of the competitors. Listen at the very beginning and you can hear a Marine using a strange voice to speak to the victim/participant. This is Frog Voice. You will also see what is known as the "Omnidirectional Ass Chewing" in which multiple D.I. will be screaming at you in unison as you attempt to make sense of the universe around you."Why do all these things you ask?" Because it is the easiest way to get a human being who is unaccustomed to performance under stress to take action while being placed under an extreme and sudden stress environment (combat). It trains them to block out the noise and the fear and the stress and just do what they need to do. We can't actually shoot at the kids you know. (Oh God, that actually does make sense.) So the Omnidirectional Ass Chewing is one of the most important parts of onboarding that most militaries go through, and the yelling really never stops after that. What is extremely important to know is that just as quickly as these men started yelling they can turn it off just as quickly. It is mostly an act by these drill instructors to instill aggression and help military people cope with combat stress without actually experiencing combat. These men aren't bullies. What you just saw was extremely important training, mental training. No one in the comments section will ever dissuade me from this position it is one of the most important things a Marine Corps Drill Instructor can do for a young recruit.Now that I say that I am reminded of that one Drill Instructor, the truly evil one. The one you wrote home about. Drill Instructor Staff Sergeant Tucker (Yes, that is how we had to say their name every time.) He was the one I talked about on the reaper hike who hated me until that day. I was larger than the other recruits and one day I had a dessert with my lunch. He called me "Treats" for the next month. After the reaper he didn't focus so much on me anymore, I am going to consider that a sign of respect. No now he was evil to everyone. He actually wasn't the yelling type as much as the sadistic one. Absolutely a nightmare. He was like one of those evil geniuses who knew how to make people do mundane things that caused massive amounts of pain. I remember that it was so bad that a year later I was in Iraq and joked with Jennie on the phone one night,"Hey Babe, you'll never guess who joined the unit? Tucker!""What? You're kidding!""Yeah that would suck though wouldn't it?"Well guess what. A few months later we got back home and were holding inspections. We were all wearing our alphas and I look over and see this Staff Sergeant. Hmm... he looks familiar. Then he reaches over and straightens the belt of the guy in front of me. Where have I seen this before? That hand? That mannerism? That... that..."Dear God! It's Tucker!"I stood there in shock for a few minutes. I looked at him several times and he saw me do it. He looked over at me for a few seconds."I know you from somewhere...""... I believe you called me Treats through all of second phase."..."Davis!"That night I got back home and had to tell Jennie."Jennie you're never going to guess who joined the unit!""Tucker?""How'd you know?!""Yeah right. You already tried that on me back when you were in Iraq."Want to hear the rest of this story? Jon Davis's answer to What are some of the most memorable things your drill sergeant ever said?SummaryThe logic is there. It is terrifyingly present in every subtle action of the Drill Instructors. As I said before, everything they do is for a reason. Boot camp, and particularly that of the Marines, is made to psychologically change a child into someone capable of performing under combat situations. In most cases it is intended to take from them the aspects of their civilian lives that will make life harder for them in the military, and sometimes get them killed, no longer part of the calculation. The yelling, the sleep deprivation and being cut off from friends and family are part of the process of becoming a warrior. It is also part of becoming a cult. And that is what it is. Normal people can't do the things warriors are asked to do. They can't imagine it and shouldn't be forced to. But there are those that do. For these people though, there must be a transition from "civilian" to "warrior". Boot camp is the means of that evolution and every part of it is necessary.This answer also appears in Military Boot Camp: What is the logic behind why Military bootcamps are so intensive?Liked this? You might also like my YouTube Channel. You can also connect with The War Elephant on Facebook. If you want to help me make more content like this, please visit my Patreon Page to find out more.

