Young children are natural risk takers. I delighted watching my granddaughter, Lexi, when she was learning to walk. She pulled herself up on the leg of a chair, took a wobbly first step and fell. Undeterred, she pulled herself up on the chair and tried again. Lexi fell many times. Eventually she maintained her balance and took her first step. She progressed in the way we all grow: by falling or making mistakes and learning from them. Lexi had courage. She didn’t fear failure.
Thomas Edison failed ten-thousand times inventing the long-burning electric light bulb. One attribute of his genius was to call these “failures” feedback. He used each “failure” as a stepping stone that led to his next experiment. He was bold. The German philosopher Goethe observed: “Boldness has genius, power, and magic in it.”
Having courage and being bold can save your life. My wife, Mary Elizabeth, showed me how. Not so long ago she received a call from her primary care physician, Dr. Mark Smitherman. He requested that she get a new chest X-ray to follow up on a small spot that had shown up some months earlier. “I don’t want to get this X-ray,” she said. “What if I have cancer?” In spite of her reluctance she got it promptly. The result was equivocal. Only one of the six radiologists who viewed the spot thought it could be cancer. Five did not. I hung onto the fact: five saw no cancer.
Both of Mary Elizabeth’s parents had died from lung cancer, her father in his fifties. I did not want to think she might have cancer. I told myself the spot was most likely another remnant of her histoplasmosis exposure, a fungus common in children who grew up in the Ohio River valley. Spots from this fungus had shown up in her previous chest X-rays.
Dr. Smitherman recommended that she get CAT and PET scans. She got them immediately. The scans were inconclusive. Dr. Smitherman referred her to a pulmonologist. We went to this lung specialist, who looked at her X-rays and scans and did more pulmonary tests. His findings were inconclusive. He recommended a biopsy of the spot in her lung. She immediately had the lung biopsy. It showed hyperplasia, an abnormal increase in cells, but not cancer.
By now a growing dread that Mary Elizabeth had cancer gnawed me. I kept it to myself. At moments, however, I found myself thinking what my life would be like without her. A deep pain stabbed my heart as I pictured myself alone, without my life’s companion. I would lose the person with whom I share memories of forty years together, of parenting of our children, of grand parenting of our grandchildren, of caring for Jack, our grand-dog, and of meals with our friends. I count on her to give me honest feedback about my writing and my teaching. I would lose the person with whom I sing, “It’s a Good Day for Singing a Song” as we arise in the morning, with whom I pray, hold hands, and sing “Praise God” before dinner, whom I kiss good morning and good night.
Through the years my wife shared with me her fears about having cancer. She prompted us to have total body X-ray scans a few years ago to make sure we did not have cancer. These studies first showed she had spots in her lung from histoplasmosis. Her vigilance regarding cancer motivated her to take action quickly when phoned by Dr. Smitherman. Her father was visiting her when his lung cancer was diagnosed. It had spread through-out his body. She cared for him in the hospital and was with him when he died a few weeks later. Years later she went back to Ohio for months to take care of her dying mother. She was facing her worst fear: having lung cancer like her mother and father.
The pulmonologist recommended she consult a surgeon. “It’s too much,” she said. “I don’t have the energy to find a surgeon. I’m tired, exhausted. Would you find one for me?” I readily undertook the task.
I phoned Jeff, a friend who had experienced surgery for lung cancer. He had undergone a thoracotomy, a chest operation, to remove one lobe from his lungs. Jeff told me he still had pain and felt fatigued nine months later. His operation required a twelve inch incision from his chest to his back, the breaking of three ribs, and cutting through the muscles of his chest.
From talking with Jeff I was determined to find a minimally invasive form of surgery for my wife. I searched all over Florida where we live. I found Dr. Eric Sommers at Tampa General Hospital who performs robotic surgery for lung cancer. He was less than an hour away from our home in Clearwater. We liked Dr. Sommers immediately for his straight-forwardness. It turned out he was a pioneer in bringing minimally invasive surgery for heart and lungs to Florida.
After examining Mary Elizabeth’s test results, Dr. Sommers said to her: “I do not recommend surgery because your X-rays, CAT and PET scans, and biopsy do not confirm that you have cancer. I recommend that we continue to follow the spot with frequent X-rays to see whether it progresses.”
“No,” Mary Elizabeth responded. “That is not ok with me. I do not want to live another day with cancer growing inside me! I need to know what this spot is!”
“At first,” I said to her, “I thought it was a good idea not to have an operation unless we know for sure you need one. I respect Dr. Sommers for not recommending he operate, which other surgeons might. But when I consider your living with a spot in your lung that could be cancer, I see your point. I wouldn’t want to do that either.”
“I agree with both of you,” Dr. Sommers said. He made eye contact with us and spoke calmly. “I’ll do a wedge resection of the spot robotically. I’ll have a pathologist in the operating room to determine whether there’s cancer in the tissue. If there is, I’ll do the lobectomy. If not, I’ll close up.”
We returned home feeling good about our plan. We had to wait five days until the operation. Mary Elizabeth questioned how long she would have to stay in the hospital. Dr. Sommers’ assistant connected her with a patient of theirs. He had just undergone a lobectomy and had left the hospital within forty-eight hours. He told her he was recovering very well at home. She was inspired to follow his example, if possible.
Just two weeks after she received Dr. Smitherman’s initial call, Mary Elizabeth underwent surgery at Tampa General. I was in the waiting room. I hoped when Dr. Sommers called me he would report no cancer. Pastor Carol Schwenke from our church surprised me when she came to the waiting room to keep me company. While we talked an eternity passed.
