John McCain: end of a career

A few weeks ago, John McCain seemed to be having a bit of word-finding problems (dysnomia) and was a bit confused as evidenced on some broadcast senate hearings. 3 days ago he underwent surgery for a blood clot (hematoma) in the left frontal lobe. At age 80, this isn't so surprising, as due to brain shrinkage (atrophy) blood clots can often form after minor trauma. Most clots are benign, in the sense that they are unassociated by other brain abnormalities. But in this case, McCain wasn't so lucky. He underwent a sub frontal (inferior to eyebrow) craniotomy for an 5 cm diameter blood clot. 5 cm is the size of a golf ball. The clot was located in the left frontal lobe, actually the part called pre-frontal lobe. This is the last cerebral area to mature, often not fully developed until age 25. The pre-frontal lobes are important in executive functioning (decision making), self-monitoring, especially in social situations. Emotional constraint is also a critical part of prefrontal function. Typically the left pre-frontal lobe is the more "analytical" portion relative to the right pre-frontal lobe but both are important regulators of cognitive, emotional, and social function.

The biopsy, which is routinely performed with any removal of tissue from inside the cranium, revealed glioblastoma. Glioblastoma is one of four grades of intrinsic malignant brain tumors. They are based upon unregulated growth of glial cells. Glial cells outnumber neurons 9:1. They play important roles in neural nutrition, protection, physical support, and very likely non-cognitive functions. Glial cells like neurons require blood supply. The blood vessels accompanied by normal glial cells are, for lack of a better word, normaL

Gliomas are typically divided into four groups, ranging in severity. The divisions are usually based upon tissue morphology (histology) but other factors enter into this. Mixed glioma types are not rare so that portions of the tumor may look more benign or less benign than other parts of the tumor. No matter what the grade of malignancy, ALL gliomas infiltrate surrounding normal tissue. Gliomas can be localized through direct vision or imaging to some extent, but the microscopic spread is impossible to detect with the naked eye, operating microscope and even sophisticated neuroimaging.

The four basic types of glioma, from least malignant to most malignant are:
1. Astrocytoma
2. Anaplastic astrocytoma
3. Glioblastoma
4. Glioblastoma multiforme

The Mayo Hospital derived biopsy report as well as the neuroimaging pre-operatively are so far unavailable to the public. Important considerations are location, size, histologic invasiveness and patient comorbidities.

"Cure" of gliomas is so rare as to be reportable in medical journals. Control is the best that can be hoped for, but control is not cessation of growth. In the usual cases of glioblastoma, the cavity left in the brain from tumor resection can be filled up with new malignant tumor in a surprisingly rapid manner. The faster this occurs, the worse the prognosis.

Typical surgical adjuncts consist of chemotherapy and external radiation. Intracranial radiation may also be used for high local dosing but is generally ineffective for diffuse control. The typical radiation is whole head with/or without stereotactic (highly focused) radiation. Treatment doses can be anywhere from 20 to 30 sessions, usually administered either 5 times a week or every other day, depending upon circumstances.

The acute and subacute results of whole head radiation are not simple. Besides the inevitable hairloss, intense scalp "sunburn" occurs. Taste sensation is lost or severely reduced, at least temporarily. Appetite is markedly curtailed, so weight loss and relative malnutrition occur in the subacute period.

But more importantly in the perspective of John McCain as a sitting United States Senator, his ability to function during the period of radiation will be completely halted. Chemotherapy, deepening upon the agent(s) used may have additional negative aspects.

Despite all the optimism voiced on TV, by all the pols, etc., the prognosis for John McCain returning to work in a productive manner is close to zero. A neurosurgeon from Mayo said on television yesterday that survivals of 5 years or longer have occurred. But such prolonged survivals are almost unheard of for grades 3 and 4 gliomas. Even if McCain survives to his next election, extremely unlikely in my opinion, he will be almost totally, if not totally, ineffective as a legislator--regardless of your opinion of his politics.

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Big Al's picture

@CB

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CB's picture

Take your neocon anti-Russian war mongering and shove it up your ass.

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Bollox Ref's picture

Almost failed Annapolis; crashed several very expensive planes; Keating Five; Sarah Palin; a crabby old rich guy, living off the public dime.

Hardly an illustrious career.

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Gëzuar!!
from a reasonably stable genius.

