Live web stream of Paul's funeral

For those of you who are overseas or unable to attend Paul's funeral, you will be able to view it on the web. Due to the large numbers expected at Paul’s funeral service tomorrow, VUW staff in Wellington are invited to attend a live web stream of the service in the Hunter Council Chamber, and members of the public are also welcome.The Hunter Lounge will also be screening the service for students.

The service begins at 1pm NZ time tomorrow. The web stream will be available from 12.30pm at http://www.r2.co.nz/20120328/

Funeral Arrangements

Paul's funeral will take place at Wesley Church, 75 Taranaki St, Wellington at 1pm on Wednesday 28th March. We look forward to welcoming you there.

As seating is limited, we recommend you get there early. There will be reserved seating at the front for immediate family, pallbearers and speakers.

Refreshments will be served after the service at Wesley Hall, next to the church.

There will be a private final committal for family at Lychgate Funeral Home, corner of Willis St and Aro St, at 4.30pm.

Paul Terence Callaghan 19 August 1947 - 24 March 2012

Paul passed away peacefully just before 9am today, Saturday 24th March. Miang, Chris, Mary and I were with him. It was just as he would have wished.

We are heart broken. But we are so pleased that we were able to be with him at the end. It was our final gift to him. He showed us how to die with courage, dignity and flair. It was his final gift to us.

We will post details of the funeral as soon as we are able.

(The beautiful painting of Paul was painted by Miang.)

Philosophy

(Typed by Catherine and drafted by Paul)

"Dear friends
I am so grateful to Catherine for her maintenance of my blog these last few weeks. We discussed whether I might say a few words, given that I am still lucid. Actually there is a reason for me, obviously first and foremost to thank you all. Your encouragement through the blogging and the many emails has been so sustaining and has made me so proud.
But there is also a serious matter which has been at the heart of the blog, and indeed to which I referred during my last entry, and that is the philosophical problem. Part of the response is the writing of letters to grandchildren and part is the chance to fully enjoy life with my immediate family. But there is a question " why stop fluids?", "is that a form of giving up?". No. This form of palliative care is the best possible when there is total loss of bowel function. In the four weeks in hospital, I could eat nothing, it was all vomited back. For the last two weeks I could drink nothing, it was all vomited back. During the last three weeks there was no bowel movement nor did I pass wind. So by about one week before the date of my release last week, it was the consistent opinion of the oncologists and palliative care team, that my bowel had stopped. At that point, I made the decision to stop fluids because it was best advice. Indeed it has allowed me to increase substantially my quality of life by allowing me new options. Yesterday I got the medical team to insert a NasoGastricTube to my stomach, never fun in the insertion, but once there very comfortable and enabling me to drink a full cup of tea, with all the delicious associations, just to have it immediately diverted to my drain, with no influence on the ongoing dehydration.
As a consequence all discomfort has gone. As weakness grows my sleep becomes deeper and for longer, and with good dreams. I am entirely without pain. I am surrounded by love and, while I am so sad to leave you all, and especially Miang with whom I only got to share 8 years (Ah but what years!) I am happy."

The photograph shows the elegant teapot and cups which Paul is drinking his tea from. We don't want to frighten you with any more photos of Paul!

Paul is now at the stage where he has decided he won't have any more visitors, apart from immediate family. We hope you understand.

St Patrick's Day

It has been a sunny and balmy St Patrick's Day here in Wellington. Paul has had a good day, again surrounded by family. His sister Mary is now out of hospital and spending time at his bedside, along with her husband Tom. Our cousin Kathryn Lindsay joined us for supper. And of course Miang, Chris and I are with Paul too.

Paul is now very dehydrated, thin and tired. Speaking is an effort. But he remains pain-free, he is lucid, calm and contented, and he still has his sense of humour. Tonight he told us he wanted to be part of our family gathering downstairs, so we brought our wee party to his bedroom upstairs. He then insisted on trying some of our gin & tonic - and he gently sipped 1 ml. After declaring it delicious, he insisted on sipping some of Tom's pilsen beer. He slowly drank a mighty 5 mls. He thought this was fine stuff indeed. He topped it off with a special treat of a few crushed ice cubes.

You can see him in this photo enjoying his beer, holding his hand-carved wooden rakau (a wonderful gift from his former graduate student Craig Rofe), and holding court as usual. He suggested that an appropriate caption for this photograph of our party could be: "This household is well-stocked with morphine."

This evening was special for us all and provided a moment of much-needed levity on a sad and difficult journey. But Paul is making the process easy for us - he is incredibly brave, he is at peace, and he remains fully in control of, and engaged in, the path ahead.

At Home

It is Catherine here again. Paul has now been discharged from hospital and is at home. He has his own hospital bed and is currently sitting in it looking out his bedroom window with views of Mt KauKau in the distance. He is comfortable, pain-free and very happy to be home.

The situation has changed over the last day or two. Paul's stomach and bowel have now shut down. He is unable to take fluids by mouth, and IV fluids have simply increased the fluid collecting in his stomach, which has caused a lot of vomiting in recent days. So Paul has decided that there will be no more fluids administered. This obviously means that Paul's time is now limited.

Chris has arrived from the UK. I have decided not to fly back to the UK tonight. Miang, Chris and I will help nurse Paul at home until the end. If you need to contact us, please call our home number (04) 977 9261.