After about two and a half hours, Dr. Sommers phoned from the operating room. He told me they had found cancer. I swallowed hard. I wanted it not to be true. I wanted to deny his words. He said he had done the lobectomy and removed twenty-five lymph nodes. He found no cancer other than the one spot. We would get the pathology report in about five days. He told me Mary Elizabeth was doing well and I could join her in the recovery room. I immediately went there. She looked tired but smiled a big smile at me. I took her hand and kissed her forehead. It was fabulous to see her.
We spent that night at Tampa General. The nurses were exceptionally attentive. I could not get all that comfortable on the narrow chaise beside her bed, but given the situation we both got more sleep than I’d expected. The next morning the nurses woke us around 6 a.m. Dr. Sommers checked on Mary Elizabeth a couple hours later. He examined her and said she was doing well. He asked whether she wanted to stay in the hospital or leave. She replied she wanted to go home as soon as possible. Dr. Sommers approved. We left for home just twenty-four hours following her entering Tampa General.
At home our house quickly filled with flowers, get well cards, letters, phone calls, and meals brought to us and sent to us. We were astonished. This surprise was the work of our community at the Episcopal Church of the Ascension. The outpouring of caring and love lifted Mary Elizabeth up. It lifted my spirits too. I cannot express how grateful we were for the support and love we received. I urge every one of you in this community, or in one like it, not to underestimate the power of your caring and love. What may seem small to you was huge to us.
Five days after we arrived home Dr. Sommers’ nurse called to report that all the lymph nodes removed during the operation were negative for cancer. My heart jumped with joy. Shortly thereafter we saw Dr. Sommers at his office. He told us that Mary Elizabeth’s type of lung cancer rarely recurs, and that her chances for a cure are 90 to 95%. He gave us the name of an oncologist at Moffitt Cancer Center and said she needed to be seen every three months for the first year. If there is no recurrence of her cancer for five years she will be considered cured. I felt relieved but not totally out of the woods.
One year later Mary Elizabeth’s follow-up MRI showed a small spot in her right lung. Her oncologist recommended we follow it using X-rays. She again did not want to take the chance of living with this new spot in her lung. Her oncologist prescribed Levaquin, a strong antibiotic to heal the spot in case it was caused by an infection. After the two week treatment with Levaquin the spot remained. We went to Dr. Sommers who again performed minimally invasive surgery this time on her right lung. He found no cancer! I felt greatly relieved.
While taking Levaquin Mary Elizabeth felt a tightness and pain in her right leg, like she had pulled something. It turned out that the Levaquin had dried out her right Achilles tendon. We learned, after the fact, that Levaquin can dry out the tendons in your body as a side effect. She was diagnosed with a ruptured Achilles tendon. At our next visit with her oncologist I told him I was angry and disappointed that he had not warned about this side effect. Since then we have both made a point of warning people to be aware of this possible side effect from Levaquin and its sister drug Ciproflaxin, often called Cipro.
Mary Elizabeth underwent surgery to have her Achilles tendon re-attached. The recovery from the surgery was painful and slow. She was in a below the knee cast, had to remain in bed and use a knee walker to scoot wherever she went. She could not get up and down stairs except one at a time on her bottom. We had to set up a bed for her on the first floor of our home. At one point when getting back into bed she slipped and fell.
When Dr. Thomas Odmark examined her Achilles tendon two weeks following her surgery he found the attachment had ruptured again. We were not pleased to say the least. We thought her fall may have caused another rupture. I began to ask myself how much of this Mary Elizabeth could take. I was having a hard enough time myself and I wasn’t the one being operated upon and going through the recoveries. Dr. Odmark repeated the operation a second time going through the same incision with an increased risk of infection. This was Mary Elizabeth’s fourth surgery within one year.
This time the operation worked. Her recovery took at least one year requiring physical therapy along with her cast and knee walker. My wife said her recovery from the Achilles tendon operations was ten times more difficult than from the lung surgeries. As anyone who has ever had an Achilles tendon problem knows, you only fully appreciate how much you rely on this tendon until it isn’t working. I admired Mary Elizabeth for her spirit to keep going no matter what. When the going gets tough, the tough get going.
Mary Elizabeth has now been cancer- free for two and a half years. She walked forward with courage, boldness, trust, and faith in every decision she made. Albert Einstein, the physicist renowned for his Theory of Relativity, said: “There are only two ways to live your life. One is as though nothing is a miracle. The other is as though everything is a miracle.”
Mary Elizabeth’s experience with lung cancer was full of miracles—Dr. Smitherman’s careful follow up on the small spot in her lung, one radiologist concluding she could have cancer, finding Dr. Sommers near us with his expertise in minimally invasive lung surgery, the diagnosis and surgery for her cancer happening in just two weeks, her lung cancer having been detected so early it had not spread and could be totally removed, the thorough medical care she received from her physicians, the superb nursing in the surgical recovery unit, her favorable prognosis for being a cancer survivor, and the outpouring of support and love from our church community. If we needed proof of miracles, we got it. We even got it with her Achilles tendon surgery. Persistence pays. What doesn’t work the first time doesn’t mean it won’t the second time. She is now walking again.
There is one more point I want to make. You may fall. Most of us fall. Few people age without falling physically, mentally, or emotionally. It may be the loss of balance, the loss of memory, cancer, heart disease, the loss of a loved one, a stroke, anxiety, depression, or something else. My mother fell from losing her balance and my father from atrial fibrillation of his heart.
The point, however, is not about falling. It’s about getting up and going on. The Japanese have an inspiring saying: “Fall down six times, get up seven.” When you are faced with whatever comes to you and with making important decisions, take your courage in hand to do what feels right to you. Be bold. Whatever you decide, remember that God is always on the road ahead to walk with you and comfort you. Miracles follow.
© Doug Welpton, M.D.
