Every question Leroy asked was important. When he sat with his doctors and discussed treatment, rarely did he accept their suggestions at face value. He had questions, and ultimately he'd say, "What else have you got?"
For some doctors, this didn't sit well. But as you'll see in today's blog from Hopkins radiologist Dr. Joe Herman, Leroy's questions will provide better answers for future patients.
Leroy was a very successful war correspondent. He would leave his family and friends for long periods of time and travel great distances to cover wars throughout the globe. Often he would risk his own life to bring the reality of war and hardship to those at home in the U.S. and abroad. While other reporters would stay on the fringes where it was "safe", Leroy would travel into the war zone where even armed soldiers would fear for their lives... He was determined to tell the real story about war.
In 2001, he was diagnosed with early stage rectal cancer. He underwent surgery to remove the tumor, and he went back to work. Then, in 2005, he developed blurry vision. CT scans showed that his cancer had come back and had now spread to his brain and lungs. He had surgery to remove the tumor in his brain, and was sent to me in January of 2006 for whole brain radiation therapy.
I distinctly remember meeting Leroy. He was a cancer patient, but he was still a journalist. Only this time, he was reporting from the trenches of his own war ... his war on cancer. Although I did not know it at the time, I now realize that we (the doctors, nurses, and other health care personnel) who cared for him may have been similar to the soldiers and civilians he would interview in the war zone.
I explained that he needed whole brain radiation. Why? he asked. While most patients would take my explanation at face value and accept the radiation, he persisted. What are the side effects? What happens if new lesions appear? Can I get more radiation in the future? What are my other options? His inquisitive journalistic nature persisted.
Only this time, it was Leroy's war, and he wanted to make sure he would be able to continue reporting as long as possible. He was concerned that whole brain radiation might decrease his memory and cognition. We discussed the potential risks and benefits of whole brain radiation, and after we addressed his questions, we decided to delay the treatment and start chemotherapy.
This experience and many more over the years have taught me the importance of educating patients and listening (very carefully) before making final treatment decisions.
Over the next few years, Leroy received chemotherapy and radiation therapy to many body sites from another physician in our department. I saw him in passing one day when he was waiting for his radiation, and said hello. Soon after, I was flipping through the channels and saw his Ted Koppel special on TV. Leroy was again reporting about his war. He was presenting the bitter truths about the war, his war, on cancer. His comments about his struggles were poignant and, to some, maybe controversial, but they were honest.
Dr. Meyer (his medical oncologist) asked me to see Leroy again for some palliative radiation to his spine. By this time, his disease had progressed. He was clearly losing the war. Like a strong soldier, he had suffered through many hardships, including chemotherapy, radiation, and radiofrequency ablation of lung nodules. He had had brain and spine surgery. He was often in pain and required medicine that caused confusion and constipation.
Despite this, in his trenches for the final time, he reported on his war. Thousands logged on to his blog daily to hear about his war on cancer, and were amazed by his perseverance and determination to survive despite his suffering. He fought cancer with the same pride as the soldiers he had reported on over the years. He was determined to win, despite the cost and suffering that it might cause him. He was an inspiration to others fighting the war on cancer, including me.
Leroy and his wife Laurie invited me over to their home for dinner about two months ago. I have to admit, I don't usually have dinner at my patients' homes. I am not sure why I don't, but for some reason, the doctor/patient relationship often doesn't leave the hospital.
I had grown quite close to Leroy and Laurie, like many of my patients, and was very intrigued by both of their life experiences. He was a war correspondent, and Laurie was a sports reporter in an era when women were not very welcome in the clubhouse. Both of them survived very hostile environments.
As I ate nachos (great salsa) and sipped wine, I listened to their stories and memories from over the years. I was so impressed by their relationship. How strong their bond remained, despite being away from each other for long periods of time. Laurie explained that sometimes the only way she knew he was still alive was if she saw him on television on the evening news. Leroy shared stories about risking his life in Iraq and the death and suffering he saw in Rwanda.
It was then that I realized we shared a common bond. We both met people daily where the space between life and death may be very short. Leroy met soldiers and civilians in war zones where they knew that life might be cut short by an attack. As an oncologist, I meet patients daily who have terminal cancer, and whose deaths may be imminent.
Knowing that the people in front of you may not have long to live changes you. It makes you appreciate every minute you have on this earth, and inspires you to make a difference. Although Leroy was losing the war on cancer, he was still determined to make a difference by sharing his story.
Leroy also shared with me how we (the doctors at Johns Hopkins) had succeeded, and how we had failed. While he was very happy overall with the care we provided, he specifically stressed, "It's very important to listen to the patient and explain what to expect with each treatment. For example, the radiation table is very hard and the room is very cold. It seems like a basic thing, but to us patients it is a big deal."
Lance Armstrong often says that you can beat cancer if you fight hard enough. Unfortunately, for some patients, no matter how hard they fight, the cancer is destined to win the war. This was the case for Leroy.
Although he has left us, he has left a legacy. His final report on war -- his war -- is one that has touched all of us. I know I am a better doctor for knowing him, and will continue fighting this war for him.
-- Laurie
7:00 AM ET
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08-27-2008
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