I was very arrogant about my health until recently.At 59, I had never been sick, I’m very fit, and look quite a bit younger than my age. My father is 90 and lives the same lifestyle now as 30 years ago, living in his own home in the Texas Hill Country.I’m a physician and have almost daily occasions to offer health advice, and I have a healthy, thriving practice.I am a fan of Nortin Hadler, MD, who writes extensively on intelligent, informed healthcare, offering facts and studies a healthcare consumer should be aware of before giving or refusing consent to commonly recommended medical screenings and treatments for conditions such as high cholesterol, blood pressure, or glucose; colonoscopy; mammography; PSA screening and more. Lest you think he’s fringy, he’s Professor Emeritus of Medicine at UNC School of Medicine at Chapel Hill, and Harvard and Yale educated. You can see his brilliance and relevance in this PBS interview.For 20 years or so, I’ve seen a wonderful internist yearly, but, would abdicate responsibility for this behavior, saying. “The only reason I have a doctor is I have a wife.”Thank goodness I have a wife.September, the year before last, 2018, I had previsit labs for my annual visit with Rick Earnest, who was Chief Resident during his internal medicine residency at Emory, he’s top notch.My white count was low. Rick’s nurse called and said he wanted another CBC and a folate. White count low; folate normal.Then, I saw Rick in his office and we chatted dispassionately about the neutropenia… WBC was around 2, with 4–12 being normal.He told me he had talked to a local heme/onc that morning and then, he shrugged his shoulders and said, “Looks like you need to see a hematologist…” I agreed.About a month later, I had extensive labs at the local oncology center; met the delightful hematologist, Kavita Nirmal, who recommended a bone marrow biopsy.I knew this was coming and, once again, being very healthy and having no signs or symptoms, I thought serial CBC’s would do.However, after my consult with Kavita, I had no urge to refuse the bone marrow biopsy, and it was done that day.Things moved quickly from there.The next day, Kavita called and said I needed to see a specialist at Baylor. Five minutes later, she called back and said, “You could also go to MD Anderson.”Baylor is two hours, MD Anderson is four.Initially, I balked at accepting an MD Anderson referral, as this meant, in my mind, saying, “This is serious.”Over the next 24–48 hours, I had the strong intuition I should go to MD Anderson.I responded to Kavita’s phone call about my treatment choice in a way I found funny/odd… I said, “I owe it to my family to go to MD Anderson.” I thought, “Wow, Dude, you can’t even take responsibility for your choice to go to MD Anderson.” (It wasn’t a big deal… but, interesting.)My records and actual marrow specimen were Fedexed to MDA; I went there for labs and another bone marrow biopsy; and met with a national leader in leukemia, Naveen Pemmaraju.All this occurred in a very compressed period of time and in a context of general surreality, punctuated by briefs periods of extreme surreality.I had accepted there was something wrong with my bone marrow. I had actually been aware I was neutropenic as far back as August 2016; but, again, arrogant invincibility had me ignore it.In Longview, I was told, based on microscopic evaluation of my marrow, and an estimated 13% blast count, I had myelodysplastic syndrome (MDS), something I was familiar with when a fellow staff psychiatrist told me he had it. It was a significant health scare for him, but that was in the 90’s and he and I were in touch for at least 10 years after that, and to my knowledge, he’s still fine today… (we both moved on from that mental health center years ago).Then, as I was going through the process leading up to seeing Dr. Pemmaraju, a nurse who was checking me in and reviewing my chart, was reading out loud to herself… as I listened, it was all quite routine to me as a health care provider, until the letters “AML” came out of her mouth.They weren’t intended for me; she was just one of those people who reads out loud when they read. Perhaps she thought I knew. Perhaps she didn’t know she was reading out loud. It is a cancer center…I can’t think of an adequate adjective to put in front of “stunned” and “frozen” to adequately express that instant as the biggest WTF! of my life rang out in my mind…“It’s leukemia?! I have leukemia?!!!” My mind was reeling with that shock…It was quite a mental shift, in an instant, unsuspecting, unprepared, from MDS to AML.I suppose it was helpful to have the time to be past that initial reaction later, as I sat in one of Dr. Pemmaraju’s exam rooms, waiting to see him. He burst into the room almost as enthusiastically as Kramer on Seinfeld. He was young, energetic, positive and extremely enthusiastic.There I was, sitting face to face with one of the finest allopathic physicians… a hematologist/oncologist who only treats two types of leukemia and MDS.It was a briefly challenging/confronting situation on a philosophical level.You see, I’ve been writing, Power Without Pills: A Curious Psychiatrist’s Guide to Healing and Growth in the Modern World since Googling John Sarno, MD in February 2006. And, I have talked some trash about modern medicine. Not irresponsibly or inappropriately… but, trash talking nonetheless.I was challenged with substantial, in-my-face