Another update from Hospital (from Catherine)

Paul and Mary are still in hospital. Mary is still struggling to get over this nasty infection, but she is slowly on the mend. She has been able to visit Paul a couple of times, in a wheelchair, and she is very keen to get better soon so that she can help nurse Paul. Her husband Tom has been doing a great job of keeping her company and keeping our spirits up.

Paul's condition is relatively stable at the moment. He is still reasonably comfortable and pain free. He is still conversing at length with visitors and keeping up to date with current affairs. We are working towards him being discharged from hospital on Tuesday, and moving back home. A hospital bed is being delivered to his home on Monday, which should keep him comfortable. Paul's son (my brother) Chris is arriving from the UK on Monday morning and will be just in time to take on the role as chief nurse/medical adviser to Paul while Mary is still recovering.

Now that I know Chris is on his way, and Paul is comfortable with the path ahead, I am flying back to the UK on Tuesday. If you have any queries about Paul or want to visit him at home, please contact Miang.

Thank you again for your kind messages of support and I hope you will understand if I have not been able to respond yet.

Tuesday

It's Catherine here again. First of all, in relation to the C. Diff infection, Paul is showing no symptoms at all of this dreadful bug and the antibiotics have clearly got it under control in his case, although he remains in an isolation room and gloves and gowns remain necessary to visit him. Mary has been hit far harder by the bug, has not yet started to recover, and has been in an isolation room at the hospital now for 3 days. We have been very worried about her. Her husband Tom is flying out from Australia to be with her tomorrow. We are all hoping that she starts to turn the corner soon.

Turning now to Paul's condition generally, the last few days have seen some major changes and decisions. The palliative care team at the hospital have become involved in Paul's care and have made some modifications to his drug regime that seem to have been successful in getting his bowel symptoms and nausea under control. They have also raised the base level of pain management. He is now feeling more comfortable, and is currently pain free. He is lucid, able to hold conversations without difficulty, occasionally taps away on his laptop, and is in a calm and peaceful state of mind.

He has made some decisions about the route ahead. He has decided not to do a second round of chemo, the first round having had no apparent benefit. He is not going to start intravenous nutrition. He is aiming now to get the drug regime stabilised, and once we are confident that his care can be managed from home, the aim is to move him home some time next week so that he can begin the final journey. We all support his decisions and are grateful for the fantastic care he is receiving from the hospital staff.

It is a fluid situation and the picture will obviously change but that's where we are currently at.

Thanks again for all your messages of support.

Sunday

I have attached a photo of Paul's great friend Eiichi Fukushima and Paul's Magritek colleagues who were out for dinner on Saturday night in Cuba St. In the photo are Petrik Galvosas, Craig Eccles, Bertram Manz, Mark Hunter, Eiichi Fukushima and Andrew Coy. Miang took the photo and really enjoyed having an evening off. Paul was honoured and touched by Eiichi's visit to see him.

Sunday has been another difficult day. Unfortunately Paul's sister (my aunt) Mary has also been diagnosed with Clostridium difficile and was hospitalised this morning. She is being kept in isolation in another ward at Wellington Hospital. Today was spent shuttling between Paul's room and Mary's room to visit them both, having to put on gowns and gloves in each room. Jeanine, Paul's older sister, drove 7 hours today to be with Paul and Mary, and provide support to Miang and me. Ironically, Paul does not seem to be suffering any more symptoms of the infection, so it looks like the hospital caught it early in his case. Mary is devastated that she is not able to see Paul until she is clear of the infection, and of course we are all upset for her that she is so unwell.

We are managing ok and are pulling together as a family. Thank you again for all your messages and best wishes.

A difficult Saturday

Today has not been the easiest of days. Wellington (and most of the North Island) experienced a violent storm today, with wind and rain lashing the city. It is expected to pass overnight. Paul has managed to eat some clear broth and jelly today, without vomiting or nausea, which is positive. Unfortunately, he is continuing to experience unpleasant bowel cramps (for which IV drugs offer relief). In addition, he has had diarrhea over the past 24 hours or so. This caused the hospital staff to test him for infection. The bad news is that he was diagnosed this afternoon with Clostridium difficile which is an infectious bacteria often picked up in hospital. As a result, he has been moved into his own room and isolated from other patients. Any visitors will need to wear gloves and a gown to see him, and will need to be scrupulous about washing their hands before and after visits.

Dad has enjoyed visits from his brother Jim and overseas friend Eiichi Fukushima for the past two days, as well as the company of Miang, his sister Mary and of course myself. Given the onset of this infection, we do think it may be best for visits to be kept to a minimum for the next few days, to allow Dad time to recover his strength. We hope you understand. If you have any questions, please email Catherine on catherine.callaghan@me.com or call her on her NZ mobile 021 02556381.

Update from Hospital

It's Catherine here again. I have now arrived in Wellington and have spent the afternoon with Paul. Paul has been receiving IV chemotherapy for the past 3 days, with the aim of reducing tumour size to try to relieve the bowel obstructions. We are all hoping that this will provide some benefit. Paul is still requiring IV fluids. He is grateful for all the expressions of love and support which he has received from friends and colleagues around the world, but has limited energy at this time to respond to individual emails.

Now that I am here I will try to post updates every few days.

