PATIENT ADVOCATE

Unfortunately, bad things often happen to good people. Our first reaction is to state the unfairness of these situations. However, the universe has no room for fairness or unfairness. Things happen - and not necessarily for a good reason.

I was reminded of this with a recent patient, whom I met in clinic. He had recently been diagnosed with an aggressive form of prostate cancer. and wanted to transfer his care to us 

I could not point to anything he had done to increase his risk for this cancer. It was caused by mutations that occurred by chance. He had lost the genetic lottery, but I did not feel that explaining this to him would provide much in the way of comfort. Rather, I tried to focus on what we might do to help him. I explained the odds were long and that he had already had a "Hail Mary" with his first treatment that took place when he was quite ill in the hospital. I was concerned about what more we could do to effectively shrink the cancer. Despite that, I explained that we wanted to be aggressive about reducing the symptoms the cancer was causing. With that, I admitted him to the hospital for further work-up and symptom management.

He and his family seemed relieved to be going back in, but I could also sense that they felt overwhelmed. I cannot imagine what it is like to be in there position. The only experience from my own life that comes close is when my mom was admitted after a surgical procedure. Fortunately, one of my med school friends knew her doctor and put us in touch. Over the course of that weekend, her doctor kept me updated and even listened to my many suggestions. I felt empowered knowing that I was playing a productive role in helping my mom get better. 

I now appreciate that families who come off as "demanding" or "difficult" are just trying to advocate for their loved ones. Let that be a reminder that we should all be so lucky to have an advocate like that. 

GRATEFUL

I have many reasons to be grateful, but none greater than my family. Nicholas was home this past week, and we enjoyed every minute with him. We watched many sporting events, read many articles, and discussed many current events. All of these might seem quite quotidian, but they were so enjoyable. Nicholas' presence brought a new lightness and light into our lives whose absence these past few months we did not fully appreciate.

Today, he headed back to school. I was so excited for him to keep chasing his dreams and seeing him juggle the many demands of being a student, sports editor, writer, and leader. He is becoming quite an independent and accomplished young man. However, it was definitely bittersweet to see him leave.

Cate has been very busy with school, practices, and she did not feel well this week. Despite that, the four of us  enjoyed several moments together. We went on a few walks, including to the Arboretum. We went downtown and ate out. We also took in some soccer games and played one of our favorite games, Scattergories, last night.

Afterwards, Nicholas and I stayed up late to watch the Timbers match. Of course, the Timbers surrendered a goal late! Timbers gotta timber! 

I will cherish this past week, and I never take time with my family for granted. I am so lucky to have these amazing people in my life!

HONING HIS CRAFT

For as long as I can remember, Nicholas has been curious and has gone deep on the subjects that interest him - key attributes for a journalist. His first foray into journalism was his eighth grade independent project, which included an interview with a professional soccer player. For that project, he was mentored by a journalist from our local paper, The Oregonian.

Since then, he has continued to immerse himself in the journalistic craft. He started the Gryphon Sports Live media outlet at Greenhills High School, elevating the athletes and bringing play by play coverage to many sporting events. This was a lifeline during the COVID pandemic when fans were not allowed to attend games. He had the opportunity to call games at Michigan Stadium and Ford Field. He contributed in-depth articles to the school newspaper, The Alcove.

From there it has only been up. He started a substack on the beautiful game. He became a sports writer for The Daily Orange, Syracuse's school newspaper his freshman year and has filed some detailed player profiles and gripping accounts of games - accounts that felt more alive and vibrant than the sporting event on which they were based that I had just watched. He excelled as a summer intern at the Ann Arbor News, and so many of my friends commented on how well-written his articles were.

This year his peers encouraged him to apply for the position of sports editor, which he secured. During our European vacation he somehow juggled vacation and waking up in the middle of the night since the Syracuse sporting events were happening six hours earlier. Check out the recent Syracuse Lacrosse Guide that he helped to put together and his feature article!

He is unflappable, and I so admire his passion and ability to keep going. I look to him for inspiration and want him to know how much he matters to those with whom he works, his readers, his fellow students, his friends, and our family. I cannot wait to see where life takes him. I know it will be interesting!

A LIFE CUT SHORT

Last month, Tatiana Schlossberg, the daughter of Caroline Kennedy and an environmental journalist, passed away. She was diagnosed with an acute myeloid leukemia in the immediate aftermath of giving birth to her second child less and passed way less than 18 months after being diagnosed. 

