Medical realism often focuses on death, not life

Life and Death. That’s how we always say it. In that order.
Of course we prioritize Life. But there are times when Death comes first.
Right now, I’m thinking about the recent death of Jeffrey Weiss, a hero to all the readers of the Dallas Morning News who learned from him not just about his terminal cancer, but how he was handling it, and himself. His series, Going Out Like Fireworks — those long pieces on knowing he was nearing life’s finish line but wanting to make his last steps really count — was education and truth combined, offered as final gifts from a truly gifted journalist.
Ironically — or perhaps one of those seeming “coincidences” I’ve learned to call occasions when God wants something done but would prefer to remain anonymous — I’d just finished reading Swimming Upstream, the harrowing account of a dual struggle: one doctor fighting unbelieving others to get help with his dreadful cancer he had diagnosed on his own.
I recently wrote about having had, years back, removal of a parotid gland tumor that left me with unpleasant salivary effects, plus a long-lasting Bell’s palsy followed by partial, permanent facial paralysis. Dr. Sajjad Iqbal, a Pakistani American practicing in New Jersey, got the Bell’s palsy first, before diagnosis of his disease. If I hadn’t had such a quick diagnosis, that would probably have happened to me. But his cancer threw off the medicos whom Dr. Iqbal consulted, because Bell’s palsy can have many causes. I think now of that old saw: “Physician, heal thyself!” I’m happy that, after he had diagnosed his own problem but was rebuffed by many other doctors, he finally found help in my own hometown, and from among our own people — a Jewish doctor in Pittsburgh who listened to him when he had figured out for himself what he was dealing with, and — most importantly — believed him.
My own father, a long-ago physician who wouldn’t even recognize medicine today, gifted me with this life-saving advice: “When you are too aware of any part of your body,” he would say, “there is something wrong with it.” That persistent little lump behind my right ear was hardly worth noticing, but I paid attention to it, and took it to a doctor who made a quick diagnosis and did quick surgery to remove the tumor, which turned out to be “mixed”: full of elements including potential cancer. Dr. Iqbal’s tumor was full-blown cancer before his diagnosis was believed, and his book is the saga of the consequences of delay. But after walking a very hard road, he is still alive to tell his tale.
I wouldn’t recommend this whole book to everyone, but I would say its final two sections ought to be required reading for all adults. Bright Hope on the Horizon is encouraging: “Recent progress in medical research has dwarfed that of even the last few years,” he says. “Today, we can look back on how we treated cancer as recently as the 1990s and equate it with the Dark Ages.” What he calls the “one-size-fits-all” use of chemotherapies has given way to targeted treatments and the recognition that one cancer, when spread to other organs, may not be a new cancer, but a “relocation” of the original, needing the same treatment. And he cites glioblastoma as one of the cancers benefiting from this new knowledge.
The book was written just this year; glioblastoma is what killed Jeff Weiss. Unfortunately, the new studies and treatments have not yet reached the point where they could save him. And Dr. Iqbal is, of course, a medical realist who knows that promising research takes time for fulfillment, and there is not always enough of it for any particular individual: Death.
His last section — You Have Cancer — Now What? — offers both physical and emotional approaches to confront this enemy, but no promises. Not everyone wins, as he has, at least for the present: Life.

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