Another Point of View

When I turned on the early NFL game yesterday, I instantly knew it was October. Yep, there was pink this and pink that and courageous this and heroic battle that, all over the place. October is breast cancer awareness month, people! Pink out!

Seriously, can there be one single person in this country not living in a cave who is not aware of breast cancer? The October shenanigans alone have been going on annually for twenty-nine years, and when you add in the TV advertising, professional sports hoopla, and everything else pink and ribbony that is going on seemingly everywhere, you got some serious awareness, right?

Well maybe. But I take another view, that we have succeeded in turning a horrible, terrifying disease into some kind of national party, a decidedly for-profit orgy of merchandising and marketing. God forbid you should suffer and die from it! It’s all about positive attitude, fighting the battle, and “beating” cancer.

I’ve got news for you: cancer kills people. It’s what it does. Nobody "beats" cancer. Some of us are lucky enough to get effective treatment and survive, at least for a while. There are literally millions of good folks who do everything right and still die from cancer. The whole “pinkwashing” of our society every October is deeply disturbing to many people who are living with, through, and hopefully beyond the dreaded diagnosis of cancer. No amount of insulting, juvenile “Save the Boobies” campaigns will change this fact.

I’m not saying awareness is not a good thing, and there is a lot of money raised for cancer research every October. But could you stop for one minute and consider how much more could be done if every penny spent on the annual commercialization of breast cancer were spent on real science instead? On research into the genetic causes of cancer and the promising new immunotherapy treatments, the first new approach to cancer treatment in almost a hundred years. We could end the “cut, poison, burn” trio of surgery, chemotherapy and radiation.

So what about awareness? How about becoming more aware of the literally hundreds of cancers that people know little or nothing about, like bladder and esophageal cancer, or the host of incredibly cruel cancers that prey primarily on our young children.

Think about it.

Portland, OR  

October 6, 2014

Perfect-Every-Time Pan fried Oysters

When I find a particularly good dish preparation in a restaurant, it is not unusual for me to attempt some version of it at home. One of our favorite Portland eateries, Wildwood (now mourned,) used to serve fantastic cornmeal crusted, pan fried Wilappa Bay oysters. I tried quite a few times to cook them at home, with uniformly awful results; the oysters were either under or over-cooked, and the coating of egg wash and cornmeal was a half-fallen-off greasy glob. One Saturday afternoon after buying some Wilappa's at the farmer's market, I Googled pan fried oysters. Needless to say, there were tons of links to recipes, but one at the bottom of the results page caught my eye. The subtext read, "perfect pan fried oysters every time!"

They weren't kidding. Here's my version.

Ingredients: (serves two for main course, four as an appetizer)

1 8-ounce container of extra-small Wilappa Bay oysters (or similar)

Panko (Japanese crispy breadcrumbs)

1 egg, beaten

Canola oil

1/4 tsp unsalted butter
Sea salt and black pepper

There are two things in this preparation that I did not see in any of the other recipes. First, the oysters are blanched first. Second, they are left in the egg wash and then the breading for a carefully measured period of time.

Dump the oysters into a medium-sized pot of lightly salted water that has been brought to a full boil. Blanch for one minute, then drain them in a colander until cool.

Place a cup or so of Panko into a gallon plastic baggie. Add salt and pepper to the egg wash. Take the cooled oysters an place them in a small bowl with the beaten egg, which should just cover the oysters. Let sit for five minutes, then stir the mixture so all oysters get equally soaked. Let sit for five more minutes.

Place the oysters in the bag with the Panko and shake thoroughly until all the oysters are well coated. Lay the oysters carefully on a sheet of waxed paper. Let them sit for exactly five minutes. Sprinkle a little more Panko over any spots that look thin, then carefully turn them over. Sprinkle them with a bit more Panko and let sit for another five minutes.

Heat about 1/4 cup of canola oil  until it is wavy but not smoking in a large non-stick fry pan and carefully add the butter (helps the browning process.) Put all the oysters in a single layer and fry until golden brown, about a minute or so. Turn them over with long tongs and do the same with this side.