@Bollox Ref

being son of an admiral helps.

also married into Hensley beer money. https://en.wikipedia.org/wiki/Jim_Hensley

and onto the public tit.

nice going.

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WoodsDweller's picture

is that he's too stubborn to resign. He can hold onto his seat, and (like Kennedy) he will be unable to make it to the floor to vote, which chips away at McConnel's fragile coalition and further erodes El Trumpo's ability to do anything legislatively. This, along with investigations, is all a delaying action until we can re-establish gridlock.

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"The greatest shortcoming of the human race is our inability to understand the exponential function." -- Albert Bartlett
"A species that is hurtling toward extinction has no business promoting slow incremental change." -- Caitlin Johnstone

@WoodsDweller I mean, come on folks. Look at his destructive record. Is this someone you want to be represented by? Can't seem to vote him out (AZ)??? Beyond evil. time to go.

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@QMS

Can't seem to vote him out (AZ)???

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Alligator Ed's picture

@irishking "You won't have John McCain to kick around any more". I wish for John McCain all the best he wished for us--now what was that?

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Alligator Ed's picture

@WoodsDweller at least until the 2018 elections when the Dems will lose more seats--especially if the Evil Queen campaigns for any of them. So, at best, we can forestall further ill-doing in the B and S (bought and sold).

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SpamNunn's picture

My humanity does not permit me to think like that. I believe that hate consumes the hater.

Hate the sin, love the sinner.

[see my sig]

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It's just my opinion. It can't hurt you

@SpamNunn Oh, I see. You have a sense of "humanity" and the rest here don't. You don't get it. People who are commenting harshly about McCain ARE hating the sin(s) of this man, big time. And since the behaviors are attached to the person, being happy that this person will no longer be able to have the power to author misery for millions (war and healthcare), it is that happiness over his impending death that is the actual HUMANE position.

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"Without the right to offend, freedom of speech does not exist." Taslima Nasrin

CB's picture

@SpamNunn
McCain has lived long past the time he could be forgiven. Some people are pure evil. McCain is such a person. He has zero respect for humanity. His solutions and responses to the world's problems have been more death and destruction. The entire world would be aflame right now if he had got his way in the Senate each time he advocated for military interventions.

It appears McCain is going to his deathbed the same way he lived - war mongering based on outright lying and misdirection. He's now bitching about cancelling the $500 million 2018 Pentagon program to arm and train the so-called "rebels" in Syria to continue waging war against the legitimate president. There would not have been 500,000 men, women and children now dead plus 11 million more maimed and displaced if it was not for the US and its allies deliberately fomenting war and strife in that nation. McCain played a major part in this fiasco.

This is what happens when asshole McCain doesn't get his way:

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dervish's picture

@CB but then never speak evil of them again, out of respect for the dead. It works over there.

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"Obama promised transparency, but Assange is the one who brought it."

CB's picture

@dervish
As long as he is still breathing and trying to kill more innocent people in foreign countries he is fair game. I can believe his dying words will be "Bomb Iran. Nuke Russia."

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snoopydawg's picture

@SpamNunn you have made your feelings known as have others here.
No one's opinion is worth more than another's here.
People are free to express their views here that would get people possibly banned from DK if they expressed their views there.
This is what makes this site special, IMO.
No one is trying to change your mind on how to feel about McCain's upcoming death or his actions.
I hope you will continue to stick around stay involved with this community. Especially since we have been thinking about creating a real community when the shit hits the fan Smile

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Which AIPAC/MIC/pharma/bank bought politician are you going to vote for? Don’t be surprised when nothing changes.

SpamNunn's picture

I don't presume to speak for anyone else, or impose my beliefs on them. I just take no joy in the suffering or misfortunes of others. Schadenfreude is not an emotion that comes as easily to me as to some others.

Also, one man can't be responsible for all of the suffering you attribute to him. He wasn't a dictator. He was one of a hundred Senators, any 41 of which could have prevented a lot of misery.

Allow me my empathy, and I will allow that you may feel differently - or is there another line I need to toe that I am not yet aware of?

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It's just my opinion. It can't hurt you

CB's picture

@SpamNunn
to prevent armed conflict to being neutral to actively advocating for it. I can think of no other senator that has pushed as much and as consistently for armed confrontation as a solution to conflicts in the world than John McCain. Even the other war-mongering senators, Joe Lieberman and Lindsey Graham, rode McCain's coattails. These men even went out of their way on their own time to advocate for armed conflict personally right on the front lines.

