Tuesday, November 01, 2016

A Brutally Candid & Profoundly Inspiring Book About Looking Death In The Face

When I suffered a stroke in 2002, chance occurrences -- which is to say a large element of luck -- had much to do with the course of my treatment and recovery. 
If you are going to have a stroke, I would highly recommended that you do so while in bed with a critical care nurse, which my companion of many years happened to be.  After I struggled to wake her, she diagnosed me in a flash and within a very few hours had talked our way through the ER and upstairs to the stroke unit of a very good regional hospital where it turned out that the neurologist on call not only was highly regarded, but serendipitously was a blast from my past -- my late mother's neurologist and the only physician who had been astute enough to see that she was not suffering from Parkinson's but had an exceedingly rare brain disorder.
After Frank Sadowski returned home from a vigorous workout at a Seattle area gym in October 2007 and to his horror peed blood, chance occurrences also would prove to be important to his very survival. 
When Frank's wife drove him to an ER, the urologist on call was the very best in the Pacific Northwest save for one other specialist, an acquaintance of the doctor who serendipitously was the very best in the region.  The first specialist diagnosed Frank with late-stage bladder cancer, which is so virulent that the three-year mortality rate is a sobering 95 percent even with the most successful initial outcomes.  The second specialist, Dr. Sia Daneshmand, took over Frank's case in a mere day or so and to Frank's horror but eventual acquiescence scheduled radical surgery to remove his bladder and fashion a neobladder out of a section of his small intestine after explaining that anything less would be a roll of the dice because the chances of an eventual recurrence of cancer were extremely high.   
It helped immensely that Frank's wife was smart, astute and loving, and was a cancer survivor herself.  But what really shines through in Frank's eloquent memoir of his ordeal -- Back to Life: A Bladder Cancer Journey -- is his indomitable will to live.  He simply never gave up. 
Back to Life not only apparently is the first book to discuss metastatic bladder cancer from the perspective of a survivor, it is a gem.  
Frank (and I refer to him by his first name because we are longtime cyber buddies) was an editor of my college newspaper several years after I departed, then went on to a career in consumer electronics and e-commerce.   He certainly was less prepared to fight bladder cancer than he was to write a book about it, because he writes beautifully, imparting Back to Life with a plain-spoken passion and self-deprecating humor. 
He elected to have his surgery as soon as possible, which turned out to be four days before Christmas 2007.
As they started the IV and made me comfortable in the pre-op area, I was not the slightest bit nervous or concerned.  I was so relaxed that when they told me they were going to inject a mild sedative into my IV so I would not be anxious, I joked that I might pass out and miss the whole show.   I did mention I was incredibly thirsty, and told them I was concerned about dehydration. They assured me that they were hydrating me with the saline IV and that I would be able to have ice when I made it to recovery.  Here is where I would ordinarily crack the obvious joke:  "You mean, if I make it to recovery."  But not today.
The operation took almost eight hours. 
Dr. Daneshmand pronounced it a total success.  He had built a new bladder out of my body parts. . . . They had snipped a small section of the ureters and urethra and rushed them to the pathology lab as a biopsy.  It was only after the biopsies were determined to be completely cancer-free that the decision was made to proceed with the neobladder.
If the surgery and in-hospital recovery had been difficult, the days after Frank returned home were hell.  He was encumbered with a catheter, urine bag and other post-surgery accouterment.  He fell on his face in the bathroom, dislodging the catheter.  But nights were the worst because he began hallucinating banks of television screens, among other fantasies, instead of sleeping because, in part, of the powerful painkillers he had to take.
The images began to change, morphing one screen at a time from moving patterns of colors into images and snippets of what looked like TV shows. . . . I saw people I knew and strangers, places that were vaguely familiar and strange alien landscapes. . . . I was losing my mind. 
Frank describes the return to Dr. Daneshmand for a 25-day follow-up examination as "the second-worst day" of his life.  The doctor explained that they had found and excised a second tumor in his bladder that had been hiding behind a cauterized layer of tissue from an earlier procedure, but every lymph node was clean.  Frank was in full-blown remission.
I felt as though I was about to lose it and just break down and cry. . . .  After a few minutes, I composed myself somewhat and looked tearily across at this face.  His smile was back. 
"You saved my life," I said. 
"You made the hardest decision of your life, and no doubt the best.  So, no, Frank.  I did your surgery.  You saved your life."  
Back to Life includes a chapter on sex, which Frank warns might give the reader "a case of the yips." Long story short, he and his wife were able to resume "a real sex life" less than eight weeks after his return home, and he also was able to resume bike riding, which was his great passion.
Where we used to bang out fifty to sixty-five miles on a weekend ride, I felt myself hitting a brick wall at about thirty-five miles.  Thirty had become the new sixty. 
Frank had the benefit of comprehensive health insurance and access to top-notch care because he made big bucks and had caring employers, something he does not mention.  
At the time of his surgeries in 2007, nearly 50 million Americans had no health insurance and would not have had his medical-miracle treatment options, or any options at all, had they been diagnosed with late-stage bladder cancer.  They probably would have died.   When Back to Life was published in 2015, the number of uninsured had dropped to 28 million -- which is still scandalously high for a supposedly advanced country -- because of Obamacare, and perhaps more lives were saved.   
And so Frank also had a bit of luck being who he was, although that should not take anything away from his ordeal, ferocious determination to live and the power of Back to Life.
As Frank regained his strength, he resumed international travel and found, to his shock, that the Japanese he encountered were shunning him because he had had cancer.  People in other countries generally were more sympathetic, but he acknowledges the stigma and pain cancer causes when friends vanish suddenly.  And then there is the inevitable survivors' guilt, which can lead to depression, which Frank himself succumbed to a few years on.  An antidepressant has taken care of the problem.
The vocabulary of those writing about cancer is dripping with comparisons to war. Nobody dies from cancer; they "lost their courageous battle."  Almost every one I have spoken to in the cancer community hates this.  As one of my favorite cancer wits puts it, "When someone dies in a car accident, you never hear about how they lost their brave battle with a Subaru."
Most commonly, cancer survivors want to forget the entire awful experience, while some devote much of their lives to counseling those with the disease, as well as their loved ones, as Frank Sadowski has done.   
And in his case, even write a brutally candid and profoundly inspiring book about looking death in the face and then staring it down.  

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nina said...
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