That's all there is to it! The blanching insures that the oysters will not be undercooked so you can fry hot and fast, which seals in the juices and makes a great non-greasy crust on the oysters.

I serve them with a simple salad with balsamic vinaigrette and Wildwood lemon-garic aioli (Whole Foods house brand.)

Un-oaked Sauvignon Blanc is our wine of choice, either a New Zealand or a Sancerre from France.

Now go eat some pan fried oysters!

(Portland, March 23, 2014)

Here is a "commercial" created by our oldest son, Keith Sadowski, who works at Cirque du Soleil in Las Vegas.

Brilliant!

A Close Encounter

This blog is usually pretty straightforward, as it’s title suggests. At the risk of being uncharacteristically schmaltzy, I offer you this brief post on an experience that was strange enough and touching enough to share.

On January 27^th I flew to Burbank, CA, and checked into the Hilton San Gabriel. The next morning I was to undergo my annual day of tests at USC Norris Comprehensive Cancer Care Center under the supervision of my surgeon, Dr. Sia Daneshmand. It had been just over six years since my cancer surgery.

I started my day the next morning with a light breakfast at the hotel, and reported for the first phase, labs, at 9:00am. After giving enough blood to supply Lance Armstrong and Keith Richards for a year, I proceeded to the waiting room for the imaging department, where you check in for X-rays, CT scans, ultrasounds, and/or MRI’s. When I entered the waiting room at a few minutes before ten, there were three other patients there. One was a painfully thin older man with wispy white hair and a deeply lined, pale face. Another was a woman of indeterminate age, morbidly obese, sitting on a motorized scooter with an oxygen bottle attached to the side of it. A clear tube snaked up her arm and rested in her nostrils.

But it was the third patient that grabbed my attention. She was a girl, no more than fourteen or fifteen, and seated directly across from me. I smiled at her quickly, and was met with that uniquely teenaged look between a frown and an outright sneer. Her eyes were dark and unblinking. She was dressed like a Goth: black skinny jeans, black boots, and black lipstick. She wore a black baseball cap with a single white question mark, and an oversized black t-shirt with the words “FUCK CANCER” on the front in large white block letters. I looked at her more closely and realized she had no eyebrows, and not a hair protruded from under the black cap.

Chemo.

While we had been sizing each other up, the white-haired man had left and a nurse had called the scooter lady back for her tests. We were alone. The girl looked me straight in the eyes.

“Do you have cancer?” she said, her voice surprisingly soft.

I attempted a weak smile. “I certainly hope not,” I said. “But I guess that’s what I’m here to find out.”

We looked at each other for a long few seconds.

“I don’t know if I still have cancer or not,” she volunteered. “And I guess that’s what I’m here to find out too.”

She looked so small and vulnerable, yet she sat straight up and had a look of fierce determination on her young face. A nurse with a clipboard opened the door to the lab.

“Frank Sadowski.”

I stood up quickly, and the black-clad girl stood up too. I realized then how tiny she really was, the top of her head not even reaching my shoulder level. She stepped close and put the side of her face on my chest and wrapped her arms around my waist, giving just the slightest squeeze.

Then she turned her head away and sat back down.

Stunned, I said nothing and followed the nurse into the lab.


Portland - February 10, 2014

Thanksgiving and Veteran’s Day

Today, December 21^st, is my Thanksgiving and Veteran’s Day.

Many of my friends have urged me to write about my cancer experience, and I certainly have enough material to make it book-length.  I will take this occasion to pen my first public comments by way of a short and to-the-point blog post.  Maybe someday that book will come, too.

On October 30, 2007 I discovered blood in my urine.  After an emergency room visit, a CT scan, and an ambulance ride to a downtown Seattle hospital, on Friday, November 2^nd I underwent a procedure called a TURB (Trans-Urethral Resection of the Bladder) to remove a tumor.

On November 5^th, 2007 I was diagnosed with advanced bladder cancer.

When the urologist had first looked at the results of the CT scan, he told me to expect the worst.  While he was very clear that he could not give an actual diagnosis until he removed and analyzed the tumor, he said that from the size and location of the growth, in his experience it was most likely T3 disease, which is cancer that has spread beyond the bladder. The 3-year survival rate for T3 bladder cancer is 5%.

