What does living with cancer mean?

Diagnosis: Cancer affects about 13.7 million Americans who are at various stages of living with their cancer, according to 2012 numbers from the American Cancer Society. Although cancer mortality statistics are generally improving, people fear the diagnosis of cancer. When people first learn that they have this disease, the response may be disbelief. They may think the worst and feel overwhelmed. Many questions will surface and may not have definite answers. To provide the best care, the health care team will need to make certain tests and stage the cancer to see how far the disease has spread. With this information, patients and their health care providers can make decisions on treatments to cure, to control the disease, or to minimize symptoms. Each person experiences cancer differently; becoming a partner in the treatment plan means making choices in many aspects of life.

Education: C. Everett Koop, former surgeon general of the United States, advised that “the best prescription is knowledge.” One effective way for patients to face life with cancer is for them to learn as much as possible about the specific diagnosis. Numerous sources are available to provide further education on cancer in general and in detail. Cancer patients may want to know about statistics, risk factors for their type of cancer, staging terms and what they mean, treatment options, and the likelihood of the patient to survive and recover from the cancer and treatments (prognosis).

The first contact for patient education is the health care provider. These professionals can offer information specific to the patient such as the type of cancer, stage of cancer involvement, and options for therapy. Cancer patients should take the initiative to talk with their health care providers to fully understand their unique situation. With that information, patients can pursue other avenues of education.

There are many sources for learning more about cancer. Information can range from simple explanations to complex scientific documentation. Patients can read articles in popular magazines, buy books on most aspects of cancer care, study health care journals, or look up their cancer on the Internet. Generally, reliable information comes from well-respected and well-established cancer care centers, cancer care organizations, government agencies, or health care organizations.

Another source of education is other cancer patients. Attending local support groups and conversing with others who are at different stages of cancer can support and encourage patients. Online Web sites offer message boards where cancer patients can share their personal experiences. Though these can be useful, it is important to remember that this type of information comes from a particular person’s point of view. Cancer patients need to seek further information and clarification from their health care providers or other reliable sources before acting on what another cancer patient says.

Coping with cancer: A cancer diagnosis can be stressful for both patients and their families. Patients respond in different ways to their cancer. Many emotions may surface, such as shock, disbelief, fear, sadness, anxiety, depression, anger, and guilt. Patients may question why they have cancer and what lies ahead. Disbelief may come to those who feel physically well. Fear is a common emotion, but the reasons may range from fear of the treatments and side effects to fear of death and the impact on remaining family members. Fear feeds anxiety, which can interfere with normal daily functioning.

Guilt is another common emotion of cancer patients. Patients may replay their lifestyle choices and wonder if something they did caused the cancer. They may feel guilt over the decisions they made that stole precious time from their life or guilt about their priorities. As some cancers tend to be hereditary, cancer patients may worry about the impact on their children.

Feelings of sadness and hopelessness can block recovery and resumption of meaningful life activities. Depression can come with sleep problems, loss of appetite, feelings of worthlessness, decreased energy, irritability, or lack of interest in activities once enjoyed. Physical symptoms such as headache or digestive problems may occur. Feeling sad is a normal reaction when people learn that they have cancer, but if depression continues and thoughts of suicide surface, patients may require help through counseling and prescribed medications.

Cancer patients experience the feeling of loss of control, autonomy, dreams, choices, or the future. Loss is a normal feeling and allows cancer patients to grieve over actual or perceived interruptions in their lives. Counseling may be useful for both cancer patients and their families.

Taking action: Cancer can be a long-term disease and last for many years. Cancer patients experience an initial adjustment to their diagnosis and treatment. The focus of their first thoughts may be on dying, but as time goes on, these thoughts shift to their normal lives. Taking certain steps can help cancer patients reengage in their usual activities of daily living.

One helpful step is paying attention to personal needs for rest, nutrition, recreation, and relationships. Relaxation activities such as meditation and guided imagery can assist in healing and encourage good mental health. Adequate nutrition is important to keep the immune system at an optimal level.

Participating in activities that patients enjoy, such as going to the movies, listening to music, going to lunch with friends, or pursuing their hobbies, can relieve depression. Creative expression though journaling, writing poetry or stories, reading, or drawing can keep patients’ minds off cancer and minimize projecting into the future. Simply going shopping can be a boost to the morale.

