Wednesday, January 6, 2016

Stay Strong, Brother

“Stay strong, brother.”

I smiled weakly.  Certainly, he deserved acknowledgment.  He was reaching out, trying to be encouraging, supportive, and friendly, but I was late.

I was late because I had driven to the wrong site for my Reclast infusion.  I drove to Hartford Hospital through treacherous morning traffic, pissed I was late due my own ineptitude. I wasn’t going to cope with employee parking, either.  Every orthopedist thinks he or she is Dale Earnhardt.

So, I drive up to the Valet parking.
A young kid (these days, anyone under 32) runs to my car.

I’m here for my treatment at the cancer center, ” I say. “May I park here?”
He gives me a sad look.   "Sorry, its no longer free…” he trails off, not finishing the rest of the sentence, "... For you cancer warriors." I did actually think parking was free.
“Fine,” I say, “Thanks.”

 I jump out, and head for the Helen Gray Cancer Center
Stay strong, brother” He calls after me.

“Stay strong brother” the statement carries dread and peculiar emotional weight.
I’m pretty sure,   “stay strong brother” Is not the response when a patient pulls up and says:
“ I’m here for the AA meeting, where can I park?”
“Where is Diabetic training?”
Or even (and this is weird)
“Where do I park, I have an appointment   at the Chronic Heart Failure Infusion suite?”

Why do I get a free ride?
More to the point, why don’t I stop and say,  “Oh no, you misunderstand, I had cancer, Now I’m in remission, and prednisone has caused osteoporosis, so I need a Reclast infusion.”

That’s why I am here.    In my mind, Cancer is a tragic but non-lethal disease that leaves its victims sadder but much wiser.   Fighting cancer apparently was the only way I could have gotten a New York Times Op Ed piece.   I would not have been published if my piece began,
         “ I have ambivalent feelings about my job.”
I would not have been published without help from friend Judith, but that’s another blog.
Cancer is less lethal than end stage chronic heart failure,
         “ I spend one hour a week receiving infusions that permit me to live a few years more, because circumstance beyond my control has denied me the chance at a heart transplant and survival.”
         Oh wait… Judith, you reading this?
         In my 30 years in medicine, the death rate among those receiving infusions for CHF is   still 100%, while the survival rate for chemo insensitive  CLL has gone from 0% to… well, much more.
Cancer may be  a serious  disease, but curable ( ptoo ptoo) in 100% of the bodies in which I have inhabited.
         Prednisone, on the other hand, is a tablet of pure misery, Satan’s own Pharmaceutical.    Prednisone has ravaged my body , turning my skin to paper and my  lenses to opaque,   cataract -clouded stones. Prednisone has dissolved my bones giving me a T score of -2.7 ( look it up, on a roll)
         Since my hip bones will transform into chalk within 5 years, I receive Reclast, a bi phosphanate.  It binds to the bones, and makes difficult for our osteoclasts (cells that remodel our skeletons ) to destroy our lovely bones.

There is a wonderful aside here about how plumbers discovered that   bi phosphanates unclog soap- clogged  (read calcium- containing compounds) pipes. That’s for another time.

         Cancer has become a lovely, benign tool for me.  This reminds me of Curb your Enthusiasm when   Larry David discovers that saying,  “ I can’t come because my father just died” is such an effective dodge that he uses it well after Shiva is over.
         When must someone stop play the cancer card? When Chemo is over?   That’s true at the Farber, where suddenly parking is no longer free.
         Must one return to the banal world of the cancer-deficient  after one has a statistically good chance of long-term survival? For me, that was ( ptoo ptoo) over 2 years ago.
         Or, is cancer like the military, 20 years after the battle is over, one can still get a Free sundae at Friendly’s on veterans and I presume, cancer survivor day?

I’m cranky these days from a withering combination of my medications, the effects of prednisone and the overall irreversible bodily mayhem that   occurs even years after treatment. 
         I have the lungs of an 80 year old, and, believe me, after a day of seeing a mandated 2.2 patients an hour, those 80 year old lungs are fighting for survival.
         Is it fair for me to say, “I just can’t see another patient, Olga, it’s...”
         “I know, Doctor Weinreb. Stay strong.”

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