Following the TURB, the official diagnosis was not as bad as he expected.  He and a second-opinion doctor both recommended bio-therapies and a second TURB to look for any other tumors.  The experience gained in four years of volunteer work with the Lance Armstrong Foundation kicked in, and I sought a third opinion as well as reading everything I could find on and off line about bladder cancer.  I soon learned that there are two opposed schools of thought: the “bladder sparing” proponents, also known as the Sloane-Kettering or east coast school, and the “radical surgery” proponents, known as the USC or west coast school. Realizing that all three opinions were solidly from the bladder sparing side, I asked my urologist to recommend a doctor from the opposing school for a fourth opinion.  This turned out to be Dr. Sia Daneshmand at OHSU (Oregon Health and Science University) in Portland, OR, considered among the finest bladder cancer surgeons in the world and a veteran of the USC Norris bladder cancer program.  I met with him on Monday, November 12, 2007, and after a day of tests and consultations he recommended immediate surgery to remove the bladder.

I will never forget his words. “This thing only exists for one reason,” he said. “It exists only to kill you. You must play offense.  If you play defense it will always win, and you will die.”

On December 21^st, 2007 I underwent a Radical Cystoprostatectomy with Lymph Node Dissection and Orthotopic Ileal Neo-bladder Diversion, performed at OHSU by a surgical team led by Dr. Daneshmand.  The surgery took almost eight hours, and involved creating a new bladder (neo-bladder) from a one-meter section of living small intestine (Ilium) and installing it where my original bladder had been removed.  The recovery was hard.  From a urological standpoint, I was like an infant when I came home from the hospital six days later.

My recovery was slow at first but gained speed quickly after the first three weeks.  I was walking a mile a day after week four, and I took my first wobbly one-mile bike ride around the neighborhood in week eight.  Today I am fit and healthy.  Of course if I had a choice I would never had gotten sick, but we don’t get to make that choice, and cancer for me has been a great blessing in my life.  I can honestly say that the last five years have been the happiest of my life, by far.  Over that time I have watched my youngest two children graduate from college, and three weeks ago I held my first granddaughter.  Tomorrow I will turn 60 years old.  I never thought I would see any of these things on November 5^th, 2007.  I feel I am a better friend, a better father, and a better husband because of what I have experienced and what I have learned.

I have been cancer-free for five years today.

Dr. Sia Daneshmand and the author

That explains why today is my Thanksgiving pretty easily, but what about Veteran’s Day?

Through my work with the Lance Armstrong Foundation, dealing with cancer in my immediate family, and of course my own cancer experience, I have talked to a great many people who have dealt with this disease.  Here are three of the most significant things I’ve found:

There is still stigma attached to cancer.  Yes, we’ve come a long way in our country, thanks to the Pink Ribbons, the Foundation, and many other well-meaning organizations.  In rural Africa, those afflicted with cancer are routinely driven out of their village and left to suffer and die alone.  But major stigma still exists even in first-world post-industrial countries like Italy, where it is taboo to talk about cancer, and cancer in a family is considered a deep dishonor.  It exists here too, if in a lesser form.  Exactly 100% of the people I’ve spoken to who are living with and through cancer and its aftermath have told of friends who have simply vanished permanently from their life, apparently unable to deal with the reality of cancer so close at hand.  Regrettably, I have experienced this myself.

Hold the battle metaphors, please.  The vocabulary of those writing about cancer is dripping with comparisons to war.  Nobody dies from cancer; they “lost their courageous battle,” etc.  Almost everyone I have spoken with in the cancer community hates this.  As one of my favorite cancer wits put it: “When someone dies in a car accident, you never hear about how they lost their brave battle with a Subaru.”

