here it comes

     My dad has an admission date for the stem cell transplant.  It's March 1st.  He'll actually start with getting all the preliminary stuff (echo for the heart, PET scan, lung function, dentist, etc) starting February 15th.  On February 24th, he'll receive his first chemotherapy in the form of Rituxan as an outpatient.  He's had that one before.  The first couple of times, he had a moderate reaction to it but the last three he was fine with it (had them give the steroid before).  Then on March 1st, he gets admitted to the hospital.  That's when the chemo really starts in earnest as they lay waste to his bone marrow.  On March 8th, he receives that (hopefully) life giving stem cell transplant that someone (thank you whomever you are) graciously decided to donate. 

     I'll take this moment to again plug that you, the reader, consider becoming a potential marrow donor.  Just go to bethematch.org and they'll tell you what to do.  It's an inconvenience to you but potentially life saving for the recipient.  Not a bad trade.

How Doctors Die

An interesting article about what types of decisions doctors make at the end of life, at least anectdotally.

How Doctors Die

strength in weakness

     15th floor.  Leukemia and lymphoma ward.  My dad was admitted here twice, the second time the same day my brother died.  I knew the floor well.  I had finished up with my patient and was waiting for the elevator.  A phenomenal case.  History of FOUR different cancers.  Pulmonary embolism.  Triple coronary bypass.  A stroke.  And still alive and kicking at 80 years young.  Truly a touching experience.
    While waiting for the elevator a young guy walks slowly up with his IV pole.  He's big and broad shouldered.  I'm not exactly slight of frame but he towers over me.  Probably in his early 20s, he sports a baldness that could easily be fashionable but his absence of eyebrows says the lack of hair is due to far more grim reasons.  And below his eyebrows, his eyes catch me.  There is a yearning in them.  Something so elementally human which desired contact.  I hesitate but then decide to let my sorrow and weakness guide me into uncharted elements of human contact. 
    "Taking your pole for a walk, huh.  Have you named it yet?" I ask of him.  He must see some openess back in me which is surprising because I'm told that when I put on my white coat, I assume my old football persona.  A take charge quarterback.  But he sees something different and it comes out in his response.
    "Nah, not yet.....But I should.  It's been my sixth pole.....I've...I've just been angry for so long.  Ya know?  It took awhile to work through that."
    "It is hard.  I watched my brother fight his own battles with those poles."
    "Lymphoma?  How's he doing?" I sensed a hope in his voice that he wanted to hear a story with a happy ending.  Hear how someone beat this damned disease.  Sorry, partner.
    "He passed away this past May due to thymic cancer.  No, it's my dad who has lymphoma."
    "Geez.  You a doctor?"
    "In-training."
    "Man, you're getting called to go into cancer."
    I grimly chuckle and reply, "I know.  You sound just like my wife."
    The elevator settles down onto the first floor and the doors open.  I turn to face him,grasp his hand firmly, look him straight in the eyes, and try with all my effort to convey compassion in my own eyes, "Hey, I wish you the best in your fight."
    "You, too.  And God don't make no mistakes."

    A wise and wizened rabbi had counseled our class to engage each patient more fully.  To not be so quick to put up our defences.  To not be afraid to show our humanity.  To truly connect as human beings.  To do everything nearly opposite of what we are doctors are trained to do.  And to do so we would be graced with a more rewarding career and less chance of burning out.  I think I just had my first experience with that being true.

it begins anew

"The mills of the gods grind slowly, but they grind exceedingly fine."  Sextus Empiricus ~2nd century AD

     As always, it begins with the phone call.  It's always a phone call.  My brother's disease.  My dad's first strange blood result.  I can remember exactly where I stood on each of these occasions.  This time it heralds that the process of stem cell transplant is starting anew for my dad.  Hope?  Or, cancer calling western medicine's bluff?  The gears of cancer begin to grind again.  Not that they ever stopped.  Perhaps we just stepped out of the mill these past few months.  I could lie and say that I took advantage of this time by making the most of it.  By making every moment count.  By embracing the extra time away from cancer and greeting it with a cheery and grateful disposition. 

     I had a friend whom I hadn't seen in awhile recently ask me how I was doing.  He asked it in a way that meant more than just the idle pleasantries of conversation.  "Surviving," was my answer.  It's not optimistic, but it is honest.  To survive each day, each hour, each minute, even if it feels like I'm failing.  Confront each challenge, even if it's weakly from my knees.  Honor each feeling, even those most hollow and empty.  Take stock of each sunset, even the bittersweet ones.  Not to capitulate but first, to endure.

blackout

     Finally, I have a day where I don't have to fight traffic and go to the med center.  An entire glorious day to be very productive while studying at home.  Uh-oh.

I don't know what congress is doing (I can guess they're misguided as usual) but if they're pissing off wikipedia and google, that ain't good for med students.  How the heck am I supposed to learn today?  I need to see about coinfections of HIV and Hepatitis B and how that's treated.  I gotta use a book now?  For rapidly changing fields, those things are outdated before they even hit the printing press.  Seriously, books?  Sigh.

away

     It's been awhile since I've posted.  I was locked out of my google/blogger account and didn't have time to trouble shoot it until now (finally figured it out, no thanks to google) so I'll be posting again after some fun weekend studying.

reflection

     It's the New Year.  Society dictates that I set goals about what I want to accomplish.  To quote my son, 'Meh'.  My goal is large enough that I don't need anymore to look at.  I looked to the past instead.  I went back and looked at some of my older blog posts.  A cognitive dissonance rapidly set in, to say the least.  Who the hell is writing this?  Why the hell is the guy writing this?  What the hell does he hope to gain?  Surely, he's embellishing this.  But if he's not, he must've really loved his brother...and still loves his family.  What lunatic would continue down a medical path after this happens to his family?  He must be a glutton for punishment.  I think if I were that guy, I probably would've cracked by now...............Only, I am that guy.  B-I-Z-A-R-R-E.