Session 3 of chemotherapy in Parma began without incident after an early morning trip to the Clinic for radiation.
I made it the Kaiser facility with time to spare for breakfast. Lynn, the straps of camera bags slung over her each shoulder, tripod wedged under one arm, found me happily munching an omelette and home fries in the Kaiser Kafe.
Today would be the day Lynn and I would show smokers just how fun chemo can be. The day began with a consultation with Dr. Verma, which Lynn could not film. The shy doctor became the only medical professional who did not consent to appear in the documentary. I did not try to persuade him otherwise. His role of cancer fighter was quite good enough for me.
Dr. Verma told me this morning that he was leaning toward six sessions of chemo instead of four but had not made up his mind. I told him my obvious preference but agreed to follow his lead.
I mentioned to Dr. Verma how Dr. Greskovich had shown me scan of the tumor having shrank. Dr. Verma did not seem impressed. He reminded me that small-cell cancers often respond quickly to aggressive treatment but that small-cell is resilient. It has a habit of mutating and making itself resistant to treatment.
“So that explains the high morbidity rate?” I asked.
"Yes," he replied.
I asked for the first time what happens when this initial, aggressive course of treatment fails. Dr. Verma said they try other drugs. He did not have to explain that it typically doesn't work.
Finally, I asked what is expected outcome for someone with small- and non-small cell cancer. He said he didn't know, but would check to see if there was any research on this.
He ticked off the list of chemo side effects and wondered if any had appeared. "How's your hearing?" he asked. I said I'd been cranking up the TV volume as of late and have been asking my wife to repeat herself more often usual. Dr. Verma immediately typed in a referral on the computer for an appointment to see an ear, nose and throat doc.
“Are you okay with the possibility of losing your hearing,” Dr. Verma asked.
“If it gets rid of the cancer and I can live a long life, I guess I'll get over it,” I said.
Appointment completed, I went out into the busy infusion center. I've grown accustomed to this routine as well. First, I'm given an Emend, the anti-nausea pill and am poked in the lower right forearm with a needle to establish my IV line.
On this morning, it's Richard who is hanging the bags: saline solution; anti-nausea stuff; a big bag of magnesium; and, once the blood tests results are back, the big bag of Cisplatin, the rotgut whisky of chemotherapy meds.
Next comes a bag of the slightly less toxic VP16, an injection of Lasik through my IV port to clear the Cisplatin from my kidneys and more saline. As best I can tell, they're dropping about a gallon of liquids into my body.
Kaiser finally sent someone official around to see me: Dr. Aaron Smith, an ER doc who doubles as “head of external affairs” for Kaiser in Cleveland.
Dr. Smith lauded me for my willingness to tell my story. This gave me an opening to talk about the help the cancer fighters at KP and the Clinic had offered to break my nicotine addiction – none.
I found it absurd that no smoking cessation help was ever mentioned. My family doc wrote me a prescription for nicotine patches weeks before my diagnosis. He also offered a drug called Chantix, which I declined after reading about its myriad side effects.
I asked Dr. Smith this: What if I were a heroin junkie dying from my addiction, don't you think someone, somewhere would have tried to get me off smack while they treated me? He acknowledged that they would.
Nobody tried to cure me of the addiction that might be killing me. I did not quit until a week after chemotherapy started. My cravings persist.
Nicotine is a poisonous drug, doctors. Please don't forget that.