Survivor, or surviving?  Many of the folks I have spoken with are deeply uncomfortable with the whole “survivor” terminology.  To many, it demeans those who die from cancer, and let’s face it, more people die from cancer than are cured.  It seems like you are self-identifying as somehow superior, when all of us know how fortunate we are to be among the minority group whose treatment has worked, if only for now.  We’re surviving, I suppose, but does that make us survivors?  One of my favorite writers, Mary Elizabeth Williams (Salon.com) was diagnosed with malignant melanoma a few years back, and we have had some interesting discussions on these issues, including the survivor thing.  If we’re not survivors, then what do we call ourselves?   We’ve not yet come up with the perfect name, and I don’t think there really is one, but she likes to call us “veterans.”  I must say I like all of the connotations of that word in relation to cancer, even though it does suggest the old war analogies.  I’ve run this one by many cancer – ahem – veterans, and most seem more comfortable with this one than others.

So, please join me in wishing a very happy Thanksgiving and Veteran’s Day to, well….me.

Now where’s that corkscrew…

Lance Takes a Pass

As a cycling fan and cancer veteran, I was saddened – and yes, incensed – by the news that broke last night, that Lance Armstrong would not submit to arbitration in the doping case that the USADA has brought against him.  It is indeed a sad day for him, his fans, and the sport of cycling, as so many sports writers and pundits have written over the last 24 hours.  But the majority of them have gotten it mostly wrong, exhibiting very little understanding if not outright ignorance of the USADA “arbitration” process that has caused Lance to take this unexpected turn.

The very first post on this blog was titled “Stirring the Lance Pot.”  It was an attempt to present an alternative, reasoned explanation to just how Lance could have achieved similar or superior performance to that of his top competitors, many of whom are proven dopers.  I never said, nor do I now, that I know Lance to be innocent of doping; none of us will ever know that for sure because we weren’t there.  As someone who has worked as a volunteer for the Lance Armstrong Foundation, participated in the Ride for the Roses in Austin, TX, and raised several hundred thousand dollars personally for the Foundation, I have had the opportunity meet and speak with Lance many times, on and off the bike, and I have the utmost respect for him.

Let’s look at the primary themes of today’s articles. The main thread that runs through most of the superficial analyses is that Lance is refusing to proceed because he knows that damning evidence will become public.  The flip side of this is the consistent claim, even by the head of WADA (World Anti-Doping Agency,) that Lance’s refusal to submit to the arbitration process is tantamount to an admission of guilt.  The facts are just a bit different, and it is necessary to bring in a brief bit of history.

The USDA (United States Anti-Doping Agency) was formally founded in 2000 as a taxpayer funded non-profit charged with implementing and enforcing the World Anti-Doping Code.  It’s original charter was to protect the rights of American Olympic athletes who had tested positive for PED’s (Performance Enhancing Drugs,) ensuring that the standards of testing and analysis were fair to the athletes.  Under the USADA’s original mandate, no case could have possibly been brought against Lance because although he has been tested over 500 times in and out of competition he has never once had a positive test result.  However, in 2004 the WADA introduced the World Anti-Doping Code as a guide for all the national Agencies that followed the WADA guidelines.  Included in this Code was the little-understood and seldom-used “non-analytical positive,” a poorly defined and decidedly gray-area ruling that enabled the national WADA-affiliated organizations like the USADA to impose sanctions where there was no positive test result, declaring a doping positive based on non-analytical evidence, primarily eyewitness testimony or documents indicating doping violations.

This is the basis for the USADA case against Armstrong.  They bring their case in secret, with no evidentiary rules.  The accused may submit to an “arbitration” process that is wholly controlled by the USADA.  The arbitration board, which USADA repeatedly misleadingly calls a “neutral” board, is made up of a majority appointed directly by Travis Tygart, the CEO of USADA.  The “evidence” is not shared with the accused prior to the proceeding, and may include signed statements rather than live testimony.  Contrary to most articles out today, there is no guarantee that any of the evidence would have been made public; in fact, there is substantial evidence that the USADA has made deals with riders, guaranteeing them immunity even after their admission of doping, in return for their sworn statements supporting the USADA’s case.  There is no right of cross-examination.  The accused bears the burden of proving the charges false; he is literally guilty until proven innocent under this process.

