Pam — you ask if you are alone when you ask this question?

Yes Pam, you are alone. Very, very alone!

Sent by S.R. from Australia | 9:39 AM ET | 01-12-2007

I didn't think Pam's e-mail deserved my comment but I definitely think yours does. My mother has Stage IV breast cancer and your daily posts have helped me so much. I thank you for your blog and please continue with it. I pray for all people with cancer to get better and the rest of us to never experience it.

Sent by John Pappas | 9:41 AM ET | 01-12-2007

Dear Mr. Sievers,

I have written before to thank you for your courage in sharing your experiences. "Let he who is without sin cast the first stone" was what came to mind when reading this mornings blog. Pam has no experience with cancer and admits it, so it must be difficult to understand the worth and expense, fears and decisions behind your journey. I learn from your words and it has been a tremendous help in better understanding what my mother and my mother-in-law must have been thinking as they battled cancer. Your willingness to share is enlightening, personal and worth so much more than time or money. Perhaps the best response to Pam is compassion for her ignorance, and hope she never has to face her words. With grateful and humble thanks.

Sent by R. L. Janus | 9:44 AM ET | 01-12-2007

When cancer came to us we were grateful for the blessings we had, like living in a one floor three room flat with an elevator in the building, like the most loving family doctor whose office was across the street and he would make house calls and did — sometimes daily, like having health insurance where the customer service personnel were literate and handled our bills competently so we could handle other things, like the Family Leave Act that allowed me to spend the last three months caring for my husband with leave time that I previously earned. Also we had saved for a rainy day, and guess what — it was raining.

After my husband died from cancer in 2006 a woman colleague was visiting my home. Her opinion was that we all had to worry about health care costs and that perhaps my husband's life ought to have ended sooner. I wanted to slap the crap out of her and throw her out of my home. Any attempts to change her thinking would have been a great waste of time. I do think escalating health care costs are a concern, but not providing care is not the way to fix it.

I would be willing to bet that this woman who wrote to you, just like my colleague, has spent no time around people with cancer as some of their compassion would surely have rubbed off on her.

My husband and I often did things for those less fortunate. When you pray tonight and ask God to help the poor people he might just tell you I already did, so take it from your pocket and do the right thing.

Sent by Irene | 9:49 AM ET | 01-12-2007

Seems to me that if we question who deserves what quantity of treatment, we'd need to question just every other aspect of wealth, all of the time, as there is no objectively fair and equitable distribution of personal wealth, safety, education etc. Does Donald Trump (to use a hackneyed proxy) deserve all of his wealth? Does a middle class family in a suburb of Iowa deserve their safety and security from threats that families in Rwanda experience? Does Pam deserve to sit comfortably at her computer each morning, sipping coffee and reviewing world news?

As with you, Leroy, and at 52 I realize that not much is fair in the world of wealth and suffering. We do not each get what we "deserve" as a direct product of our personal inputs. So, yeah, Pam's question is heartless and especially ignorant. And naive. I'm glad for her if life is working out so far, and I hope it continues to do so. But blaming the victim for the care they require and are getting is pretty low and pretty smug.

When do we start redistributing her wealth?

Sent by Teri | 9:51 AM ET | 01-12-2007

I hope Pam is alone in her ignorant thinking. Sitting there with her first cup, deciding whether or not you deserve treatment, I think is really sick. I could go on and use other choice words, but she's not worth it. Rock on, Leroy, I love that your sharing your experiences with us, it gives us a view of what friends and family have gone through when we were otherwise unable to find out. Thanks again.

Sent by Sharon Mathieu | 9:53 AM ET | 01-12-2007

I've had a similar encounter with a colleague. He asked me how I was doing. I gave him a brief account thinking that was what he was asking. Then he told me he had no sympathy for me — it was the kids being killed in Iraq he had sympathy for. And that money should be spent on stopping the war instead of on research for cancer. It still leaves me cold when I pass him in the hall. On the other hand, when I ran out of sick days, 15 teachers anonymously donated personal leave days to me. Most people I just pass in the hall with a brief hello — their responses to my thank you note put me in tears with the depth of their compassion.

Sent by Cheryl M. | 9:55 AM ET | 01-12-2007

Leroy,

You always speak from the heart. And we appreciate it. You can NOT put a price on a life, no matter what age/color/race. I have seen our own medical bills. The medical field accepts 10% of what is billed to insurance companies. That is sad for people without insurance, and just shows how too high a price is put on treatment. Ex. monthly bill is $100,000 and they settle for $10,000 payment. Crazy. Keep on bloggin'.

Sent by Jane | 9:57 AM ET | 01-12-2007

Leroy, you responded to Pam's heartless question way better than I could have. It made me angry, too. I know that it's only easy to ask a question such as that if neither you, nor anyone that you love has struggled with cancer. It can't be an academic question if you're the one taking hundreds of dollars worth of medicine monthly, and hoping that you never loose your drug coverage, because then what will you do?

The question also struck me as the kind that may have been asked, and still may be by dictators, or those who feel more worthy than others. Our own government asked it in the Reagan administration when choosing to ignore the AIDS epidemic because of who was getting it at the time — mostly gay men and IV drug abusers. I could go on and on, but Leroy, you did a masterful job of responding.

