anagenesis

Fran has her hair back--silver and curly and thick.

Her breast is gone, but perhaps the cancer is gone as well. She has her hair back, though, and with it, a bit more energy. Like Samson, her strength waned when her hair fell out.




Most of the hair on your head is actively growing; this is called the anagen phase, and lasts several years. The hair follicle then enters a resting period, the telogen phase, which lasts about 1 to 3 months. (There is a winding down period from anagen to telogen called the catagen phase, which lasts 2 to 3 weeks). About 90% of the hair on a person's scalp is in the anagen phase.

Ana-: up, again, anew....gen: to be born, to become. Anagenesis, according to the OED, means "a reproduction or regeneration of structure." Anagenesis. A good word to learn on the day of the vernal equinox.

The hairs you lose while routinely shampooing your hair are usually from follicles in the telogen phase--the resting follicle easily gives up the hair. A new shaft will soon develop.

Chemotherapy is designed to kill actively growing cells. Cancer cells divide at ferocious rates, and are quite susceptible to the systemic poisons physicians administer. Other active cells, however, are also affected.

Effluvium is a flowing out, often associated with sewage. In medical terms, effluvium is the flowing of hair out your scalp. Anagen effluvium is what happens when chemotherapy stuns your hair follicles. You lose huge patches of hair, sometimes overnight, often with devastating psychological effects.




Spring arrived a few hours ago. My seedlings are in various stages of development. The first leaves sprouting from a seed are cotyledons, or seed leaves. Cotyledons among different types of plants look similar. The cotyledons feed the growing plant as it struggles to find sunlight and water.

No matter how long I have been gardening, the emergence of the first true leaves from a seedling startles me. My rosemary seedlings look like anything else the first week or two, then the first blades of rosemary leaves emerge. My tomato plants all look the same until the potato leaf of the brandywine clashes with the spiny leaf of the yellow pear tomato.

I studied enough botany to understand our models of how seeds work, with nucleic acids expressing proteins that determine how a living thing transforms itself. Still, when a purple serrano thrusts brilliant purple leaves from a pale brown seed no bigger than a starved tick, something has occurred beyond a simple model.




If we truly understood the model, we could figure out a way to make Fran's breast grow again. Every nucleated cell in her body, trillions upon trillions, holds the genetic code that transformed her mother's energy into two small infant breasts. A decade later, hormones awakened a tiny part of her DNA, and her breasts developed. A few decades later, something again triggered a small nest of cells to grow wildly in the same breast, threatening her life. Cancer comes from within, from our deepest secrets of life.

Physicians do not yet know how to control the genetic code that triggers malignancy; we do know how to poison actively growing cells. For all our fancy tests and technology, fighting cancer still depends on cutting it out, poisoning it, or frying it with radiation.




The body does not forget how to make hair; remove the poisons, and the hair follicle wakes up, and starts making fibers again. Sometimes the hair returns thicker than before, sometimes a different texture. It is virgin hair, untouched by years of shampoo and dyes, agents to make it curl, agents to make it straight.

It is hard to resist touching an infant's new curls; I felt an urge to touch Fran's new silvery locks, but civil adults follow customs, and one does not impulsively stroke another's hair (unless it be a lover or a small child). In a culture that celebrates youth above wisdom, cancer remains a dirty secret. We have not developed the social graces needed around patients with severe life-threatening disease. Fran is getting better--people flock to her these days.


When my mother was dying, people came to see her, but the uneasiness could not be washed away with grim smiles. Many people find fewer visitors their last few weeks. "She needs her rest... her family needs its privacy... she does not need the stress of visitors right now." Even in hospitals, doctors pull away from the doomed.

Thank God for nurses, and assistants, and technicians who care. The doctor writes an order and walks away. A nurse injects the poison, a tech irradiates the tissue. A nursing assistant cleans up the pools of vomit and loose stool.

Dying here in the States can be a lonely activity. We have professionalized the dying process. Hospices do wonderful work, but I still think there is something terribly amiss when we rely on strangers to escort our loved ones to their death.




Today, however, is the first day of spring. Fran's hair is back, her husband is growing his first beard after shaving for almost a half century, and my rosemary seedlings know enough to make rosemary leaves. Anagenesis. I pray that in this season of exuberant growth, a few cells stay quiescent.

Amen.