October 21, 2012 – Death of a Cancer Treatment Pioneer

Today, I run across an obituary for a true cancer treatment pioneer, Dr. E. Donnall Thomas, who died at age 92.

I’d never heard of Dr. Thomas till I read his obituary, but I’ve certainly heard of the procedure he perfected: the bone-marrow transplant.  He shared the 1990 Nobel Prize in Medicine for this work.

His obituary in today’s New York Times includes this:

“When Dr. Thomas began his research in the late 1950s, bone marrow transplants were seen as a frightening last resort. Patients suffered dangerous complications from the procedure, and survival rates were grim. The patient’s immune system would either destroy the transplanted marrow as foreign, or the transplanted marrow, which contains immune system cells, would destroy the patient's lungs, kidneys and other organs.

The only successes were in identical twins because their tissue types matched.

Many physicians abandoned the approach, believing that bone marrow transplantation would never be safe enough to be practical. Dr. Thomas persevered, despite numerous failures and the criticism that he was exposing his patients to undue risks....”

Dr. Thomas’ story reminds us of how difficult cutting-edge cancer research can be.  Sometimes – as was his experience – repeated setbacks lead some researchers to give up on a specific strategy. In such an event, only the truly committed remain in the game.

It takes a certain mix of confidence, stubbornness, and gutsy perseverance to continue to tweak the experimental treatment protocols until obstacles are finally overcome and success is achieved.

Before gladiatorial contests in the ancient Roman coliseum, the equivalent of playing the national anthem was for the combatants to stand before the Emperor and say “We who are about to die salute you.”

There are a great many cancer survivors who could very well bid farewell to Dr. Thomas with a slight variation on that theme: “We who are not about to die salute you.”

A big thank-you to all who persist in the field of cancer research, despite setbacks!

October 16, 2012 – Time to Close Down the Floating Medical-Insurance Crap Game

“We all make mistakes, and a humane government tries to compensate for our misjudgments. That's why highways have guardrails, why drivers must wear seat belts, why police officers pull over speeders, why we have fire codes. In other modern countries, Scott would have been insured, and his cancer would have been much more likely to be detected in time for effective treatment.

Is that a nanny state? No, it's a civilized one.”

The writer is the New York Times’ Nicholas Kristof. His subject is his college roommate, Scott, who just died of too-late-diagnosed prostate cancer.

The reason Scott waited so long to go to the doctor?  Lack of insurance.

The reason he didn’t have insurance? Because he was between jobs, and couldn’t afford to buy insurance on the open market. As Scott himself wrote:

“I didn't buy health insurance because I knew it would be really expensive in the individual policy market, because many of the people in this market are high risk. I would have bought insurance if there had been any kind of fair-risk pooling.”

I know other people who could tell similar stories. The one that comes most clearly to mind is a fortysomething single mother of 3, who discovered a lump, figured it was probably cancer, but didn’t go to the doctor because she was sure that, if a cancer diagnosis ever got recorded in her medical file, no company would be willing to insure her, ever again.  Instead, she immediately took steps to get into an employment situation with benefits, but that took a while.

By the time she finally did get back into a job with medical insurance a few months later, and saw a doctor, her unusually aggressive cancer had progressed much farther than she’d ever imagined.

The doctors are trying every desperate measure they can think of, but the bottom line is, she probably doesn’t have long to live. With an earlier diagnosis, things could have turned out differently.

She told me later she’d known she was gambling with her life. If she’d had one of the slower-moving cancers, she probably would have won the crapshoot. She would have had her cake and eaten it, too — avoiding utter financial destitution and getting reasonably timely and successful treatment, besides. She just didn’t bank on her odds being as bad as they were.

She was thinking about being able to afford college for her kids, when she should have been thinking about her own survival.

Not the wisest decision, in retrospect.  But, as Nick Kristof points out, how on earth can a civilized society expect a profoundly frightened person who’s just discovered a suspicious lump and has no experience dealing with cancer, to make a cool, calm, balanced and wholly rational cost-benefit analysis?

This is why the American Cancer Society now considers lack of insurance to be a risk factor for cancer. Just like cigarette smoking and working in an asbestos factory.

This is why those who are clamoring for the repeal of Obamacare are either deeply immoral individuals, or are deluded in thinking there is no moral dimension to this issue.

It’s a moral issue precisely because, if Obamacare is repealed, people like these two individuals will die needlessly.

What we really need is national, single-payer health insurance for everyone. Just drop the qualifying age for Medicare to zero. It’s as simple as that. And if Grover Norquist doesn’t like the tax increase that will be necessary to pay for it, patriotic Americans ought to shun him like the corrupt political boss he is.

Obamacare doesn’t go nearly far enough. But for now, it’s all we’ve got.

It sure beats the alternative.

October 6, 2012 – Thank God for Cancer?

When I saw a Huffington Post article by an Episcopal priest titled “Thank You, God, For Cancer,” of course I had to read it. I discovered something of a kindred spirt: a fellow pastor like myself, who’s also a cancer survivor — and who, like me, found the cancer experience to have been formative in some ways she never could have envisioned.

Catherine B. Dempesy, rector of Good Shepherd Episcopal Church in Buffalo writes, of her experience with breast cancer that began two years ago this month:

“Because of cancer I learned lessons I didn't know I needed to learn. Because of cancer I discovered a depth of love, faith and gratitude I never knew existed. Because of cancer, I learned that bad news is best handled when infused with the Good News. The Good News of Faith, the Good News of Love, the Good News of Gratitude.”

Not that her journey was easy:

“Cancer is not for sissies. Cancer is not fun. Cancer stinks. But through the grace of God and the power of prayer and the faith of a community, cancer made me a better priest, a better pastor, a better person.”

Mostly, the note she sounds, this side of the acute treatment phase of her disease, is that of gratitude.  Thank you, God, for having world-class treatment facilities close at hand. Thank you for doctors who know what they’re doing. Thank you for supportive family, community, church.

“Thank you” is the message I sound as well. Not “Thank you that I got it,” but “Thank you that the experience has been such a powerful — although stern — teacher for me.”

And, it still is.