COINCIDENCE
I’ve heard people say there’s no such thing as a coincidence, but my story defies that assumption. Maybe medicine is an exception since we meet so many patients in our careers with coincidences bound to happen. The story is more than 52 years old, the first part beginning in 1963.
I graduated from medical school in 1960, then completed my internship before going on active duty in the Air Force as a flight surgeon. It was 1963 and time for me to begin my residency in medicine and fellowship in gastroenterology.
My first rotation was in a cancer hospital associated with Columbia-Presbyterian. I was on the first team for admissions, first up to meet the new patient. Mike was my age, 31, and his demographics the same as mine. Like me, he was married with two children and Jewish.
He was being admitted for evaluation and treatment of Non-Hodgkin’s lymphoma. This was a first for me. We bonded, but I was the lucky one meeting this brave man. After undergoing diagnostic X-Rays- no CT’s or MRI’s then- his treatment plan was developed, and he began a course of chemotherapy as an outpatient that would extend over the next three months.
Mike’s early progress was not encouraging, but his condition remained stable with only slight intermittent improvement. We answered his questions and expressed our opinions and optimism that he was improving. However, each time he returned for another round of chemo, he appeared pale and thin. We offered more encouragement, but he knew we weren’t telling the truth. He was overcome with depression and expected that he would die. He was haunted by the fear of dying and continued shouting hysterically that he didn’t want to die.
He was hospitalized for more intensive treatment, but it was futile. At night he continued calling out, “I don’t want to die”, but, sadly, he died, and I found telling his wife the most difficult thing I’d ever done. I held his wife, and we both cried for a long time. I never forgot Mike, and many times in my career I thought of him.
As an aside, my mother died of pancreatic cancer. As a first degree relative, I was at high risk and underwent CT scans twice a year. In 2014, my scan showed a mass in my pancreas. Fortunately, the biopsies showed auto-immune pancreatitis, mostly a benign disease responsive to steroids. Subsequent scans showed improvement and complete disappearance of the mass. But something else was behind my pancreas. Biopsies proved the mass to be large cell, B cell Non-Hodgkin’s lymphoma. Just like Mike.
I underwent chemotherapy, and like most patients, I lost my hair, but unlike most patients who have undergone chemo, I developed a handicapping neuropathy affecting my legs, resulting in frequent falls. I graduated from canes to a walker then a wheelchair. Still, my follow-up scans were negative. Sitting in the chair getting chemo, I thought about Mike and his experience in 1963, both of us having the same disease. When I complain, it’s not deserved-and I think of Mike. I’m alive but Mike is gone. I’ll deal with the complications since I know how precious life is. Mike was gone at 31; I’m so lucky-I’m 91. He missed life-his family and work. I had a growing family, a successful practice, and most of all, a long-life. Still I’ve never forgotten Mike and the horror he experienced, alone in the darkness of his room.
Jerome H. Siegel, MD, RPh
New York
Thank you for having the courage, the compassion and the perspective to write this. To me, it's not as much about coincidence as it is about having our life cut short or receiving the gift of living it.
Dear Jerry:
Zie shtark un freilich un zie gezunt!