You’ve Got 3 Months To Live

I had always been skeptical of stories about patients who were cured of cancer by eating a certain root or drinking an extract of elderberries, or such.  I would feign interest while to myself I would say, “idiocy.”  Life subsequently made me less of a scoffer.  In Love, Medicine and Miracles Bernie Siegel states that every doctor has a cancer patient who experienced an unexplained cure.  In fifty years of practice I encountered two; each was puzzling and humbling.

The first was Nick, a retired steelworker, who came to my office because of abdominal pain.  Reluctantly he consented to being hospitalized.  When routine tests failed to turn up any cause for his pain, I performed a nuclear scan of his pancreas. This was my first attempt at such a scan, as I had just returned from three days of studying the procedure in Cleveland.  To my unabashed and disgraceful joy the scan showed a tumor.  How proud of myself I was with my newly discovered talent.  A subsequent biopsy demonstrated malignant cells, confirming a diagnosis of cancer of the pancreas, a death sentence since almost all such patients at that time died within one year.  Nick refused to undergo surgery, which seldom helped anyway).  I told Beth, Nick’s wife, that there was no other treatment (these were the days before chemotherapy, fortunately for Nick as it turned out) and that his days were numbered in months, not years.

To my surprise and chagrin Nick never returned to my office.  Periodically I kept in touch by phone, hearing only that he was well.  I remember one particular phone conversation with Beth.  “Can I speak with Nick?”

“He’s out in the garden.”

“How’s he feeling?”

“Fine.”

“How much weight has he lost?”

“None.”

“How’s his pain?”

“He doesn’t have any.”

Desperately seeking to elicit one little symptom, I pleaded, “Does he burp?”

“No. He’s just fine.”

In disbelief I had eminent pathologists review the microscopic samples taken from Nick’s pancreas.  Always the same answer: “cancer.”  And my Cleveland mentor confirmed my interpretation of the nuclear scan. My isotope scan of Nick’s pancreas was even published in a textbook of nuclear medicine as a proven case of cancer of the pancreas!

Five years after my prediction of an inevitably early demise, an ambulance brought Nick to my office parking lot for the formality of my pronouncing him dead.  At my urging Beth agreed to an autopsy.  Knowing what the pathologist had to find, I prevailed upon him to be more meticulous than usual.  Lo and behold the cause of death was an acute myocardial infarction, a common heart attack; there was no cancer to be found.

With no other hypothesis to fall back on, I’m left with believing that perhaps Siegel’s thesis is correct, that a proper attitude on the part of the patient can positively influence the course of his cancer.  I now, at least, recommend gardening.

Helen, my second miracle case, was a nurse at my hospital and a personal friend.  How proud I was of myself, and yet wretched (in that order), when I diagnosed colon cancer from a barium enema I performed in my office.  I had to remind myself that I hadn’t put the cancer there.  On Thanksgiving Day that a cancer surgeon operated on Helen.  I watched as he deftly removed the cancer and one cancerous lymph node. 

Three months later while I was out of town, Helen experienced renewed pain in her abdomen. I received a phone call from a surgical colleague.  “Dave, I just opened Helen’s belly.  It was sprinkled with tiny metastases everywhere.  Oh, yes, I did splash in some nitrogen mustard (the only chemotherapy drug at that time) before I closed her but you know that can’t do much good.”  The surgeon told Helen’s husband that she had three to six months to live.  I concurred.

Against all odds, Helen continued to live in good health defying my prediction, just as Nick had.  Questioing my initial diagnosis, I sent tissue samples from both of her surgeries to two university pathologists who confirmed the diagnosis of metastatic cancer.  Not one of the many oncologists I consulted would credit the nitrogen mustard for her remission.

In the ensuing years Helen remained symptom-free with occasional checkups disclosing absolutely no abnormal findings.  Her husband would ask, “Doctor David, how do you explain our good fortune?” 

At a loss for words on each occasion once I did offer, “Well, you know that the night before Helen’s first operation, I attended a Brotherhood meeting with Bishop John Wright (later Cardinal Wright) and he agreed to offer a special prayer for her.”

 Helen lived thirteen years, after the second surgery, continued nursing (not gardening), until death came from a massive stroke.  It was not surprising to me at that point that the autopsy showed no evidence of cancer. 

Whatever the reason for these miracle patients, it is incumbent on me, and all physicians, to be truthful and humble; that includes not setting rigid limits on the projected life span of any patient.  I only wish that when I used to estimate the amount of time “left,” I could have been wrong an additional time or two or three ….

(Abstracted from my memoir, By All Means, Resuscitate)