Paul is back in hospital

It is Catherine here again. Paul was released from hospital a few days ago. Unfortunately after one good day at home, Paul has gone downhill again, in pain and unable to process liquids through his system. He was taken back to hospital on Saturday afternoon (NZ time). He is in the oncology ward where they are administering fluids (saline) through the portacath. We know that this is the best place for him at this time, and that they will be able to monitor and relieve the pain he is in.

Miang has been doing a fantastic and tireless job of looking after Paul. In addition, his sister Jeanine and her husband Murray are staying in Wellington until Monday. His sister Mary will be arriving tomorrow. I will be flying out from the UK in a few days' time, arriving next weekend.

I'm sorry we can't give you better news at this time.

Update - Slightly better news

Paul is still in hospital but may have finally turned a corner. He was able to eat some soup (Miang's famous chicken broth) for the first time on Sunday. There was no adverse reaction from the bowel and no nausea. Miang reports he is starting to get bored and wants to go home. Hopefully these are all good signs, and hopefully he will be home soon.

Posted by Catherine

Paul in Hospital

This is Catherine here. Paul was hospitalized on Thursday morning with a bowel obstruction. The obstruction seems to have resolved itself on Friday morning. Later on Friday, Paul underwent an operation to have a portacath installed, so that he has the option of chemotherapy being directly administered. He will be kept under observation for the rest of the weekend. He is doing ok, but he is tired and his stomach/bowel has not settled down yet.

Rising to the challenge

Last year I had committed myself to giving a public lecture on Zealandia, entitled "The Sanctuary Vision and its importance to New Zealand. I wondered as the due date of February 13 approached whether I could manage the task. My good friend, ecologist Professor Charles Daugherty, offered to act as understudy for me, if necessary taking over on the evening if I should falter. The venue was the Rutherford House lecture Theatre of the University. We were fully subscribed and ran an overflow video in an adjacent theatre. As it turned out, I was able to complete the lecture, sitting down from time to time to relieve the abdominal discomfort. I took a good dose of morphine in advance and it carried me through. The audience gave me a standing ovation, no doubt in part because of my completion of the mission!

That was last night. Today I have been utterly exhausted, sleeping most of the day. There has been some wonderful feedback. I understand that the lecture was videoed and when the link comes, I will publish on this blog.

And, while I remember, here is the audio link to my Rua Rautau lecture delivered at Te Herenga Waka Marae on January 29 and broadcast on national radio on Waitangi Day, February 6.
http://podcast.radionz.co.nz/wrr/wrr-20120206-2106-2012_-_sir_paul_callaghan_and_hon_luamanuvao_winnie_laban-048.mp3


Part 4 and final: Wellington

I moved my group to Victoria University of Wellington in 2001. I was ready for a change, but I had no idea just how big a change it would be. First, I ended up establishing a new research institute, the MacDiarmid Institute for Advanced Materials and Nanotechology, named after Kiwi Nobel Laureate Alan MacDiarmid. Alan, who won his prize for co-discovering conducting polymers, was a national hero. Based at the University of Pennsylvania, Alan was a regular visitor to his homeland and a great communicator of science. Being in the capital city plunged me into the world of science communication as well. Motivated by Alan’s example, I followed my route in trying to bring science to the general public, with a radio show, television documentaries, and popular science books.

Then something quite surprising happened. While at Massey University, I had started collaborating with a brilliant electronics engineer named Robin Dykstra. Robin had been with Craig and me on some of our Antarctic visits. In 2004, Robin, Craig, and I, along with my PhD student Mark Hunter, discussed the possibility of starting a company to commercialize the rheo-NMR attachments, a one-sided access NMR system that Mark had designed, and the Earth field spectrometer that Robin had improved so much, by comparison with its 1980s genesis. The company was formed in late 2004, headed by a CEO of great talent, the same ex-PhD student of mine, Andrew Coy, who was already well known in NMR circles for his work with me on q-space diffraction. Andrew had been in the business side of IT in Sydney and London for nearly a decade. He turned up in Wellington, heard we were starting the company, and expressed his interest in running it. Magritek has never looked back, in its 6th year now, with 21 staff and with export sales of NMR systems around the world. Suddenly I had entered the world of science commercialization, and my university research group was expanded to include NMR technology, along with our continuing work in soft matter and porous media.

I have had a wonderful life in magnetic resonance, learning so much from my students and collaborators. Much of what I have done, as well as the work of international colleagues, is summarized in my recent book published by OUP. I have always enjoyed dreaming up new ways of extracting information about molecules by manipulation of nuclear spins. And my particular interest in doing this is to gain insight regarding how molecules organize, align, and move about. Such insight is of some importance in helping physicists understand soft materials, self-assembly pathways to nanotechnologies, and the behavior of complex fluids and porous media. Of course, such understandings can assist a whole array of applications, from food science, to biotechnology, to biomedicine. That’s a motivational factor, but for me, it’s not the main one. It’s the beauty of magnetic resonance that holds my interest, as well as its essential veracity.

Photos: The Zealandia lecture, The Magritek founders and the PM

A weekend of downs and ups

On Friday I awoke to the sad news that my friend Lloyd Morrison had died. Lloyd was a legendary Wellington businessman and philanthropist whom I had got to know through our shared struggle. He had acute myeloid leukemia. Lloyd had founded infrastructure investment firm, Infratil, was a prime mover behind a campaign to change the New Zealand flag, and a generous patron of the arts and the local soccer franchise, the Phoenix. He was a far-sighted visionary, unconventional, extraordinarily intelligent, and passionate about Wellington and New Zealand.