cognitive dissonance.I resolved it for myself quickly.I had been throwing the baby out with the bath water.I had been all “mindbody medicine is where it’s at!” and, then and there, I realized I had been going to an extreme.I once heard a man say, “You’re just as half-assed no matter which cheek you got.”So, I decided, “Alright... I like this guy... I trust this guy... I’m going to roll with this, and I’ll handle the mindbody part... and he’ll handle the traditional medicine part…”Both cheeks were suddenly firmly in place.He told me they have a clinical trial, using the CLIA protocol, where they’re getting upwards of 90% complete remission rates in frontline AML.All three drugs are FDA-approved for AML, but no one is using all three together. “We are gonna rock this thing! We are going to crush it together!”, he said, beaming.He told me I’d need some preliminary tests, like an echocardiogram, to qualify for the study... a formality.Then, I would be admitted, given five days of chemo, be in isolation, and have a total of around 28 days inpatient before being discharged to outpatient treatment where I would receive five consolidation rounds of the same three chemotherapy drugs every 28 days.He said I’d be in complete remission by Day 28.That conversation was on the Friday before Thanksgiving. He told me to go home and spend time with family... my wife was there in that initial consult and throughout, but I hadn’t seen my father in Austin in a while... it was a wonderful, deeply meaningful break/visit with close family before I went inpatient… ostensibly 28 days, in isolation.On the eve of Thanksgiving Day, I was admitted to the Leukemia Specialty Care Unit at MDA, at around 7 pm, and began chemotherapy that night.How I’ll be bathing in isolation for the next 3–4 weeks…My wife and father-in-law visit me in the square bubble…This woke me up in the middle of the night, tickling my nose…Going…Gone. My hair didn’t survive.It went exactly as he said; except I had a Day 21 bone marrow biopsy in the hospital. The next day, the attending on the service strode briskly into my room, smiling, and said, “Go home. You don’t need to be here any more.”My blast count had gone from 30% to 4%, complete remission, in 21 days.I said, “Uh… I’m not ready.” (My wife was four hours away and expecting me to be discharged in about a week).I went home the next day, six days early, for good biological behavior.I was in complete remission.There was suspense though. I was told through some magic called flow cytometry, they could give a measure of prognostication, MRD, Measurable Residual Disease. With MRD, they could find traces of leukemia, the presence of abnormal blasts, “down to levels of 1:10,000 to 1:1,000,000 white blood cells (WBCs), compared with 1:20 in morphology-based assessments.”[1]A few nervous days later, at my first outpatient follow up, I was given the news, “You are MRD negative.”A Senior Coordinator of Clinical Studies, Department of Leukemia, MD Anderson Cancer Center, Rabiul Islam, who’s worked there since 2003, gave me that wonderful news, and he added, “I have never seen an MRD negative patient at Day 21.”As I have said, I highly value and practice mindbody medicine; parts of that are a positive mental attitude and faith in the healing propensity of the body and the intelligence of life.And my positivity and faith had been rewarded at every turn (even developing leukemia, which I would not have consciously asked for); but it was never the kind of faith and positivity that produced a reaction to, “You are MRD negative,” of, “Well, of course, I’m MRD negative.”I cried when he told me and it brings tears to my eyes now as I write this. I am deeply grateful.And, along those lines, I have taught mindbody medicine concepts for over 20 years and was pleased to find nothing changed with being diagnosed with an illness that has a 25% five-year survival rate. I found, not surprisingly, I walked the talk. Yet, you don’t know how solidly your ship is moored until there’s a storm.As interesting foreshadowing, for years, as one approach to mindbody medicine, I would discuss the hypothetical situation in which someone was diagnosed with a type of cancer that had their physician say, “The 5-year survival rate is 5%.” I would then say, “I wouldn’t say, ‘Oh, no! Those are terrible odds!’ I would say, ‘What did the 5% do?’’’ (My apologies for the complex, and possibly incorrect sentence structure.)I have had many profound blessings in the powerful life lesson leukemia brought to me.To address the question:The leukemia was caught on a yearly routine blood test before I was symptomatic.I am young and healthy, with no comorbid illnesses, and I really stood out on the Leukemia Specialty Care Unit because of my youth, fitness, and lack of comorbid illness.I got the best cancer treatment in the world, I assert.I’ve had an excellent attitude throughout.I never fought the leukemia. I was never inclined to. At the local cancer center, the narrative was everywhere about fighting cancer; even the wifi password had that rhetoric… yet, I could not abide by that narrative.I’m not suggesting that people not adopt that narrative; it’s fine with me if they do; it’s just not for me. I’m not going to start a “Fight Fighting Cancer!” campaign.I do want people to know there’s more than one narrative to adopt in the face of cancer. Pick according to your gut.I’ve said thousands of times: “What you resist persists.” I would not fight. I would listen.I viewed the leukemia as a messenger, and my job was/is to get the message.I have enjoyed Louise Hay’s work, and was aware of the fact she gave meaning to particular illnesses.I thought, “Leukemia is a childhood disease…” Hmmmmmmm…I had started guided journaling at What is Self Authoring? many months earlier, and had started with the Past module (there are also two for the present and one for the future… starting with the past made the most sense to me…) but, I quickly fell into procrastination…One obvious message was, “I wouldn’t do that if I were you…”, meaning, I got one message as, “Don’t keep putting off deep work.”Now, acute myeloid leukemia is relatively rare with about 20,000 newly diagnosed cases a year. That’s an incidence of 0.006%. It’s rare.But, things would likely be much darker (which sounds weird to write, because I can’t say they’re dark (though I can admit if one looks at the five year survival rate for AML, one would be inclined to say they’re dark… but, that’s a statistic, and part of good mindbody medicine is not being negatively influenced by stats…)) if I hadn’t been getting yearly routine labs.TLDR:Get yearly routine labs like a CBC and complete metabolic panel.The risk/benefit ratio argues for it.Think of it as insurance… you definitely want to have it, even though you don’t want to use it.Extra credit edit:So as to exclude as few readers as possible, I am adding an important point…I have used the word, “blessing” more than once, and said that there is meaning in this life challenge/lesson, thereby asserting/strongly implying it’s not random; we don’t live in a strictly mechanical Universe, in which we humans are machines that break and consequently go to doctors that intervene on our behalf and restore us to health.I was ultimately convinced of that mechanistic worldview until the age of 23. I no longer believe in or inhabit that worldview… but no matter…I’m working on a reply to the gentleman’s comment in which it’s asked what I think caused the leukemia.My reply involves logic I learned from my mother, an adept at logic. She changed her worldview late in life with logic.She told me one day, she had done a thought experiment in which she made a matrix of cells… the particulars will be in the reply when I post it.It is the particular thought exercise that’s relevant here:Let’s say you can’t abide by the notion of an actual blessing, or the idea there’s meaning to be mined in a disease, especially a life-threatening one like leukemia, you can still potentially get the value of that system/belief through this exercise:Let’s construct a matrix of four cells: 2 rows, 2 columns…I’m blessed really/I’m not actually blessedI believe I’m blessed/I reject the possibilityThen stand in each cell and look out at the world as if those conditions are so… what do you see? Is that possibility empowering?You see, it isn’t the truth that I was blessed and it isn’t the truth there is meaning, not randomness, in the leukemia… it’s a powerful place to stand.For the strictly “If I can’t see it in a lab, it doesn’t exist,” Do you want to be empowered, or do you want to be right? Or, if your health isn’t good, do you want to be healthy, or do you want to be right?Consider everyone is a house with four rooms: physical, mental, emotional and spiritual.In the modern world, you risk falling prey to the paradigm, the physical level of reality is all there is… It’s all matter and energy… if you can’t see in the lab it doesn’t exist.That worldview may be true, and obviously, it may not be.If you hold yourself as a house with only one room, physical, which gives rise to the illusion of the other three rooms and that’s not the case, there may be a dear price to pay.EDIT (April 16,2019):I can’t say I’m about to add materially to my answer of the question; however, I can see how the reader might be curious as to what’s up as of today… I don’t remember when I wrote this; I see my last update was February 16th.There have been three excitements and one very sad loss since I last updated. I’ll end with the loss.About six weeks ago, after receiving a unit of red blood cells, an infusion which took about two hours, I drove home and sat on the couch. I started to feel cold and hot at the same time. Cold won out and I got underneath an electric blanket and turned it on. Very shortly I was having hard chills.My instructions from MDA since my December discharge were, “Go to the ER if your temperature hits 101 or more.” I didn’t have to take my temperature. My wife drove me to the ER. It was a Friday afternoon and the ER was packed. Getting into the ER was