Friday, November 7, 2014

What I Learned From Cancer

By Jay Ellis, MD

Editor's Note: This is the last in a series of articles written by San Antonio anesthesiologist Jay Ellis, MD, a member of the Bexar County Medical Society Communications/Publications Committee. The series, published monthly in San Antonio Medicine, examines the physical, emotional, financial and spiritual burden of life-threatening illness. Check out parts I, II, III, IV, V, and VI.

“The daily life of a (cancer) patient becomes so intensely preoccupied with his or her illness that the world fades away. Every last morsel of energy is spent tending the disease.”
 Siddhartha Mukherjee, The Emperor of All Maladies: A Biography of Cancer

My friends and teammates encouraged me to train to run, even when walking was a challenge.
 From left: Don Rhine, Dr. Robert Johnson (in back), retired Gen. Ed Rice,
Tim Parker, the author and Jimmy Keaton. Courtesy photos 

I am out from that dark time when I was solely preoccupied with my illness. I feel better than I have in years because the chronic lymphocytic leukemia was making me progressively more anemic, and chemotherapy knocked that back as well. I went from near death to remission and good health in just six months. It feels like a miracle. So, after all I’ve been through, what do I have to show for it? I certainly received an education in life. I guess the first thing I learned was that you cannot do strenuous exercise with hemoglobin of eight, unless of course your workouts allow for periods of unconsciousness. On a more sober note, I was forced to ponder those existential questions we put off to a distant time, like forever.

The things I thought about most during my illness were faith, family, and friends. Faith allowed me to make some sense out of my illness, knowing that if I didn’t survive I would go to a better place. As stated before, I had no fear of dying, but I did have fear of being disabled. My wife, Merrill, never liked me saying it, and she won’t like reading it, but my biggest fear was not being the man my wife married. I didn’t want my children to remember me as a feeble, gasping-for-breath shadow of my former self. There may be a day when that will come, but I wasn’t ready for it then. I passed through the dress rehearsal for old age. I hope I handle the next performance with grace and dignity.

During my illness, family was always on my mind. My wife and my mother were my constant attendants, and I cannot comprehend how I would have survived without them. Proverbs tells us, “It is hard to find a good wife, because she is worth more than rubies.” I will never look at Merrill again without those words coming to mind. My children were a constant source of joy, and the one item of unfinished business I truly wanted to complete was the opportunity to hold my new granddaughter and pray a grandfather’s blessing over her. I didn’t worry about the office, or my group. They would be fine without me. I did ponder whether I provided well enough for my wife and family.

Last item on my bucket list: to hold this little girl
and pray a blessing over her.
I have been blessed throughout my life with many friends. I would gladly list them all here by name if space permitted and my memory was reliable enough to list them all without error. It was their visits, their calls, their notes, and their bringing food that brightened my darkest days. There is an old Russian proverb that says it is better to have 100 friends than 100 rubles. If that is the case, I am rich beyond measure. I will deviate from listing friends to make just two examples. Dr. Bob Johnson always made time on his Sundays to walk with me in the park. It must have been hard for an athlete of his accomplishments to cut back his pace to accommodate the efforts of the chemo patient with the hemoglobin of 8. Those walks were the highlight of my week. My academy classmates Tim Parker, Billy Nichols and Jim Keaton insisted on holding my place for our annual run even though the odds were against me. It was their optimism that planted the little seed of hope in my mind that I might come through this and one day feel well. Their visits and calls were a great break in the monotony and they gave the greatest gift of all, the gift of their time.

On the left is Tim Parker, and on the right Billy Nichols,
my Air Force Academy classmates and airline pilots.

The most important thing I learned was that there was little that was unique about my predicament. Others endure as much or more, and if there is anything unusual about my experience it is that it was brief, and I was fortunate to recover all of my lost function. I marvel that I was so ill at the beginning of the year and feel so well today. Certainly there are lots of reasons for my good fortune. My physician friends tell me that I had great doctors, great nurses, and the advantage of living in the country with the best cancer treatment in the world. That is all true. My friends with a bent toward business remind me that the economics of my profession allow me access to the best care available. Also true. My friends at the gym tell me it is because I was in good physical condition. It allowed me to weather the treatment and my life-threatening pneumonia. Possibly true as well. I speculate that my good fortune seems almost unfair when I consider those around me who have suffered so much more. Some say it’s because I lived a good life, but I know that can’t be true because if it were, there are living saints around us who would never suffer adversity. Life is not fair, and the rain falls on the just and the unjust. That can’t be it.