Later on Saturday my spirits were lifted by a visit from Miang's cousin Lily and her husband Anthony, who had flown over from Sydney for the weekend. Saturday was the 6th anniversay of my marriage to Miang. I joined them all later in the afternoon for a drive around the Miramar Peninsula and the South Coast, including a climb up to the Ataturk Memorial. The latter exhausted me. Walking is now quite painful for me, but I try to force myself to exercise for 30 minutes each day.

On Sunday morning Catherine texted me to say that her friend Kent Gardner had been made UK New Zealander of the year at an awards ceremony in London. Kent was behind the "Step Up for Christchurch campaign", a fundraiser involving climbing the Gherkin tower owned by his company.

And this afternoon, Sunday, the weather was so beautiful that Miang and I decided to go to Pukerua Bay, the place where we had celebrated our first anniversary in 2007. She swam in the sea while I watched happily from a seat on a bank above the shore.



Part 3: Antarctica, Porous media and soft matter
Another odd area of interest for me in the 1980s was Earth field NMR. We did the first spin echo experiments using 180° audiofrequency pulses. Later, in 1994, Craig and I were to take this apparatus to Antarctica to measure brine content in sea ice. We were joined in 1996 by an American postdoctoral fellow, Joe Seymour. Joe not only contributed to our Antarctic program, measuring brine diffusion in sea ice, but also introduced me to chemical engineering, his own undergraduate specialty. Joe and I set out to see what we could do with pulsed-gradient spin echo (PGSE) NMR to measure dispersion, the process whereby molecules starting together are separated by flow. This collaboration was very fruitful, and porous media dispersion and diffusion studies became a major part of our research interests.

My Slovenian link was also revived in a wonderfully productive sabbatical visit by Janez Stepisnik. We were able to demonstrate experimentally the validity of his idea that the spectrum of molecular velocity autocorrelation functions could be measured using modulated gradient spin echo NMR. By the 1990s we had been exploring the use of NMR microscopy to study heterogeneous flow in shear cells, combining rheology with NMR, inspired by Ed Samulski, a U.S. sabbatical visitor to my lab. Our work in rheo-NMR led to another serendipitous collaboration that in turn generated a major field of research in my laboratory. In 1996 we were introduced to worm-like micelles (WLMs) by visiting Dutch physicist Bas Smeulders. Later, we used NMR microscopy to measure shear banding effects in WLMs, and we have been pursuing the complex rheodynamics of these systems ever since.

Of all the work we have done, the most cited has been the “q-space diffraction” and “q-space imaging” research. The history of this is interesting. In a review paper on PGSE NMR, published in the Australian Journal of Physics, I pointed out the formal analogy between PGSE NMR and the incoherent fraction of inelastic neutron scattering. In neutron inelastic scattering, the symbol q is used as the reciprocal space dimension conjugate to dynamic displacement. The term “q-space” first appeared, in the NMR context, in the title of a paper on NMR velocimetry that I published with Craig Eccles and Yang Xia in Journal of Physics E, in 1988. But the impetus to see the potential of diffraction effects in diffusion studies came about as a result of a visit made in 1989 to Ken Packer’s group at BP research in the UK. Ken, of course, had been the first to see non-Gaussian echo attenuation when he carried out a PGSE NMR experiment on pipe flow. Those 1989 discussions with Ken centered on the idea that the Fourier transform of the “q-encoded” echo was the propagator for displacements, and this led to speculation as to whether diffraction effects might be seen for small-molecule diffusion in porous media. I worked though the theory of this. A simple limiting case was that of the isolated pore, where it turned out that in the long diffusion time limit, the propagator reduces to the autocorrelation function of the pore structure.

We dashed off a short paper on q-space diffraction and oscillatory echo attenuation effects to the Journal of Magnetic Resonance. Concurrently (and submitted before us to Magnetic Resonance in Medicine), Al Garroway and David Cory had come up with a similar idea, namely that the Fourier transform of the echo decay for an isolated pore was the pore autocorrelation function. Of course, the key step was to do the experiment. Working on an isolated pore was difficult (that experiment came later). It was much easier to work on an interconnected porous medium imbibed with water. The interesting theory extension to interconnected porous media was based on the idea that, in effect, the pore structure factor is convolved with the pore lattice structure and modulated by a diffusive envelope. With a reasonably ordered system, diffraction effects might be seen there. On return to New Zealand, I suggested to my PhD student Andrew Coy that he try the diffraction experiment on a close-packed monodisperse latex sphere system. The oscillatory features of diffraction were immediately evident on the echo attenuation function, and a paper in Nature, jointly with the Packer group, resulted. In a later, more detailed paper on this in the Journal of Chemical Physics, we were greatly assisted by some subtle theory insights provided by BP theorist, Dave MacGowan.

Later, Andrew and I verified the isolated pore predictions by using an array of rectangular glass microcapillaries, and this work subsequently led to a number of papers on the subject from our group. The advantage of q-space imaging is that one is not constrained by voxel signal-to-noise limitation. These days, the method is used as a contrast in medical imaging, where the distributions of displacements so obtained tell something about compartmentation of tissue, along with compartment size.