fun; because I have staff privileges there, but the staff up front and the triage nurse don’t know me from Adam. So, I went in the back doors of the large ER, bald, with an overnight bag slung over my shoulder and said, “I’m Dr. Murphy. I’m in treatment for leukemia and I have a fever.” Most of the dozen or so doctors, nurses, technicians and unit clerks behind the counter stopped what they were doing to stare at me. I stared back at them. Eventually, a nurse broke the deadlock. “17 is open,” she said stepping out to escort me.I was deathly ill. All the routine things… blood cultures, chest xrays, etc. were done, looking for a possible source of infection.For the next three days I lay in the dark, sleeping as much as I could. They left me alone, which I thought was odd, but appreciated. At MDA I don’t think they would have let me lay in the bed 24/7, and didn’t even when I had RSV (another story).Monday rolled around; nothing had grown in the blood cultures; and, I had started to feel better. About 11 am, having enjoyed a great rapport and relationship with everyone there, I said politely to the nurse, “Um, I’m going to be discharged. I just need to know whether it will be AMA or not.” 10 minutes later I was signing routine discharge orders, and I went home. I felt like crap.In retrospect, the most likely explanation was a non-hemolytic transfusion reaction, something that occurs in about 1 out of every 1,000 RBC infusions. This can occur if WBC’s stow away in a batch of inadequately washed RBCs. They cause a cytokine reaction, the kind of thing that makes you feel awful when you have the flu.Gradually, over the next few days, my energy came back.The second excitement was going back to MDA on a Friday, my chemo rounds always start on Friday, and had labs in the morning to prep to see Dr. P, who would then order the 3-day round of chemo.My WBC was below 1,000, even though, due to circumstances, I was on Day 35 of a cycle. Being in a clinical trial at MDA, there are protocols and guidelines and chemo was off; it couldn’t proceed.Once again, Dr. P predicted the future. He said, “We’ll do a bone marrow biopsy; you’ll still be in remission. You’ll go home. Have a great weekend. Come back Monday morning. We’ll do labs and give you a shot of Neupogen Monday and Tuesday mornings, and we’ll restart your chemo on Wednesday.”That was an exciting weekend; because, while the blast count was likely ready Friday afternoon, no one was there to read it. And, while I mentioned a couple of potentially arrogant sounding behaviors around febrile neutropenia hospitalization; I’m not the type to be inclined to try and get the results before Monday.I was able to think positively throughout most of the weekend. I did allow my mind to think about a recurrence, but not to dwell on that possibility. I wasn’t in denial; I knew the results of the biopsy could be bad news staying alive-wise. But again, I mainly stayed in positivity and continued to visualize my 90th birthday party (my father, Stu’s 90th birthday party is next month) and to affirm, “I am so happy and grateful now that I’ve released the patterns that gave rise to the leukemia.”Monday morning, after having had my labs, I was sitting and waiting in the 8th floor leukemia waiting area, waiting to be called back for an injection of Neupogen, my cell phone rang. It was Dr. Islam. “Your blast count is 2%.”I cried with joy, once again, as I did when he told me, “Your MRD is negative. I have never seen an MRD negative patient at Day 21,” months before.To be continued… fatherhood calls at the moment…there’s more coming… and… 95% of what I write on Quora is via iPhone… somewhat constraining…My two older sisters and I with our father at his 90th birthday party last month, May 2019. He’s a huge inspiration, and not just because that’s his house we’re visiting and he’s had CLL for ten years and has only accepted monitoring of it.I’m coming up on 6 months complete remission. There’s much more to write; and, my commitment is that what I write make a difference for you.And, as promised above, there’s more to the story and I will flesh out what I believe made the difference in the face of a potentially terrifying disease…Today, my hair, like springtime blossoms, is sprouting again… a sign of the life force, irrepressible, pushing up through the cracks in the sidewalk…Here’s to New Life……and again, more to come…Edit: July 4th, 2019Today, the 4th of July, enjoying Life. I’m 60 now… my hair’s sprouting… the sprouting started this Spring after the chemo was finished… I gave that timing meaning… Springtime… new life…I intend to share more about this experience, and yet, I’m not sure this is the place to do that given the original question.So far, it has been a pleasure to have this forum to share my experiences with leukemia and everything related. If you have a suggestion as to a better forum/platform to share my knowledge, experience and hope with regard to leukemia, let me know.EDIT Saturday, July 27, 2019:I had surgery Thursday to have a myringotomy and