Dialogue

Person: Can you help me?

Me: I believe that is why I am here, ready with a new treatment, a loaded gun and many tricks up my sleeve.

 P: Is it always this hard?

 M: Yes.

 P: Is there hope?

 M: Without it, we will not survive.

Imagine this dialogue that starts in the pit of someone’s stomach, a mixture of fear, anger, hope, and courage.  I partake in it and I do not dismiss it. Have you ever been afraid?  Where the walls caved in and it seemed confusing? Where what consumed others felt petty, trivial and meaningless. When you sit on the edge of a diagnosis of cancer and are worried about yourself, your family and your loved ones. This is the human I meet, sometimes confused, often afraid, and always hopeful. This is the person from which courage emanates. With this person, I stand united.

Cancer: I am here.

Me: Who are you? And why have you invaded us?

C: I am a product of survival, a state, a process. Who are you?

M: I am here to kill you.

These are my words when I look at cancer, the perfunctory introductions. A long battle is about to ensue. This is the enemy I know well. On this battlefield, a new sword has to be forged, to fight in the face of fear, uncertainty, and discouragement.  Every day a different person walks into my life and stands stronger against this common threat. Our unique existence, our individuality is a paintbrush that brings to life our depths and our dreams. In life, we march only forward regardless of how timid we feel or where our hearts want to be. I sharpen the reality that was thrust upon this person with my words. My patient stands steadfast in trust and belief.

And the dialogue resumes………

 Me: Which way this time? Cancer, are you ready?

 

Quiet

“I don’t need this right now,” he said as I finished telling my patient the plan of his care. He had been quiet. I sighed and made my way back to my chair to settle down. Sitting down, I let my mind wander. It’s not easy to change things midstream but I think oncologists should re-examine when prompted subtly or blatantly, to what they are actually saying to a patient. I started to eliminate the stressors that plague every day practice. It’s a busy clinic, 40 odd some patients to see, bouncing between good and bad news. We were both quiet. In his silence I sensed his resentment, and I felt sad. Behind his silence, there was anger.

He fidgeted. I watched him remove his cap, stifled by the news I had just delivered. They try to teach you this in medical school as my mind raced through my training (14 years), empathy they called it. As a physician I have learned not to depend only on my training to help my patients but also on my life experiences that have brought me to where I am. I searched for something within my life that he could relate to; I know adversity and I know anger. I looked specifically for strengths that I had understood at his age when I myself had faced difficult situations. Yes, I thought quietly, I know where you are. You’re angry. I let that emotion into me, a little bit of self-exposure, and the patient and I became one. Sometimes it’s hard to invite a complete stranger into your own home, but anger was not a stranger to me.

I was young when I was touched by a war – the Gulf crisis as it is referred to. I was angry then, like a young person would be if their life had been interrupted by something they had no control over. Cancer is a war. It demands a constant engagement of every aspect of our humanness to fight. It does not mean we fight without emotion. It does not mean we are raving lunatics either. It’s a constellation of problems, an inconvenience, a cost, and an interruption. It puts a halt on education, careers, motherhood, retirement, and vacation. It consumes time, money, and emotions. There is never a good time for it, and there never will be. Empathy is a deep connection that exists between two humans where one can show true understanding and bring meaning to a difficult situation. Empathy is not observed it is felt.

We sat quietly. Nothing more needed to be said. In the end, like a spilt jug of water on the floor, we both got up and started to pick up the pieces and clean the mess. Cancer, you can’t defeat the human spirit. Cancer, you are just in the way. Cancer you are not winning anything. Cancer, you have a lot to answer to. Naive is my scientific brain, just as bravery is when facing a formidable foe. I am not the one to bring cancer to its knees but I do believe that those who suffer from it do that daily.

Mo

 

Eureka!

As I sat and watched, with awe, Vice President Biden’s summit speech on his vision of the cancer moonshot, I came alive and transformed… I felt empowered and validated. Oh the calamity of thoughts that went through my head. “By golly he’s got it!” Everyone has been there at some point, that delirium that accompanies figuring something out. “Eureka!” I thought. Mine hit all at once, and I have been reeling ever since that day of June 29th but my mind is settling to tell you a story. My friends, I am back, maybe not as often, but I will tell you I never left.

He sat across my stool afraid. He was bright eyed, sharp and thinking through the things I had discussed. “You are going to do what?” he asked, “Inject my sarcoma with a herpes virus?” I remained calm but my passion was bursting out of me because I was excited. This was my idea, an idea that has been brewing in my mind for the last 2 years, an idea that allowed me to use my knowledge to help someone, a clinical trial that I wrote. I don’t know how my patients do it; they find the wisdom, the courage, the generosity and open-mindedness to accept my words. Was it that I danced in front of him telling him about the science? Was it the cancer that inspired him to be creative? Was it his immense trust in me? It did not take him long to contemplate the proposal, to believe as he told me. Enter Subject 001.

Cancer, as VP Biden clearly remarked, is a threat the human race can unite to double the rate at which we make progress in trying to push and propagate the knowledge we have to solve its mysteries. As I reflect on this statement, the one person who comes to mind is subject 001- I get the equivalent feeling that we as humans were able to conquer space to get to the moon and back, I reflect on the day I put my patient on my trial, a trial that was unique in its rights, different and innovative. Subject 001 to me, is the first person on the moon. What a feeling!