Starting or resuming an exercise program can help cancer patients increase strength, improve flexibility, and build endurance. Studies show that exercise can also improve long-term survival. Radiation treatments can result in fatigue, but light or moderate walking can boost energy and stimulate the appetite. Another benefit of exercise is that the release of natural body chemicals, called endorphins, can improve patients’ moods and help relieve pain. Various levels of exercise, such as walking, swimming, cleaning the house, gardening, or dancing, can provide pleasure as well as health benefits.

Almost daily the media reports on the value of alternative or complementary therapies. Cancer patients may become interested in these therapies as ways to relax, to reduce side effects of cancer treatment, or to cure their disease. Some of these practices, such as massage, guided imagery, acupuncture, or hypnosis, may be useful when used along with traditional cancer treatments. Vitamins and herbal supplements have gained monumental popularity in the United States. Although some sources claim that herbs and vitamins can cure cancer, these statements are often unfounded. Cancer patients should speak with their health care providers before using alternative therapies.

Sometimes cancer patients are unable to perform activities of daily living without assistance. However, by seeking help they can continue to go to the grocery or to church. Friends and family often welcome the opportunity to provide meals or transportation so that they can show love to the cancer patient. Asking for help is not always comfortable for cancer patients who covet their autonomy. However, taking action to seek help is a healthy behavior.

Sexuality:
Having cancer does not alter the human need for sex and intimacy. However, having this disease can temporarily alter people’s attitudes and desires. Changes in emotions are normal for cancer patients but can affect their relationship with their partners. Physical side effects from cancer treatments such as nausea, vomiting, and fatigue can decrease interest in sex. Cancer therapies can affect the patients’ body image and lessen the confidence in their attractiveness. Women may experience dryness of the vagina, and men may have trouble having or maintaining an erection.

Some people believe that cancer can be passed to another person by intimacy. Partners may be hesitant to engage in sexual intercourse with cancer patients. Also, cancer patients may need to refrain from sex for a period of time because of surgery or a lowered immune system. This can be difficult for both the cancer patient and the partner. Communication is key to resolving misunderstandings. Cancer patients should be open and honest about their concerns with their health care professionals. These professionals can help make referrals for counseling and support when needed.

Family dynamics: Cancer changes all aspects of family life. Priorities change and unresolved emotions may surface. There may be more struggles in the family dynamics. Roles may change as cancer patients must use energy and time to take treatments or care for themselves. A reassignment of roles can be overwhelming, especially for older children or youths who now become caregivers. Patients must be allowed to continue to fill as many parts of their family role as possible and not be treated as an invalid. If the dynamics of family life become dysfunctional, a family counselor can help.

Spiritual support: Cancer is a serious illness that can challenge people’s spiritual beliefs. Spiritual distress (unresolved spiritual conflict or doubt) can compromise patients’ coping skills. Unlike religion (a set of beliefs, practices, or doctrine), spirituality includes the person’s sense of purpose, relationship to others, and beliefs about life’s meaning. Some cancer patients may feel they are being punished by a higher power or may lose their faith, while others experience a deepening of their faith during their illness.

Pastors, rabbis, or other faith leaders may be valuable resources during this difficult time. Some home health and hospice care agencies have chaplains on their interdisciplinary teams and offer home support for cancer patients. The best person for cancer patients to talk with is the one who provides compassionate and supportive communication. Spiritual support can create an improved quality of life for cancer patients. Patients may experience decreased stress, anxiety, or pain. Connecting to others results in less isolation. Spirituality can help cancer patients tolerate treatments better and bring peace in a time of chaos.

Life after cancer: Cancer survivors face different challenges. Intensive cancer therapy can leave people with lifelong health concerns. After the treatments or surgery are complete, patients have new questions. Will the cancer come back? Will my life be the same as before I was diagnosed with cancer? Will I need continued observation? Where do I go from here?

There will be follow-up care that includes regular medical checkups, usually with the primary physician. Tests will most likely occur at specific intervals to check for continued remission (when the cancer is reduced or disappears). If any tests indicate concerns, cancer patients are referred to the cancer health care provider for further assessment.

Many survivors say that life has new meaning for them, and they see life in a new light. Priorities have changed. Their bodies have changed. Cancer patients may have made new friends and developed new relationships. Even their diets may have changed. Life and all it has to offer have changed forever.

Felder, Tamika. “What Cancer Taught Me About Living.” Essence, July, 2006: 145–99. Print.