Date night with Merrill
after I am found in remission. 
As I write these articles and reflect back on what happened, my mind returns to small miracles. For our anniversary, Merrill was going to buy me a new wedding band to replace the one that I lost while cleaning the pool. Our friend Alicia heard the story and told Merrill she was going to find the ring. It seemed a well-intended wish without any chance of coming true. I had searched the backyard many times. There was not a day when I walked through the yard that I didn’t glance in the pool or at the ground looking for my ring. It never appeared. Alicia and Bob Joyner came to the house one night, and Alicia walked in the backyard with Merrill to check the garden and spotted the ring right next to her feet. She rushed into the house to give it to me, and I was speechless. I had walked past that very spot dozens of times, and Merrill must have walked past it 10 times that number. How could it just be there that day?

The other minor miracle occurred in the early morning hours of Dec. 27. When I awoke with my pneumonia, I knew I was sick, but I didn’t realize I was near death. That night what I really wanted was a glass of water, some Tylenol, and to sleep until my alarm went off in the morning. Instead, I found myself sitting on the couch staring at my pulse oximeter while it blinked 66 percent. To this day, I can’t remember how I got my car keys, found my way into the garage, opened my bag, and pulled out the pulse oximeter. Maybe it was my anesthesiology training leaping from my unconscious to check my ABCs. No. I was hypoxic, confused, and had trouble forming thoughts. I don’t know what prompted me to get the pulse oximeter.

What is even more interesting is why I have a pulse oximeter. If you ask average anesthesiologists, they don’t own one. Several people have asked me why I do, because there really is no need for us to carry one. They are everywhere in the hospitals. We have them in my office. I seldom use the one I own. Until I was asked the question, I never stopped to ponder why I carry one.

I own a pulse oximeter for only one reason. When I was in the military we conducted humanitarian trips to South and Central America. I then made one trip with my church to Guatemala. These trips always reminded me why I became a physician and gave me a renewed sense of purpose. Just before the last trip, I purchased a pulse oximeter so I would always have one no matter where I might practice. Had I not had this pulse oximeter, I would have gone back to bed on Dec. 27, and Merrill would have found me cold and stiff later that morning.

Did the Almighty place the pulse oximeter there so that I would survive this event? Why me and for what purpose? For those who don’t believe, the jokes practically write themselves. “Little miracles are now available from Plus, if you are an Amazon Prime member, your heavenly missive arrives with free shipping!” It is hard for me to believe, even as I write this. I shared the story with Richard Fetchik in the doctor’s lounge one day. After I thanked him for taking care of me, he reminded me that people think the voice of God manifests only in the burning bush or the booming voice. Richard reminded me that sometimes God speaks in whispers.

If that is the case, then I have a new task. I have to figure out what I’m going to do with this very special gift of extra time. How does one decide which activities are wastes of precious time and which ones serve a special purpose? I’m going to try not to overanalyze. I’m not going to win a Nobel Prize, and I’m not going to end world hunger. I’m going to have to settle for just trying to be a better physician, a better husband, a better son, a better father, and a better man. I had plenty of time to think over the past six months, and I found it to be a useful endeavor. Bob Johnson asked me if I was ever short of things to think about, and the answer is no. One of the things I thought about was all the things that were taken from me during my illness. One of the great ways to learn the value of something is to lose it. I can dance with my wife again, and the Baptists are right. Dancing does lead to other things. I can enjoy food and drink, and now have to watch my weight instead of forcing myself to eat. Mostly, I treasure the small blessings I took for granted.

My daughter called one day with a story about my grandson. He was walking home from school and found a balloon. This unexpected discovery prompted him to declare it “the best day ever” of his three years on earth. So I’m going to push away from the keyboard to go for a run. I don’t need to run, but now that I have the capability again, I want to take advantage of it. I want to use the gifts returned to me to their full benefit. I want to enjoy the little pleasures of life that I missed so deeply. If I’m lucky, on this run, on this day, I might find a balloon.

Looking for balloons.

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