Sent by Nancy K. Clark | 9:59 AM ET | 01-12-2007

That comment jumped out at me the other day too, and frankly, I didn't think it deserved a response. 1) As you're aware, I have lung cancer, too. The amounts expended are not unknown, or else they would be uninsurable. I pay $13,000/year for my health insurance, and I'll be g*da**ed if I'm going to apologize for using it. 2) Same with Social Security Disability. I paid in far more than I will ever get out. 3) We all pay taxes and lots of them go to things we don't agree with. It's called living in a democracy. Our country has an obligation to take care of its own citizens.

You were wrong to call her ignorant, Leroy. Ignorance can be cured; "stupid is forever."

— Wash. Post May 15, 1969

Sent by Thomas J. Clarke Jr. | 10:33 AM ET | 01-12-2007

Even though I have not written in a while, I have been keeping up with your blog and your progress every day. My husband seems to be almost on the same schedule in the sense he finished his chemo treatments in Dec. and now has moved on to radiation. The chemo shrunk the tumor a lot but not in the right place to make him "respectable surgically" (he has non-metastized pancreatic cancer) so now they are trying radiation to shrink it some more. He has had issues with blood counts and infections so things are not running all that smoothly, as you know. We don't know what is going to happen, but he certainly is still in the fight and intends to stay there as long as there is something that can be tried. Yes, it is very expensive, but I would sell all my worldly possessions and move heaven and earth if it meant keeping my husband alive. Yes, it consumes all our time and effort, but he is worth it. He wants to live and I want him to live.

That being said... I have thought many times over the last couple of months... does Leroy ever get angry? I mean really angry at having cancer. Does he ever strike out at the people he loves and love him? I know we do. Sometimes we say things to each other that neither one of us mean out of frustration and fear and anger. We love each other very much and are very frightened by what is happening. I am relived to hear anger in your blog.

I guess it never ceases to amaze me how ignorant people can be. I only hope Pam or someone she loves never gets cancer. Who is she to judge whose life is worth something and whose isn't. How can you put a dollar value on human life?

We have not experience anything in our lives like you have. We were two normal happy people enjoying our "mundane" lives, traveling a bit, dining out with friends, enjoying our family. Then cancer invaded our lives and changed everything.

If I sound angry... I am. But we will never give up and when we can we enjoy each other as best we can. But your life and my husbands life and every other person on this earth whether they have cancer or not is precious and nobody, including a heartless ignoramous like Pam is going to convince me otherwise. Keep fighting!!!!!

Sent by Amy Wile | 11:12 AM ET | 01-12-2007

Better questions for Pam to ask are why are such resources so expensive and why have we cut the research dollars looking into a cure for cancer? If we could lower the costs and find a cure I wonder if her question would then move to another arena such as education. I am sorry for Pam — it must be a sad way to live always wondering about such questions and judging.

Sent by L.J. | 11:17 AM ET | 01-12-2007

Leroy,

Well said in truth and honor. I would not have objected to you letting yourself go and rebuking Pam with all your might. But what would that have accomplished?

You are someone that has seen up close the horrors of this world and are living with a terrible disease that takes away so much. Thankfully, you know, as do most it seems who battle cancer, that life is precious. It does us no good to repay each others evil with evil, and although Pam's note was not "evil", it was born of an uneducated perspective. Through your composed response, hopefully she can see from your perspective why hers was hurting others.

I'm continually amazed at us as humans. We are capable of unfathomable cruelty, yet also limitless compassion.

Sent by Phil Dreger | 11:20 AM ET | 01-12-2007

THANK YOU, THANK YOU, THANK YOU... for responding to Pam's note.

I, too, read all that you post and I was also disturbed by her thoughts. Maybe Pam ought to read Left to Tell, by a Rwanda survivor. Compelling story and beautifully written. It is from that story that I have gather my strength to battle my cancer.

There are so many more people out there who have much more tragic stories than myself and are mostly likely much sicker than myself. I never lose sight of that. I remind myself daily how blessed I am to have worked so hard for what I have. Should I be denied the latest and greatest drugs for my cancer? It may not matter to Pam what becomes of me, but it matters greatly to all the people in my life what happens to me in the future. It is for that reason that I will continue on this white-knuckled roller coaster ride called cancer.

Sent by Marianne Dalton | 11:23 AM ET | 01-12-2007

Ironically, this comes up on your blog a couple of days after the publication in the Journal of the National Cancer Institute of a study entitled "Patient Time Costs Substantially Increase Burden of Cancer Care."

That study, just like Pam's comment, makes me, a cancer patient with stage IV kidney cancer with bone metastasis, uncomfortable. Why? Because it sees me as a cost factor rather than as a human being, as a cog in a productivity-based system rather than as a person.

At first glance, I appreciated the fact it put a value on my time: time spent in waiting rooms, time spent waiting for appointments, time spent undergoing exams and so on. But then, that is in turn looked at as time where I am not productive. My social value is seen as my ability to work, earn money, allow an employee to earn money for an employer. The moment I can't do that, or can only do it less, my value diminishes. I become a cost factor.

What about the human factor, purely and simply the human factor? Is a life something that should be valued only in terms of monetary value? Is an American worth more than, say, a Canadian or a Mexican? Is an Israeli worth more than a Palestinian? Is a Christian worth more than a Muslim?

