Thursday, January 28, 2016

Happy New Year


I find I greet the new year with both anticipation and anxiety–anticipation because it’s the start of a new year, and all that is coming up­–my children’s next birthday, the next Dizon family reunion­ and also, all that is possible: submitting a grant, publishing a book, travelling to a place I’ve never been. Anxiety too, because I realize that all the work I’ve committed to will become due–papers to be written and talks to be given. All the while, the clinical practice of oncology never stops. Patients still get admitted, new patients are still scheduled, and my established patients continue to be seen in clinic.

This year, however, has thus far been tinged with sadness. We have seen the deaths of several high-profile figures and their passing has been marked far and wide­­–David Bowie, Alan Rickman, Lemmy Kilmister, and René Angélil. Each time the news broke, my thoughts went to the lives each lived, the momentous roles they played in American (and international) culture, and to their families, knowing each would be missed in a profound and personal way that only loved ones can experience. At the same time, I knew each would be celebrated for just how many they touched.

But I realized as well, patients continue to die due to cancer or its complications, far from the national headlines. And this was true in my own personal circle. My friend, Nora, also died of cancer; in her case it was lung cancer. I had tried to help as much as I could in the three years she was treated­–finding a multidisciplinary clinic in the South Pacific, choosing chemotherapy that made the most sense for her (and afforded the best chance of survival), navigating insurance to ensure her tumor was tested for mutations, and then arguing with them for erlotinib when we found out it harbored an EGFR mutation. Through it all, Nora lived. She never became a “cancer patient.” Alongside her spouse, Bernie, she prioritized friends and family, choosing treatment at home on Guam, rather than travel to the continental U.S. for the “best” treatment, especially if it meant the possibility of never seeing the shores of the South Pacific ocean once more. Towards this last year, we had successfully obtained treatment with a PD-L1 inhibitor for her, but unfortunately, it made her sicker instead of helping. She had become oxygen-dependent, but despite this, continued to live her life as best as she could­–and it was pretty good. No matter what cancer threw at her, she saw her cup as half-full, never half-empty.

If I could convey how Nora’s life was lived, it would be to use the widely used term “survivor.” Yet, the term seems wrong. Nora did more than survive–she lived. She travelled, she threw parties, she saw friends, and she laughed often. Even when I last saw her­–toting an O2 tank around–her eyes sparkled and she smiled brightly. Even when talking was hard because she would easily lose her breath, she engaged all of us, and while her death did not make the front page of any newspaper, it was a profound moment for all that knew her.

With her passing, I realized that cancer continues to threaten the lives of many, and deaths from cancer are going to continue even as we strive for better ways to prevent, cure, and treat the disease. But my hope for 2016 is that we all embrace a common wish for our patients and their loved ones with cancer. Let’s help them live, live well, and laugh often. Let’s understand their goals, their preferences, and their wishes. Let’s help them prepare for an uncertain future, but learn to see what is here, right now.


And to social media, I posted one last remembrance of my dear friend:

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