tympanostomy tube placed in my left ear. It went perfectly.Fluid filled my left middle ear during my last hospitalization (for febrile neutropenia) in April. There were two complications from that hospitalization, I presume from high dose IV vancomycin and cefipime… a sudden and persistent left ear effusion and neuropathy of my distal feet bilaterally.The tube has all but resolved the effusion (it’s present in the morning, but drains within and hour or two). And the neuropathy, which consists mainly of the sensation my socks, no matter what their fabric, are filled with sand in the toes, and there is pain at times, increased initially with hard shoes and jogging. However, the jogging actually seems now to be a force for its resolution.I set a goal of running a 10K by September 29th, a goal RunKeeper helped me to decide on. Thanks to my varsity tennis playing son, Elliot, for that app tip.I had preop labs Tuesday, and coincidentally, two month followup labs for my heme/onc, Kavita Nirmal, on Wednesday. Not surprisingly, they were both very close…WBC 4.1Hgb 16Platelets 157,000It’s all good.EDIT Thursday, September 12, 2019:Reporting in for the curious…My post above starts with the yearly routine labs I had done September of last year, 2018. That’s cool, and relevant to the question.I’ve had two haircuts since my nuked hair decided it was OK to start growing again. Gone is the childhood fear of the barber or stylist getting it too short.I’ve run 5 days a week since July 21st, and I am registered in Texas Oncology’s Celebrate Life Survivor’s 5K on the 28th.There are two big benefits of running 5 days a week.One is the health and fitness benefit which is enough on its own.The other is, who I am for myself today is larger than who I was when I was saying, “I need to start running again,” for SEVEN years. (I was shocked about 4 months ago, in a moment of self-clarity, I caught myself running that line of bullshit past myself, and I stopped and asked myself, “When was the last time I exercised regularly?” …2012. Damn, Dude. You’ve been saying that to yourself for SEVEN years.)About 3 months ago, I started making the bed if I were the last one out. I’d heard Dr. Jordan Peterson recommend this one before solving any of the world’s problems. “Make your bed.”About a month later, during breakfast with my varsity tennis playing son, I downloaded an app, RunKeeper, he’s using to log his many runs.It started pressuring me to run a 10K in a month. I reacted, “I’m 60 years old. I’m not running a 10K in a month… I’ll run one in two months,” and on July 21st, I started running 5 days a week.Another recent shift in who I’m being in the world is manifested by the fact that I’m writing again.UPDATE: September 30, 2019I beat my oncologist in a 5K this weekend! Sorry, Dr. Nirmal. Good run!Not that long ago, my hemoglobin was 7 and I got winded climbing a flight of stairs. Now it’s 17 and I can run a 5 kilometers!UPDATE: October 25, 2019:It just occurred to me it is getting close to the one year mark that I went to MD Anderson for the first time and I don’t think I’ve adequately acknowledged them.To me, and probably by objective measures, MD Anderson is the best cancer treatment center in the world. It must be one of the largest with over 20,000 employees and over 15,000,000 sq ft of space. Yet, it is one of the best run organizations I’ve ever seen of any size. That’s important. But, not as important as the care and concern I saw everywhere. The ethos there is healthy, upbeat, nourishing and inspiring.In particular, I want to acknowledge and thank to a depth appropriate to one given to someone who participates in literally saving a life. Naveen Pemmaraju, thank you for saving my life. I am the father of a now 3-year-old, precious boy. I am also the father of two other boys, 19 and 17, who shouldn’t lose their father, either; yet, the biggest save was saving the life of the father of this precious 2-year-old boy.December 13, 2018 - Just discharged from MD Anderson’s Leukemia Specialty Care UnitThis is what I’m talking about, Naveen. This is such a huge gift. Words aren’t adequate to express the depth of my gratitude. Thank you.Rabiul Islam, thank you for your relentless close support and encouragement. You repeatedly went above and beyond calling me on my cell and keeping me informed. And, the moment you told me I was MRD negative is one of the happiest moments of my life. You didn’t have to add, “I have never seen an MRD negative patient at Day 21.” But, you did and that made a deep, profound positive impact. It has been some of the best medicine mentally and emotionally, and probably physically and spiritually. All boats rise with the tide. What a profound gift. Thank you.Michael Andreeff, thank you for who you are personally and professionally. You were my first inpatient physician contact, and it was, interestingly, on Thanksgiving Day. You walked into my room with an entourage of residents and fellows and said, “Who are you, and vot are you efen doing here?” (Sorry, that’s my recollection of your