Should we start putting a price tag and a productivity tag on every living thing on this planet? OK, we can let this species of plants, of animals go extinct, they don't bring in any cash, and besides, they're not human and not generating any revenue for anyone. Never mind that they are living beings, as entitled to life on this planet as we are.

Let's set a line beyond which we don't bother taking care of seniors. After all, they are beyond their money generating years, therefore they are liabilities in the accounting books.

Let's deny care for the homeless and the unemployed. They are already unproductive; let's not turn them into an additional financial liability.

Saving a life, or attempting to save a life, isn't a matter of dollars and cents. All living beings are worth the same, and they all deserve the best we, as human beings, can muster to preserve that life.

We would do well, as a species, to remember that.

Sent by Benoit Bisson | 11:33 AM ET | 01-12-2007

Good comeback on today's blog. But, I must admit I'm glad she got a rise out of you. I bet you haven't been that angry about anything (except cancer) for some time. Your anger had nothing to do with cancer and that just goes to show that cancer hasn't gotten your spirit. You're still Leroy!!

B.T.W. — I read you every day for insight. I, fortunately, do not have the disease yet, but since everyone in my family had died from it I read you to help me cope when it may be my time.

Sent by Mary Lynne Carlisle | 11:34 AM ET | 01-12-2007

Leroy,

I just wanted to send you a quick note about your post today and the question that a writer named Pam posed to you about whether we where spending too many resources on one person's survival and your comments. I have been reading your blog for some time now and I have written to you before. You wrote in your blog today that you sound angry. I disagree.

I thought your response to Pam was most dignified and you struck me again as you often do as a sensible, thoughtful man, I only hope to follow in your example.

Sent by Jerry R. Steuewald | 11:36 AM ET | 01-12-2007

Leroy,

I read this blog every morning and have for several months now. My mother has cancer and this blog has been a great source of solace for me, knowing that there are many others like me out there, not only victims, but also family members who have to deal with the prospect of an impending major loss.

I also read a lot of other blogs — mostly political. One of the great things about blogs, and the Internet in general, is the free form dialogue and the ability for everyone to have a voice. Usually, on the political sights I haunt, for those of you who don't know, there are what are referred to as trolls. People that will leave outrageous, sometimes inflammatory comments to rile others up. The term "trolls" is derogatory and commenters will either ignore them or jump down their throats. But I posit that trolls are an essential part of transforming a blog from an echo chamber, where commenters will consistently applaud the blogger for his/her ability to write effectively, to a real community resource where many different subjects are brought up and many opinions and points of view are on display. It is here that true discourse is accomplished. The term devil's advocate comes to mind.

I completely understand the offense you took to Pam's comments, but the post you make here which ties together all of human suffering with the suffering endured by patients of cancer, and the metaphysical questions posed concerning the expenditure of precious resources on the sick and needy, would never have been made were it not for someone like Pam to make a comment that no one really wants to hear.

Blogs are the answer to the lonely & vacuous opinion/commentary pages in our newspapers. No longer do we have to listen without recourse to someone else's opinion — we now have the ability to achieve true discourse and further the obligation to consider everyone's point of view. And that, I think, is a great accomplishment.

Sent by Ben Turkel | 11:46 AM ET | 01-12-2007

I admire your restraint in responding to Pam's smug missive. Talk about "privileged"! She sounds like the embodiment of the luck that has, so far, kept some of us from cancer and a host of other ways to suffer. I don't actually wish any of those on her, but I wouldn't mind if she got close enough to get a whiff and maybe even try to understand.

Sent by Vicki Lambert | 11:47 AM ET | 01-12-2007

Amen. Right on, Leroy! It is obvious Pam is on the other side of "that line." There is another view I've often taken regarding two other camps the world is divided into... the Clueless and then everyone else. Our local paper did a story on it years ago, and somewhere I still have it. Fabulous article! A little bit like the "Sixth Sense", it said that the clueless don't know they are clueless. They will never cross over the line and become clueful.

Sent by Carol | 11:50 AM ET | 01-12-2007

Rock on, Leroy! After I read Pam's note yesterday, I was incensed. I agonized over how to respond to such a heartless (yes, heartless) sentiment as was expressed in her writing. Then I read your blog this morning, and raised both fists in the air and shouted, "YES!" There are many appropriate forums to discuss the allocation of health care resources and whether we spend too much on treating disease rather than on prevention. On this forum, our concerns are different. Instead of peacefully enjoying our "first cup of the day," some of us wake to face another day of nausea, pain and that awful stab of existential terror. Pam states that she has "never been the victim of cancer," and for that I am thankful. Perhaps her cold-hearted perspective would change if she was diagnosed with the disease and had to endure the slash, burn and poison which is the standard treatment. Someone in this blog aptly called chemo and radiation "weapons of mass destruction."

This blog has explored humanity struggling with some of the worst things the universe can inflict on a sentient being. People contributing to the discussion are facing things most of us would rather look away from than even consider. Yet they maintain their civility, sensitivity and even their sense of humor. I would love to see the insights of Leroy and the other people sharing their experiences organized into a book which could go on to help others in their struggles with cancer. I continue to suffer the ravages brought on by colon cancer treatment, and this resource is invaluable to me. It is a tragic failure of modern medicine when a person has to ask that one big question: quality of life versus quantity of life. But the greater moral failure would be to deprive the individual of the right to ask the question.