The photos are respectively of Lloyd, Miang at Pukerua Bay, and Ed and me two years ago.

Nicholas Kurti and Erwin Hahn

In continuing these installments of my scientific reflections, I should say a little more about Nicholas Kurti and Erwin Hahn. Kurti was my scientific "grandfather", one of the brilliant Jewish refugees acquired by the Clarendon Laboratory in the 1930s. He held the record for achieving the lowest laboratory temperature of 1 millionth Kelvin when I first knew him. Nicholas was immensely kind and he and his English wife Gianna regularly hosted graduate students in their home.

I first met Erwin Hahn in 1971 on one of his visits to Nicholas and Gianna Kurti in Oxford. I had the pleasure of meeting him again in Krakow in 1974. I had no idea how great was his science. If any work ever deserved a Nobel Prize, Hahn's discovery of the spin echo certainly did. This is what I wrote of him in my 2011 book, "Translational Dynamics and Magnetic Resonance". "Of all the developments that have assisted NMR measurements of translational dynamics, none is as important as the discovery of the spin echo by Erwin Hahn in 1950. Indeed, it can be argued that the power of the spin echo underpins all of modern NMR. The formation of the echo, with its inherent time-reversal properties, not only causes lost signals to re-appear, it also has the effect of removing some nuclear spin interactions while retaining others. Hahn pointed out that in the case where the magnetic field was inhomogeneous, the signal obtained by method was sensitive to translations of spin-bearing molecules, providing, for example, a means of measuring random Brownian motion."

Erwin was to become a friend, mostly through my association with Alex Pines in Berkeley. He describes his current position as being emeritus "postdoctoral fellow" in Alex's lab!




Part 2: Pamerston North
I stayed in Oxford for another year as a postdoctoral fellow, but I was determined to go back to New Zealand to attempt the task of doing international science from my home base. My forebears, Rutherford included, just had to make the shift to expatriate status in order to do any serious science. But things were changing at home, not the least of which was the advent of cheap long-haul air travel. Suddenly NZ was connected to the world in a different way. And there were some brave pioneers from whom to take inspiration. Kiwi theoretical physicist Dan Walls had, in 1972, returned from Roy Glauber’s group at Harvard to start a school of quantum optics in NZ. Dan later became a Fellow of the Royal Society and winner of the Dirac medal and prize. Cancer claimed him too, in 1999. I returned home in late 1974 to a lectureship in Physics at Massey University, an upstart institution with an agricultural college background, and a small but feisty science faculty led by a larger-than-life biochemist, Dick Batt. Dick came from my hometown of Wanganui. Maybe that’s how I got the job. But I was grateful for the employment, and joined a small group of physics colleagues inside a larger Chemistry Department. There was no physics research equipment at all, but the chemists had just acquired a JEOL FX60 NMR spectrometer. It was just a remarkable machine, with a lovely light pen interface, the first for JEOL of the new generation of pulsed Fourier transform instruments.

The physical chemist in charge of the FX60 was a Lancastrian immigrant, Ken Jolley. I couldn’t have had a better teacher or more generous colleague. He allowed me to share in this wonder and to start a research program using the spectrometer. And being in that chemistry environment could not have been better for me as I made my transition from a rather narrow-focused physicist to one who saw the wonders of chemistry, of the world of molecules, with all the opportunities for physics that this field of research presented. With Metka Luzar’s talk in my mind, I set about building a pulsed field gradient system that we could attach to the FX60. In that I was assisted by an able graduate student named Craig Trotter. We built the electronics and gradient coil and quickly discovered that there were some technical problems plaguing this method that were ripe for tackling. These included gradient pulse area mismatch, sample vibration, and eddy current effects. By good luck we made some progress, and that led to a fruitful period in which my collaborators and I measured polymer diffusion, as well as small molecule diffusion in anisotropic and heterogeneous environments.

It wasn’t long before NMR micro imaging became a focus of our work. The apparatus building was result of a most remarkable graduate student named Craig Eccles. Craig was not only a fine physicist but also an electronics and software genius. In the mid-1980s, with Craig, and new Chinese student Yang Xia, we were using our NMR microscope to image flow in wheat grains in vivo, impossibly difficult but very effective. This work helped start a new field of research in which sub-100 micron structure was revealed in soft materials and biological tissue from the perspective of the interpenetrating liquid molecules. NMR Microscopy was the subject of my first book, published by OUP in 1991.

Photos in order: Nicholas Kurti, Alex and Erwin, Erwin and me, Ken Jolley and me.

What to write?

I have struggled to write this blog. My small daily actions, what and how much I eat, how I manage my walk in the evening, my tough moments and my better moments, all assume great importance to me, but accounting for them is hardly the philosophy I promised. Friends ring, email and visit, though I tend to tire a bit with talking.

One dear friend of 40 years, Maurice Ormsby, proposed a solution to my philosophical problem in a wonderful long letter, finishing with the suggestion that I write to my grandchildren. My son suggested I write more, a sort of synopsis of my life with stories from the family. That also, I am now doing. And in starting this writing, I remembered that I had penned a brief account of my scientific life, published last year by OUP in a multi-author volume, improbably entitled "Diffusion MRI: Theory, Methods and Applications" and edited by Derek Jones. It was reprinted late last year, with permission from OUP, in Chemistry in New Zealand. I think it would be of interest to readers of my blog, and so, with indulgence from OUP, I will present it here in installments.

