Why can’t doctors frame the bad news differently? “You have a dangerous disease, but we have tools—chemotherapy, radiation, surgery—to combat it. People have beaten this disease. I can give you the names of a few that you can talk to. I’ll handle the medical treatments, but you have to be part of this by keeping a positive attitude.” That’s all we want, Doctors—no promises, no false cheer, no warm and fuzzy New Age horse-shit. Just a positive outlook and a glimmer of hope.
”…nothing they could do for me”—the brutal insensitivity of the radiologist from Boston two years earlier returned to haunt me, like the cancer itself. To hand out a death sentence the day before I began a bone marrow transplant! When I gathered my wits I called my oncologist at the Boston hospital and exploded in anger at the treatment I’d received: “You shouldn’t allow that guy to talk to flesh-and-blood people… you should lock him in his room with his X-rays and his isotopes and turn the machines on full blast!”
“Yes, he’s done this to other patients,” the oncologist agreed sympathetically. “It’s really unfortunate, but he’s part of our consulting staff. I wish he was more optimistic with people, but there’s not much I can do.”
Now, two years later, and this formerly sympathetic oncologist pronounces a death sentence over the telephone—not to me, but to my doctor. She wouldn’t even talk to me. She let my doctor do the dirty work.
Why? Admitting me for a second transplant would acknowledge that the first transplant did not work. Failure would adversely affect the hospital’s cure rate, which might affect future funding. It’s a numbers game, like any other business.
Those doctors did not owe me the right to further treatment, but they did owe me a face-to-face explanation. After all, I had endured the grueling schedule they set up for me: months of preliminary chemotherapy and testing, a month in the hospital for the transplant procedure, then more tests and follow-up visits. Several times I had had to wait over three hours for my appointments, nauseated and weak from chemotherapy treatments. Three hours! The Pope wouldn’t make sick people wait three hours.
But to the doctors at this transplant center, I was just an account number that showed up at the top of every billing statement, medical chart, prescription and computer screen concerned with me. Even the plastic ID bracelet I wore in the hospital listed my account number before my name.
AND THEN THERE ARE DOCTORS….
“Whatever happens, I’ll continue to treat you,” Dr. N., assured me. “Hang in there.” We had been through a lot together during the five years I had been her patient.
“Thanks, Doctor. I’ll hang—because if you’re born to be hanged, you should have no fear of drowning.” I recited Shakespeare’s bravado sentiment from The Tempest, but not with a great deal of conviction. She nodded, gave my bicep a gentle squeeze, and opened the door to the hallway.
I turned back to look at her and said: “You know, Doctor, it’s easy to appear macho about facing this disease… but when I think about what I have to lose—my wife, my children—I don’t feel so macho.”
Her gaze wavered ever so slightly. It seemed to me that her eyes filmed over. Mine did. In that instant her compassion fissured through the dam of professionalism she maintained to insulate patients from the knowledge of the severity of their condition, as well as to keep her sanity.
After all, this was cancer she was attempting to overcome, for me and a few dozen other patients. It was her job to break the bad news about negative test results; she had to deal with the desperation of disease relapses. Despite the best efforts of medical science, she had to watch patients wither from the combination of the disease and the chemotherapy and, often, die.
Then she had to go home and pretend it was just another day at the office. Why did she choose oncology, when she could’ve had a brilliant career in podiatry?
The next day Dr. N. called. The University of Connecticut Health Center would take me into its transplant program. The UCONN program entailed a rigorous, six-month protocol beginning with three four-day hospital stays before the month-long transplant. During these short hospital stays I would be bombarded with about the same amount of “atomic bomb” chemotherapy I’d received during my bone marrow transplant two years earlier in Boston. Then I’d enter the hospital for the actual transplant and the more lethal “hydrogen bomb” chemo.
In the meantime, she would treat me with the CHOP chemotherapy protocol (Cyclophosphamide, Hydroxydaunorubicin, Oncovin, Prednisone). We hoped it would at least control the spread of the lymphoma. With luck it would do more than contain the disease; it could plunge it back into remission. But the odds were against that.
“Zero doubt—I have zero doubt that you will beat this thing in the long run,” Denis Miller, M.D., said in his South African accent. He’d been our family doctor since my wife and I got married.
I was gearing up for my transplant, soliciting advice and support that would carry me through. Beowulf and his buddies, war masks on, would’ve smacked their shields with the flat of their sword blades to get their blood up. How little times change.
“Protoplasm, Bob,” he explained. “You have good protoplasm. And this lymphoma is beat-able—look at that Olympic wrestler who beat it twice. He’s fine now.”
Dr. Miller usually didn’t say much; he’d ask a question and fix a gaze like an X-ray on me while I spilled my guts. So when he talked, I listened.
“Besides, you’re a fighter, Bob. That will make the difference. I wish I could write a prescription for what you have inside, and hand it out to some of my other patients. Zero doubt, Bob.”
Zero doubt. Whenever the fear begins to take over, I’ll chant it, a new mantra. Maybe I’ll get it tattooed on my forehead. Zero doubt. Two words of encouragement from a doctor you respect—that’s all it takes to swell your courage. This guy wouldn’t lie to me. He’s a real doctor—and a friend. Besides, guys with X-ray vision don’t tell lies.
FINDING THE RIGHT TEACHER—SYNCHRONICITY OR COINCIDENCE?
When the student is ready, the teacher appears. I met mine by happenstance. The same week cancer was diagnosed in my shoulder, a friend sent me a flyer advertising a Qigong seminar in Stonington, Connecticut. Ramel Rones—a disciple of renowned Kung fu, Tai qi chuan, and Qigong master Dr. Yang Jwing-Ming of Boston—was presenting an introduction on the value of Qigong in strengthening the immune system and the internal organs.
Maintaining my body’s immune system was vital to me; chemotherapy kills cancer cells, but it also damages the bone marrow, which manufactures the blood cells that comprise a person’s defenses against disease. The chemo also can wreak havoc on the heart and internal organs. Many people undergoing treatment die from the chemotherapy long before the cancer would’ve killed them.
Why torture myself with these mind/body exercises? Couldn’t I just take a bigger dose of painkillers, and hope the chemotherapy would destroy the tumor? Because I wanted to be part of the healing process—and have some control over my existence.
Control. Ha! Cancer is the ultimate state of a loss of control. Your body’s own cells mutate into mindless cannibals in full revolt against their host. Their mission? To be fruitful, to multiply, to eat away at healthy tissue and destroy the body that bore them. It is a kamikaze mission, because the cancer cells die right along with the body. Absalom, Absalom.
Ramel consulted with Dr. Yang, who developed a Qigong program to fit my needs. I practiced diligently, despite the pain. Every exercise, from the most basic stretch to the most sophisticated meditation, included the principle that the mind, breath, and body should be coordinated. In essence, you put awareness and intention into every Qigong exercise, so every exercise becomes a meditation.
During this time Dr. N. treated me with CHOP chemotherapy, which had destroyed the original cancer in my right hip five years earlier but wasn’t supposed to be effective for a relapse. Remarkably, it did seem to work, because after several months of treatment