Sent by Mike B. | 11:52 AM ET | 01-12-2007

I read Pam's note and it puzzled and angered me as well. In one sense she's simply raising the public policy debate of cost/benefit analysis of end of life care — and that's ok as a medical economics exercise looking at broad statistics. What angers me is that those statistics are real people struggling against illness that can rob them of all the normal experiences the non-victims take for granted. Ten years ago when my wife was in the final stages of breast cancer and holding on by a thread she and I would have done anything for more time. Even when she began to slip in and out of consciousness I wanted to do everything I could just to my three daughters could see her smile at them one more time. Did that make her or me social parasites for using precious and costly medical resources. No, it was just evidence we were human. Leroy, hang in there and grab all the life you can!

Sent by Roland Woodward | 11:55 AM ET | 01-12-2007

Pam should ask my children and fiance if I am worth it. All I can say is THANK GOD Pam is not my caregiver. Heartless? Oh Yes!

Sent by Debbie | 11:57 AM ET | 01-12-2007

I am stunned by Pam's logic. Would the victims of war, genocide, hunger and poverty be better served if we spent less dollars extending the lives of the "privileged" ill in this country? Does it seem more just to her that if some can't be saved none should be? I don't see her point. Surely we could work harder as a nation to fight world hunger. Look at the funds that were instantly available to fight the war on terrror. Pam's suggestion that the life of an ill "privileged adult" is cheap is disturbing to say the least. I lost my husband to cancer in 1999. We fought it for 4 years before he died. They were the best years of our lives because the cancer taught us much... like how precious each and every day really is.

Sent by Susan Rook | 11:59 AM ET | 01-12-2007

It sure makes one wonder just how Pam will change her tune when she is faced with a life threatening illness, be it cancer or perhaps a serious accident that involves multiple surgeries, etc. Not that I would wish that on Pam or anyone, but it happens. I, too, believe Pam has a very shallow perspective on life. Perhaps she hasn't known what it is to love or be loved. At any rate, perhaps one day she will know one day what love is or loss is.

Sent by Karen | 12:05 PM ET | 01-12-2007

And even if I bought into Pam's premise, which I don't, who would determine where and how those extra resources would be spent? Somehow I doubt they would be being used to stop the death, destruction and sadness in those wrong places in the world. We each are placed where we are placed and must fight the battles presented us as best we can. Yes, we all need to do what we can to promote justice wherever we can in the world, but does my refusing a chemo treatment really help the orphan in the Sudan?

Sent by Stephanie | 12:07 PM ET | 01-12-2007

I am appalled by Pam's comment, and hope that she is speaking from ignorance, not a version of enlightenment. As an oncology protocol/research RN, I am employed through the University of Pittsburgh Medical Center, and located at one of our community sites. McKeesport, Penn. is an area that was hard hit by the demise of the steel industry. To say that the population is at risk is to put it quite mildly. As a protocol RN, I am in a position to further enhance the cancer care of the local population via enrollment in cancer protocols that are open to them in their own community hospital, with the support of the UPMC Cancer network. There is in place a Patient Navigator Program to afford support in all aspects of patient care from transportation to MD visits. We are all working together to advocate for our patients — to give them choices — to give them opportunities to live as full, productive, and symptom-free a life as possible. Thank you for your incredible sharing of your experience, and I will keep you in my prayers.

Sent by Patty Hartman | 12:09 PM ET | 01-12-2007

Dear Mr. Sievers,

I've been reading your blog daily since you first started writing. It is the one column that I read every single day. I am completely moved by your experience and the grace in which you live your life on a daily basis. I find strength and wisdom in the things that you write and also peace and comfort in your words. Once in a while I am drawn to someone because of the things that they are able to teach me. I have read quietly each day... never commenting, but always keeping you in my thoughts and prayers.

Today is a little different — after reading the comments that Pam submitted, I wanted to make my support of you known. I don't believe you can put a value on human life as I don't believe that one life is worth more than another. I don't believe that we have a right to choose who will live and who will die, but I do believe that we can and should do everything in our power to serve and help and heal whenever possible. That is why we are here: to help one another. I realize that there is great destruction and devastation throughout this world, in no way do I think that diminishes the value of someone that has had the fortune of living a full life in this wonderful country; on the flip side of that, I don't think our lives are worth more than theirs either.

It does sadden me a great deal to know there are so many that suffer so much on a daily basis, however, this does not mean that we should not provide and have a great desire to provide any type of help/assistance that we can to anyone else in need. I believe that we are here to help one another - not choose who should or should not receive that help. I don't want to ramble as there are so many thoughts floating through my head, but I agree with you, I don't feel that we have the right to make the decision of who should receive care, rather we should care in any way we can and give that care (whatever it might be) as freely as possible. Honestly, if the tables were reversed and Pam were in your shoes maybe she'd look at this differently, maybe not? But whatever her thoughts or feelings I would like to believe that our society is one that would choose to care for anyone in need and not place boundaries on that care for any reason. We aren't going to be able to help/save/fix everyone, but we have a responsibility to try our hardest without passing judgment.

I'd hate to think we live in a world that has Pam's mindset — that would scare me — rather, I'd like to believe that there is more compassion, more of a desire to care for one another for the mere fact that we are all human beings! I think horrible things would happen if we were to start to try and choose who does and doesn't have a right to live based upon their "status" in life. That just isn't our place!! Instead I am grateful each day for the medical Doctors that are available and for their knowledge/insight/compassion and desire to help and for the support of others that are willing to stand beside us during difficult times and give their support. You have my complete support and as I said earlier I have learned a great deal from you, for which I am very grateful!!!