The USADA is the prosecutor, judge, and jury, and they have the right change the rules as they see fit, even retroactively.  A perfect example of this is their decision to change the rule on the statute of limitations.  Their own bylaws include an eight-year statute of limitations, which would limit any sanction to Armstrong’s last two Tour de France victories.  But they have retroactively changed the rules, allowing them to go back seventeen years.  If you read Lance’s entire statement, it is easy to see how he is justified in calling this proceeding a “witch hunt” and the arbitration board a “kangaroo court.”  Many articles have said Lance would never give up a fight and that proves his guilt.  I say that Lance would never give up a fair fight.  Outside magazine, which has been very critical and suspicious of Lance in the past, published a long article on the un-American nature of the whole USADA process that is well worth reading, and today published a follow-up indicating that may be a bit more complicated than the USADA seems to think.

The second theme running through all of the articles on line today is the “stripping” of Lance’s titles, including all seven of his Tour de France wins, several other major race wins, and his 22 T. de F. stage wins.  Not so fast.  The UCI (Union Cycliste International) is responsible for actually taking away a race win, and the Associated Press and the New York Times are both reporting today that the UCI has already asked USADA for their evidence, indicating that they may not just automatically take action, even though they are pledged to abide by WADA decisions on doping.  Further complicating the issue is the UCI’s own eight-year statute of limitations, and there is clear relevant precedent here.  When Bjarne Riis admitted to doping to win the 1996 Tour, it was outside the statute of limitations, and he is still listed as the winner by the UCI.

There are numerous other points that speak to the inconsistency and hypocritical nature of USADA’s actions.  First, although they claim repeatedly, including in their official statement today, that Armstrong was part of a vast conspiracy (The United States Postal Service Conspiracy,) they have not charged a single rider other than Armstrong.  Why not, if they have a huge preponderance of evidence?  As stated, they seek to strip Armstrong of all his titles and T. de F. stage wins.  What about all of his teammates titles and stage wins?  What of the USPS team time trail stage wins?  This single fact is the most compelling evidence that Travis Tygart is using the unfettered power of a taxpayer-funded agency to perpetuate a personal vendetta against Armstrong that has been going on for years.

Lastly, let’s take a look at the final absurdity of this case.  If Armstrong is in fact stripped of his Tour wins, the runner-up in each year will be awarded the win and the coveted Yellow Jersey.  Who would those riders be?  Of the seven runners-up from 1999-2006, only Andreas Kloden in 2004 was never sanctioned for doping, and even he was under investigation before the 2006 Tour.  Jan Ulrich finished second three times, in 2000, 2001, and 2003, served a ban for doping in the Operacion Puerto affair, and eventually retired in disgrace and paid a huge fine.  The other second place finishers, Alex Zulle (1999), Joseba Beloki (2002) and Ivan Basso (2005) were all sanctioned after either admitting to doping or failing doping controls (positive tests.)

So here’s a great idea: Let’s strip seven Tour wins (most of which are past the statute of limitations anyway) from a guy who retired years ago and never once tested positive in over 500 blood and urine tests over 17 years.  Then we’ll hand those seven titles over to five other riders, four of whom were officially sanctioned for either admitted or analytically proven doping during their cycling careers.

When I give this whole tragic, illogical, and blatantly unfair process the sniff test, it fails miserably.  Due process?  Innocent until proven guilty?  An agency set up to protect athletes from unfair persecution over PED’s?  This is America; we’re supposed to be a lot better than this.

Update 08/28/2012:

The Los Angeles Times published a great article on the unfairness of the USADA's "arbitration" process on August 26th, written by columnist Michael Hiltzek.  Well worth a read!

Introducing....Recipes!

Salmon with Pink Sauce

All of my friends and family know that I love to cook.  Many readers of this blog have suggested that I post more often, and quite few others have asked me for some of my favorite recipes.  So I’ve decided to combine the two, starting off my recipe blogging with a family favorite that is also one of the simplest and tastiest dishes I make.  It's a variant of a recipe I saw done on some long ago cooking show.  The original recipe came from the Oyster Bar at Grand Central Station in NYC.  It is perfect for the Springer Chinook salmon that is available everywhere in the great Pacific Northwest right about now. (Note: don’t run the other way after reading the ingredients list if you despise anchovies.  If you had the dish without knowing in advance you’d never guess they were there.)

