When Life Gives You Lemons

When I was about ten years old, swimming on a Texas swim team, I remember hearing that the child of one of the local coaches had been diagnosed with leukemia.  The idea of a kid dying of an untreatable disease was so foreign to me that I am sure that I have blocked out most of the details.  I do know that the child died, and it didn’t take very long.  In the fifty years since, the landscape of childhood cancer has changed dramatically for the better.  Today, most children diagnosed with acute lymphocytic leukemia—the most common type—survive.  But in the past, we oncologists significantly underestimated the cost of that survival.

For the last six months, I have been taking care of one of the earliest survivors of childhood leukemia.  In her late forties now, she was treated with life-saving combination chemotherapy when she was six years old.  A couple of years later, she relapsed with leukemic cells in her brain and spinal cord, and received cranio-spinal irradiation—radiation therapy to her entire brain and spinal cord, a toxic treatment associated with short stature due to reduced growth of the spine, lowered IQ, and a depressed immune system.  Again she survived, and grew up to be a teacher of disabled children—the ultimate in “giving back.”

In 2005, she was diagnosed with breast cancer, likely a consequence of the radiation exposure she had as a child.  She underwent a mastectomy, and then did well until last fall when she noted a lump in the medial aspect of her breast reconstruction.  A staging work up revealed a benign appearing brain tumor which, again, was likely a late effect of her brain irradiation.  Since she had no symptoms from her brain tumor, her medical oncologist forged ahead with chemotherapy for the breast cancer, followed by removal of her reconstructed breast and its residual cancer, followed by radiation to her chest wall and lymph nodes given by me.  All of this she bore without question, without complaint.

I saw her in follow up on Friday and she was doing well, but she knew she needed to undergo more testing for an enlarged and nodular thyroid—possibly a thyroid cancer, also radiation induced.  She also needed to have a follow up MRI for her brain tumor, to be sure that it is not growing rapidly.  She was matter of fact about the inconvenience, not to mention the anxiety, of having multiple additional tests and procedures over the next few weeks and months.

I am continuously amazed by her grace and equanimity.  I said to her, “You are my hero.  How do you just keep going, day after day, month after month, year after year, dealing with cancer, one cancer after another?”  She said, “When I was a child, dying was NOT an option.  My parents never even mentioned the possibility, so I was never afraid.  I just did what I had to do.  Now it’s the same thing—I know that this is the price I have paid for the wonderful life I have led.  I just keep putting one foot in front of the other, one day at a time.  I know that I will be okay.”

Here’s the thing about oncology folks:  It puts everything else into perspective.  If this brave woman can take the lemons life has given her and make lemonade, so can you and I.   This is the crux of the matter; this is what has kept me going in this field for over thirty years.  If this woman considers herself lucky, so should we all.

3 thoughts on “When Life Gives You Lemons

  1. What an inspiring outlook she has! I know an almost 80 year old local dairy farmer who survived stage 4 metastatic melanoma forty years ago in an experimental trial of vaccine at UCLA, flying down monthly for treatments, got his family raised, then a few years ago had a localized renal carcinoma treated with surgery, and now is wrapping up chemotherapy for a rare type of lymphoma. His perspective in church today? Why not keep giving the treatments a try if there is hope for more time with his family? He had the bad fortune of getting bad diseases, but the good fortune of responding well to the treatments modern medicine has to offer.

  2. What a beautiful, brave outlook on life & death. My sister’s 2 yr old son was diagnosed of ALL in 1966 & received chemo that kept him alive until 1970. Now, my 48 yr old nephew ( from another sister) just completed his 1st cycle of chemo for AML. Although it appears to have been successful, the side effects of the chemo have taken a big toll on him. He has not been able to eat for a week & his legs are swollen – either from the lack of protein or the current poor kidney function. Difficult to see people have to endure all this. He is being treated back east & whenever I call him, he states he is doing great. I get the actual details from his mother. Hopefully, he will get through this and he has six siblings if they get to the point where he might be eligible for transplant If it wasn’t for all the advances throughout the years, your patient & my current nephew would not still be here. May they both continue to thrive, thanks to their medical treatment from caring doctors like you.

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