You are in my thoughts each day!! Keep fighting the good fight!! And thanks so much for sharing your incredible journey with us!

Sent by Cris | 12:38 PM ET | 01-12-2007

Pam's question was not ignorant. I would probably be angry, too, but I hope you will give the question a more thoughtful response when your anger subsides. I have read all of your posts and, like others, I have found all of them to be deeply intelligent and compassionate and insightful and generous. Your post today was a glaring exception.

Sent by John D. | 12:39 PM ET | 01-12-2007

While Leroy has said it well, I also feel honor-bound to put in my 2-cents worth.

We are starting a biotech company, whose lead product candidate is in oncology. The odds are difficult, but try, we must.

I lay awake nights thinking about Leroy and my friend, T, who has cancer. I think about my grandmother who survived breast cancer in 1950! By a new "hail-Mary" treatment called radiation.

It is an indelible part of the culture we grew up in, that we try to leave no one behind. This drives and compels us to try our best, under the circumstances given to us. We look ahead, where the horizons are absolutely unlimited.

My old boss used to say that "fairness is not a principle of life." It sure hasn't been fair to T or to Leroy, or the rest of you out there. But legions of us in the pipeline are risking most of what we have, to help make a difference. To do any less would be to dishonor generations of lives cut short, that perhaps we can ameliorate within the next generation.

Sent by Emile Bellott | 12:42 PM ET | 01-12-2007

When I read the blog last night I came across Pam's comment/opinion and I thought "Wow, these comments are really clueless." I thought I should just let this go and not get wrapped up in Pam's ideas, but I can't let go them just without commenting.

I would like to take that myopic telescope that she views the world (don't worry Pam, I wont smack you with it) and turn it around. Here on this blog you will find people, often facing impending death, that know how precious life is. Not in an abstract way but it a real tangible, gut-felt way. We "victims" of cancer have had to look real hard at the possibility of losing our lives. We know in an un-abstract way how precious life is.

I have faced death and would have slipped down that drain if it wasn't for the doctors who grabbed my hand and leg and pulled me out. They kept me alive. Should they have just let me go since the odds are that I wont make it more than 2 or 3 years? Should they have let me die because it will cost quite a bit of money and resources to keep me going? By that same logic I suppose we needn't care that a child is dying of typhoid, after all if she is living in a country in the midst of war she might die. Or she just might die in childbirth?

Perhaps if those additional $6 billion that are proposed to be spent to accelerate a war could be redirected to funding health care in Africa or in the United States our world would be better. Such a change would likely bring more peace to and security to the world.

Today I go for treatment of metastatic cancer. I know I'll be with others who are struggling to stay alive. I am so fortunate really to be with people who know what a treasure life is.

Have a great day Pam.

Leroy, thank you for tackling this straight on.

Sent by Susan M. | 2:25 PM ET | 01-12-2007

Dear Leroy,

I respect your response to "Pam" (I would have responded much harsher). Actually, I will respond much harsher. I personally think she is extremely HEARTLESS and does NOT know what she if talking about!

What you write every day is so very important, you are helping so many people cope with their illness and treatment. You inspire us all. I consider you to be a strong and courageous man. Until I started reading this blog I had a hard time opening up to the people in my life about my illness. Which is unfair to them as they want to know how I am feeling and what can they do to help. I now ask for help when I need it.

As for having led a privileged life, from all accounts you are a hard worker and have put your life in danger many times, all to help people understand what is happening in this world. If we don't know what's going on how can we help to fix the problems?

Maybe Pam would like to talk to my 13-year-old son, who just this morning was talking to me about my death and also my 16-year-old daughter who won't talk about it at all? Explain to them that I should also quit "expending unknown amounts of resources extending the life of one adult victim who, it appears, has lived a privileged life up to this point". Like you Leroy, I've also had a great and happy life. You know what Pam? Call me greedy, I want more!

Leroy, keep up the good work!!!!!!!!

Sent by Sherri | 3:03 PM ET | 01-12-2007

Hi Leroy:

Your tact and diplomacy is as inspiring as your sensitivity and candor. The next time Pam sits down for her "first cup of the day," I think she ought to switch to DE-CAF!

Sent by Nancy | 3:05 PM ET | 01-12-2007

Dear Mr. Sievers,

I have yet to have cancer, but since my parents have each had a bout (or two), I expect it is in my future. Were I to be in your position, I would be fighting just as vigorously. That said, I don't think that Pams question is "ignorant" or unfair.

It is legitimate to question the distribution of health resources, even while you are benefiting from an unequal share. Of course, for those of us who rely on insurance, this is largely an academic exercise we have little power to redistribute the time and money spent on our care to immunizing children in lesser-developed countries. Nonetheless, questioning the systems and institutions that distribute opportunities so unfairly throughout the world is the responsibility of an ethical person. What you view as a personal attack is really an indictment of all of us.

I will keep you, and all who suffer from cancer, in my prayers.