Eureka! The day has come for us to find out that I am out of a job, that cancer has been cured, that the world is at peace, that we have overcome our fears and that we have won the war against despair. Yeah sure, we all dream. And maybe that is what makes us achieve our dreams; our hopes, our engagement and our efforts. Perhaps it’s a man standing up and saying, “What’s wrong? Why can’t we do this?” I sometimes recognize how hard it is for a General in the army to will his soldiers to go to battle. This is a war, an urgent need to develop cancer breakthroughs and a strong message for us to do things without submitting to bureaucracy, greed, and negative inertia.

“My patient is interested in joining this clinical trial” the bark of a General that does this daily. The coordinator picks up her task; she is as excited as I am. What drives people to work so hard behind the scenes to actualize a clinical trial still fascinates me. It is this ownership, this dedication that can turn the tables in this fight against this devastating disease… let’s not turn against each other, retard each other’s progress, allow politics and competition to stop us.

Don’t just sit there, do something! Don’t put it off for another day, don’t lean on reasons not to act, but rather seize the moment you are in and become part of the history-changing initiative, become a part of how we revolutionize cancer treatment.

Mo.

To the moon!

We’re sharing a blog post written by the director of the Holden Comprehensive Cancer Center, Dr. George Weiner. Tomorrow Dr. Weiner will be in Washington DC, as a guest of Vice President Joe Biden, to attend the Cancer Moonshot Summit. Back here in Iowa City, we will host a satellite summit that can be followed live through the HCCC Facebook page. This summit is just the start to what might be the best chance our nation has of ending cancer as we know it.

“Mo, what’s your cancer moonshot?”

“My moonshot is for us to remove cancer from the human race and
put me out of business.”

 

About a year ago, I blogged about “going to the moon” as a metaphor for cancer research. More recently, the phrase “cancer moonshot” has taken on new meaning. In his state-of-the-union address, President Obama charged Vice President Biden with refocusing the nation’s effort on cancer and cancer research. To quote the President – “Vice President…

via Cancer moonshot – all systems “go” — Holden the Line on Cancer

Waiting

 

Today’s post comes from guest Blogger, Fletcher Summa. Thanks, Fletcher, for sharing your story with us! 

 

 

I sat in the waiting room on February 8, 2013 in the Cancer Center preparing to tell Dr. Mo that I didn’t want to do this anymore. My treatment was entering the 11th month and my body was bloated and scarred and bore little resemblance to my pre-diagnosis self. I looked around the waiting room and I focused on what I wanted to say to Dr. Mo and settled in to wait for my name to be called. Waiting is something you become very good at as a cancer patient; my mom sat next to me lost in her usual game of Candy Crush Saga on her phone. This situation had been part of my life for almost a year: the two hour trip to Iowa City every other week, wait for a bed, get hooked up to chemo, stay for days, go home, feel awful, get better, then repeat. However, this time I could no longer go in and just face it the way I’ve done in the past.

The chemicals were really starting to take a toll on my body, especially my heart. The methotrexate I was scheduled to take had been cancelled due to my lab results. This meant that I would have only two rounds of treatment remaining—“only” two but it was dependent on the results of my heart scan. Regardless of the result, I planned to tell Dr. Mo that I was done with all treatment.

It all began when I was diagnosed with Osteosarcoma on March 21, 2012 and within weeks I began treatment, then on June 21, 2012, I underwent surgery. The surgeon removed the tumor and if the tumor was over 90% dead then I would have a shorter treatment plan; if it was below 90% then the treatment would be more intense. Yet because my heart scan results had not improved I was informed that I couldn’t receive further treatment without risking permanent damage. Though it doesn’t quite sound like it would be, this was indeed good news. This was the day that I waited almost a year for. “No more chemo.” And it was finally over.

I smiled when I heard this news and feelings of joy overwhelmed me. I could get on with my life and not deal with any more side effects. Aside from the doctor appointments every three months, I thought I never had to think about cancer again.

I was wrong.

What I didn’t take into account was just how much this experience had consumed my life. Living and surviving became indistinguishable. Together with the nausea, the doctor visits, the questions from friends and family, the pills and treatments, and the pain, being a cancer patient became who I was. My return to the real world after the chemo was extremely difficult. I simultaneously wanted to talk about it and to NOT talk about it.

 

Yet life goes on and my life had to continue to move forward. My hair was growing back, I was losing weight and I had more energy than I’d had in a long time. The mindset I had throughout chemo was that each round was a victory and that every small nauseating triumph would accumulate to success overall. And what is cancer but a concentration of painful battles? If I had won against that, then surely I deserved to live without any more inconvenience.

Again, I was wrong.

Without this understanding I might have gone through life thinking that the world owed me something and that every hardship had to be reimbursed. What if I spent the rest of my life asking “why me?” or cursing the wind every time my leg hurt, then there would be no time to appreciate the fact that I made it through the treatment. Sometimes, often times, life is unfair. But that is only part of the picture and a small one at that. Maybe this is the real lesson I learned.

It’s been 29 months since my chemo ended and I’m still not sure I’ve really ever left that waiting room. What remains though after spending so much time waiting and reflecting on my life, is an enormous appreciation for those who supported me throughout this journey. The fact that so many people supported me, including my wonderful family who sat alongside me in the hospital all those days bored out of their minds and not knowing what the future holds. To the doctors and nurses who were able to balance their work responsibilities while being kind and compassionate, proves to me that people are capable of extraordinary acts of kindness and strength. It is because of them that I made it through an otherwise horrific experience, and it is because of them that I appreciate life so much more now.