Part 1: Wanganui, Wellington and Oxford

I was born, and grew up in Wanganui, where physics seemed to surround me. I built my first crystal set radio while at primary school and was delighted to be able to pick up two radio stations. When I was 10 years old, Sputnik was launched, with many more satellites following, some of which could be seen at night with the naked eye, repeating their orbit after 90 minutes. In my early teens I was a boy chemist, with a backyard laboratory and pursuing adventures that would today be considered foolhardy at best, and criminal at worst. There was a 200-meter-long tunnel in a local hill that led to an elevator that allowed hilltop residents to avoid the 70-meter climb. It made wonderful echoes, over a second apart.

Among that mix of radio waves, molecules, echoes, and the evident triumph of the laws of physics may have been sown the seeds of a life in magnetic resonance (MR). Certainly I had never heard of it. I first came across MR as a final-year physics student at Victoria University of Wellington. But my interests then were in nuclear physics and solid-state physics. I discovered a field of research that combined them, the use of hyperfine interactions to orient radioactive nuclei. And so my doctoral ambitions took me, courtesy of a UK Commonwealth Scholarship, to the Clarendon Laboratory at Oxford University, where I joined the team of Nick Stone and grandfatherly mentor, Nicholas Kurti. There we used adiabatic demagnetization of paramagnetic salts to get down to 10 milliKelvin, at which temperature the hyperfine interaction would overwhelm the Boltzmann energy to cause radioactive nuclei in a ferromagnetic host metal, attached to the cold finger of the apparatus, to align, so directing their gamma rays preferentially along the quantization axis. The degree of orientation could be used as a measure of the interaction strength, so that nuclear magnetic moments or local fields could be measured. But by far the best way of precisely measuring that interaction was by sweeping an RF field in the vicinity of the Larmor frequency. At resonance, the gamma rays would suddenly change their angular distribution and the axial count rate would change dramatically.

So that was my introduction to magnetic resonance, a phenomenon detected through gamma emissions! It wasn’t until the last year of my DPhil that I came across Faraday detection and the mainstream. In 1973 I had the chance to go to a conference in Krakow, Poland, the 1^st Specialized Colloque Ampere. It was a most remarkable meeting and one that completely changed my professional life. I knew only one person there, Erwin Hahn, a regular Oxford visitor of Nicholas Kurti. Alex Pines presented his work, Proton Enhanced Nuclear Induction Spectroscopy. Peter Mansfield spoke about nuclear magnetic resonance (NMR) diffraction in solids. Someone asked if he had seen the paper by Lauterbur, Fourier Zeugmatography, which had just come out in Nature. And a young graduate student from the Ljubliana group, Metka Luzar spoke about using pulsed magnetic field gradients to measure diffusion in liquid crystals. I was fascinated. Many years later, in the early 1990s, I met up with Metka at an NMR meeting in Portoroz, on the tiny coastline of her Slovenian homeland. I sat down next to her and said: Metka Luzar, you changed my life. I am sure she thought me quite mad. Sadly, she died of cancer less than a decade later.

Chris

For six days Miang and I have had Chris with us. He flew back to the UK yesterday, and I have to admit, it was hard to say goodbye. He is a most extraordinary man, an accomplished surgeon, about to take up a consultant's post at Guy's Hospital in London, and an all-round wonderful person. Chris has a very kind bedside manner and he has been particularly kind to his old dad.

Keeping him company in cheering me up from afar is his sister Catherine. "My daughter the lawyer, my son the doctor", I tell my Jewish friends, surely qualifies me as well.

I'm proud of them both, I have to say.

A day to remember

I did promise readers good news when available. My first good news is that I have had no bowel obstruction for 14 days. My second is that I am managing to sleep reasonably well at nights, using the morphine kindly prescribed by my medical advisers. My third is that sister Mary and her husband Tom have been visiting from Melbourne, staying with friends in Lower Hutt, and helping take me to medical appointments. My fourth is that my son Chris has taken a week off work to come to New Zealand to be with his Dad. And my fifth is that today has been a remarkable day.

This morning I rode in an E-type Jaguar and had the joy of looking inside its bonnet. For lunch I had Dim Sum with Miang, Mary, Tom, Chris, cousin Merle and husband Sam, and old friend Craig Rofe and his daughter Anahera. Sadly, I drank Fortesip while they tucked into the feast. And in the afternoon I gave the Rua Rautau address on the theme of the Treaty of Waitangi, on the beautiful Te Herenga Waka Marae of the University, with my whanau present, along with many distinguished guests including ambassadors and members of parliament.

The pictures show me with Sir Eddie Durie, retired High Court Judge, the Maori leader who started the Rua Rautau series 11 years ago. I shared the occasion with my good friend and fellow cancer comrade Luamanuvao Winnie Laban who spoke after me.

A gift

Marcel Nogueira d' Eurydice is a Brazilian physicist who worked in my lab a couple of years ago. Marcel is bright, handsome and very warm-hearted. Recently he sent me a remarkable gift, this picture of Thomas on my shoulders made of around 300 pictures taken from my blog.

I have had many kind messages and emails from friends, all of which serve to keep my spirits high. I finished my 5 day course of electron beam irradiation today and hope soon to get some benefits. It is possible that we might identify some other near-surface pain sites and irradiate them as well.