Harpman, Wendy Schlessel. After Cancer: A Guide to Your New Life. New York: Norton, 1994. Print.

Kaelin, Carolyn M., and Francesca Coltrera. “Cancer and Staying Fit.” Newsweek 26 Mar. 2007: 69–70. Print.

Kaelin, Carolyn M. Living Through Breast Cancer. New York: McGraw-Hill, 2005. Print.

Krychman, Michael L. One Hundred Questions and Answers for Women Living with Cancer: A Practical Guide for Survivorship. Sudbury: Jones and Bartlett, 2007. Print.

Lucas, Geralyn. Then Came Life: Living with Courage, Spirit, and Gratitude after Breast Cancer. New York: Gotham, 2014. Print.

MacDonald, Gayle. Medicine Hands: Massage Therapy for People With Cancer. 3d ed. Forres: Findhorn, 2014. Print.

Ovitz, Joanne K. Facing the Mirror with Cancer: A Guide to Using Makeup to Make a Difference. Chicago: Belle, 2004. Print.

Turner, Kelly A. Radical Remission: Surviving Cancer Against All Odds. New York: HarperOne, 2014. Print.

Name some reasons Julius Caesar may be considered a hero.

The question of whether Julius Caesar was a hero or villain is very popular when discussing Ancient Rome in class. The answer usually depends on whose perspective is used. Some of the actions of Caesar make him worthy to be considered a hero. For one, Caesar was a brilliant military tactician that gained the respect of his troops in battle. He greatly expanded Rome's boundaries with a variety of military victories.

Caesar was also heroic in his efforts to achieve political power. He is generally considered a strong politician.  He had brilliant negotiating skills and could convince his enemies to fall in line and work with him. He understood who the important players were in Rome's political scene and allied himself with them to gain favor. He would only use these political alliances as long as they suited his aspirations.

Julius Caesar was a hero to the lower classes of Rome as well. He instituted a number of reforms for the plebeians that dealt with their political and economic rights. Included in these reforms were debt relief and land reform. He also changed the calendar of Rome during his short tenure as dictator.  

Why is George not justified in killing Lennie in Of Mice and Men?

In Of Mice and Men, George is not legally justified in killing Lennie because his act would be perceived by officials of the law as murder.

Though George feels that he executes a mercy killing, much as Dr. Kevorkian felt that he was ending the pain of those in whose suicides he assisted, such a choice to end another's life is not really available to another man. Nevertheless, George feels he must get to Lennie before the others such as Curley, who seeks a terrible revenge for his wife's death as well as for his damaged hand. Carlson also becomes excited by the thought of inflicting pain upon Lennie, whom he suspects of having stolen his Luger. 

Later, after the other men catch up with George, the sadistic Carlson wants to relive what has happened to George:

"Did he have my gun?"
"Yeah. He had your gun." 
"An' you got it away from him and you took it an' you killed him?"
"Yeah. That's how." George's voice was almost a whisper. 

Despite the immorality of George's act within the narrative of Steinbeck, who himself makes no moral judgment, the reader is prone to accept George's shooting of Lennie. It seems more an act of friendship and love than it is murder--the lesser of three evils--as the reader realizes that George cannot bear to think of poor, animal-like Lennie locked into a cell or put into an asylum, or, worse yet, possibly torn apart and shot by the vengeful Curley and sadistic Carlson. 

In an act of friendship, wisdom, and understanding, Slim, who sees everything with his "God-like eyes," consoles George for preventing the others from getting to Lennie by shooting him, "You hadda George. I swear you hadda. Come on with me." Slim knows that it is not George's fault that his and Lennie's "well-laid plans" have "gone awry."

In The Cay by Theodore Taylor, which German political party started the conflict on Phillip's island?

In The Cay by Theodore Taylor, Hitler's National Socialist German Workers' Party (the Nazi Party) was responsible for the attack on Curacao where Phillip lived. Hitler had come to power as Chancellor of Germany in 1933, and shortly thereafter proceeded to set up concentration camps for political opponents, which soon gave way to others Hitler deemed "undesirable," particularly the Jewish people. He then began his takeover of Europe when he annexed the Sudetenland and Austria in 1938 and attacked Poland in 1939.

