March 24, 2026 -- Another Day, Another Beam

Hello, friends. I don't have any medical news to report. But I did think some of you may be interested in knowing what it feels like to get radiation beam therapy,

The short answer is: nothing. Going under the radiation therapy device is much like getting an x-ray. In many cases, I'm told, it is an x-ray. The radiation beams are delivered in far higher concentrations, though, than any you or I ever received to check for pneumonia or a broken arm.

Whether my particular treatment is souped-up x-rays or some other kind of radiation such as proton therapy, I couldn't tell you. That's above my pay grade.

Stuart, a friend from our church -- a nuclear physicist who travels all over the world consulting on the installation of machines like the one used on me -- could no doubt explain it to me. Maybe I'll ask him about it the next time I see him.

What I do know is that, through some high-tech wizardry, the radiation beam is carefully shaped to wrap around my larynx and esophagus -- focusing on tissues right around those vital structures, where microscopic thyroid-cancer cells may linger like stubborn members of the Nazi Party pretending to be French peasants. This is after Dr. Lelia Mady, my surgeon, has already removed all the tumors she could see -- both through computer imagery and through her eyeglass-magnifying gizmo ("eyeglass-magnifying gizmo" is a technical term).

Cancer cells are fast-growing, and radiation beams tend to fry fast-growing cells before any other kind. That's the theory behind radiation therapy, and is the effect Dr. Harry Quon, my radiation oncologist, is counting on. He's very familiar with the just-enough-and-no-more sort of calculations that tell him when, exactly, to instruct the members of his team sitting in the radiation-room cockpit to cease fire. (Pro tip: it's not "when you see the whites of their eyes." It's more like "survival of the driest.")

The only hitch is that there are other fast-growing cells in the neck area that aren't cancerous. These tend to be moist tissues like mucous membranes, salivary glands and the cells that line the esophagus. That's why I've been experiencing certain well-predicted side effects like dry mouth and a severe throat pain. These symptoms are being treated with medications, including some pretty hefty doses of pain medicine. I've been told the side effects are likely to get progressively worse as the weeks go on. The hope is that these collaterally-damaged cells will recover in time, although no one's issued any promises on that score.

When I was a kid, I knew a man who'd been treated for thyroid cancer. He used to walk around with a little brown bottle in his hip pocket, from which he'd tipple from time to time. He frequently assured anyone in the vicinity that it was only water in the bottle, and that he had to keep his mouth moist to compensate for underperforming salivary glands. That was decades before today's highly-targeted, computer-guided radiation therapies, so I'm hopeful his fate won't be mine. (Even if it is, "hydrating" is a well-accepted thing these days, so I don't imagine it would be all that awkward.)

Here's what happens on my daily trips to the radiation suite. It's remarkably consistent from day to day. In fact, it calls to mind that old Bill Murray movie, Groundhog Day. Show up at exactly the same time, at exactly the same place and go through exactly the same routine in the presence of the same people. Unlike the movie, there's no life lesson to be learned from all the repetition -- or if there is, I haven't picked up on it yet.

I make the 10-minute drive to the Johns Hopkins main hospital, pull into a basement parking garage underneath the Sidney Kimmel Cancer Center, and aim for a row of reserved parking places marked "Radiation Oncology Patients." (It's an exclusive club I belong to.) I ride the elevator down to the members-only level, the second sub-basement where radiation oncology machines are safely housed. I've even got a frequent-traveler card that lets me skip the line at check-in. I just wave it under the scanner, give a friendly nod to the receptionist and make my own way back into the radiation-treatment area.

Before I enter the waiting room, I step into a little changing-room cubicle, where I remove my shirt and don a hospital gown that's waiting for me there. Other patients have to remove more clothing than that, but since the focus is on my neck, that's all that's required of me.

I take my place in the waiting room. My fellow patients are mostly the same people I see every day. We're on the same schedule. Like daily commuters on our way into the city, we recognize and nod to each other.

The day of my first treatment, I heard a bell ring somewhere off in the distance, like an old-fashioned ship's bell. I smiled to myself when I heard it. I learned, back in my chemo days, that in Cancer World this is the universal sign that an oncology patient has gotten his or her wings (has completed the treatment series, in other words). I haven't heard the bell ring since, but with extended treatment schedules like the ones we're all on, I suppose that takes time.

When it's my turn, a technician steps in and asks for my frequent-traveler card. He or she goes back to the treatment area, and a few minutes later beckons me to come on back. In the interval, I presume someone has scanned my card again, so the dosimetrist (technical term: technician who measures out the radiation dose) uses my coordinates and not someone else's. They also double up with the familiar hospital name-and-birthdate check, just to make sure.

Back in the treatment room, a couple nurses or technicians help me up onto the narrow table, on which I lie back with my head on a little plastic headrest. I don't breathe so well lying flat on my back (due to the large abdominal hematoma scar-tissue mass that lifts up my diaphragm, compressing my right lung), so I've pre-arranged for an oxygen tube and nasal cannula. It's a big help, especially after I'm lying there immobilized. Next, they lower the custom-made plastic-mesh mask down over my head and shoulders and use it to literally bolt me down to the table so I can't move my head or neck.

