Wednesday, 27 January 2016

Guest Post: Nik Devidas & Stephen Roux - Cam’s Food Odyssey - 2016

Cam’s Food Odyssey - 2016

To carry on the theme of Cam’s blog, we’re sticking with tennis and sport in general.
Momentum in the physical world is pretty well understood. p=mv to be precise. (Cam is super smart and will appreciate that.. We had to look it up). Momentum in sport, however, is largely an enigma (known as Psychological Momentum: PM).

You’ve heard it before: “in the zone”, “on a roll” and from one of Cam’s favourite 90’s video games: “he’s on fire!”. And then the opposite, negative PM: “he’s looking flat out there”, “can’t seem to get going” or again NBA Jam: “can’t buy a bucket”.

In sport, psychological momentum has been defined as ‘a bi-directional concept, affecting either the probability of winning or the probability of losing as a function of the outcome of the preceding event’. Psychological momentum has also been defined in relation to perceptions of moving towards a goal.

If you could bottle positive PM, you would... and you’d take it every day.

Upon hearing the news of Cam first feeling the effects of the tumour in October 2014 (which he mentioned exactly as “Well I’ve had an eventful weekend!”) Team Brown was born and we’ve been trying to keep positive PM going for Cam.

Team Brown’s primary mission is to distract. Not in a nuisance kind of way, but to distract both Cam and Nikki from their day-to-day grind of doctors, appointments, medicines and the anxiety that comes from dealing with a terminal illness.

Whilst Team Brown has arranged many outings and experiences, he has been bombarded with his great love: food. Food was never going to fix his cancer, but it does have a powerful psychological impact on one’s sense of self.

Since Cam’s diagnosis, we’ve all marvelled at his approach and dedication to try anything that might enhance his quality of life. Since knowing Cam we’ve also marvelled at his eating capacity, which is breathtaking to say the least.

Cam has been a vegetarian for as long as we’ve known him and he even had a few stints as a vegan, so it was with a great sense of amusement that he announced that he was going to follow the ketogenic diet (which is mainly proteins and fats). Ketogenic diets reduce seizure activity in epileptic patients and it’s believed it can slow tumour growth - the diet did have a positive impact on the former.

So whilst Cam’s Food Odyssey did actually start quite soon after diagnosis, this article will cover off some of the more memorable moments for Cam since he arrived back in Australia on 14 October, 2015…

“Stuff this Ketogenic diet, bring me a vanilla slice!”
A few days after they landed we arrived at Nikki’s parent’s house to the sight of an incredibly shiny Cam Brown. He’d been off the ketogenic diet for only a few hours and had managed to stuff his face full of as much chocolate as he could find - but what he really wanted was vanilla slice!

5 vanilla slices were presented (and 2 slices of hedgehog) and he downed 3 vanilla slices, 2 hedgehogs all topped with ice-cream. His shiny complexion became more of a sticky feature on his skin and he called an end to the night early as he drifted off to sleep.

The next morning Nikki requested that we don’t bring any more sugary goodness because the sugar farts even kept the dog up all night… plus he experienced an almighty seizure that night as well.

It didn’t take long before chocolate started creeping into his diet. Nikki was trying to get a balance between keeping Cam happy and keeping sugar farts to a low…

Coffee loading

Once Cam was admitted to palliative care in November there was a moment of peace for Nikki’s nostrils where Cam followed the ketogenic diet and occasionally indulged on some 98% cocao chocolate.

Coffee was the most requested item and you would be given some evil looks if you didn’t arrive with at least one double-shot flat white. Nikki had to get in early on her coffee otherwise it would be snapped up by Cam quite quickly.
Coffee down Brunswick St.
Espresso martini! Moments after this picture was taken a Fitzroy "druggie" tried to steal Cam. One thousand Thank You's to the good Samaritan who stepped in and stopped them!

During this time Cam and Nikki were able to enjoy some home cooked meals from family and friends, a highlight coming when Carly and Ange had the ingenious idea to bring in a Thermomix so that Cam could cook a meal for himself.

The inbuilt, computerised recipe book and touchscreen wizardry meant that Cam could do the cooking by pressing a button. That night he was able to treat his friends to a marvellous ketogenic dinner of beef stronganoff, cauliflower rice and a mixed berry smoothie.