By the time Hitler's submarine showed up near Curacao in 1942, Hitler had begun his "Final Solution"--his plan to rid the world of all Jews. He attacked Curacao because of a petroleum storage facility there. The Nazis hoped that by blowing up the petroleum plant, they would be able to slow down the Allies' response. Their mission failed, however, and their U-boat (submarine) barely escaped the Dutch.

Were the SALT treaties effective in reducing the number of nuclear weapons?

The Strategic Arms Limitation Talks (SALT) were two treaties that had the shared goal of ending the arms race between the U.S. and Soviet Union. Due to a number of factors, the treaties did not succeed in reducing the number of nuclear weapons possessed by either country.

The first SALT talks began in 1967 under the administrations of President Johnson in the United States and Premier Kosygin in the Soviet Union. The idea for talks was born out of U.S. intelligence reports that suggested the Soviet Union was building an Anti-Ballistic Missile system to shoot down incoming American nuclear missiles. Johnson, believing that the system would bring the U.S. and Soviet Union closer to war, met Kosygin in 1967 to propose that both sides limit the construction of new nuclear weapons.

After over two years of negotiations, the U.S. and Soviet Union ratified SALT I in 1972. This represented the first time that both sides of the Cold War had come to an agreement concerning nuclear weapons. Though a powerful and important achievement, the treaty did not reduce nuclear stockpiles, but limited the construction of new Anti-Ballistic Missile systems.

Throughout the 1970s, the U.S. and Soviet Union continued negotiations in the hopes of ratifying SALT II. The goal of SALT II was to reduce nuclear stockpiles and the number of nuclear missiles deployed by both countries. Though it seemed that both sides had reached an agreement in 1974, neither country could agree upon the exact number of warheads to destroy. This roadblock, along with issues concerning nuclear armed bombers and multiple re-entry warheads, caused a five-year delay in negotiations.

In 1979, the U.S. and Soviet Union finalized the SALT II treaty. It seemed as if the two countries would finally reduce their nuclear stockpiles. President Jimmy Carter signed the treaty that year, but due to opposition in the Senate, the treaty was never ratified. Carter pulled his support for the treaty after the Soviet invasion of Afghanistan in December 1979. The policies of disarmament that SALT II represented were subsequently cast aside during the presidency of Ronald Reagan.

What are hallucinations in the field of psychology?

Introduction

Hallucinations are defined as sensory experiences that occur in the absence of sensory stimulation. Hallucinations, therefore, are false perceptions. There are five major types of hallucinations, which correspond with the five senses. Visual hallucinations occur when a person sees something that is not there, such as a person whom others do not see. They usually involve the false perception that one sees God, the devil, or a meaningful person in one’s life. Visual hallucinations are usually reported to appear in black and white. They can be very frightening for the individual experiencing them. An individual initially may be reluctant to tell others about these visual phenomena. Auditory hallucinations are more common than visual hallucinations and refer to the phenomenon of hearing things that others do not hear, such as voices that seem to be coming from the person’s own mind. Tactile hallucinations correlate with the sense of touch and involve the perception of feeling things that are actually not present. The mistaken perception that bugs are crawling down one’s arm is an example of a tactile hallucination. The insistence that one feels two strands of hair in one’s eye is another example of a tactile hallucination. Gustatory hallucinations involve the false perception of tasting things that are not present, such as experiencing an imaginary metallic taste in one’s mouth. Olfactory hallucinations involve smelling things in the absence of stimuli to create such smells, such as the smell of burning flesh.

A hallucination is a perceptual experience that differs from the occasional mistaken perception, such as the belief that one’s name has been called or that one has seen a friend or acquaintance across the street. Instead, a hallucination is believed by the person to be real, in spite of repeated evidence to the contrary. Individuals experiencing hallucinations will insist vehemently on the existence of such stimuli and will reject explanations that suggest they are mistakenly perceiving something. (If an individual experiences a hallucination but recognizes that it is not real, it is called a pseudohallucination instead.) Hallucinatory behavior is often recurrent.

Hallucinations are altered states of consciousness
or awareness and can result from several different causes. They may be caused by changes in neurological stimulation, such as a high fever, delirium, or epileptic seizure. Different somatic, or bodily, states may foster the development of hallucinations. For example, the effects of starvation, oxygen deprivation, sleep deprivation, or a heightened state of awareness can increase the likelihood of hallucinating. Hallucinations also may be a symptom of a psychological disorder such as schizophrenia or major depression. Hallucinations may be induced with psychoactive substances, such as hallucinogenic drugs.