Each day, my sister Mary and her husband Tom, who are visiting from Australia, have taken me to the hospital for my irradiation appointment. Mary's nursing knowledge has proven a great help in suggesting additional questions during my various consultations, with hospital and hospice staff, as well as in advising me and Miang.

Tomorrow Chris arrives from the UK. He will be with us for a week.

Public property

In September 2011, the Dominion Post ran a front page story with the headline "Bastion of Science turns to alternative medicine". They had discovered from my blog that I had been taking intravenous vitamin C and rang me in the UK to ask for a comment, saying that they would run the story whatever I said. I told them that I had no indication as to whether or not the treatment was effective. I turned down requests for radio and TV interviews that resulted from publication of that story.

Since then the DomPost has twice contacted me seeking information about the status of my health and my IVC treatment. I told them I had no more information about the IVC effectiveness. On Wednesday this week I was sent a copy of an article published by a New Zealand organisation promoting IVC therapy, in which I was quoted as being in support of the therapy from which I had gained benefit. This assertion, coupled with my knowledge of individuals who had taken up IVC simply because I was trying it, prompted me to action.

I contacted the DomPost on Wednesday evening, informing them that I had finished my IVC experiment and that there was no evidence to suggest any benefit in my case. They sent a photographer Thursday and ran the story the next morning. This was excruciating, having my personal difficulties in the public domain, but I felt I had no choice but to cooperate fully so as to stop the spread of misleading information. The story, written by their health reporter Kate Newton, was fair and accurate.

http://www.stuff.co.nz/dominion-post/news/6286215/Vitamin-therapy-fails-to-deliver

I agreed to give a live interview to National Radio on Friday morning so that I could get the message to the whole country, but refused all TV interview requests.

http://podcast.radionz.co.nz/kiwisummer/ksm-20120120-0923-sir_paul_callaghan_-_vitamin_therapy_for_cancer-048.mp3

The story got high profile national coverage, and I have no doubt that it has stopped in its tracks, any future attempt to justify this treatment using my name. It also resulted in a deluge of crank emails to me, phone calls offering the salvation of God and in one case, an offer of advice on reincarnation. The Dompost web article attracted several comments, mostly scornful of me - "straw-grasping exercise by a dying man", "of course the IVC didn't work-he'd taken chemotherapy which wrecks the body", "He should never have said he was trying Vitamin C in the first place, then he would not have to deal with all the misuse of the information he foolishly chose to make public", "as bizarre as his recurring fantasy that he is an economist", and various other theories from people who don't know me and who choose to project their unhappiness.

Sunday Star Times columnist, Michael Laws, a man not noted for delicacy and kindness, made me the subject of his column. He was less cruel than usual when he wrote "The news that such an esteemed rationalist had embraced such quackery provided a positive fillip for the odd, dippy and deranged everywhere."

Did anyone imagine that I enjoyed having to go public on this? It's hard enough facing death, even with morphine as an aid, without having to do so publicly and for the entertainment of others.

But there was one email that came today that was so singular in its kindness, and which restored me in a moment of quiet tearfulness. It was from a man named Kevin Kevany, a journalist with whom I had worked in writing a series of articles for the New Zealand Manufacturer last year. I reproduce it here, just to show that someone saw my motives differently.

"Paul

To your courage, you now add bravery, in your willingness to protect others at the expense of a loss of privacy.
You are a mensch of the first order. Your gifts to New Zealand in so many spheres testify to that.
My thoughts are with you dealing with this bastard thing.

Bestest
Kevin"

Good days

Part of the solution to the philosophical problem concerns the concept of "good days". When I meet people they ask "how are you?", the answer to which question would sensibly take a PhD thesis. But in my state there are bad days and good days.

Take last Friday for example. That was a bad day. Exhausted after an all-night bowel obstruction, I dragged myself, along with an equally exhausted Miang, to my hospital oncologist who completed the exercise of knocking me senseless by sharing the horror show of my PET scan, as if the radiologist's report wasn't enough. Seriously though, he is a wonderful man, and I wanted to see the images. He ensured that I got an immediate IV litre of saline, then called up the radiation oncologist who put the proposal for some palliative electrons, whisking me off to radiation physics to have a planning CT scan done for beam irradiation to start within days. The care cannot be faulted.

On Sunday the obstruction exercise repeated. But on Monday night, after a day recovering and aided by morphine, I had an excellent sleep, waking to one of those magical clear, calm, warm, blue-sky days which we locals refer to, ironically, as "a typical Wellington day". I called in at the office, at Magritek, and to each and everyone who questioned me I was able to cheerfully reply, "I am having a good day".

Good days are to be relished, and what better way to round one off than to go fishing. We headed out to the Days Bay wharf and threw in our lines. Miang immediately caught a fish, a small fish to be sure, but one worth a photograph. It was a balmy evening with kids jumping off the wharf and swimming from the beach. I had another excellent sleep last night.

Today I had the electron beam for the first of five successive days. As I lay under this marvellous instrument with its multiple axis control, laser beams flashing in all directions to ensure my correct positioning, I noticed that it was made by Varian. Russell Varian carried out the first Earth field free induction NMR experiment in 1954 and founded the company, famous for its NMR spectrometers as well as its medical accelerators. I carried out the first Earth field spin-echo NMR experiment in 1981 and helped found Magritek which began by selling Earth field instruments. I felt at home with Russell looking over me.