McCain, Lieberman and Graham: The Senate’s three war-crazed amigos

When John McCain, Lindsey Graham and Joe Lieberman join forces, you can be sure of one thing: It will involve state-sponsored violence. Today, they want us to arm Syrian rebels. Though, you know, what they really wanted to call for was actually bombing the hell out of Syria, until there is freedom. They’re just taking it slow.

The Senate’s three most predictable and least credible warmongering “moderates” frequently join forces to publish joint Op-Eds or hold press conferences and the one thing they always, invariably want is for the United States to have just a little bit more war than it currently has, somewhere far away. Sure, we could draw down in Iraq … or we could listen to McCain, Lieberman and Graham and draw back up. We could draw down in Afghanistan … or we could stay the course and keep sending troops there until we win! Americans may be tired of endless war with no coherent goal, but on the other hand, “only decisive force can prevail in [whatever country John McCain, Lindsey Graham, and Joe Lieberman are talking about now].”

As the Hill recently explained in a story on how John McCain, Lindsey Graham and Joe Lieberman were pushing for a resolution basically promising to make war with Iran, “Graham, Lieberman and McCain are considered some of the top foreign policy experts in the upper chamber,” because they always, invariably support military intervention everywhere for any reason, and that is invariably considered a sign of “seriousness” in Washington. If you don’t like waging wars everywhere, forever, you are a weird kooky hippie, and everyone laughs at you. If you believe that bombs and troops have the power to magically solve all problems, you are invited on all the Sunday shows every week to offer your sober analysis of the foreign situation.

Lieberman is gone. McCain is on the way out and Lindsey Graham is powerless on his own. Now we will just be left with the non-elected war-mongers that they empowered to deal with.

To give peace a chance you have to first get rid of the influential war-mongers. In the last two decades, none have been more powerful than McCain.

The world will be a better place without these men in it. I'm not sorry Ted Bundy is gone. I won't be sorry when John McCain is gone. They were both sociopaths in their own right.

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CS in AZ's picture

@SpamNunn

When you reply to comments on this site, leave the little snip of code that begins with @ and is followed by some numbers, which automatically appears at the top of the reply window. Don't delete the code or type over it.

This code is what causes your reply to be properly nested in the thread and include the name of the person you replied to. (Like how your handle appears at the top of this post.) Also you can click on the @username in the reply and it will open a popup window with the original comment; this is very helpful in following longer threads.

If you delete the code or type over it, your reply goes at the bottom of the list as a new comment, and it's very difficult to tell which comment you're replying to.

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SpamNunn's picture

@CS in AZ
Thanks!

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It's just my opinion. It can't hurt you

CB's picture

Here's a wholesome daughter/father duet in the car. There's still some good and decency in the world.

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Pluto's Republic's picture

@CB

Real people. First TV appearance.

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____________________

The political system is what it is because the People are who they are. — Plato

John McCain is going to continue trying to cause big trouble, right up until his last dying breath. It's a good idea to exercise caution, if you are dealing with an angry rattlesnake at close quarters -- even one who appears to be mortally wounded.

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native

snoopydawg's picture

@native I'd be looking back at my life and considering how I would change some of the things I had done that caused people harm.
This is definitely not what McCain is doing. He is continuing thinking of ways to create more deaths and misery for people who are no threat to our country.
I have no idea why he is so set on continuing his actions. It's not going to affect his life in any way, so I just don't understand why he's still pushing for funding the Syrian rebels.
He has to know about the atrocities they have committed. They beheaded a 12 year old boy for gawd's sake. What type of person could think that is okay?

And he still wants to kick millions of their insurance! For what reason does this make sense? The money for this isn't coming from his pockets.
No, he's doing this just because this is the type of person he is.

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Which AIPAC/MIC/pharma/bank bought politician are you going to vote for? Don’t be surprised when nothing changes.

@snoopydawg

may have been psychologically damaged during his stay at the Hanoi Hilton.

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native

CB's picture

@native
The Soviets were also directly advising and training the Vietnamese on how to bring down the American bombers. The Soviet missiles and anti-aircraft fire were highly successful in neutering the Americans. Without Soviet assistance, the Americans could have bombed the shit out Vietnam with impunity like they did in Laos and Cambodia.

