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52 DAYS The Cancer JournalA True Story
By Jordan Lane
iUniverse, Inc.Copyright © 2012 Jordan Lane
All right reserved.
Chapter OneThursday June 2nd, 2005
"You gain strength, courage and confidence by every experience in which you really stop to look fear in the face." -Eleanor Roosevelt
"Ring, ring. Ring, ring." I did not look toward the phone as it rang. I was focused on the television. I was watching a rerun of a gripping episode of M.A.S.H titled "Life Time." In this episode there were two wounded soldiers whose life and death directly affected each other even though they never met and were unaware of their connection.
One badly wounded soldier, who arrived at the mobile army surgical hospital by helicopter, had a severely lacerated aorta. He desperately needed a transplant to survive. This soldier needed a new aorta in less than twenty-six minutes from his arrival to the hospital – the clock was ticking. A superimposed timer counted down onscreen as Hawkeye, B.J. and the rest of the 4077th raced to save the life of the GI. Once the time expired, the GI would die. The doctors and television audience knew how much time remained before it was too late. Unfortunately the M.A.S.H. unit did not have an aorta graft that was large enough for the wounded soldier. As the doctors and nurses brainstormed on how they could try to save the first soldier, another wounded soldier arrived in the compound by ambulance.
This eighteen year-old had a severe head wound. He was a perfect donor for the soldier lacking the aorta. The problem was that the soldier with the head wound was not dying fast enough for the transplant. He was brain dead but not physically dead. The medical staff were waiting and preparing for the one soldier's death which, they hoped, would save the other life. The most touching part of this episode was when the Catholic priest, Father Francis Mulcahy, said a prayer asking God to take one boy's life in order to save the other. This is a difficult prayer for anyone to make, and it must be especially taxing for a priest.
Like most M.A.S.H. episodes this episode's conclusion was satisfying if not particularly happy. One soldier's death barely saved the other's life. However, everyone was still in the grip of an immense, misunderstood and unfortunate conflict.
I also did not answer the ringing phone, because the only person calling at this hour of the evening was usually a telemarketer asking if the owner of the house was available or if I made the purchasing decisions in the family. At this time my wife and I did not have Caller ID. We do now. I would rather not speak to telemarketers and, even though I had seen the M.A.S.H. episode at least three times prior, I did not want to miss any of it. It was a classic, co-written by the show's medical consultant Walter Dishell. The phone stopped ringing and no message was left. I convinced myself that it was a telemarketer since they hardly ever leave messages. My focus went back to the television and the phone was quickly forgotten.
A few minutes later the phone rang again. "Ring, ring. Ring, ring." Again I did not answer. This time, however, I became more suspicious because the home phone rarely rang at that hour, and twice in a row was very unusual. Maybe my wife, Sara, was trying to reach me or one of Sara's friends was trying to reach her to set up a tennis match. Maybe it was another telemarketer. Maybe a family member was hurt or needed to speak with me. I was not sure. By the time I decided that I should answer the phone, it stopped ringing and no message was left. My attention went back to M.A.S.H. I did however, take the phone from its holder and placed it on the table in front of the couch in the event that it rang again.
A few minutes later my cell phone rang. This got me off the couch quickly. I walked to a table where my phone lay and I opened the phone to see the number. The number was from the 650 area code, but I did not recognize it. My parents and my wife's parents and various other family members live in the area which that area code covers. Since I did not recognize the number, and my family usually calls the home phone, I did not take the call. I convinced myself that it was a wrong number. Once the phone stopped ringing, no message was left.
Then, a few seconds later, my cell phone rang again. The number was the same one from the 650 area code. This time I answered the phone without hesitation. On the other end was my father-in-law, Bill. I could immediately tell that something was terribly wrong. I felt a pang of guilt for not answering the phones earlier.
He asked me if Sara were there. I replied "No." She was teaching a tennis lesson and would return at about quarter past nine. He paused and took in a shallow breath. I knew that he was about to tell me something that was extremely difficult to say and, I assumed, difficult to hear. He told me that his wife, my mother-in-law Miriam, went to a doctor earlier that day, and they discovered an abnormal mass of tissue above her chest. Bill sounded tired and was getting choked up as he spoke.
I needed to say something remotely intelligent in response to this devastating and completely unexpected news. I asked if there was anything I could do to help. I do not remember the exact response. The call ended with me telling Bill that I would have Sara call him right away when she arrived home. I flipped my cell phone closed.