Schizophrenic Hallucinations

Schizophrenia is a mental disorder characterized by a loss of contact with reality and the presence of psychotic behaviors, including hallucinations and delusions. Symptoms of schizophrenia are classified as positive or negative; positive symptoms of schizophrenia refer to behavioral excesses, whereas negative symptoms refer to behavioral deficits. Examples of positive symptoms of schizophrenia include hallucinations, delusions, and disorganized speech. Negative symptoms include the neglect of one’s hygiene, social withdrawal, and a flattening of one’s emotions.

The most commonly experienced hallucinations among schizophrenic patients are auditory hallucinations. Schizophrenic patients will report that they hear voices commenting on their behavior. Others will report hearing voices that are arguing with each other. Some with schizophrenia state that the voices they hear are insulting and antagonistic toward them. The voices may be of either gender. Command hallucinations are hallucinations that involve voices that order one to do something, such as cause harm to oneself or others. Research has suggested that individuals with command hallucinations are more likely to obey a command hallucination if they recognize the “voice” issuing the command. These perceptual experiences can be very distressing to the person experiencing them. A person suffering from schizophrenia may feel plagued by the voices that are heard. An individual experiencing chronic auditory hallucinations may wear headphones in a desperate attempt to stop the perceived voices. It is common for the individual experiencing auditory hallucinations to experience depression.

Schizophrenia is also characterized by the presence of delusions, or false beliefs that persist in spite of contrary evidence. Delusions might involve the false and persistent belief that one is being followed or poisoned or that one’s thoughts are being broadcast for others to hear. They often develop due to an effort by the individual to explain his or her hallucinations. Individuals who experience frequent auditory hallucinations may develop the delusion that others are plotting against them and are lying when they say that they do not hear the hallucinatory voices.

The auditory areas in the temporal lobes of the brain are associated with hearing ability. Stimulation of these parts can create the false perception of sound. Magnetic resonance imaging (MRI) scans of the brains of schizophrenics who experience auditory hallucinations reveal activity in the auditory centers of the brain even when no external sound has stimulated that brain region. Research has suggested that patients who claim to be hearing voices may actually be unable to distinguish their internal thoughts from external stimuli. Therefore, an individual experiencing auditory hallucinations may be attributing internally generated thought processes to an external source. This research, however, fails to offer plausible explanations for the occurrence of visual, tactile, olfactory, or gustatory hallucinations.

Schizophrenic patients are often treated with
antipsychotic medications to alleviate the psychotic symptoms they experience. In the 1930s and 1940s, French chemists developed a group of medications called phenothiazines. The phenothiazines were found to be effective for decreasing positive symptoms among schizophrenic patients, such as hallucinations and delusions, but they also carried the risk of serious side effects. In the 1980s, new antipsychotic drugs known as atypical antipsychotics were found to be effective in treating both the positive and the negative symptoms of schizophrenia with fewer side effects than phenothiazines. Clozapine, risperidone, and olanzapine are some of the atypical antipsychotics that became increasingly popular in the 1990s. These drugs have been especially successful in treating schizophrenia symptoms such as hallucinatory experiences. Research studies have suggested that cognitive behavior therapy (CBT) is effective in treating schizophrenic patients who experience hallucinations and delusions.

Drug-Induced Hallucinations and Delirium

Certain psychoactive drugs
(substances that affect the brain’s functioning) can induce hallucinatory experiences. Hallucinogens are the class of psychoactive substances that include lysergic acid diethylamide (LSD), psilocybin, ecstasy, and mescaline. All these drugs are powerful and potentially dangerous substances that have proved harmful to many who have ingested them in a recreational context.

LSD gained notoriety during the 1960s. Harvard University professor Timothy Leary
was an influential advocate for the use of LSD, touting its ability to induce a greater self-awareness. LSD is a powerful hallucinogen that is odorless and tasteless. After using the drug, the individual will experience about eight hours of altered perception, accompanied by mood changes and other symptoms. Psilocybin, another hallucinogen, is found in certain types of mushrooms. Psilocybin is a less potent hallucinogen than LSD and has for centuries been considered sacred by the Aztecs in Mexico and Central America. Methylenedioxymethamphetamine (MDMA), more commonly known as ecstasy, stimulates the central nervous system, resulting in hallucinogenic experiences. Mescaline is a hallucinogen derived from a cactus plant called the peyote. For hundreds of years, Native Americans have used peyote during religious ceremonies to facilitate and intensify spiritual experiences.

