By Isaac Van Sligtenhorst
Isaac van Sligtenhorst is a physician-in-training in the Texas Medical Center. He blogs about his training, as well as battling cancer from the perspective of a caregiver. Read more of his approach to grief, hope and life-in-general at heartofalonelyhunter.blogspot.com.
Monday morning, brand new week.
I took a jog in the morning sun before the thermometer had a chance to flirt with triple digits. I don't particularly like running.
In fact, after about the first mile, I pretty much hate it. But I need to exercise and I need something mindless. So I go for a Monday morning run. Exercising means music and I crank it up.
And out of the blue, a line from a song hits me like a blow to the stomach.
"Suddenly, you were gone
from all the lives
you left your mark upon... "
Waves of sadness
The waves of grief and sadness over the loss of my brother from thymic cancer have been flowing over me with greater occurrence lately.
Sometimes, they are triggered by events that warrant anticipation or expectation - holidays, birthdays, special occasions. Surprisingly, those I can handle because I expect it and brace myself for the emotions. It's those little ones that creep out of nowhere, like a predator stalking a prey that is unaware of the danger lurking around a corner. Sometimes, they're brought on by a song, sometimes by a dream, or many times by nothing at all.
Those are the ones that hurt the worst. And they're becoming worse. Like running while tears flow freely down your face.
Though his death was five months ago, visions of my brother's final days still flash freshly through my mind. I let them dance in my head and eventually they fade.
But forecasts of something going horribly wrong with my dad are right behind them.
We know he has an aggressive Chronic Lymphocytic Leukemia (CLL). We know any meaningful remission is out of the question. We know a stem cell transplant is his only chance at life. We know the first attempt at collecting stem cells from his brother failed.
It seems we know a lot and yet nothing simultaneously. I'm out there trying to clear my head before going to class. Apparently "clearing my head" is permission for something else to take its place.
And then another song shuffles through the iPhone of my brother with these lyrics:
"For my father and my brother
It's too late
But I must help my mother
Stand up straight"
That's it. Forget this. I'm done with running and am actually looking forward to school by now.
Exercise has done anything but unwind me.
Can't escape this disease
I drive the 33 miles down to the med center for my group work, where for two hours every Monday, Wednesday and Friday, eight of us, under the instruction of a doctor, unravel a case and practice how to be physicians.
Pieces of information are fed to us slowly with probing open-ended questions so that we can hone our skills at each stage of the diagnosis and treatment.
This case? Patient comes in with fatigue and unexplained weight loss. After identifying the "problem list," we're now free to start compiling our Differential Diagnosis.
There's a bit of a pause becomes symptoms so nondescript as this patient can be almost anything. But I say, "Anytime there's unexplained weight loss, especially with fatigue, you have to include cancer."
As the scribe today, I write that as the first line on the dry erase board: C--A--N--C--E--R. I know too well where this case is going and I bet it's not going to end well.
I can't run fast enough to escape this disease.