One Hundred Days: My Unexpected Journey from Doctor to Patient

( 4 )

Overview

It is a situation we all fear and none of us can imagine: a life-threatening diagnosis. But what if the person receiving the diagnosis—young, physically fit, poised for a bright future—is himself a doctor?

At thirty-one David biro has just completed his residency and joined his father's successful dermatology practice. Struck with a rare blood disease that eventually necessitates a bone marrow transplant, Biro relates with honesty and courage the story of his most transforming ...

See more details below
Paperback (Reprint)
$13.70
BN.com price
(Save 19%)$17.00 List Price
Other sellers (Paperback)
  • All (23) from $1.99   
  • New (10) from $10.03   
  • Used (13) from $1.99   
One Hundred Days: My Unexpected Journey from Doctor to Patient

Available on NOOK devices and apps  
  • NOOK Devices
  • Samsung Galaxy Tab 4 NOOK
  • NOOK HD/HD+ Tablet
  • NOOK
  • NOOK Color
  • NOOK Tablet
  • Tablet/Phone
  • NOOK for Windows 8 Tablet
  • NOOK for iOS
  • NOOK for Android
  • NOOK Kids for iPad
  • PC/Mac
  • NOOK for Windows 8
  • NOOK for PC
  • NOOK for Mac
  • NOOK for Web

Want a NOOK? Explore Now

NOOK Book (eBook)
$13.99
BN.com price

Overview

It is a situation we all fear and none of us can imagine: a life-threatening diagnosis. But what if the person receiving the diagnosis—young, physically fit, poised for a bright future—is himself a doctor?

At thirty-one David biro has just completed his residency and joined his father's successful dermatology practice. Struck with a rare blood disease that eventually necessitates a bone marrow transplant, Biro relates with honesty and courage the story of his most transforming journey. He is forthright about the advantages that his status as a physician may have afforded him; and yet no such advantage can protect him from the anxiety and doubt brought on by his debilitating therapies. The pressures that Biro's wild "one hundred days" brings to bear on his heretofore well-established identity as a caregiver are enormous—as is the power of this riveting story of survival.

"...a doctor's account, both harrowing and inspiring, of his battle with a life-threatening illness...a serious, yet ultimately optimistic meditation on illness, medicine, family, and fate."

Read More Show Less

Editorial Reviews

From the Publisher
*New York Times Book Review

"Canty's forte is to examine human relationships with the precision of a Sue Miller or Louise Erdrich within the context of a fast-moving narrative. Once he's got you in his thrall, you're as helpless as his lovers in the hands of fate."
—Newsday
on Nine Below Zero

"This is first love in all its swift and overwhelming intensity. Both poignant and honest."
—Detroit News/Free Press on Into the Great Wide Open

"A darkly nuanced, exquisite first collection of stories. Canty navigates the many gulfs and eddies of skewed relationships with unflinching concentration."
—Entertainment Weekly on A Stranger in this World

"Gripping Canty possesses an instinctive ability to create old-fashioned, highly-plotted stories, rich with incident and narrative tension."
—New York Times

"Kevin Canty is a storm of talent His imagination is a dark wood with wildlife in it."
—Harry Crews

"These are lean, powerful stories, which is not to say they are lacking in tenderness. Canty knows how to hurts us the way Flannery O'Connor did."
—Los Angeles Times

"Kevin Canty's stories are direct portrayals of indistinct moments. As with Didion and Carver, the white space is as important as what's filled in. Canty charts a landscape all his own."
—Ann Beattie

Publishers Weekly - Publisher's Weekly
Just as he was hitting his stride as a successful dermatologist, Biro became what physicians call a "zebra"--someone with a rare disease--at age 31. Diagnosed with paroxysmal nocturnal hemoglobinuria, a blood disease that afflicts only one in a million people and, if untreated, is often fatal, he elected to have a bone-marrow transplant. In clear, compelling prose, the author describes what it felt like to undergo the dangerous procedure, to be hospitalized in isolation for eight weeks at the Sloan-Kettering Cancer Center in New York City, to deliberately destroy his immune system with radiation and chemotherapy, to have bone marrow transplanted from a healthy donor, and finally to endure the agonizingly slow, painful and depressing period of recovery. Mingled with the author's absorbing account of the transplant is an affecting portrait of the precarious family dynamics resulting from his illness. Daniella, his wife, a busy fashion industry executive, loved and assisted Biro throughout his ordeal, but felt a deep resentment of his parents and three sisters that surfaced as Biro's family intervened in caring for and supporting him. While Biro's youngest sister became the marrow donor, and his mother cooked, shopped and did the necessary cleaning to keep his apartment germ free after he returned home, Daniella maintained a cool if not hostile posture toward them that pained her vulnerable mate. Although Biro relates that his experience transformed him from an extremely self-confident individual to a man riddled with anxiety and insecurity, he believes that having been a seriously ill patient made him a more tolerant physician. Agent, Julie Merberg. (Feb.) Copyright 2000 Cahners Business Information.
Library Journal
At 31, happily married, a recipient of an Oxford Ph.D. in literature, and launched in his New York City family-based medical practice and teaching career (he had just finished his dermatology residency), Biro was suddenly struck by tragedy. Within a week, a seemingly minor health complaint was diagnosed as paroxysmal nocturnal hemoglobinuria (PNH), a rare and very serious blood disease. The therapeutic option he chose was a bone marrow transplant--a devastating therapy. While the PNH drama is absorbing, the most intriguing aspect of this life-threatening crisis as recounted here is the physician as patient. Biro was an unusually advantaged patient (he had 24-hour telephone access to the medical establishment), and the reader realizes how much more miserable the not-so-well-connected PNH victim would be. Biro's PNH trial is a harrowing read, and one believes that he has emerged a more humane physician for having endured this pitiless ordeal. Highly recommended.--James Swanton, Harlem Hosp. Lib., New York Copyright 1999 Cahners Business Information.
Read More Show Less