Ingredients: Serves four

1 teaspoon good olive oil

2 teaspoons butter

1 medium shallot, finely diced

4 anchovy filets, roughly chopped

¼ cup dry white wine

1 pint heavy cream

½ tsp white pepper

2 teaspoons tomato paste, divided

2 pounds thick Chinook or King salmon filets, deboned, skinned, and cut into four 6-7 ounce squares, at room temperature

2 tbsp cornstarch

1 tbsp softened butter

After skinning and deboning (pulling the little pin bones from the filets) the salmon, individually wrap the squares in paper towels to absorb any surface moisture, which ensures a good sear.

Heat the butter and olive oil over low heat in a medium sauté pan.  Add the shallot and cook very slowly until translucent but not browned.  Add the chopped anchovies and cook slowly, stirring with a wooden spatula until they basically dissolve, about a minute.

Turn up heat and add white wine.  Scrape up all the shallots and anchovy paste into the wine and boil until reduced by half.  Add ¾ of the cream and the white pepper and bring to a simmer boil.  Add one teaspoon of the tomato paste and stir it until it is completely dissolved in the cream sauce.  Add a little more if you want it a little pinker.

Simmer for eight to ten minutes on low heat, adding a little more cream or water if it thickens too quickly.

While the sauce simmers, dredge the salmon squares in the cornstarch, rubbing off any excess.  Let the cornstarch absorb into the flesh, further drying the surface.

Quickly sear the salmon squares in a large, non-stick skillet, just until crisply browned on both sides, about 2-3 minutes per side depending on their thickness.  This will yield medium rare salmon, which is absolutely the best way to prepare it.  Cook it longer if you must. Remove the salmon to a warm plate.

Pour the sauce through a strainer into a Bain Marie or small saucepan over very low heat, and add a bit of cream if the sauce feels thick.  Whisk in the softened butter.

Arrange the salmon on warm plates and pour the pink sauce over it.  Garnish with a little chopped parsley and serve with rice or mashed potatoes and a steamed green vegetable such as asparagus, broccoli, or zucchini.

A final comment: The key to the simplicity and ease of preparation of this delicious dish is the anchovy.  It obviates the need for seafood stock or clam juice, providing the perfect subtle fish flavor and just the right amount of salt.  The beautiful pink color enhances the beauty of seared fresh salmon.  I couldn’t find a photo of this dish, but I promise the next time I cook it I’ll snap one and update this post.

Feedback always welcome!

June 4, 2012 Update:

Well, last night I finally got around to making the pink sauce again, the occasion being the first Copper River salmon of the season.  This is Coho, and the really great stuff, the Copper River king, should be along in the next couple of weeks.  Rather than just take a picture of the final plated dish, I snapped some of the preparation steps as well.  I took some liberties with the original recipe above.  First, we chose not to have rice or potatoes and just enjoy the fish and asparagus.  The asparagus was grilled on the balcony with black pepper, sea salt flakes, and good olive oil instead of steamed.  Lastly, I put the sauce under the fish instead of pouring it over, just because Copper River salmon is so gorgeous!

A good friend who read the original post also took me to task for not including wine recommendations, so here goes.  Salmon With Pink Sauce can be paired with either red or white wine.  In the case of white, I recommend a full bodied chardonnay that can hold up to the strong flavors of both the salmon and the sauce.  If you got your bonus check recently, go straight for a white Burgundy like the 2005 Vincent Girardin Puligny Montrachet "Les Combettes."  Or, since we're talking Pacific Northwest seafood, stay local, save $80 or so, and pick the 2009 Domaine Drouhin "Arthur" Chardonnay.

If your taste runs to the reds, stay away from overly robust, alcoholic varietals like Cabernet or Syrah-based wines.  Pinot Noir is perfect.  Once again, if you feel like a splurge head for Burgundy.  Perhaps the 2005 Nicholas Potel Volnay 1er Cru "Santenots."  Following the same logic as the whites above, you can save a few bucks (OK, very few) and stay local, maybe with the 2007 Domaine Drouhin "Laurene" Pinot Noir from right here in Oregon.

And what did we drink last night?  Ahem...the  2005 Potel Volnay Santenots, I'm happy to report.

Cheers, all!