Sometimes miracles do happen.
In 1999, I was called for an emergency consultation on a young man in his early 40’s who had come into the emergency room. He had been involved in an automobile accident, and the police were trying to arrest him for drunk driving since he could not “walk the line”. His breathalyzer test was negative, and finally it dawned on the police that there was something physically wrong with the man, and they brought him to the emergency room.
An emergency CAT scan revealed that the patient had a solitary brain tumor in the cerebellum, the part of the brain that affects balance. This was the real cause of the car accident, an undiagnosed cancer growing in his center of equilibrium. He was taken immediately to the operating room where the neurosurgeon resected a large mass, and got out as much as he could without doing damage. The pathology returned as “metastatic lung cancer to the brain.” Lung cancer? What lung cancer? But sure enough, a chest X-ray revealed a single large tumor in the man’s left lung.
Suddenly the prognosis was dire. The patient had gone from a previously healthy human being who was mistaken for a drunk driver, to a man with Stage IV lung cancer, with a median survival (statistics, statistics!) of 6 months. NO ONE wanted to operate on his lung, since that would be, proverbially speaking, like “closing the barn door after the horse had gone.” He was referred to me, for radiation to the brain (to clean up any cells that had been left behind) and to the lung, to prevent him from having symptoms of airway obstruction or coughing up blood.
I looked at this man and said to myself, “Well, even though he’s not likely to be cured, let’s give him the best shot possible to live the best quality of life for the longest time possible.” He was young and healthy and he had children to raise. I prescribed aggressive radiation doses to both the brain and the lung. The patient made it through the treatment and was able to be tapered off the steroid medication that prevented brain swelling. He never did have any symptoms from his lung tumor.
He came in regularly for follow up, always asking for a renewal of his Percocet prescription. I don’t know why–he didn’t take his pain medicine much, if ever, but he always wanted to be prepared, “just in case”. When I left that job in early 2004, my former staff told me that he came back a couple of times to see the physician who took my place, but then stopped coming. He just plain dropped out of sight. For years, like “The Ancient Mariner”, I recited his case when seeing new lung cancer patients so that they and their families would have hope. I told every resident and medical student I came across. I championed aggressive approaches in Tumor Board meetings. I was a believer in the impossible.
Last fall, in October of 2011, I got a call from a colleague. He was on the medical school admissions committee and had just interviewed a young woman who was applying to our medical school. He could barely contain his excitement. He said, “Do you remember a patient named JS?”. I said, “Of course I remember him—he is my case study in miracles!” He said, “Well GUESS WHAT!! I just interviewed JS’s daughter for our medical school class of 2012. And do you know what she said? She said you cured her father of lung cancer over ten years ago when she was a kid, and now she wants to go to medical school because of YOU. She wanted you to know that.”
As I said, miracles DO happen.