Sent by Travis | 3:07 PM ET | 01-12-2007

OK NPR, you may need to edit my message. We will see... I have been reading Leroy's messages, I don't have cancer, but a lot of my friends do. I love all the postings and how people are helping people and talking about what needs to come out of the darkness and fear so we can learn and help one another. On that note, I'll get on with my comments about and to Pam. Pam, please remember that what these folks are going through is a scary painful experience and on top of physical pain there is also psychological pain and words can hurt. The cool thing about words though is they can also build and teach. Pam, you "question the morality of expending unknown amounts of resources extending the life of one victim." Wow! Pam, you're using some fairly large words and you've put them together in an argumentative statement so I'm not sure using the old Saturday Night Live phrase of "Pam, you're an ignorant..." is accurate, but I digress.

Pam, have you ever considered that the work being done to help extend the lives of cancer patients is helping to come up with stronger, safer, and more successful cures? The treatments that Leroy is going through now will help with a breakthrough that ultimately will help save you or one of your family members in the future, if God forbid cancer comes into your life.

Pam, in the future please be careful in what direction you fire your words.

Sent by Tom | 3:25 PM ET | 01-12-2007

Leroy,

Pam's lack of compassion is very sad. Your response was gentle, considering her comment.

While I'm sad for your circumstances, I'm glad you write about it. You're smart and brave to research the disease and various treatments and not just sit back and "wait." Keep on! And, may God bless you and give you strength for the journey.

Sent by Judy F. | 3:39 PM ET | 01-12-2007

Leroy,

I have never posted on your blog before, and to be totally honest, I don't read it everyday. However, on the days I do read it, it changes me. I think about things differently... I think about how lucky I am. I don't have cancer, nor do I have anything life-threatening and in the moments it takes to read your blog, I realize that I'm blessed.

Unlike Pam, I know a few people who have had cancer — some have survived and others, unfortunately, have not, and the thing that Pam doesn't understand (lucky for her) is that one person's cancer or sickness affects hundreds of people. Although you may not be the person who has cancer, I can't help but wonder how many family members, friends, and other loved ones wake up in the morning and read your blog for support and some insight into how their loved one is feeling.

The last thing I want to touch on is Pam's life? I can't help but think... Pam, do you have a family and more importantly do you have children? Because if the answer to either of these questions is yes, what happens when you need the support of strangers?

Sent by Melissa | 3:42 PM ET | 01-12-2007

What is mystifying about this Pam issue is this: Is it possible she has had no contact with cancer?? Is there a person alive who has does NOT: have cancer, be related to someone with cancer, work with someone who has cancer, have a friend with cancer, or any combination of those things!!?? I work my behind off to enjoy the insurance coverage I have, and pay monthly for the extra (cancer) coverage I started three yrs ago. And thank God for that, as I have been treating breast cancer now since April 2006. How would my not-treating or my death help anyone else? I don't understand Pam's argument from an economic/financial standpoint either. And who among us would refuse treatment because there are sad and unfortunate global tragedies that are always there (somewhere in the world)? If Pam or her husband, child, mother needed cancer treatment, would she consider them too privileged to get it and let them die?

Sent by Sherri Eggleston | 3:45 PM ET | 01-12-2007

Your courage in the face of a very, very difficult situation is commendable. The life of a privileged person is just as valuable as the life of one who is not so privileged. You and I did not choose to be born to our parents and neither did we choose our country of birth. I happen to have been born in the U.S. of American parents in the early '50s, but raised elsewhere. I have lived out of the U.S. most of my life and have an abundance of world neighbors and friends from many countries, some privileged, many not. I would not wish cancer on any of them. I am a wife, mother, and caretaker of an elderly parent with dementia. I work full-time and have good insurance. If my melanoma returns, I will not wish it on anyone. Life IS unfair. I'll deal with it. May you continue to have valor and strength in your battle, and you certainly have my understanding.

Sent by Linda Catano | 3:56 PM ET | 01-12-2007

I thank my lucky stars for insurance every day. (At a price tag of over $200K in the past two yrs.) No one should make the decision as to the value of a person but a (much) higher power then anyone on earth. I was 49 on my diagnosis with an 11-year-old and a 20-year-old. Is it ok to spend lots of money on my cure because I have a young child? What if I have no kids? What about the brilliant surgeon that gets cancer? Should he get more/better care then my neighbor who is 91 and "lived a full life" because he can contribute more? I just don't think people can make these judgments until they are faced with their own diagnosis, not even those who are very close to someone with cancer. Ya gotta be living it to really see it. Thank you for your blog. Reading it has been a real pleasure and I look forward to it every day. Best to you.

Sent by Jenene K. | 3:59 PM ET | 01-12-2007

Leroy — Just as in other times in life, as soon as Pam (or someone she loved dearly) received a diagnosis of metastatic cancer, she would eat her words. It seems to be human nature for individuals to not truly understand the difficulties of someone else's life journey until they are experiencing it themselves.

Your blog keeps me going day in and day out. And you can't put a price on that. Thank you.

Sent by Elena Widder | 4:25 PM ET | 01-12-2007

Let's see how Pam feels about her naive response, should she be in a similar position in the future. Unfortunately, ignorant people are everywhere.

Best wishes to you, Leroy.

Sent by Peter Hoberg | 4:27 PM ET | 01-12-2007

Wow! Pams statment was thought-provoking if nothing else. I have the Ashkenazi Jew gene mutation, which gave me an 84% risk for the cancer I have. (Gilda Radner also had this.) This mutation was unknown a decade ago, so I unwittingly have passed it to both of my children who are now in their 30s. I suppose by Pam's account, we should all be tested at birth and us "mutants" be disposed of before were a bother to her.