delightful German accent.) I loved our banter. When I told you I was a psychiatrist, you told me, “I vanted to be a psychiatrist, but I vound up being this.” You were part of the development of flow cytometry in the early days in Heidelberg. Flow cytometry told me the leukemia was gone down to a resolution of 1:1,000,000 WBC’s compared to 1:20 resolution possible with a microscope alone. Thank you for the quintessential physician that you are; and, thank you for having me look forward to witty banter every morning at morning rounds. What a delight.Zeev Estrov, thank you for who you are. Two memories stand out. You came into my room the morning after my Day 21 bone marrow biopsy and said, “Go home. You don’t need to be here anymore.” And, after I started to recover from the seeming near death experience from RSV, I perked up for your morning rounds; and, you and your entourage of residents and fellows came in. I had finally had a good night’s sleep and told you so. You turned to your students and said, “That! will tell you more than any lab test.” To me, such a brilliant moment of teaching. In medical school, I remember the lesson of one of my professors, “You treat the patient, not the labs.” You are another star in the MD Anderson firmament.To the staff of the 12th floor Leukemia Specialty Care Unit and to the nurses who inserted my PICC line, I cannot say enough to thank you and express the gratitude I have for my treatment there. It is a difficult thing to be a young man, otherwise healthy, diagnosed with a life threatening disease and facing an uncertain future, knowing it included, at the least, chemotherapy and weeks of isolation. I don’t think I’ve told anyone this because it sounds weird. When Dr. Estrov told me to go home on Day 22, I was disappointed. That’s partly your fault. Good job. I’d say, “Keep it up,” but that would be silly. It’s who you are.To the 8th floor Leukemia Clinic and staff, thank you for always being friendly, upbeat, professional but not dry or stiff, and always being a well-oiled machine. Wow. You and your clinic and lab are part of the reason that the thought occurred to me, “This is the best run organization I’ve ever seen of any size.” Amazing. Thank you.To my individual nurses, inpatient, outpatient and chemo, because all of you were so extraordinary in skill, compassion and presence, I got to be right every time about how great MD Anderson is, every time. Every contact. Thank you.To the nurse who put in my PICC line, when I was the most alone and scared, Wednesday night, alone before Thanksgiving Day, thank you for your flawless insertion of a central line, your calming bedside manner, and thank you for telling me you had multiple myeloma years before and remain disease free. (The only thing that could have made the whole experience better, for the next patient, consider leaving out the part about your PICC line getting infected. :) ) Thank you.There are so many people to thank. Right now I am acknowledging you, MD Anderson. Thank each and every one of you. I am weeping now in gratitude as I get in touch with the magnitude of the gift and how you gave it. Jackson just turned 3. He will thank you one day. For now, I thank you on his behalf.Oh my! There are so many people to thank!To be continued…EDIT: January 7, 2020An interesting “problem” is arising here… the longer I live, the less appropriate the word “recently” in the opening line of this answer is… in December, less than a month ago, I went back to MD Anderson for my first checkup since July. All is well and my MRD continues to be negative over a year after entering remission. Thank you, Dr. Pemmaraju and all of you at MD Anderson.And, as I mentioned above, there are many more to thank. I will address two of you now:To Nortin Hadler, MD, of UNCSOM. Nortin, your startlingly deep compassion and ability to read between the lines of what I was saying moved me to tears. You heard me asking things I didn’t know I was asking. Your clinical acumen and profound compassion were so intense at times it was hard to be with. You encouraged me at a deep level. Not long before I was diagnosed with AML, I wrote you to thank you and tell you how much your work has meant to me as a physician and reader. I didn’t expect a reply, let alone one of such thoughtfulness. Then, during my struggles with leukemia, you shined as a lighthouse of steadfast personal and clinical wisdom. Thank you for hearing what I didn’t even know I was expressing and addressing it.To Steve Derdak, DO. My sister, one of the finest physician’s I know, refers to you as the smartest physician she knows. That’s quite an endorsement. I still remember visiting you when you were in medical school and thumbing through your Harrison’s Principles of Internal Medicine to find it thoroughly highlighted. Years later as an intensivist at Brooke Army Medical Center you brought your vast clinical experience to me personally in a very frightening and challenging time. Thank you for being there. And thank you for your sweet, personal bedside care of Marty at our home during her final days.And thank you Quorans for your views and upvotes. I deeply appreciate it!More to come.Edit: June 21, 2020Went back to MD Anderson a couple weeks ago for a routine followup. Results were all good except MRD.CBC great. Bone marrow aspirate showed 1% blasts (normal is < 5%). All very exciting. 