Then, everyone vamooses. It's just me and my machine. Pop music is playing softly through the sound system. Today's selection from the radiation-room jukebox is, surreally, Ghost Riders in the Sky.

Lying there on the table, I can see out through the little holes in my mask. I watch the different parts of the radiation machine slowly rotate around my head. The largest piece, I know, delivers the radiation beam, guided somehow by green laser lines. Another, on the opposite side of my body, receives it. I'm not sure what the other two do, but I think they have something to do with shaping the beam in 3-dimensional space. It's a whole lot more complex than the flat rectangle of photographic film that was the target of my grandfather's diagnostic chest x-ray (did I tell you my grandfather was a doctor?).

That's about it. The machine parts stop whirring and rotating, the heavy lead-lined door to the room opens back up and the team comes back in to unbolt me and set me free. "See you tomorrow," one of them says, cheerily. I haven't heard anyone say "Same bat-time, same bat-channel," yet -- but they're all too young to get the boomer cultural reference.

If everything's running smoothly and there isn't a back-up, I can be in and out of there in 15 minutes.

As for tomorrow -- well, it will be Groundhog Day again, won't it?

March 6, 2026 – On the Table

My machine, "Versa 2"

Today was my third daily radiation treatment – out of 30 or so yet to come. Already there’s a familiarity to it – even as I lie on the table with my head and neck immobilized by a custom-made plastic-mesh mask. Even listening to the nurses and technicians cheerily say “see you tomorrow” when it's over. (Well, they didn’t say it today, because all of us in radiation-land take the weekend off.)

Lots of people, I’m told, dread the mask, but I’ve found it to be OK – once you get used to the idea that the purpose is to keep you from moving while the radiation-beam emitting device is slowly circling your body. I do want to stay absolutely still, believe me – so nothing gets irradiated that’s not meant to get irradiated. The mask is a comfort in that sense. It’s a benevolent imprisonment. It takes the pressure off. All I need do is lie there. The fit is so accurate, it makes me feel enfolded and protected. By what, I’m not quite sure. Maybe God.

Today I found the radiation table to be an excellent place to pray. There are no distractions during those several minutes, other than the whirring and beeping of the machine. You can see the machine going through its motions through the holes in the plastic mesh – kind of like a fencer’s mask, I expect. And once you’re bolted down to the table, there’s nothing you can do about it anyhow.

I just prayed a simple prayer for healing. Because that’s what this is all about. I felt love beaming towards me, along with the protons or whatever else is coming my way, directed at the little sharpied “X” marks on the neck portion of the mask. The technicians in the control room are also using a CT scan built into the machine to image the structures of my neck in real time, so they can precisely direct the beam.

My mask

I’m alone during the 5 minutes or so of therapy, as the nurses or technicians or whoever they are have taken refuge behind thick layers of lead lining the walls of the treatment room. As I entered the room, I noticed a sliding door that’s about the width of five ordinary doors layered together – no doubt, also lined with lead. Once that ponderous door’s slid shut, they can see me through a camera and converse with me by microphone.

Earlier today I had a teleconference appointment with Dr. Douglas Ball, my endocrinologist. Most of my recent consultations have been with people from the fields of surgery or oncology, but I realized Dr. Ball has been closely tracking it all. It’s a team effort. He told me a few things I hadn’t fully comprehended from earlier conversations.

He told me that Dr. Lelia Mady, my surgeon, had interrupted the operation to consult with him by phone. She explained to him how difficult it was to remove all the thyroid-cancer tissue. The only way to be sure of removing it all, she told him, would be to remove a portion of my trachea and esophagus, then pull up on the remaining part of the esophagus to re-attach it. That would result in my stomach being pulled upwards as well. They agreed that this radical approach was not called for, and that it would be better to stop where she was, sew me up and pursue radiation therapy directed at the surface of the trachea and esophagus. The goal, of course, is to irradiate the cancer cells, both those in close proximity to those structures and those that may have infiltrated their upper layers, while not going so deep that the radiation damages healthy tissue. Making sure that doesn’t happen is Dr. Harry Quon’s (my radiation oncologist’s) department – and I feel confident that, in him, I’ve got one of the best in the world looking after that.

Something else Dr. Ball told me also instilled confidence. The meeting of the tumor board that signed off on my neck-surgery plan – in which he participated –  consisted of no fewer than 20 Johns Hopkins doctors. That’s a lot of brain power gathered in one place. I’m glad to get the benefit of it.

So now I’ve got a little sabbath ahead of me – Saturday and Sunday without the short daily drive to the Weinberg Building of the Sidney Kimmel Cancer Center at Johns Hopkins. But Monday will come soon enough. And I'll be looking out for the radiation side effects soon to come.