After the call ended, I took a deep breath, said a short prayer for Miriam, and walked to the kitchen. I went to the garden window above the kitchen sink and peered out. The window faced west and the sun was setting. Large and round, it looked like a giant fiery saucer. There were fluffy white clouds dancing around the setting sun, they glowed red and were scattered across the sky. The sun and clouds were hovering above the Pacific Ocean. It was an absolutely gorgeous scene. I uttered another prayer for Miriam and asked God to aid those who would be affected. I went to the freezer and made myself a stiff drink of cheap vodka and ice. I went back to the couch and placed the sweaty drink on the table. Another episode of M.A.S.H. had begun. I had seen that one also. I turned the television off. I knew my life was about to change.
I picked up the phone and dialed Sara's cell. I knew she was teaching a tennis lesson so I left a voice mail. I remember my message distinctly.
"Hi Honey. It's me. Please come home right after your lesson. I have to talk to you."
I hung up the phone and took a deep drink of the vodka and ice. The cool liquid, however, did not quench my thirst. My throat was tight and dry as I tried to clear my mind.
I closed my eyes and replayed Bill's call in my mind. I felt numb and helpless and was trying to determine how I would be able to comfort Sara when I relayed the frightening news. I also wondered what this would mean for our lives. I put down the cold drink, took off my glasses and rubbed my eyes.
Miriam epitomized health. She ate the right foods, exercised regularly, played tennis, took long walks and played with her young grandson. She even had a personal fitness trainer. She was nothing but healthy. For all the years I had known her she had been a fit and active person. I kept trying to reassure myself that the mass was not a concern. Someone so fit and wonderful could not have something seriously wrong. I knew this would most likely not be true. I sat and waited listening to the IKEA clock tick, tick, tick the seconds away as the sun sank into the Pacific Ocean signaling the end of another day.
At around eight-thirty the home phone rang again. This time I did not hesitate to answer. "Hello," I said.
It was Bill. He informed me that he and Miriam were going to bed and to have Sara call in the morning. He also told me I would need to help Sara. I was again lost for intelligent words and said something about being there to help. I hung up the phone knowing that Sara would not wait until tomorrow to call her parents. I suspected Bill knew this as well.
At nine fifteen Sara was not home and I had not heard from her after leaving the message an hour earlier. Her tennis lesson was scheduled to end at nine. I again called her cell phone. She answered and said she'd received my message, was talking to her tennis students, and was on her way home. My voice message did not instill the reaction in her that I thought it would. I thought she would have sensed the urgency and fear in my voice and hurried home. I was mistaken.
I pleaded with her to please hurry home. My voice cracked and quivered as I spoke. Listening to myself speak I sounded like a scared little boy. In many respects I was. Sara picked up on this immediately and now knew that something was wrong. I seldom insist on anything, but when I do, Sara knows it is serious and I mean what I am saying. She asked what the matter was and all I could mumble was to please come home. When I hung up the phone I walked to the back door, anticipating her arrival.
When I saw her walk up the steps from the garage toward the back door I opened the sliding glass door and screen door to let her in. She looked at me with shifting, inquisitive eyes. I knew she had a million questions and thoughts swimming in her head. I was acting out of character with the cryptic phone message and abrupt follow- up asking her to come home immediately.
I assisted her with her large tennis bag. This bag held the tricks of her trade – tennis balls, a couple of rackets, a change of clothes, a bag of snacks and water bottles. I frequently joked with her about the weight of her cumbersome tennis bag. It was heavy.
Once the bag was off her shoulders I held her close to me and looked deep into her striking blue eyes. Holding her, I told her that a mass of tissue was found above her mom's chest. Before I could say any more she broke down and began to sob, "No, no, no." All I could do was hold her.
I knew Sara was not expecting me to say that about her mother. I imagined she was relieved to know what the news was, but at the same time she was terrified.
Holding her tight, I tried to comfort her as tears and "no"s continued to flow. I told her about the two phone calls with her dad and how he said he would talk to her tomorrow, and that they did not know any more than that the doctors had found a mass. They did not know what the mass was. The word cancer was not mentioned.
I knew that Sara was going to (and should) call her parents immediately. And that was what she did.
Sara spoke with her dad first and her mom second. I do not recall the entire conversation but it was very serious and exceptionally melancholy. I left the room for most of the call because I wanted to give Sara and her parents' time together on the phone. Miriam was going to Stanford Hospital the next day to be assessed by specialists. She had gone to a local community hospital earlier that day and was not satisfied with the experience. Stanford seemed like the better option.
Once Sara hung up the phone we went to the computer and made plane reservations to fly from Los Angeles to San Jose the next morning. I do not recall if we ate dinner that night.
* * *
I would later learn how the mass was discovered and why Miriam was going to Stanford Hospital instead of the closer community hospital. Here is the story I pieced together based on various conversations and from personal observations.
Miriam had a regularly scheduled general physical with a doctor she had been going to for some time. Neither she nor Bill was particularly fond of this doctor, but like many bad habits, it can be difficult to change physicians even if the care provided is not up to par. Miriam thought the doctor was tolerable, but Bill suggested that there could be better options.
