Evan Handler’s book – week three

Handler 2Just a few notes before we begin our Book Club discussion.  The virus from last week really packed a punch.  I am still feeling the effects, thus the late post.  I did manage to publish a new movie review last week.  The movie was a good one My Life Without Me. Watching movies is easier for me than reading entire books.  So for a while we might see the Movie section grow more rapidly than the Book section of the Reviews page.

As we rejoin Evan Handler, he is engaging in his second battle with leukemia.  Relpase carries its own distinct challenges.  If the initial diagnosis seemed totally unfair, then to have the cancer recur after you have suffered so much, sacraficed so much and fought so valiantly, then relapse is certainly adding insult to injury.  Evan struggles with these issues too.  In addition he has to rectify why his own health has failed a second time even as he embraced portions of New Age philosophies that speak of personal responsibility for health and healing.  In this case embracing the belief that learning to love yourself is a prerequisite condition towards healing yourself.  But if this is true, is its corollary – that recurring disease implies that in some way you did not love yourself enough.  That relapse is, in part, your responsibility also?

His adventures at Sloan Kettering continue to embarass me as a retired professional.  A new oncology fellow rather callously renders an end-of-life discussion at his addled roommate at 5:30 in the morning.  As his infection continues to baffle the medical staff, they start to distance themselves.  I have seem this happen.  I always thought that I was one of the “good nurses” and found myself wishing that I were working at the bedside once more, ready to help people through some of those crises moments.

I hope that everyone has meet a Dr Gee during their own episodes of illness.  “There was a reverence in his touch…Dr. Gee practiced medicine as if he were attempting to commune with divinity.”

I was also struck by Evan’s realization of what his girlfriend had been going through as he lay for weeks in the hospital.   He became more aware of what she was experiencing at his bedside beyound the role of stalwart supporter.  Her psyche was already preparing itself for the possibility of his demise.  And though he accepted it as entirely understandible and appropriate, healthy even, he had difficulty that he now saw in her eyes doubt as well as affection.

The contrast of his experience at Johns Hopkins with that at Memorial Sloan Kettering is evidence of how institutional philosophy can set the tone and standard of its institutional culture.  The culture there, at least at the time, is more egalitarian and inclusive.  Patients and families are included as co-authors of the process rather than objects of it.  I think that this is evidence also of the different cultures of the general oncology world and the world of transplant.  Transplant is borne of oncology but is newer, younger, and, of necessity, was obliged to look at the sick person in their totality.  Transplant employs the concept of rebirth not just as a metaphor but also as a physiological reality.

Evan dreads, as I suspect many of us have, the loaming threat of fungal disease.  As a cancer nurse, I had witnessed too often dangerous. intractible fingal infections.  I remeber sharing with Tish, my own fear pf them when I was an immunocompromised patient.

His return to the Belvedere Hotel, where his parents and Jackie had been living in Baltimore for eight weeks, is triumphant and worry of inclusion in some movie.  Indeed we have seen it before, the returning hero standing meekly before a cheering crowd.  It recalls the scenes of triumph we all experienced when we left hospital.

Reading Assignment: finish the book’s final three chapters and Endnote.

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About Dennis Pyritz

Dennis W. Pyritz, RN, BA, BSN, has been a cancer nurse since 1987 and a cancer and bone marrow transplant survivor since 2004. In December 2001 he was diagnosed with t-cell prolymphocytic leukemia (T-PLL), a rare aggressive form of chronic lymphocytic leukemia (CLL). Dennis was treated with the then new monoclonal antibody, alemtuzumab (Campath) as this disease has a median survival of 7.5 months. He achieved a 26 month remission but relapsed in February 2004. He was retreated with Campath and went into a second remission. In August 2004 he underwent an allogeneic peripheral blood stem cell transplant with his brother, Mark, as donor. Dennis has remained in remission since - a near miracle. Throughout his career as cancer nurse and patient, Dennis has had the opportunity to speal to both lay and professional groups. Dennis has spoken on cancer topics and survival issues across the country as well as in the United Kingdom, Norway, Austria, Portugal, Honduras, Panama, Guatemala, Trinidad, United Arab Emirates, Jordan, Cyrpus, Israel, and India.

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