AT THE STARTING LINE

AUGUST 11, 2022 – Eight months into my “diagnosis,” I summoned the curiosity (actually, the courage) to Google, “multiple myeloma.” The online Oxford definition squares with what my oncologist told me at the outset: “A malignant tumor of the bone marrow.” Elsewhere on the internet, I read that the disease is “rare,” with only 200,000 cases reported in the U.S. each year.

“Rare”? Hmm. My dad died of it (in his late 80s; wholly untreated), as did my father-in-law (20 years ago at age 82). Also, a neighbor—another lawyer—who lived across the street from my parents; and a good lawyer (yet another!) friend of a good lawyer friend of mine. More “Hmmm” (or, “Too many lawyers!”) Then the kicker: While I was waiting for an infusion a few months ago, who should walk by the room but a former member of my five-member book club—a guy also recently diagnosed with multiple myeloma, after months of misdiagnosed “back problems.” (Rest easy: he’s not a lawyer.)

In fact, symptomatically, the disease usually manifests in bone pain, often in the back, as the result of multiple (hence inclusion of that adjective in the name) skeletal lesions. As my oncologist reported after a full body scan, “Your skeleton is like Swiss cheese.” That’s why he told me, “No skiing for you—this season.”

I hung my ski hat on the implicit optimism in “this season.” Sure enough, early this spring, after the treatment regimen prescribed by Dr. Kolla had worked its intended effect and he discussed with me the next phase—the stem cell transplant I’m about to undergo—he said, “You’ll be skiing next season and for many seasons after that.” (Part of the treatment includes restoration of the bones.)

He added, “The transplant won’t be a picnic. I’m not going to sugarcoat it. You’ll feel pretty crappy for a couple of weeks, but then you’ll start feeling better, and within a couple of months, you’ll get back to normal.” I appreciated his use of medical jargon that I could easily grasp.

When, pursuant to Dr. Kolla’s referral, I made my way to the nearby University of Minnesota for the transplant business, I encountered another whole world of top-flight medical care. However “rare” my condition might be according to the internet, the BMT (“Bone Marrow Transplant”) group at the University of Minnesota cancer clinic treats multiple myeloma otherwise. Thanks to remarkable advances in research, “autologous [meaning, my own; not a donor’s] stem cell transplantation” has become the standard of care, and the U of MN has become a leader in that  research and its application. For me, the entire process will be conducted on an out-patient basis, with daily (including weekends) visits to the clinic for monitoring.

Being an “out-patient” doesn’t mean I’ll be “out and about,” however. First, in the words of my good doctor, I’ll be feeling “pretty crappy.” Second, the chemo-blast portion of my upcoming procedure will obliterate my immune system. Until my blood counts are restored, my spouse and I must reside in total isolation (except for the daily trips to the clinic, masked to the max). Additionally, all my vaccinations and inoculations—going back to childhood—will be knocked out; the “resets” have to wait a year. (Fortunately, I’ve received an injection of Covid-19 anti-bodies under a recent FDA emergency authorization; these will survive the chemo-blast, and by the time they lose their efficacy, I’ll be eligible for a Covid vaccination (an exception to the year-long wait for all the other shots).)

Throughout my treatment—the initial phase and the ramp-up for the stem cell transplant—every single care-giver with whom I’ve interacted, exudes expertise, competence, confidence, and caring—all of the highest magnitude—and exhibits genuine enthusiasm for their individual work and collective mission. All involved in my care have found their calling. This extraordinary commitment impels me to make everyone involved a winner.

The cost of this world-class medical care is doubtless staggering. Given my senior status, much of the expense is covered by Medicare; another significant portion is paid through supplemental insurance. All this coverage, of course, far exceeds my premiums.  But please know, fellow tax/premium payers, that my mindfulness of the expenditures provides enormous added motivation: I’m determined to make every cent worth it by staging a full comeback and going way beyond that—by serving others as I’ve been served. I will give people, love and light as I’ve never so given in my life to date.

And to honor my dad, my dad-in-law, my parents’ neighbor, the friend-of-a-friend, I will barrel through the next several weeks of predicted unpleasantness and enjoy thereafter, an abundantly wonderful life for years to come.

Last but hardly least are you, my friends—my fellow travelers, however vicariously. I’ll keep you at my side as I plunge into the adventure that awaits me. I’ll make you cry and laugh and ponder as I curse and struggle, then smile. In due course, you’ll accompany me across the deserts, through the jungles, then up the icy peaks into rarefied air. And why? Aha! For the vista of realms that will inspire and edify, give greater meaning to life, and reveal the better sides of our humanity. The loneliness of the long-distance runner will be overcome, then overwhelmed, by the mutual support of us joint-expeditioners.

Now . . . on your mark, get set . . . (Cont.)

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© 2022 by Eric Nilsson