Sent by Patricia | 4:29 PM ET | 01-12-2007

Dear Pam,

Get a life.

Sent by Marisa Niemczyk | 4:30 PM ET | 01-12-2007

Leroy,

As a bleeding-heart-liberal type I have had moments of conflict about the money being spent on my care. One morning, someone was on NPR questioning the validity of spending $5000 on a PET scan for one patient when so many need basic health care. As I had a PET scan scheduled for that day, I felt my face grow red from shame at such selfishness. Should I cancel the appointment? In the end, I went. Who would it really have benefited by not going? My insurance paid 10% of the $5000 bill and I learned that the cancerous lymph node in my chest was gone. Health care in this country is surely a mess, especially for the uninsured, but after both open-heart surgery and breast cancer, I'm very grateful I live here.

More importantly, will you continue chemo? I have a strong feeling that you will, and that you should. When faced with the choice of doing radiation or not, I finally had to realize that I didn't want any regrets, that I did what I could and my family knows that also.

As for side effects, we are human and can't help being a little vain. Shave your hair before it starts falling out, and a lint roller works great at getting rid of the little nubbins that are left! You're right that chemo is work, but there are good and bad days, and you live for the good days. Maybe the best job title is to be "surviving cancer."

Sent by Marcia | 4:32 PM ET | 01-12-2007

I hope Pam is not in the medical field, caring for patients or in the medical insurance business deciding insurers' coverage in this country. That would be scary. She should probably also refrain from having children, if by some odd chance she does already. I doubt anyone who has raised a family, or has been raised by a decent family with morals, would place such little value on a human life just because they happened to have been stricken by cancer.

I wonder if she got into a horrific car wreck one day and lost her right leg, and her other leg got infected by some fungus, so surgery was needed to save the other leg and prevent the fungus from growing more, if she would be singing the same tune along the lines of, "Well I would like a new leg and would like to have the surgery, but I have lived a privileged life up to this point and I really feel I am not worth surgery. Besides, walking and living are so overrated."

Sent by Lisa V. | 4:34 PM ET | 01-12-2007

I wish that words could be as precise as mathematics. Perhaps we would then better understand Pam's comments.

From her worldview, I think we would all agree that the extent and magnitude of suffering is horrible. Among the people dying of war, malnutrition, and disease, we are losing potential world leaders, doctors, etc.

But from an individual view things are the same. I also feel badly about friends dying of cancer. If Lance Armstrong had not used the medical help available to him we would not have his Lance Armstrong Foundation.

If Leroy did not avail himself of help we would not have his healing words. And, who knows what Leroy (and many others) will do in the future, for us individually, and for mankind, in general.

Sent by Don Winslow | 4:37 PM ET | 01-12-2007

I think that Jane touched on the fallacy that is part of Pam's premise — cost of care being a true measure of the value of care — and that the costs printed on our medical bills are an accurate accounting of the cost to deliver care. I've come to believe that the costs printed on our medical bills are often the result of the providers chosen accounting practices — whether for surgery, chemo, drugs or hospitalization. We're all familiar with the $50 Tylenol tablet that appears on a hospital bill. More recently, the cost of medications for senior citizens varies enormously by country, even when the medication is manufactured in the same facility! In my own cancer treatment therapies I've seen prices vary significantly (by several thousand dollars) for prescriptions, depending on whether they were provided by my clinic or my HMOs pharmacy. It's hit so close to home that even my staunchly conservative husband believes in nationalizing all pharmaceutical research, production, and distribution! So one grain of truth in Pam's argument may be that every dollar spent in other countries can indeed purchase much more treatment. And, the shame is that with inflated "costs" in the U.S. we use money that could otherwise be spent on humanitarian aid.

In the meanwhile, my husband and I are truly grateful for our excellent health and long term disability insurance care, subsidized by a generous employee benefit policy. And we are grateful to be living in Eastern Massachusetts, where the availability of care for most cancers is unparalleled.

Sent by Sheara | 4:40 PM ET | 01-12-2007

Maybe we can forgive Pam for not understanding. Every person fights a great battle. Who knows, maybe her family is dealing with a great battle, but isn't getting enough attention, causing her to feel resentment.

Sent by Kevin Hillstrom | 4:56 PM ET | 01-12-2007

This is why conservatives often can build a good case against liberals... we sometimes are too liberal and make statements like this, dumb statements, in an attempt to maintain some ideological continuity... it doesn't work that way.

Sent by Brit | 4:59 PM ET | 01-12-2007

Pam, supposed someone you really loved was affected by cancer or some other disease, could you really say, um, you have spent enough, let them die.

Sent by Phil | 5:01 PM ET | 01-12-2007

There is nothing more I can say that you haven't said and said it well. God forbid that she or a loved one does not have to deal with this disease. I am sure she would think differently.

Sent by Roger | 5:05 PM ET | 01-12-2007

Go, Leroy! You tell it like it is.

Yesterday I got very angry with a friend who had said something I found mean/ignorant/unjust... and I really laid into him and told him what I thought! Later, we both realized that was the first time since before my diagnosis a little over a year ago that I'd disagreed with anyone so openly. I think it's hard to express anger (especially to people you care about) when you are numb with fear and fighting for your life. So — it felt good to be back, feeling and showing all the "normal" emotions. And I'm glad to see your fighting spirit aroused, too!