Product Details

  • ISBN-13: 9780375706738
  • Publisher: Knopf Doubleday Publishing Group
  • Publication date: 2/27/2001
  • Series: Vintage Series
  • Edition description: Reprint
  • Pages: 304
  • Sales rank: 466,410
  • Product dimensions: 5.15 (w) x 7.98 (h) x 0.67 (d)

Meet the Author

David Biro was educated at the University of Pennsylvania and at Columbia and Oxford Universities. He teaches dermatology at the State University of New York's Downstate Medical Center and practices in Brooklyn. He has written previously about his illness in the New York Times Magazine. He lives in New York City.

Read More Show Less

Read an Excerpt

Chapter One

Wednesday morning in September. A brisk fall morning sends sunlight flickering through the blinds. I wake to the sweet stirrings of an old alarm clock. I am a doctor, thirty-one years old, just graduated from residency and the newest employee in my father's dermatology practice in Bay Ridge, Brooklyn. I awake, I'm not ashamed to say, with youthful vigor — life is good. My first stop is Downstate Medical School for a conference.

In the Outpatient Dermatology Clinic, patients wait in each examining room. They will be asked questions and examined by nearly thirty physicians. Later their cases will be discussed in the conference hall. The familiar faces of my residency are assembled outside the clinic. I am now an assistant professor. Dressed in a new suit, I am expected to answer rather than ask questions. The change in status is exhilarating.

There are several fascinating cases being presented today. One resident has brought in a young girl with ichthyosis, a condition named after the Greek word for fish; the girl's skin is covered with gray, adherent scales. Another patient with generalized blisters has pemphigus ("bubbles" in our Hellenized medical lingo). There is also an AIDS patient whose face is studded with numerous pimples that could easily be mistaken for acne — only he has a fungal infection called histoplasmosis that will inevitably kill him.

"David, come see my case," says an enthusiastic young resident. "It's an unknown. Tell me what you think." He refers to a patient who carries no diagnosis, a diagnostic dilemma that the department will attempt to solve collectively. As I look at the lesions on the elderly man's face, I suddenly feel a strange sensation sweep across my right eye. It's as if someone were shining a flashlight at me. It passes.

"Are you okay?" inquires the resident.

"Fine," I answer. "I just felt this weird . . . Nah, it's nothing."

Nothing. A minor disturbance, I decide, despite the fact that it continues to come and go all day. Still, it doesn't prevent me from contributing my opinion about the "unknown" case. Nor am I unable to perform my scheduled surgeries at the office later on in the afternoon. My vision remains intact, as we say in the medical profession.

On the way home that evening, I stop at my friend Tom's house. He is an ophthalmologist at a similarly early stage in his career. We play with Tom's two-month-old baby and debate which managed-care plans to join. As I am about to leave, Tom offers to examine my eyes. I resist. I'm a doctor, after all. Trained to detect signs and interpret symptoms in others, we doctors tend to dismiss our own complaints. I learned that from my father. Tom insists.

His office is in the basement of his house. I sit upright in the examining chair and read the letters on the wall, first covering my right eye, then my left. "Vision's twenty/thirty. Good. Now let's take a look inside." Tom swings around the crescent-shaped slit lamp into proper position. "Left eye looks fine." I hear his slow, heavy breathing; his face is less than an inch away from mine. "Right eye looks . . . Shit. There . . . there . . . there seems to be a problem."

A major one. The veins of my right eye are engorged and blood is spilling out into the space in front of the retina, signs of a blockage or clot in the central retinal vein. But thromboses — the medical term — don't usually happen in young, healthy adults. They occur in older patients who have abnormalities with their circulation.