Chocolate loading

The “occasional” indulgence of chocolate turned into a competition with himself, and wow could he put chocolate away. Ange prepared a keto chocolate tart that lasted less than an hour in the room, which then led to the next loading phase.

Pick a block; any block
Is there something in my teeth?
Now THAT'S a tart! Ange Guest's famous keto tart

Cake loading

Whilst this phase obviously climaxed in the now famous 1kg cake eating contest, this phase saw Cam taste and trial all number of cakes and pastries.

Portugese tarts were a favourite, donuts (both supermarket and hipster style), more vanilla slices, baklava, custard tarts, pancakes… you name it - anything that had sugar and butter was now firmly on the menu and being devoured with intent.

Gloves off

As Cam’s ability to speak gradually declined, his appetite seemed to rise to a ferocity only seen by Japanese hotdog eating champions. Old favourites were ordered in plentiful amounts, such as fish & chips, ethiopian and afghani - mixed with plenty of home cooked meals.

Previously untouched fast food was now on the menu:
  • McDonald’s
  • KFC & Korean fried chicken
  • Dim sims
  • Dodgy chinese
  • Pulled Pork Po Boy
  • “Beef Debris” Po Boy

Beef Debris
Finger lick'n gooooood

All firsts for Cam and eaten with glee… and on almost every occasion washed down with some ice-cream.

An old favourite game we used to play was to have a selection of ice-cream’s available at a dinner party, then play a game of Paper Scissors Rock (PSR) to determine which ice-cream you could select. Summer and Ange had such a PSR competition with Cam, who not only won with his left-field strategy of going paper every time - but then demanded to eat all of the ice-creams anyway. His house; his rules.

The highlight
Without a doubt, the highlight of Cam's Food Odyssey was a dinner arranged by Cam himself - a private dinner for Nikki to say thank you. You can read more about it here.
All dressed up for the big night

Chatting to Chef Simon Wonge

The Odyssey’s conclusion

As our dear mate enters his last moments with us we’re happy to have provided him with some moments of joy in an otherwise desperate situation. We’ve done our best to keep some positive PM going - even if it’s Nikki reminding him that a friend is bringing a vanilla slice later that day: it has all helped.

They say that food is the way to a man’s heart, and we feel privileged to have been able to have brought some joy to his last few months. So many friends have contributed to Cam’s Food Odyssey (far more than can be captured in this one post) and Cam & Nikki have absolutely cherished the time with everyone.

On behalf of Cam and Nikki: Thank you :)

Thursday, 7 January 2016

Guest post: Vince Anderson

It would be of deep regret for me to not make a contribution to Browny and the Brain, a diary of Cameron’s which we have all read with a variety of emotions during the course of his illness over the past 18 months.  In honour of his current condition, I hope to kick-off his blog for 2016, though I don’t profess to approximate Cam’s wit and intrinsic ability to self-depricate, nor his delicate and unique ability to generate tennis puns…
I have known Cam since 1992, through high school, Melbourne University and beyond.  It is a friendship truly valued, as Cam – as you all know – is a person of the highest calibre.  Growing up effortlessly cool, flamboyant and talented in Bendigo in the 1990’s (who wasn’t?), Cam Brown was that slightly annoying person who was that bit better at everything than you were.  A representative visit to the Victorian table tennis championships (where we were both out of our depth) became bittersweet after Cam was selected as number one seed for our school, me number two.  Cam is the student, who in completing year twelve, got that tertiary entrance rank “a little bit more 99…” than mine was, despite more giggling and more truancy than one would expect of someone so damn smart.  He even holds the hot-lap record time for Luigi Raceway 1 in our after-school Super Mario Kart league of 1994.  Our friendship has evolved as it has been maintained, and I’ve had the privilege of travelling with Cam, including a month with him in Japan.  There we ate the most bizarre morsels together, slept on the floor together, bathed nude together – you know, all the usual stuff.  Bromance truly is a beautiful thing. 