Much of what is known about the hallucinatory experiences of people who use hallucinogens is derived from their first-person reports. Hallucinogens usually induce colorful, vivid images in the initial stages of use. These hallucinations may include images of places, scenes, people, or animals. Some hallucinatory experiences are reported to be pleasant, and sometimes inspiring, perceptual experiences. Individuals who use hallucinogens are frequently searching for a spiritual transcendence. Others who have used these substances report a “bad trip,” or a hallucinatory experience that was unpleasant or frightening and could lead to panic attacks and heightened anxiety. Heavy use of stimulant drugs, such as cocaine and amphetamines, can cause frightening hallucinations and delusions. Marijuana may produce mild hallucinatory effects, as sensory experiences are enhanced by the effects of the substance. Hallucinations can also be a part of the withdrawal symptoms from alcohol dependence.

Delirium is a mental state characterized by a clouding of consciousness in which a person may seem confused and disorganized. The symptoms of delirium have a rapid onset and include a difficulty in maintaining or shifting attention, disorientation, and at times the presence of visual and tactile hallucinations. There are many possible causes of delirium, including metabolic disease, infection, endocrine disease, and side effects of certain medications, and treatment involves identifying and then treating the source.

Sleep deprivation seems to alter people’s perceptions of their surroundings and can also produce mild hallucinations. Research suggests that hallucinations have been reported among subjects who were deprived of sleep for sixty hours.

Bibliography

Aleman, André, and Frank Larøi. Hallucinations: The Science of Idiosyncratic Perception. Washington: APA, 2008. Print.

Caballo, Vincent E., ed. International Handbook of Cognitive and Behavioural Treatments for Psychological Disorders. Oxford: Elsevier, 1998. Print.

Hagen, Roger, et al., eds. CBT for Psychosis: A Symptom-Based Approach. New York: Routledge, 2011. Print.

Heinrichs, R. Walter. In Search of Madness: Schizophrenia and Neuroscience. New York: Oxford UP, 2001. Print.

Jardri, Renaud, et al., eds. The Neuroscience of Hallucinations. New York: Springer, 2013. Print.

Jung, John. Psychology of Alcohol and Other Drugs: A Research Perspective. Thousand Oaks: Sage, 2001. Print.

Leudar, Ivan, and Anthony David. “Is Hearing Voices a Sign of Mental Illness?” Psychologist 14.5 (2001): 256–59. Print.

McCarthy-Jones, Simon. Hearing Voices: The Histories, Causes and Meanings of Auditory Verbal Hallucinations. New York: Cambridge UP, 2012. Print.

Meaden, Alan, et al. Cognitive Therapy for Command Hallucinations: An Advanced Practical Companion. New York: Routledge, 2013. Print.

Sacks, Oliver. Hallucinations. New York: Knopf, 2012. Print.

Smith, Daniel B. Muses, Madmen, and Prophets: Rethinking the History, Science, and Meaning of Auditory Hallucination. New York: Penguin, 2008. Print.

Tarrier, Nicholas, et al. “Are Some Types of Psychotic Symptoms More Responsive to Cognitive-Behavior Therapy?” Behavioral and Cognitive Psychotherapy 20.1 (2001): 45–55. Print.

In The Godwulf Manuscript, although Parker creates Spenser in the mold of Spade and other early hard-boiled characters, Spenser is also very much a...

Hard-boiled detective fiction grew from roots in pulp magazines. Writers working in this genre seek realism, but their works are often sensationalist, full of sex, violence, and, in some cases, raw language and/or slang. Detectives often find themselves tumbling into lurid situations, and drugs or drinking are very common.

All of these are definitely present in The Godwulf Manuscript. There's casual violence--Dennis, the college would-be thug who swings on Spenser for encroaching on his woman--and more serious violence, such as the death of the same character (Dennis).

Spenser only fully departs from the hard-boiled tradition later in the series, but you can identify points in this novel which signal Spenser's later characteristics. Some of these are visible early in the book: Spenser's wit ranges more widely and actively than most hard-boiled detectives.

Spenser's reading habits are also quite broad, and though these habits really evolve later in the story, one thing that sets him apart is his understanding of literature, art, and history.

Finally, Spenser is much more reflective than the hard-boiled detective, even doubting his own meaning at times.