This weekend, I was deeply saddened to hear news about three individuals close to us whose lives were affected by cancer. The father-in-law of a dear, old friend had experienced a recurrence of his cancer and was now on hospice; the mother of one of Nicholas' friends had been diagnosed with a large ovarian tumor; and one of Cate's good friends had just undergone surgery to remove a brain tumor. To say that I was stunned would be an understatement, but my feelings pale in comparison to what those families are feeling tonight.
Caring for patients with cancer has been a central part of my life for the past 17 years. Therefore, it feels very strange to not have seen a patient in clinic since we moved in July. Thankfully, I am set to start clinic again in January, and I will resume patient care hungry to meet new families and to try and make a difference in their lives.
When I heard the news from our friends of their cancer stories, I felt a sense of duty to reach out and to try to help in any way I could. Being an oncologist to me means providing comfort, information, and solace while one is prescribing treatment and even more so when treatment is no longer effective or safe. This is the only way I know how to practice medicine, and it is what I wish for every cancer patient, even if they are not my own.
Just like a friend or a loved one, it is a privilege to get to know patients and to try to win their trust. Often this does not come easily because patients often feel poorly or have had bad experiences with the medical system. Our job is to right those wrongs and to help patients and families achieve small victories that allow them to forget about their cancer - at least for a little while. In short, it is our job to try to help give patients back what the cancer has taken away.
I will remember this weekend for a long time. It is a reminder that life is until further notice and that there is no greater cause than being there for the ones one loves. These are lessons that I will take to my grave, and I can only hope that the doctor who comes to be my caretaker learns that lesson along the way.
Monday, November 4, 2019
Friday, August 2, 2019
FREE SOLO
Mountains are often used as metaphors to describe life's challenges, and I have found that that comparison is quite apt. My own life has been quite charmed and fairly flat. However, I realized that charmed or easy do not equate to meaningful. In large part, that is why I decided to turn my world upside down and leave a nice job with good friends in a city I enjoyed living in.
What I did not realize is how complicated it would be to move and to start over from scratch. Along the way, my family and I had to sell a house, buy a house, wind down operations in the lab, try to recruit new people for the lab, have several conflict-prone conversations about bringing items with me from work, move said items across the country along with ourselves, navigate finding new schools and soccer clubs for the kids, and settle into a new community all in 5 short months.
I thought of the heights we had climbed when I watched the documentary "Free Solo" tonight that tells the story of the climber Alex Honnold's quest to climb El Capitan in Yosemite without the use of ropes or harnesses. Mind you the words I typed do not do adequate justice to his feat, nor does the route he took shown below. To understand the gravity of his feat, one must watch the film or visit Yosemite - as I have.
What struck my most about Alex and his story though was his motivation. He did not seek happiness or even longevity. He craved excellence and doing something that many believed to be impossible. There were many starts and stops along the way, but he never gave up. While his ascent may have taken just under three hours, he spent years preparing himself to succeed in that moment. His story is one that I will not forget, especially as I encounter other struggles in the coming years and beyond. Fulfillment matters. Excellence matters. One must be willing to risk everything for those things because to get to the top of one's proverbial mountain in truly magnificent. Here's to Alex!
What I did not realize is how complicated it would be to move and to start over from scratch. Along the way, my family and I had to sell a house, buy a house, wind down operations in the lab, try to recruit new people for the lab, have several conflict-prone conversations about bringing items with me from work, move said items across the country along with ourselves, navigate finding new schools and soccer clubs for the kids, and settle into a new community all in 5 short months.
I thought of the heights we had climbed when I watched the documentary "Free Solo" tonight that tells the story of the climber Alex Honnold's quest to climb El Capitan in Yosemite without the use of ropes or harnesses. Mind you the words I typed do not do adequate justice to his feat, nor does the route he took shown below. To understand the gravity of his feat, one must watch the film or visit Yosemite - as I have.
What struck my most about Alex and his story though was his motivation. He did not seek happiness or even longevity. He craved excellence and doing something that many believed to be impossible. There were many starts and stops along the way, but he never gave up. While his ascent may have taken just under three hours, he spent years preparing himself to succeed in that moment. His story is one that I will not forget, especially as I encounter other struggles in the coming years and beyond. Fulfillment matters. Excellence matters. One must be willing to risk everything for those things because to get to the top of one's proverbial mountain in truly magnificent. Here's to Alex!
STORYBOOK ENDING
After we returned from France on vacation and before we left Portland, I had a chance to play one more time with my futsal team Arose-And-all, and it was a night to remember.