Tom, who rarely loses his calm, is visibly nervous. He calls his mother, also an ophthalmologist. She is even more nervous. Tom phones the chairman of his department at Downstate Medical School. Dr. Wolintz thankfully defuses some of the alarm. He claims that, while uncommon, young people can develop thromboses like mine; he's seen it happen before. And unlike older patients, they tend to have a much better course. Nevertheless, he wants to see me tomorrow morning.

Should I be scared? I'm not sure. What do I know about the eye? I skipped that part of the body in medical school. And other than a fleeting, barely perceptible sensation, I feel great. I decide to be as confident as the expert and try to convey this to my wife, Daniella, when I tell her to cancel our dinner plans at the famous Bouley restaurant. We had waited two months for the reservation so that we could celebrate our fourth wedding anniversary in style. Tomorrow. September 14, 1995. A day of consequence. She agrees to cancel only if I promise a rain check. No problem.

The next morning, I am examined by Dr. Wolintz, who repeats the benign prognosis. There is no need for concern. Chances are, the condition will persist for several months and leave no permanent damage. It is also most likely an isolated problem; he doubts there is anything else wrong with me. To be sure, though, he sends me for a few blood tests. In rare cases, a thrombosis can be caused by a hereditary clotting disorder, an autoimmune disease (like lupus erythematosus), or even the dreaded scourge of the previous century, syphilis. I won't mention the last possibility to Daniella.

Before leaving, a host of residents are called in to see my case. They are told it is a classic that few will encounter a second time in their professional lives. One of them will undoubtedly be persuaded to present me at an ophthalmology conference. Now I am the curiosity on display.

At least I'm a relatively healthy curiosity. I go for the tests that afternoon, remaining confident they will turn out negative. A nuisance, that'll be the extent of it. Just as I had concluded in my own initial assessment. A little scary. Not the end of the world.

Thursday evenings at the office are busy sessions for me. I'm glad to be seeing patients. After my brief glimpse of patienthood, I am unusually exuberant in my white coat.

"Those pimples are clearing up, Jenny. You're looking great. Keep up the good work."

"Warts are a funny business, Mrs. Jones. And little Michael seems to have particularly stubborn ones. Not to worry, we'll get 'em this time. Michael, a little freezing, that's all. Won't hurt a bit." I aim my liquid nitrogen gun at Michael's verucca and fire.

My next patient is Shoshanna Rubenstein, a twenty-three-year-old girl who has a severe form of alopecia areata, a mysterious disease that results in hair loss. Shoshanna has only a few clumps of hair remaining on her scalp, which she meticulously conceals with a wig. Ashamed, insecure and desperate, she wants eyebrows again; makeup isn't doing the trick. I want to help. Just as I'm about to inject the area with steroids, the nurse calls me to the phone.

"Dr. Biro?"

"Yes."

"This is Jody from Sherman Labs. Hope I'm not interrupting. Thought you might like to hear the results of your blood tests."

"Oh yeah. I completely forgot."

"Should I read the abnormal values first?"

The abnormal values?

"White count, 2.8. Hemoglobin, 10.3. Platelets, 47,000. The other tests are pending."

My insides drop, my entire body plummets downward. A sharp, rapidly expanding pain grips my spine, wraps around my throat and closes off the windpipe. For a second, I can't breathe. I need time to recover from the shock. Nothing makes sense. None of the values are normal. It's not possible. I feel fine. The needle-stick five years ago during my surgery rotation at Columbia flashes before my mind. Could it be AIDS? No, that's ridiculous. In fact, the whole thing is ridiculous. It must be a mistake. I gather myself and march back into the examining room, determined to go on seeing patients.

"Okay, Shoshanna. This won't hurt a bit." I pick up the syringe. Moving toward her eyebrows, my hand begins to shake. Maybe this isn't such a good idea after all. Embarrassed, I steady the syringe against my left hand and push the plunger forward, causing more discomfort than necessary. At that moment, I do not see Shoshanna. I am unaware of her pain. It's time to stop.

Fortunately, my father's associate is in the office and agrees to cover for me. I call home. My father takes the news with customary calm. He suggests we drive down to the local hospital and repeat the test. No use getting worked up unless we're sure of the facts.

The blood counts at Victory Memorial Hospital come back the same. There's definitely something wrong. We are sure now.

It's clear — relatively clear, although all this unexpected news is making thought increasingly difficult — that the most likely source of the problem is in the blood. My counts are blatantly abnormal. We drive back to the office and make calls, my father on one line, I on another. A friend from internship gives me the name of a hematologist at New York University. Dr. Raphael is not only an astute clinician, she assures me, he's also one of the nicest attendings on staff. Yes, I remember rounding with him when I was an intern at NYU a couple of years ago.