Cam, Chris Heywood, and me in Year 12

I have had many people commend me for the mercy dash to the UK eight weeks ago, though praise is something I would happily do without if it meant Cam had his health.  Besides, last year I asked Cam to visit the cultural backwater of Perth to perform a reading at my wedding, so I guess I owed him a favour.  So with eight hours notice, my bag was packed, work was on hold, and I was up, up and away.
They say that a crisis is something that gets in the way when life is being lived, and Cam and Nikki were both certainly living life to the fullest in London.  As is the usual Cam style, he’d continued his record of overachievement in the early part of 2014, graduating as one of the top of his class in a London Business School MBA!  LBS is not the Frankston Institute of TAFE – the school draws the most impressive students from all over the world.  While in London, I met several of his MBA friends who described with reverence the same Cam we all do – one of great kindness, humour and humility – and bloody smart.
For me, a thirteen-year journey from medical school to the end of specialist training has taught me a lot.  Among them is that the opponent in Cam’s case - glioblastoma - is a shit disease.  Glioblastoma with epidermal growth-factor receptor amplification, an unfortunately even more horrific sub-type, and the most highly malignant, most recalcitrant variant of all brain cancers.  In my work, I’ve witnessed a number of patients grapple with the shock of a poor prognosis.  But hope enables endurance, and a tolerance for hardship ignites courage.  As a human being it’s tough to be invested during bleak times, but as a doctor I also try to maintain a firm grip on reality.  Most tough is when that now impending reality, and all that that entails, involves your best friend.
It may be something of a cancer cliché, but Cam has confronted all recent hurdles with supreme commitment.  However, I’m sure Cam and Nikki would agree that October 2015 was a challenging time with a fairly rapid decline.  Just prior to my arrival, Cam was living in their flat in London, and walking with assistance.  Subsequently, in the days before we left for Australia, he was hospital-confined, hemiplegic, and had exhausted the limitations of all available treatments.  I watched on with an enormous frog in my throat as I saw an overtly frustrated Cam try to raise his right arm to his face – the same arm which was once a weapon on the tennis court, and the source of his famous - and fierce - kick serve.  I met Cam’s consultant oncologist at University College London Hospital for handover.  Like Ange Guest in her thoughtful visit before me, I went over the brain MRI and the chest CT scan.  Tumour recurrence at both neurosurgical sites, causing raised intracranial pressure.  Shit.  Recent massive pulmonary emboli (clots in the lung), causing potentially sudden death. Shit.
Nik and Steve, who worked miracles in arranging the logistics of an antipodean journey for someone so critically ill, deserve the highest acclamation for their benevolent efforts.  Their ability to overcome substantive obstacles made me realise there is an army of people who love Cam and Nikki just as much as I do.  I’m told that there were other airlines which refused to fly Cam to Melbourne on the basis of his illness.  Happily, Qantas came to our aid, though their written instructions to me were just as confronting as those from the team at UCL:  “Dear Doctor… aircraft not to be diverted under any circumstances, including relating to onboard medical emergency or death of the passenger”.  I’ve done medical escort flights before, though this legal caveat would not normally apply.  Armed with enough intravenous midazolam to deeply sedate all 480 passengers on the airbus A380, I took-off from Heathrow with a little trepidation about exactly what that oncologist was anticipating in-flight, but quietly confident the job would get done.  We would get our man home.

I have known Nikki since 1999, and she is a truly amazing woman.  I remember fondly Cam and Nikki’s wedding in 2011, where Nikki’s parents regaled me with stories as to why Cam was the loving and worthy husband she deserves.  I have continually admired Nikki’s willpower and optimism, particularly given recent adversity.  We laughed together and we cried together in the days we shared in London.  The flight itself was not without hiccups, but despite understandably enormous fatigue and a flux of emotion, Nikki was unwavering in her efforts to care, which have remained constant throughout.  Transit through the enormous airport in Dubai had some challenges, including some moments where Cam’s right to dignity was perhaps challenged, though he and Nikki handled it all with composure.  En route, a highlight was watching Cam tuck into Neil Perry’s business class menu with the appetite of ten men, gourmet coffee in hand.
Medicine has taught me how I can keep a patient alive through a ten-hour liver transplant and I deal with unconscious/seizing/not breathing patients every day, but what my training had not taught me is how to contain my emotions upon entering that arrival hall at Melbourne Airport.  Ultimately, the reunion with family and close friends is what Cam’s journey home was all about.  That journey - just like our 23-year friendship preceding it - is something I will never forget.
I love you mate.