Many oncologists have told me that one of the most gratifying aspects of clinical practice is the opportunity to play a central role in the lives of people experiencing one of life’s greatest challenges. I have always been fascinated by the relative emotional balance of cancer physicians in spite of the personal tragedies they observe every day, and part of the genesis of this strength may be the inspiration they experience partnering with people who demonstrate great courage in the face of enormous adversity.

In the previous issue of this series, we included a special pilot NHL patient education audio program, which featured interviews conducted in our recording studio in Miami with patients from the practice of Dr Lowell Hart, a medical oncologist from Naples, Florida. The first person we featured was a freckle-faced, boyish-appearing, 39-year-old man whose history included 12 years on the road as a drummer in a rock band called “Blackfish.”

Mr H arranged to be interviewed on a Friday evening, and we put him up for the night in South Beach, which is just a stone’s throw from our office. When I greeted him in our waiting room, my first impression was that he must have been the patient’s son. He looked like just any other young man who likes young ladies and music, but Andy was indeed a hardened veteran of Dr Hart’s infusion room and the rigors of therapy for chronic lymphocytic leukemia.

Below are excerpts from our conversation, which exemplify how some patients can adapt to the challenges of cancer therapy. There is a lot to learn here, and Mr H’s words are a reminder that oncology healthcare professionals are truly privileged to share in the most intimate and challenging moments of their patients’ lives.

— Neil Love, MD
NLove@ResearchToPractice.net
December 14, 2005

DR LOVE: What was your reaction when you learned the diagnosis?

MR H: I was freaked out — crying a lot — didn’t want anyone to know. I thought I was going to die. I remember being in the hospital and thinking I wouldn’t wake up. So I would never go to sleep. They had to shoot me up with Ativan^®. It just didn’t seem right that I was going to die. There were so many things left in my life that I wanted to do. However, I quickly learned that either you keep living with the misery of death around the corner every day, or you become positive. And so, in the hospital, I made the decision that I was going to be positive and proactive about it and not dwell in the scary part.

Since then, I’ve done a lot of things I’ve always wanted to do. I now have my own local cable TV show. I always wanted to do that but for some reason never had the courage to do it. In general, I’m a lot more aggressive now in business and life. When you think you might die, your whole life changes. Those little problems that scared me before all went out the door. It was a real kind of freeing experience and at the same time very scary.

DR LOVE: What positive things came out of this?

MR H: Cancer drops social barriers, and that was really cool — a lot cooler than I imagined. You realize that the fear of dying really limited you before. Then suddenly, when you know you’re going to die, you don’t have that fear any more. I made a list of the top 10 things I wanted to do in my life, and I just went out and did them. I rode a bull. That was just the craziest thing I’ve ever done in my life.

DR LOVE: You rode a bull?

MR H: Yep. Entered a rodeo in the Professional Bull Riders Association, the PBA. I had a buddy who was a rider, and he got me in. I didn’t do any training — just did it — walked up to the rodeo, signed up and did it. It was by far the scariest thing I’ve ever done, but the coolest thing. You don’t expect it to be fun. You expect it to be horrifying and that you might die — and that fear was definitely there — but suddenly I was sitting on a bull, and the crowd was screaming. It was a really cool experience. I rode it for a few seconds, and it threw me. But riding it for those few seconds was a cool moment that I would never have experienced before. And I was on chemo at the time.

DR LOVE: Any fears or concerns about the future?

MR H: Yeah, definitely. I could die. I could get the flu, and that could get real complicated. But it doesn’t bother me. I could also walk out of here and get hit by a piano coming out of the building, or a car could run me over. We all have that in our lives. It’s funny. I see more people dying from stuff like that than people like me dying with cancer. Why worry about it? I’ve become pretty positive about the future and in a weird way enjoyed the whole cancer process. I don’t know if you’ve ever heard this before, but it’s been kind of fun. It’s been a bunch of new experiences for me, and it’s opened doors.

I wrote a column for our newspaper, and they edited it because I was too cheerful about my condition. They cut out some of my jokes because they thought I was being too lighthearted about getting cancer and stuff. The column I wrote was a true story. In the hospital, I kept seeing this 19-year-old girl who was really hot. One of the nurses said, “Oh, she has leukemia, too.”

Every time she’d walk by my room with her little pump and bags hanging, I got mobile with mine — but I could never catch up to her. So here I am — bald and about to die — in my hospital dress, walking around, trying to find this girl. I imagined we’d meet in the library and our chemo bags would entangle and I’d have some funny line to say to her.

DR LOVE: Has your reaction to this whole experience surprised you?

MR H: Yeah, it has. But it’s true to my person. I was pretty positive before and pretty optimistic. I didn’t let things bog me down, and I didn’t stress out about stuff. But it surprised me a little bit that I’ve done so well through this, because you think that when you get cancer, you’re going to die. That’s not the case. You can beat things and get through them. Fortunately, I have a disease that’s treatable. So in that sense, I feel lucky that it’s not some rare disorder that is only seen one in a million times. I’ve been lucky to get the type of cancer that I have.

DR LOVE: It seems as if you see things differently now.

MR H: Definitely. My first night out of the hospital, I went to the beach and saw a sunset. It was just like seeing it for the first time. After being in that neutropenic bubble environment, it is now just so nice and freeing to sit in a park and be the happiest dork there because I’m just happy to be alive.