For the past 4 years, my teammates have been my best friends who provided a much needed connection - one that was unmatched by anything else in my life there.We won many titles together, including three straight league titles, but it was more the understanding we developed with each other on and off the pitch that made that team so special. Therefore, I was excited to have one last chance to play with them.
On that night in the last game of the season, we faced the top-rated team in the le
ague. Though we did not have a chance to displace them on top - even with a win - we all wanted to go out on a high note and avenge an earlier loss to that team.
For much of the season, we have been short-handed due to injuries or vacations, but on that night most of the team was present. We normally spot the opponent the first few goals, but not on that night. We took an early lead, and I scored a first half-hayrick -the first time I have ever done so! We went into the half leading and determined not to let them back in. In the second half, I played back since each player is capped at 3 goals (i.e. even if I scored again, it would not have counted). In the end we finished the match on top 10-7. A very fitting way to wrap up my time with Arse-and-all.
Afterwards, we retired to the bar upstairs for beers and homemade rice krispy treats and chocolate-covered strawberries. I do have the best teammates! At the end, we said our goodbyes and hugged.
As I mentioned, winning became irrelevant as our time together went on. It was the memories we made together - win or lose- and the quality time we spent together during or after the game that made game day - Sunday- my favorite day of the week in the past four years. While my ending with Arse was storybook, so too was every moment with them along the way. Love you Arse!
For the past 4 years, my teammates have been my best friends who provided a much needed connection - one that was unmatched by anything else in my life there.We won many titles together, including three straight league titles, but it was more the understanding we developed with each other on and off the pitch that made that team so special. Therefore, I was excited to have one last chance to play with them.
On that night in the last game of the season, we faced the top-rated team in the le
For much of the season, we have been short-handed due to injuries or vacations, but on that night most of the team was present. We normally spot the opponent the first few goals, but not on that night. We took an early lead, and I scored a first half-hayrick -the first time I have ever done so! We went into the half leading and determined not to let them back in. In the second half, I played back since each player is capped at 3 goals (i.e. even if I scored again, it would not have counted). In the end we finished the match on top 10-7. A very fitting way to wrap up my time with Arse-and-all.
Afterwards, we retired to the bar upstairs for beers and homemade rice krispy treats and chocolate-covered strawberries. I do have the best teammates! At the end, we said our goodbyes and hugged.
As I mentioned, winning became irrelevant as our time together went on. It was the memories we made together - win or lose- and the quality time we spent together during or after the game that made game day - Sunday- my favorite day of the week in the past four years. While my ending with Arse was storybook, so too was every moment with them along the way. Love you Arse!
Thursday, May 30, 2019
AHEAD OF HER TIME
This letter to our nanny (Makayla- Maki for short) from Cate speaks for itself.
What a thoughtful and amazing young woman Cate has already become at the age of 10.
Anything I have written pales in comparison to what she just poured onto that page - without any prompting, mind you.
What a thoughtful and amazing young woman Cate has already become at the age of 10.
Anything I have written pales in comparison to what she just poured onto that page - without any prompting, mind you.
Monday, May 27, 2019
COMING HOME
Last week, I did something I have never done before as an oncologist. I made a home visit to see one of my patients - a dear patient who had recently enrolled on hospice.
The reason for my visit was not to tend to his symptoms or to make medication adjustments. Rather, I visited him and his wife so they could say goodbye and thank you.
Dr. X and his wife had both been physicians in the Portland community until they retired in the past decade. Around that time, he was diagnosed with prostate cancer. Unfortunately, despite early surgery, his cancer returned and eventually became metastatic. That is when I met them roughly four years ago. We tried everything imaginable to control his cancer and keep him alive. Some treatments worked better than others, and some treatments were also more toxic than others unfortunately. Through it all, he was resolute and never complained.
At our last visit three weeks ago, I gave him the bad news that the cancer was progressing and that there was nothing more I could do to try to slow it down. I did let him know that we would continue to be aggressive about reducing his symptoms, and that is when we decided to start hospice.
That visit was even more sad because I also had to let him know that I would be moving to accept another position at a different institution out of state. He and his wife expressed understanding, but I could tell that they were concerned about how his care would be managed after I left. I re-assured them that I would still be here for two more months without letting them know that that is all the time I thought he might have left. We hugged at the end of that visit and said a brief goodbye.
Since that time, Dr. X became weaker, and his wife feared he did not have long to live. They had hoped to see me at a previously scheduled appointment three weeks later, but it seemed unlikely that he would have the strength to come. His wife said that they just wanted one more opportunity to see me.
