where the writers are
Tuesday: January 17, 2012 (Part Two)


I made it through chemo, which was just the smaller bag of etoposide, and the bone scan without incident. My nausea had subsided to what might be considered a bad case of acid reflux. But my day was not yet finished. I traveled next to the renowned Cleveland Clinic to set up radiation.

A young, attractive nurse named Trisha brought me back to the treatment area and got my vitals. Next came Dr. Jason Hearn, an equally young and attractive resident who could have been mistaken for the kid who waited on me at the Apple Store before Christmas. But young Dr. Hearn had a freshly starched white coat and his name stitched authoritatively in red. I soon learned the coat came with a medical degree from some dump called Harvard University, which counts for something I guess.

We were soon joined by Dr. John Greskovich, the doc in charge of my care at the Clinic. The first thing Dr. Greskovich noted was the golf pulllover I wore. I got it after playing a fund-raiser where I played 100 holes for the local leukemia group.

Dr. Greskovich said he worked on the ground crew at the club for 10 years while in high school and college.. There had been a number of strange signs and markers over the previous weeks. This appeared to be another.

I learned through Dr. Greskovich that my Kaiser oncologoist, Dr. Verma, is one of his favorite colleagues. That helps explain why my hook-up with the Clinic occurred so quickly.

Dr. Greskovich gave me the rundown on my treatment. Fifteen treatments over a three-week period. He would be blasting the diseased portion of my lung, the couple of lymph nodes to which the cancer had attached itself and a few other lymph nodes in the chest wall.

He said there are typically two ways to apply radiation to my cancer: Two smaller daily doses or one strong dose. He said he had decided on the once-a-day approach. I told him that would be fine. I like the aggressive approach.

After radiating my chest, Dr. Greskovich said, I would receive a prophylactic round of whole brain radiation. Small-cell lung cancer has a nasty habit of traveling north to the brain and the current protocol leaves nothing to chance.

Small-cell lung cancer is a sneaky, invasive bastard. But Greskovich said that the combination of chemo and radiation exposes its vulnerability quickly. The problem is that it does a good job of mutating and figuring out how to linger in the body.

He also provided me with some new numbers. One-half of people diagnosed with small-cell lung cancer survive to 30 months. At five years, the survival rate is 28 percent and, at that point, folks are as likely to die of something other than lung cancer.

Woot! I had been living under the assumption I had a 15 percent chance of being alive five years from now. Dr. Greskovich had damn near doubled my odds!

I now have a 1 in 4 chance of surviving this thing. And, as an added bonus, he said that on a scale of 1 to 10, for people with my type of cancer, I was a 9.5.

The tumor was still relatively small and had been found relatively quickly. Technically, because the cancer cells had migrated to some nearby lymph nodes, my cancer was Stage 3.

While he gave no guarantees that I'll live to be 90, I found some much-needed comfort in what he had to say. The  reality that I might be dead soon remained an abstract concept. Processing the numbers and probabilities did not seem quite real.

As I mentioned early on, I've been a poker player for awhile now. Friends unfamiliar with the game refer to it as gambling. While I don't deny there are elements of gambling in poker, it's largely based on math -- odds and probabilities.

You know there are a certain number of cards that remain in the deck or are in someone else's hand that can help you. The decisions you make -- bet, call, raise or fold -- must be taken into account if you expect to be a winning player.

If I were in a hand and knew that my odds were 1 in 6 or even 1 in 4, it's likely I'd be folding. The percentages, in those instances, would be unfavorable.

But now I'm playing a game where my options are severely limited. I can't fold.

I want to live.

So ladies and gentlemen, it looks like the player in seat 7 is all-in. Good luck, sir. You're going to need it.