June 14, 2016

Cancer patient to intern and the power of relationships

Imagine sitting face to face with your doctor and hearing those words that no one wants to hear “You have cancer.” Do you know what would go through your mind? What would you do? Who would you think about? Well, it happened to me 386 days ago.


My name is Jake and I’m the new intern at Fifth Letter.


There’s a certain journey of self-discovery that you’re forced to embark on when you’re faced with a disease killing you from the inside out. I refused to take that journey for about 5 months after my diagnosis. My doctor, being the realistic, experience driven oncologist with 40+ years practicing medicine under his belt, told me that while my disease was serious, my prognosis was great. Ninety percent of patients with Hodgkin’s Lymphoma respond to ABVD chemotherapy. I liked those odds.


“Not to belittle your disease, Jake, but you’re going to be alright.”

“Great, thanks doc.”


Sure, I had to cancel last summer’s internship plans and began biweekly chemotherapy treatments, but with my doctor’s words ringing in my ears, my mindset remained unchanged. I would get the treatment I needed and in 6-8 months, I’d be cancer free, living as any 21 year old would.


In the months following my diagnosis, I lived at home, slept abundantly, and dealt with the unpleasant side effects associated with chemo. To be honest, though, as a 21 year old who was otherwise completely healthy, the chemo was manageable—it felt like an annoyingly consistent string of really bad hangovers. Not fun by any means, but tolerable. So tolerable, in fact, that by the end of the summer, I had convinced my parents that I was ready and able to return to school that fall.


Walking a thin line between resilience and stupidity, I began the balancing act of taking classes, biweekly chemo, and running No Bad Apple, a venture making it easier for the Wake Forest community to have access to local and organic foods.


I thought I knew what it meant to be resilient; I thought resilience was about persevering through trying times. So there I was, persevering to continue working on my passion—making good food more accessible.


On Thursday, October 8th, 2015, I fractured one of my lower right ribs playing flag football. If I was going to be back at school, you could bet I wasn’t giving up on the all-important intramural sports. And if I was going to be playing intramural sports, you can bet I wasn’t giving it anything less than my all. And when you’re giving it your all, occasionally you break a rib.


The very next day I had my second PET scan since starting treatment. I was walking into my house at 5:34 pm when I got a call from my doctor. My heart sank, there’s no reason my doctor should be calling me at 5:34 on a Friday evening. She informed me that the lymphoma clusters in my chest had increased in both mass and energy uptake. The cancer was resistant to the chemotherapy. I was in that 10% of Hodgkin’s patients that don’t respond to ABVD chemotherapy. My life expectancy had just gone from normal to somewhere between 5-12 years.


That journey of self-discovery was thrust upon me like a dodgeball to the face.


As I began the next phase of treatment, including much more potent chemotherapy, frequent hospitalizations, radiation, and the works, my mindset became less about my career aspirations and more about whether I should get out of bed to vomit. You’ll learn humility when, as a 21 year old, you have to call a nurse to help you clean yourself because you’re too weak to do it yourself.


In this strange alternative reality inside the hospital, living treatment to treatment, I kept thinking to a book I had read in my freshman year English seminar. In Cormac McCarthy’s The Road, the reader follows the journey of a father and young son in a post-apocalyptic world as they search for food and safety. Initially, you’re continuously disappointed as the duo struggles to make it in the man eat man world while the ailing father’s condition worsens. Eventually though, as they persistently chase safety on this endless road, you begin to realize the book is less about their attempt to navigate the outside world, and more about the relationship between father and son. What is life if nothing else than the product of your relationships with others?


In my medicated haze, my outlook on life began to shift as my daily routine became ultra-simplified: wake up, attempt to eat, see doctor, attempt to eat, see family/friends visiting, attempt to eat, attempt to sleep, repeat. The only things that mattered were my blood counts and whom I got to see that day. My life was distilled down to a piece of paper indicating my well-being and my relationships with people that mattered to me.


Last November when you sat down at Thanksgiving and took a minute to express what you were thankful for, what came to mind? Health & loved ones?


Here I was living a life without the normal clutter of life. Maybe I wasn’t having those Cheerios Commercial family moments with ear to ear smiles all around the table, but I was living where my road dumped me, adopting those values in the most literal sense (and we watched Arrested Development to fabricate a few of those smiles). The world is a big and scary place, but your heart and soul belong to you and the people you care about. What else matters?


Three hundred and eighty six days after this saga began, I’m sitting in the Fifth Letter office in downtown Winston, recovered from my treatments, and am eagerly awaiting my next PET scan. But even as my day to day has normalized, I often think back to those hospital days and the lessons I can take away from that simplified life. I don’t know what my future will hold and none of us do, but I can assure you as I stumble through life (and maybe break more ribs), I’ll worry more about who I’m stumbling with than where I’m stumbling to.