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[maineman]

In November 1993 my best friend and colleague showed up in my office unable to breathe. He was a terrific person. Never smoked or drank. Was excellent in his profession. Was enormously generous to all. Ate a well balanced diet. Exercised. I diagnosed him with Acute Myelogenous Leukemia. The worst kind you can get. Over the next 2 years he suffered miserably due to his disease and the horror of chemotherapy. Weight loss, hair loss, diarrhea, vomiting. Memory loss, etc. He recovered 100%. He is thriving. He is flush with health and money, having just opened his 3rd office. He is happy, alive, and beaming. He thinks only of the future and how he will be able to give and give and give. He got lucky. Had he gotten sick even one year earlier he would be dead, but due to the rigorous and diligent work of scientists acting together around the world, through careful scientific scrutiny, trial, error and, success and confirmation, he was able to benefit from our major breakthroughs in cancer therapy. He, and subsequently many others are alive and well. To see him is to smile, smile smile. Three years ago the 43 year old son of a couple I take care of presented to the office. He was a carpenter. Smoked a few cigarettes a day and popped a few beers every night. He was otherwise well. He said that after a beer or 2 his tongue felt "thick" and he began to garble his words. I diagnosed ALS, or amyotrophic lateral sclerosis, or "Lou Gherig's Disease" (see Tuesdays with Morrie). We referred him for appropriate care. His wife does not "believe" in doctors. She goes to the health food store. She did not let him go to the specialists. She got a diet off the Internet from Australia from someone who claims to have "survived". His parents came to me worried, but we were unable to get past his wife. She switched him to a "ketogenic" diet after reading some books. The last time I saw him was just before he died, at age 45, on a ventilator in our Intensive Care Unit. He was unable to talk, due to the tube in his lungs. He looked petrified. He had lost 70 pounds from his wife's diets and was skin and bones. I am haunted by the look in his eyes every day. Last week a patient of mine who is otherwise very healthy, a deligthful psychologist, doesn't smoke, etc. presented with a lump in his groin. He thought it was a hernia, but I did not. We removed it. The biopsy came back B cell lymphoma. The CT scan of his chest and abdomen show several suspicious lymph nodes. He feels great, has no symptoms, no weight loss, etc. His wife does not believe in doctors. She is into "vitamins" and spends a lot of time at the health food store. They are neighbors. We "debate" on a regular basis while out walking our dogs. B Cell lymphoma is one of the cancers we've had great success with. He has an appointment with the oncologist in 2 weeks. I wonder how this one is going to turn out? Stay tuned.... maineman