Cate's futsal practice on Friday nights is not too far from where they live, so I told my nurse to let them know I would stop by while she was at practice. As I drove up to their house, I was struck by how beautiful their street and yard was. Inside, I was greeted by both doctors and their grown son who was slightly younger than me. Grandkids also peaked out from behind corners and ran away when I caught their glance.
We visited for almost an hour and a half, and I learned more about their own life stories and how they came to the US from India and settled in Portland. They talked about how difficult it had been to make their way in this state when it was even less diverse and much less welcoming to people who looked like us. They gave me this beautiful plate and a card.
The card was brief, but it ended with words of encouragement, "Change is hard, but your family will support each other and get through this transition."
That night, I had come to help them with their transition to death and to offer my support. However, it was they - who were now facing the biggest transition of their lives - who had sought to comfort me one last time through their own stories of overcoming challenges.
Not a clinic goes by when my breath is not taken away by the grace, dignity, and kindness of the men and families for whom I have the privilege to care. Dr. X and this home visit were a clear reminder that anything I give to my patients is far outweighed by the lessons I have learned from them and the kindness they have shown me.
If home is where the heart is, heart is what I found on that home visit.
The reason for my visit was not to tend to his symptoms or to make medication adjustments. Rather, I visited him and his wife so they could say goodbye and thank you.
Dr. X and his wife had both been physicians in the Portland community until they retired in the past decade. Around that time, he was diagnosed with prostate cancer. Unfortunately, despite early surgery, his cancer returned and eventually became metastatic. That is when I met them roughly four years ago. We tried everything imaginable to control his cancer and keep him alive. Some treatments worked better than others, and some treatments were also more toxic than others unfortunately. Through it all, he was resolute and never complained.
At our last visit three weeks ago, I gave him the bad news that the cancer was progressing and that there was nothing more I could do to try to slow it down. I did let him know that we would continue to be aggressive about reducing his symptoms, and that is when we decided to start hospice.
That visit was even more sad because I also had to let him know that I would be moving to accept another position at a different institution out of state. He and his wife expressed understanding, but I could tell that they were concerned about how his care would be managed after I left. I re-assured them that I would still be here for two more months without letting them know that that is all the time I thought he might have left. We hugged at the end of that visit and said a brief goodbye.
Since that time, Dr. X became weaker, and his wife feared he did not have long to live. They had hoped to see me at a previously scheduled appointment three weeks later, but it seemed unlikely that he would have the strength to come. His wife said that they just wanted one more opportunity to see me.
Cate's futsal practice on Friday nights is not too far from where they live, so I told my nurse to let them know I would stop by while she was at practice. As I drove up to their house, I was struck by how beautiful their street and yard was. Inside, I was greeted by both doctors and their grown son who was slightly younger than me. Grandkids also peaked out from behind corners and ran away when I caught their glance.
We visited for almost an hour and a half, and I learned more about their own life stories and how they came to the US from India and settled in Portland. They talked about how difficult it had been to make their way in this state when it was even less diverse and much less welcoming to people who looked like us. They gave me this beautiful plate and a card.
The card was brief, but it ended with words of encouragement, "Change is hard, but your family will support each other and get through this transition."
That night, I had come to help them with their transition to death and to offer my support. However, it was they - who were now facing the biggest transition of their lives - who had sought to comfort me one last time through their own stories of overcoming challenges.
Not a clinic goes by when my breath is not taken away by the grace, dignity, and kindness of the men and families for whom I have the privilege to care. Dr. X and this home visit were a clear reminder that anything I give to my patients is far outweighed by the lessons I have learned from them and the kindness they have shown me.
If home is where the heart is, heart is what I found on that home visit.
Friday, March 29, 2019
GRATEFUL
Today, I was scheduled to see one of my dearest patients who was nearing the end of his life. However, today he suffered a fall at home and was taken to an outside emergency room. A scan revealed a subdural hematoma - bleeding between the skull and the dura, or lining around the brain. Fortunately, Mr. H was stable in the hospital, and neurosurgical intervention was not required.
I called his wife during his scheduled appointment time, and she said they were hoping to get answers to a few questions about the end of his life by. Since the outside hospital was near my home, I told her I would just stop by to see them in their hospital room.
There were many things I could have been doing this Friday evening, but nothing seemed more important than meeting with this family tonight. I met with them and their son and answered all their questions. I gave them all hugs as I left for the evening.