6 days out a notification popped up on my phone that Dr. Pemmaraju wanted a telephone appointment with me.That was not welcome news, and I couldn’t wait until the next day to find out why. I called his PA, Rodney, and learned the news. My Measurable Residual Disease is now positive. I am in morphological remission, but not at the level of resolution provided by amazing technology.Dr. Pemmaraju’s recommendation is 3 rounds of venetoclax and azacitidine (VEN/AZA). Mild chemo… he used the analogy that the previous chemo is like a bomb and the VEN/AZA is like a Predator drone strike.He said my MRD will turn negative again. And he referred me back to the Stem Cell team.No problem seeing the Stem Cell team again for a consult but I was dead set against it.My thinking was why would I sacrifice feeling great for the devastation SCT is?And I’ve already created this narrative of how powerful mind/body medicine can be…It wasn’t an easy choice at all. And at one point in the last 16 days of wrestling with my circumstances I decided to do SCT but from a place of fear. (There’s a powerful distinction between choosing and deciding worth taking a look at.) Then I decided against it.At some point I looked at the scientific research and statistics on it; then I watched some inspirational videos by successful recipients and using the rhetoric from one of those people, switched to viewing SCT as an investment in my future. And I went back to my matrix of 4 cells and considered each possibility it boiled down to which mistake I would rather make…Have a stem cell transplant when I could’ve done well using mind over matter after allorNot have a stem cell transplant when in fact I needed one to prevent death by AML progression?Decision is derived from the root word “cide” or to kill off. In a decision the circumstances and considerations determine the selection… you have a pro list and a con list and the selection is based on which list is longer. The alternative is killed off by the considerations.Choice: To select freely and after consideration.Initially I decided no. Then I decided yes. All of that occurred in a field of fear and suffering.At some point I chose SCT and a feeling of peace came over me.I am at peace with the choice and the outcome.Once again, I think I will fare exceptionally well and I know that isn’t a given.I realize one outcome is death by overwhelming infection, organ failure or graft vs host disease.That is out of my hands. I accept my fate. I choose it.And I am happy to share the journey ahead.Edit: August 3, 2020Day 1 Cycle 2 of venetoclax and azacitidine. Mild chemo. The first cycle of this had few side effects and no hair loss. It was surprisingly hard on my kidneys… the cycle is Monday through Friday every 28 days (if possible) and my creatinine spiked to 1.5 on that Friday. It returned to normal and a nephrology consult concluded it was a reaction to the venetoclax. Dr. P concluded it was an idiosyncratic reaction and doesn’t think it’ll happen again.Edit: November 3, 2020Getting Busulfan at MD Anderson this morning in preparation for a stem cell transplant.I am quite well and continue in morphological remission. My MRD turned positive in June for the first time since December 2018. I’ve accepted MD Anderson’s recommendation for a SCT. It’s been their recommendation all along, but until June insurance wouldn’t pay for it and I didn’t want it. However, confronting a dead canary down here in the mine, two thoughts persuaded me.I have three boys, the youngest is four. In that context I look at this as an investment in the future; and, I’d rather have it and not need it than need it and not have it… I met a wonderful man in his early 70’s, John, in an infusion room last year. Delightful. I got to talk to him at length twice. Delightful man. He looked well to me. However, his chemo had never gotten him into remission and he died very quickly. His death hurt deeply. I grieved his death and I could feel the pain of it much more acutely than my mother’s 8 years ago, something I think odd. Perhaps it was the reminder of my vulnerability.I remain optimistic and grounded in my choice and commitments.Today is the first day the thought, “I am a writer” occurred so consonantly. Perhaps the dawning of the reality of death, not necessarily of its immanence, but of its ultimate reality, shifted my audience from what others think to what I think. I’ve a story to tell. It’s for me and that others may benefit.“The ill person who turns illness into story transforms fate into experience…” —Arthur Frank, from The Wounded StorytellerFootnotes[1] Minimal/measurable residual disease in AML: a consensus document from the European LeukemiaNet MRD Working Party