"Dr. Raphael," I say when the page operator finally connects me. "I hope I'm not bothering you." It is 9:45 p.m. "You probably don't remember me, but I have a problem and didn't know where else to turn."

"What's up?"

I tell him about my eye. I tell him about my blood tests.

There's a pause on the line.

Then he asks, "How have you been feeling lately?"

"Fine."

"Then there's only one way to find out what's going on. We have to do a bone marrow biopsy. How's first thing tomorrow morning? Can you be at my office at eight-thirty?"

"Of course. I really appreciate this, Dr. Raphael."

"That's quite all right. Just get a good night's rest. There's nothing we can do right now. We'll know soon enough."

Know what?

Do I want to know?

A good night's rest?

What will I tell Daniella?

Nothing yet. I am determined to hold my breath for the next twelve hours.

Read More Show Less

Table of Contents

Part 1 Elusive Diagnosis 1
Part 2 Waiting Game 35
Part 3 Preparations 79
Part 4 Room with a View 117
Part 5 Days of Silence 189
Part 6 Marrow Rescue 199
Part 7 Recovery 233
Acknowledgments 291
Read More Show Less

Customer Reviews

Average Rating 4.5
( 4 )
Rating Distribution

5 Star

(3)

4 Star

(0)

3 Star

(1)

2 Star

(0)

1 Star

(0)

Your Rating:

Your Name: Create a Pen Name or

Barnes & Noble.com Review Rules

Our reader reviews allow you to share your comments on titles you liked, or didn't, with others. By submitting an online review, you are representing to Barnes & Noble.com that all information contained in your review is original and accurate in all respects, and that the submission of such content by you and the posting of such content by Barnes & Noble.com does not and will not violate the rights of any third party. Please follow the rules below to help ensure that your review can be posted.

Reviews by Our Customers Under the Age of 13

We highly value and respect everyone's opinion concerning the titles we offer. However, we cannot allow persons under the age of 13 to have accounts at BN.com or to post customer reviews. Please see our Terms of Use for more details.

What to exclude from your review:

Please do not write about reviews, commentary, or information posted on the product page. If you see any errors in the information on the product page, please send us an email.

Reviews should not contain any of the following:

  • - HTML tags, profanity, obscenities, vulgarities, or comments that defame anyone
  • - Time-sensitive information such as tour dates, signings, lectures, etc.
  • - Single-word reviews. Other people will read your review to discover why you liked or didn't like the title. Be descriptive.
  • - Comments focusing on the author or that may ruin the ending for others
  • - Phone numbers, addresses, URLs
  • - Pricing and availability information or alternative ordering information
  • - Advertisements or commercial solicitation

Reminder:

  • - By submitting a review, you grant to Barnes & Noble.com and its sublicensees the royalty-free, perpetual, irrevocable right and license to use the review in accordance with the Barnes & Noble.com Terms of Use.
  • - Barnes & Noble.com reserves the right not to post any review -- particularly those that do not follow the terms and conditions of these Rules. Barnes & Noble.com also reserves the right to remove any review at any time without notice.
  • - See Terms of Use for other conditions and disclaimers.
Search for Products You'd Like to Recommend

Recommend other products that relate to your review. Just search for them below and share!

Create a Pen Name

Your Pen Name is your unique identity on BN.com. It will appear on the reviews you write and other website activities. Your Pen Name cannot be edited, changed or deleted once submitted.

 
Your Pen Name can be any combination of alphanumeric characters (plus - and _), and must be at least two characters long.

Continue Anonymously
Sort by: Showing all of 4 Customer Reviews
  • Anonymous

    Posted April 19, 2000

    Serious disease, little insight

    I thought this book was going to be about how the author, a doctor, suddenly experiences the medical establishment as a patient. Instead, he accepts the perks of being a doctor/patient without much question: He has easy access to top specialists. He gets a large hospital room with an exercise bike. Granted, he has a serious medical condition, but, to me, the book turns out to be a self-absorbed memoir.

    Was this review helpful? Yes  No   Report this review
  • Anonymous

    Posted March 6, 2000

    A compelling story

    This is a great, upbeat book that is definitely worth reading. It is well-written, compelling and informative. The author blends medical and personal data in a creative and often humorous way. Just when you begin to feel overwhelmed by his situation, he gives you a bit of humor to ease you through. His writing style is dynamic and fluid, conveying complex medical information with ease. I found his positive attitude to be inspiring throughout the whole book.

    Was this review helpful? Yes  No   Report this review
  • Anonymous

    Posted April 2, 2012

    No text was provided for this review.

  • Anonymous

    Posted August 20, 2013

    No text was provided for this review.

Sort by: Showing all of 4 Customer Reviews

If you find inappropriate content, please report it to Barnes & Noble
Why is this product inappropriate?
Comments (optional)