Bill sensed that something might not be right with his wife and insisted that he go with her to the appointment. There had been a handful of instances in the past few weeks where Miriam felt short of breath. She was also using multiple pillows at night to prop up her head when she slept. These pillows helped her breathe easier. Being short of breath and using multiple pillows to sleep were not normal for Miriam. However, these symptoms did not seem to suggest that there was anything life threatening occurring in Miriam's body. Maybe she'd caught a cold. Maybe it was nothing at all. I did not know but I am also not a medical professional.
Bill waited in the lobby as Miriam was seen by the doctor. After five minutes, the doctor and Miriam rushed out of the office. The doctor suspected that something was horribly wrong and told them to immediately go to the hospital. It was fortunate that this doctor did sound an alarm and insisted that Miriam visit a hospital. Bill took Miriam across the street from the doctor's office to a local community hospital. After waiting, filling out seemingly endless forms, and talking to various people Miriam was seen by a doctor. The doctor ordered that an X-ray be taken of her chest. The X-ray results showed that there was clearly a mass of tissue, but because of the X-rays' lack of detail, nothing more could be determined about the mass. Miriam, Bill, the doctor and nurses knew that mass was there, but did not know what it was or what to do about it.
During the process of having the X-rays taken and then analyzing them, one of the technicians told her "good luck." This comment was unexpected and upset Bill and Miriam. It sent them into a mental tailspin. What was she talking about? Miriam was healthy and strong. She only had trouble sleeping. Nothing was wrong, right? Why does she need luck? They were told to go back to the waiting room, relax and wait. They were getting very nervous, worried and scared.
After a long while in the bustling waiting room, the physician told Miriam to wait and see what happened and come back in a couple weeks. This doctor also gave them a name of another doctor that they could follow-up with. Maybe the mass was nothing. He was not sure. The X-ray was not definitive or conclusive. The recommendation was to wait and see and call the other doctor.
Bill and Miriam were not in favor of this recommendation, especially after the offhanded remark by the technician. They insisted that the doctor perform additional tests to learn more about the mass and if it was harmful, and asked that a CT scan be performed. The doctor agreed but the procedure had to be cleared by the insurance carrier. After contacting the insurance carrier in Omaha, Nebraska by phone, the representative for the carrier refused to cover the test. This upset Bill as he went back and forth with the nurses and the insurance company about getting the test completed. Three hours later the test was performed. Regardless, Bill and Miriam left the community hospital. They had hopes of getting another opinion at Stanford Hospital. They were not going to wait two weeks.
Stanford Hospital is a private hospital and is considered one of the best in the country, if not the world. It is also where Bill and Miriam first met over forty years ago. Miriam was a nurse. The hospital is located on the campus of Stanford University, in Palo Alto, California. In 2012 U.S. News & World Report recognized Stanford Hospital and Clinics as one of "America's Best Hospitals." The news magazine evaluated 4,825 U.S. hospitals in 16 medical specialties, such as cardiology and neurosurgery, for its 2011-12 "best hospitals" survey. Only 140 hospitals performed well enough to rank in even one specialty. Stanford Hospital and Clinics was named to the magazine's honor roll, which recognizes hospitals that rank at or near the top in at least six specialties, demonstrating a breadth of excellence. U.S. News & World Reports also ranked Stanford number one among all hospitals in the San Jose metropolitan area.
The Stanford Hospital medical staff consisted of 1,910 doctors and over 1,000 interns and residents. There were also 2,000 nurses and 1,000 volunteers at the hospital. Volunteers performed approximately 85,000 hours a service each year. Stanford Hospital admitted over 24,000 patients for in-house care per year. The hospital also saw over 50,000 emergency patients and over 550,000 outpatients each year. However, like any reputable, busy hospital, it could be difficult for patients to make an appointment. Scheduling an appointment at Stanford could take time. Bill and Miriam did not want to experience another hectic day in a hospital waiting room, so Bill made a phone call to a friend, John.
John lost his wife to cancer a few years earlier and was a capacious donor to Stanford University. John's wife was treated at Stanford Hospital. John asked one of the doctors from Stanford, Doctor Fisher, to call Bill that night at 8:00. After speaking for a few minutes, Doctor Fisher arranged for an appointment at Stanford for Miriam at 2:30pm the next day and asked Bill to gather all of the X-rays and other information and bring them to the appointment. Their team of doctors would evaluate her condition. (Continues...)
Excerpted from 52 DAYS The Cancer Journal by Jordan Lane Copyright © 2012 by Jordan Lane. Excerpted by permission of iUniverse, Inc.. All rights reserved. No part of this excerpt may be reproduced or reprinted without permission in writing from the publisher.
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