In the months following that diagnosis, she underwent multiple treatments, including two bone marrow transplants and experimental CAR-T therapy to target her recalcitrant cancer. She chronicled her experience as a cancer patient in a piece in the New Yorker entitled, "A Further Shore" that I found to be incredibly poignant. 

The piece was striking for the clarity of the medical history she recounted, but more importantly this essay brought to life the human toll cancer takes on far too many children, parents, and siblings - all categories to which Ms. Schlossberg belonged.

Though I have taken care of cancer patients as an attending for 19 years now, this piece made me truly appreciate the toll this disease takes on a patient and their family. There was not a single aspect of Ms. Schlossberg's life that was not turned upside down. 

Amidst her illness, she found herself remembering moments of the past both big and small. These surely served as touchstones for the life she once had and perhaps allowed an escape from the difficult circumstances she faced from her disease and treatment complications. 

After reading this piece, I was left with a much greater appreciation for the gift of health and how death is inevitable for us all. If we are lucky, we can look back on a life lived like Ms. Schlossberg full of passion, love, and dedication to causes bigger than ourselves. Rest in peace.

THE GREAT DETACHMENT

In today's New York Times, David Brooks weighs in on what he views as one of the biggest challenges human being face - loss of connection and the accompanying feelings of loneliness and isolation - that he calls the great detachment.

In one of the more poignant lines from that piece, he writes, "We all need energy sources to power us through life, and love is the most powerful energy source known to man." I have admired Brooks' writing greatly over the years - even quoting him in the two endowed chair speeches I have given to date - but this sentence profoundly resonates with me. 

The moments in my own life that were most profound were times of joy or grief shared with other people. In those moments, we were able to process the enormity of what we had experienced together, and we left feeling closer and better understood. These moments include my wedding witnessed by one of my best friends, the birth of my children, the death of my niece Jasmine, and countless clinic visits processing good news and bad with patients. In those times, I have never felt less alone and more purposeful.

These days, I often find those types of moments of attachment to be more rare. Work is more fragmented and disconnected with pressures coming from multiple sides. Nearly all my friends live somewhere other than here. My children are getting older and spreading their wings, which is precisely what is supposed to happen. However, that does not mean it is easy for parents like me!

So what is the antidote to this era of detachment? The answer plainly is to live and work closely with other people we care about and to share pursuits in which the self is dissolved into the collective. This is the elixir for the detachment plague we face. I cannot think of an intervention more vital right now.

PHOTO FINISH

One of our customs - or rather, my custom - when we travel is to have the waiter take a photo at dinner. This week we have been in Madrid, where Nicholas studied abroad last semester, and we have had many great meals already.

Today, we dined at a Thai place Cate picked out called Kai Thai, which was excellent! We ordered many of our favorites, asking for a medium level of spiciness. Turns out the Spaniards have a very different sense of spiciness as their medium was a good match for my mild level back home. 

As you can see, it was a great meal with great company. Some things never get old!

A PERFECT DAY

Yesterday was the perfect day. Nothing terribly momentous happened, but the day was filled with so many small but beautiful moments.

I started off the day with a run through the Arboretum. My watch did not sync my podcasts correctly, so I listed to an old Wilco mix. The foliage, the rushing river, and the neighborhood scenery were familiar and so comforting. 

Afterwards, Nicholas and I biked down to the racquet club, where Cate was working. We played tennis, and it was remarkable to see how much better he has gotten. If we had been keeping score, there is not doubt that he would have won! I gave him some tips on his backhand, and he made nice progress after changing up his form. I recommended he get a lesson. I think he has the makings of a great player!

In the afternoon, I spent some time at work trying to clear my head and think about how best to navigate the decision about the move. I was able to clearly see the pluses and minuses of moving forward and what I would be giving up.

I grilled turmeric chicken, and we had a lovely Middle Eastern dinner. Afterwards, we made s'mores, which were delightful! We watched the Copa America Final match with Brazil prevailing in penalties. 

I was able to connect with my old friend, Chap, who has been an incredible source of support and strength as I have faced head on what this move means for my life. I am so grateful to have such amazing friends.

As I lay my head on the pillow, I was able to appreciate just how good I have it. I was able to see all the small positives that added up to a day that felt perfect. I will hang on to this perspective and try to remember how there are so many perfect days - if only we can appreciate them.