As I was leaving, his wife thanked me for everything I had done for them. With tears in my eyes, I thanked her everything they had given me. What I could not enunciate in that moment was what exactly I was grateful for. A few hours later, the reasons seem much more clear.
Mr. H and his wife were in their early seventies, but I could tell from our conversations that they supported progressive causes, had a strong sense of justice, and that they were interested in trying to make the world a better place. No doubt this was shaped by their life experiences and the way they were raised. There was an affinity and an understanding between us that I have found to be extremely uncommon in my own life with the average person.
One might have guessed that Mr. H reminded me of my own father. However, what really drew me to Mr. H and his wife was that they made me think about myself - the person whom I hope to grow up to be and the marriage I hope to say I had at the end of my life. Needless to say, I have a long way to go to come close to approaching them.
One might have guessed that Mr. H reminded me of my own father. However, what really drew me to Mr. H and his wife was that they made me think about myself - the person whom I hope to grow up to be and the marriage I hope to say I had at the end of my life. Needless to say, I have a long way to go to come close to approaching them.
They say it is better to give than receive, but even a lifetime of caring for extraordinary men and women like this family will never repay the debt that I owe these wonderful families for what they teach me every week. Tonight, I was reminded of that debt and how I am obligated to pay forward the kindness and example of patients like Mr. H and his wife with my own patients and my friends and family. That is the least I can do for those who have given me so much. What a life.
Tuesday, January 1, 2019
THE ALUMKALS
Nicholas is quite the artist and spends several hours each day drawing in his counter back home. Even when we are on vacation, Nicholas still finds time for his passion and always brings his markers.
At the request of Aunt Jos, he decided to draw a picture of the Alumkal cousins while on vacation. Here is his picture entitled, "The Alumkals." I think you will agree that Nicholas nailed it!
From left to right: Jasmine, Ally, Antony, Nicholas, and Cate!
At the request of Aunt Jos, he decided to draw a picture of the Alumkal cousins while on vacation. Here is his picture entitled, "The Alumkals." I think you will agree that Nicholas nailed it!
From left to right: Jasmine, Ally, Antony, Nicholas, and Cate!
BLACKKKLANSMAN
We live in a world where truth is often stranger than fiction, and the new film BlacKkKlansman by Mr. Spike Lee is a very good example. The film is based on the 2014 autobiography of Ron Stallworth, an African-American police detective from Colorado Springs, Colorado who helped to infiltrate the Ku Klux Klan (KKK).
How exactly did any African-American man infiltrate the KKK you ask? He did so by making phone contact with local KKK leaders after seeing an advertisement in the local paper and then working with a white colleague who was his in-person stand in.
I will not give away the plot, but the movie was a reminder of the long history of racial prejudice in our country and how the roots of Trump may be traced back to various sad episodes in our history - slavery, reconstruction, the founding of the KKK. That those sentiments were also evident in our recent history in Charlottesville, Kentucky, and Squirell Hill speaks to the relevance of the issues raised in Mr. Lee's film.
As I watched the movie with Nicholas tonight, I reminded him that there were hateful, intolerant, and violent people in our society. However, I also pointed out that there are heroes like Mr. Stallworth, Charlottesville victim Heather Heyer, and leaders like President Obama who speak out against racial injustice. For it is only by raising our voices together and acting together that we will defeat intolerance and make our American union more perfect.
ASYMMETRY
This morning I finished Lisa Halliday's debut novel Asymmetry. This was in fact my favorite book that I read in 2018 because it highlights the power of fiction to transport the reader and author to wholly different worlds from those in which they normally inhabit.
The novel starts out describing a relationship between an older, accomplished writer who seems to be modeled after Philip Roth and a young editor who embarks on a relationship with him. That Halliday once was an editor and was involved in a romantic relationship makes the first section of the book more of a confession than a departure. However, Asymmetry reaches far beyond the author's comfort zone, and in the latter sections, the novel becomes ostensibly incongruous. This is because the subject matter turns to the struggles of Iraqi-Americans and those who are collateral damage in our incessant "wars on terror" and the end of the line for a literary lion.
That Halliday who grew up in rural Massachusetts from a blue collar background was still able to capture stories of those who are often forgotten in our daily lives, news broadcast, and books and films is truly remarkable. How is that possible you might ask? I believe it begins with a curiosity about whom other people are and what their lives are like. In a word, it is empathy that makes Asymmetry so powerful, especially since this is an emotion that is in such short supply in our lives and world today.
I will not reveal more about Asymmetry, but trust me and check this book out! It will not disappoint, and if questions remain, you can check out these spoiler reviews here and here or just ask me!
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