My radiation oncologist likes his job and enjoys his technology. They use a a very powerful 64 bit computer which morphs the PET-CT and planning CT scans into registration, precisely calculating the electron radiation dose in a contour map across the xiphisternum tumour, and
neatly avoiding damage to nearby bowel, so he assured me. We pored over the saggittal, coronal and axial plots (I show the axial one here). They are impressive. Not only did I like the machine. I liked the software which drives it. And in the end, the exercise of lying flat for 10 minutes wasn't too unbearable. Morphine is a fine drug.

PET-CT and Philosophy

I have wrestled a bit with this blog entry, as I did with the last. To what extent should I trouble my readers with the tough news? I've had Catherine here for the last fortnight, a great chance to discuss matters important and unimportant. But in discussing this particular matter, we both agreed that part of the purpose, indeed the primary purpose of the blog, was to let friends know about the state of my health. So let's get the "information part" sorted first.

Yesterday I had a PET-CT scan. Catherine drove me, at 7-15 am, just down the road to the Bowen Medical Centre where Pacific Radiology have a new facility. I am treated like a regular customer by Pacific, placed first in the queue for the 18F-labelled glucose produced that morning in the Wellington cyclotron. In the past, when the isotope was produced in Melbourne and flown over, decaying through a a couple of half-lives at least, I used to ask if I could go early in the queue, figuring that I would get more sensitivity with highest activity. Now that it is locally made, it really doesn't matter. But, rather than protest that my idiosyncrasy no longer applied, I accepted their insistence that "we know you like to be early in the queue", along with the early morning rise that it implied, two hours of advance water drinking being specified.

The scan was quite an ordeal this time. It is necessary to stretch both arms back behind the head during the 20 minutes of the gamma ray detection as the gantry steps through successive slices. This is quite a painful position for me now, and as the scan started, I wondered if I could sustain myself through it. I did, partly through counting breaths, about 70 per slice as it turned out.

By the afternoon my surgeon had already rung me to discuss the results in broad terms, though I hadn't by that stage seen the report. This morning the hospital rang to advise me of an appointment with my oncologist in two days. I was impressed with the speed. Today I received the report in the mail. It was a hammer blow against hope, the final conclusion reading,

"There is evidence of quite widespread recurrence within the peritoneal cavity involving peritoneum, liver, bowel, mesentery and anterior abdominal wall. There is also more extensive involvement of the xiphisternum and increase in size of the right lower (lung) lobe mass."

In short, I have extensive disease now, which has definitely spread to the lung and liver. The various tumours cause me quite a bit of discomfort. The xiphisternum tumour causes me to have to sleep in a sitting position since lying on my side or back compresses the chest resulting in a buildup of pain. I am being well served by the health system with extra support from the district oncology nurses and occupational therapists. Where I go next in terms of treatment, perhaps radiotherapy to reduce my largest tumour mass, or some further chemotherapy for systemic reduction, will be decided in a few days. It is essentially palliative.

So to the matter of philosophy. How am I to deal with the next phase? It is different because optimism is harder, time horizons more immediate, and my body continuously reminds me of its concerns. To be frank, I have not yet worked this philosophical problem out, but I expect that I will.

Down at the radiology clinic there was an older man from Hastings who had travelled by bus the day before, and stayed in a Johnsonville motel overnight, so that he could follow me into the PET-CT machine. Catherine chatted to him after I had been called. His condition was considerably more painful than mine, he was alone, and he was worried because he had needed to spend his limited financial resources on taxi fares and part of his motel bill, the health system having not fully provided.

I have no money worries. My daughter was able to be there with me in the clinic. My essential medical services are but a short drive away. I am not alone. More than that, I am blessed with having the exceptional love and support of Miang. I have the care of family and friends.

The truth is that I am very fortunate in almost every aspect of life, and what I face now is part of what we all face in this journey, in our own peculiar and individual ways. As regards this blog, what I will try to do, dear reader, is to write more about my thoughts and hopes, than about the rather self-absorbing details of my physical condition. And if there is good news, I promise to let you know!

2012

I do apologise for a long silence. In part this has been because it is the holiday season here and I have been away from Wellington visiting family. Catherine flew home from from London and has been with Miang and me since just before Christmas. We had Christmas day in Wellington then drove to the Bay of Plenty for a few days at Ohope, and then with Jeanine and Murray in Papamoa. The photo shows Catherine, Jeanine, me and Miang on a walk around Mount Maunganui.

But I have to confess, there has been a deterioration in my health. Christmas day was spent dealing with another obstruction, only to be repeated a week later. The experience is unpleasant, but it passes. What doesn't pass is the underlying problem. The record CEA measurement was more than a portent of trouble ahead. It has simply confirmed what my body had been telling me for some weeks. I have continuous pain now and each day brings change. But this change is different. During the 2010 chemotherapy, despite the nausea and tiredness, the tumour pain noticeably receded over the treatment. After surgery, both in 2008 and 2010, each day of recuperation brought noticeable improvement. Now, the change is in reverse, and the mental challenge that this brings is quite different. I am having to learn some new skills.

Next week I have a PET-CT scan. This will enable my surgeon and oncologist to make a decision about future options. One possibility is further chemotherapy.

I am in good spirits.