The Things His Father Taught Him

If you had asked me before today, I would have told you that I was beyond being inspired by cancer stories.  There are so many of them, and I have tried to share the ones that have been most meaningful to me with you. But today was different.  Today, Teddy Kennedy Jr. gave the keynote address at ASTRO. For those of you who don’t remember, Teddy Kennedy Jr was twelve years old in 1973, when he was diagnosed with osteosarcoma—bone cancer that was widely considered fatal at the time.  Teddy is now Edward, and he is an all grown up cancer survivor who has dedicated his life to health care law. He told  endearingly funny jokes and family vignettes as an introduction—he said that in turn of the last century Boston, his grandmother used to go to his great grandfather’s political speeches because back then Irish Catholics couldn’t become doctors or lawyers so they went into politics, and seeing how they were quite “prolific in their ability to multiply” (his words), they succeeded in getting elected.  His grandmother was quite adamant that the children and grandchildren not waste their hard earned political clout—they had to DO something with their lives.

Edward Kennedy Jr told us all what it was like to have his father tell him that the doctors were going to remove “part” of his leg.  When he asked what part, assuming that it would be the raised red lump on his calf, his father told him that it would be “all of it”—the lower leg beneath the knee.  And that when the surgery was over, he would be getting an experimental chemotherapy regimen of high dose methotrexate at the Jimmy Fund, the part of the Dana Farber Cancer Institute in Boston where they treat children.  As he put it, this was at an age where having a pimple was a disaster, and having a bald head was unthinkable.  He talked about how, as a Kennedy only a few years after the assassination of both his uncle John and his uncle Bobby, he was expected to keep up a façade of being brave.  He spoke of what it was like to have people tell him that they “felt sorry for him”.  And about how, after the operation, the doctors would come in with their entourages of medical students and residents, and look at his stump, but not at him.  And he talked about how his father, Edward Kennedy Sr told him that the biggest obstacles he would face would be the ones he created for himself.  His leg was amputated in November.  He was skiing again by March.  His father died in 2009 of a malignant brain tumor.  By then, he was called “the Lion” of the United States Senate.

The last part of Edward Juniors talk was about survivorship.  He reminded us that it is okay to be sad and to feel loss when diagnosed with cancer, and of the importance of aftercare for psychosocial and emotional issues.   He talked about the fact that when a person with cancer leaves my care, and the care of the surgeon and the medical oncologist, that person becomes a person with a pre-existing illness.   He spoke about Obamacare, and what this legislation has done for people with cancer.  He called it a godsend.  Insurance companies can NO LONGER deny a cancer patient coverage because of their pre-existing condition.  They cannot drop that person, or charge outrageous sums.  They cannot deny that person access to potentially life saving clinical trials.  He spoke of the birth of his daughter eighteen years ago, and how that event was the culmination of everything he thought would never happen to him and how grateful he feels, to this day, to the physicians who treated him.

One in four of us will get cancer.  And many of us will die from it.  Do we want to be cancer victims?  Or cancer survivors?  Do we want to help those less medically fortunate than ourselves, or not?  It is time to decide.

When I Was Young

I am in Boston, on the twenty sixth floor of the Copley Marriott Hotel, waiting out the storm. I have not been to ASTRO, my professional society meeting in three years.  I passed when the meeting was in San Diego two years ago, and Miami last year so that I could come to Boston, because I did my residency training here, started my career and my family here, and lived here for fifteen years.  And besides, New England is so lovely in the fall.  I chose my hotel carefully—not too far from the Convention Center, and very close to the restaurants and shopping in Back Bay.  I had it all planned.  All except for Hurricane Sandy.  I arrived here with my office manager on Saturday night, and managed to get in a half day at the meeting yesterday.  Today they “called it” at noon, and here I am back in my hotel room.  Tonight’s parties have all been cancelled but there seems to be a lively crew at the hotel bar.  I’m sure I will be joining them shortly.

We all say that we attend these meetings to learn what’s new in our field of radiation oncology, but the truth is that it’s very hard to learn anything when you run into an old teacher, or resident, or medical student between each lecture and it is ever so much more fun to sit and talk.  I bumped into one of my very first residents yesterday afternoon.  I mentioned that I had been writing down some of my old stories, and she piped in, “I have one for you—it’s about you!  I’ve never forgotten it.”  I said, “Oh, do tell me.”  I was a first year attending, and being responsible for a resident was a frightening prospect, although I tried very hard not to show it.

She said, “It was during my very first few weeks of residency.  I was called up to the ICU to consult on a 91 year old woman who was at the end of her life, on a ventilator.  The situation was dire, but they called us to ask about treating a large skin cancer on her face with radiation.   I knew that there was no way we could get her downstairs to treat her, but I didn’t know what to say on her chart.  So I came and asked you!”    I said, “What did I say?”   She said, “You told me to go up there and write on her chart: SURELY YOU JEST!”

Apparently my sarcastic sense of humor hasn’t changed much in the twenty seven years since that day. It’s how we oncology folk get through it all

Six Pounds of Hamburger

Six pounds of lean hamburger, two roasted chickens stripped to the bone, two pounds of green beans, a large steamed pot of brown rice, a couple of pounds of hard grated cheddar cheese and I am ready to go.  You might think that I am laying in provisions for a trip to the wilds of Alaska, but no, I am going to Boston for a meeting. They have restaurants there.  The food that I have carefully prepared is for my dogs and cat.   I will be gone for six days, and even though my husband assures me that he can take care of the four dogs, one cat and two horses still at home, it is important to me that it be done right. You may translate that to “it must be done MY way.”

I don’t know when it happened that I stopped feeding cheap store bought kibble and started to actually cook for the dogs. It may have been gradual—a sprinkling of cheese and a bit of hamburger here or there for a dog gone off its feed due to illness or injury.  I suspect that this little guilty pleasure surfaced at about the same time that my kids grew up and left the house and we all know that a mother needs to feed her children.  I measure out tablespoons of flax seed (keeps ‘em regular!) like I am doling out cod liver oil and vitamin E as my mother used to do when I was a competitive swimmer.  My husband gets into the act too—he tops off their dinners with Nilla vanilla wafers for dessert—a treat that the “laird” administers. Guests who are not dog people stare in wonder at the evening ritual, and no one more so than my houseguest from Kenya, a physician who absolutely REFUSED to believe that the creature I was carving up was a chicken—apparently they do not grow chickens that big in Africa.  Nor do they feed their dogs better than they feed their children.  I had the decency to be slightly ashamed, but not enough to go back to the cheap kibble.

Tomorrow I head out on JetBlue for ASTRO, the American Society of Therapeutic Radiology and Oncology annual meeting.  Apparently I am heading right into the “Perfect Storm”, although I thought they already made that movie.  Hurricane Sandy is due to make landfall soon, and I may be floating down Newbury Street and the Boston Common on my way to the convention center.  I don’t mind as long as I can get reservations at No.9 Park for dinner.  I will see old friends, do a little shopping, and maybe attend just a few of the educational sessions. If there is anything really new in the world of cancer treatment, I promise to write all about it.

In the meantime, my animals will be well fed, and my husband will survive—he always does.  But my writing may be a bit sparse for the next week.  Here is an open invitation to you all:  Please send your guest blogs to mfielding@crabdiaries.com   I know that my readers are nurses, doctors, front and back office staff,  psychologists,  veterinarians, dog people, horse people and of course my best friends and family.  Please write your own stories and share them with the rest of us.  I want to hear your voices, NOW!