McCain had permanent damage to his body that probably reminded him of this every night when he lay in bed - permanent PTSD.

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He will have the best care on earth, will not suffer a split-second.
He has been pushing for war and murder almost all of his life.
I hope he is too ill to cast another vote.
If he dies at one of his mansions while having had all the morphine he wanted, that is fine by me.
The world will be better off with one less killer around.
What CS in AZ said about fighting cancer is spot on. It isn't a boxing match or endurance race.
My best friend died from pancreatic cancer, died "fighting", absolutely incredulous that she couldn't beat it, with all the fighting she had done.
My husband died from melanoma, said "fuck it", spent his last days telling his friends, family, and me, that he loved us.

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"We'll know our disinformation program is complete when everything the American public believes is false." ---- William Casey, CIA Director, 1981

SpamNunn's picture

Love your avatar. Get the .gif version!

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It's just my opinion. It can't hurt you

dervish's picture

@SpamNunn but in light of the fact that the GOS is becoming an irrelevant echo chamber, it's important that we branch out to other places as well. My strategy has been to participate in several forums, with varying degrees of activity, this way if one gets onerous, others fill the gap.

C99 here is great, and a real breath of fresh air after the GOS, but others include jackpineradicals, moon of alabama, reddit sites, the progressive wing, and oddly in my case, the conservative treehouse (Sundance gets it right occasionally).

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"Obama promised transparency, but Assange is the one who brought it."

TheOtherMaven's picture

and every so often it happens to shitheels.

"If not examined too closely, it passes for justice." Terry Pratchett, The Last Hero, p. 144

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There is no justice. There can be no peace.

CB's picture

McCain's efforts to support the "rebels" and sanction Syria has directly resulted in the Syrian people losing their cancer hospital as well as access to life saving cancer drugs.

John McCain and The Cancer of Conflict
...
Before the terrorist forces occupied the eastern part of the city, Aleppo was home to one of the Middle East’s top cancer treatment centers, Al-Kindi Hospital. This is important because after McCain’s secret trip to the Aleppo area in May 2013, the very same ‘rebels’ he was cavorting with and supplying weapons to – the ‘Free Syrian Army’ (under the command of Jabbat al Nusra aka al Qaeda in Syria) would later order the bombing on this cancer treatment hospital.

Professor Tim Anderson explains the destruction of Al Kindi Hospital in December 2013, including the shameful spin applied after the fact by BBC and western mainstream media:

In an Orwellian revision of events the BBC (21 December 2013) reported the destruction of Al-Kindi with the headline: “Syria rebels take back strategic hospital in Aleppo”. The introduction claimed the “massive suicide lorry bomb” had managed “to seize back a strategic ruined hospital occupied by Assad loyalists.” Al-Kindi was said to have been “a disused building” and “according to an unconfirmed report, 35 rebels died in the attack”. In fact, these ‘rebels’ were a coalition of Free Syrian Army and Jabhat al Nusra, while the ‘Assad loyalists’ were the staff and security guards of a large public hospital.

Watch as McCain’s ‘freedom fighters’ in Syria drive a suicide truck bomb into the ground level of Al Kindi Cancer Treatment Center in Aleppo:
...
It’s fair to say that while this Senator is being treated in the world’s leading medical facilities, thousands of innocents will have died needlessly because of US sanctions and support for terrorists – all in the name of defense, energy and ever vast corporate profits. Strange as that might sound to some, for those who consider themselves members of a ruling elite and its mandarin management class, that is perfectly acceptable quid pro quo in 2017.

After World War II, the military industrial complex and the international arms trade has spread conflict like a disease across the planet, metastasizing in ways, in places, and on a scale which no one could have previously imagined before. Undoubtedly, over the last decade, John McCain has played a key role in spreading that anguish. For the people of Syria, Afghanistan and the Ukraine, that will be his legacy, not the chimerical image of a ‘maverick’ Senator or the ‘war hero.’
...

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Big Al's picture

@CB McCain deserves as much scorn as can be piled. If not, we're accepting this kind of evil.

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Alligator Ed's picture

@CB celebrating destruction of a life-saving medical institution? These beasts emerged from the dirt of the 6th century and hopefully will return there soon as worm food.

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