Sent by Doris | 5:21 PM ET | 01-12-2007

Pam, This is for you.

Your comments do not make you a heartless person, but they do open a window into who you are, or more to the point, your experiences in life.

From where I sit, and believe me, I'm sitting in a front row seat of an E-ticket ride I'd rather not be on... NEVER have I thought of Leroy as someone who is living a privileged life. He was lucky enough to be born with a brain and capable of maturing into a smart guy. He used that brain to get a good education and he turned that into becoming a solid journalist and a mentor to young people in this business, who still seek out his advice.

In short, I guess I'm saying he's damn good at what he does BUT he worked very hard to get there. Inside those 26 years of traveling to the uneasy regions of this world, where the ugliness of war, famine and death go to hide, it was Leroy, from behind the camera, bringing you the stories that you consider more important than this life saving mission he is on now.

This is the part you don't get: Leroy is fighting with everything he's got to live. He's doing that with the help of great doctors, a ton of support and an inner strength that blows me away! He is also trying to help others who are in the fight of their lives... NOT just for themselves, but for those of us who love and need and want all of these folks in our world...to share in this life.

It's not about expending resources... it's not about the research, it's ABOUT what life is all about! You ask if you are alone when asking this question... the answer is, you are alone. Period.

Sent by Laurie (Leroy's other half) | 5:26 PM ET | 01-12-2007

Leroy,

It takes great strength to acknowledge when someone poses a question that is just plain hurtful. However, none of us who know you personally or through your blog are surprised that you did just that. It's what you have done for your entire career, and we are the blessed recipients. You give words to unthinkable situations. You give hope to many in a world that sometimes just doesn't make any sense. You give it generously. It's courageous and it's changing lives. Know that.

Thank you for your strength. Thank you for sharing something so personal. Whether or not you know this — you have made this world a better place, simply by being you.

Pam, on the other hand, sounds like someone very sad and misguided. She could use a little hope. My only advice to her is to continue to read your blog because your words often cut to the heart of all sorts of suffering.

Sent by Joan | 5:34 PM ET | 01-12-2007

Hopefully, Pam will never hear those fateful words "It's positive." I wish no one would ever hear them again. Would she look at her life in dollars and cents? Would she think she contributed enough to society to be worth the cost of her treatment, even when its outcome was unknown? Would she count her contributions into health care premiums and stop once she reached that amount? I doubt it. I'm sure she would just want to live like all of us do. We're all going for the golden ring.

I've had guilty feelings about the cost of health care I received. What made me so fortunate? I don't know. I do know how grateful I am for the treatment and technology that was used on me.

Sent by Chris | 5:36 PM ET | 01-12-2007

Like many others, I, too, was taken aback by Pam's comments yesterday. At first I was angry, but now I just feel like Pam needs a little enlightenment, which, after all, is what this blog is all about. How can we judge the value of a terminal cancer patient's life? Here's how! For example, Leroy's life! How wonderful is his blog? How many of us have found solace and wisdom in his words? Many, and not just cancer patients and their families. Sometimes even people like Pam.

Another point, how many of us are in clinical and experimental drug trials, the results of which may eventually lead to a cure for cancer and other deadly diseases, one of which may effect Pam someday. Even if we are not in a trial, we are in our personal oncologists trial! What he or she learns from our experience, what helped, what didn't, gets passed on to other patients.

At the very least, or perhaps the very most, we patients are always helping the patient in the treatment chair next to us...what foods actually help with nausea, where the best wig shop in town is, how to help a child in our lives cope with having a parent with cancer. These things, no matter how small, are important to someone, and that gives our lives value like nothing else!

So please Leroy, not another minute wasted in anger. I have a feeling that because of you, Pam will come around, and you will have just one more person on your long list of people whose lives you have touched beyond measure.

Sent by Karen King | 5:38 PM ET | 01-12-2007

Dear Mr. Sievers,

I am not a cancer victim or survivor, nor do I have a personal story to share. What I do have is an opinion about Pam's note, and a strong one at that. Every morning before work I sit down to read your blog. I do this for a variety of reasons, but mainly to remind myself that life and health are precious and should never be taken for granted. I am amazed (but not surprised) that there are people out there that have the audacity to think, let alone post a comment that devalues individual life. Regardless of what Pam and others like her may think, I believe that your individual contribution to this world is priceless! Thank you for sharing your experiences and please know that what you bring to the many readers of your blog is highly valued, awe inspiring, and greatly appreciated.

Sent by Gail S. | 5:40 PM ET | 01-12-2007

Hi Leroy — I have noticed that your comments in 2007 have taken on a bit of an "edge" and I admire you so much for putting your life out there for all of us to see. I actually went back yesterday and read all your columns from the beginning and am once again reminded about the amazing ups and downs of this incredible experience. I am glad that you responded to Pam's comments in such an eloquent but up front way. I really don't separate my world (stage 3 inflammatory breast cancer but doing well now)from the "non-cancer" world because I have had nothing but positive experiences from friends & strangers alike which makes Pam's comments more stunning.

Your circumstances have certainly evolved over the course of your blog... keep writing from your heart as many of us are out here waiting to hear from you every day!

Sent by Ellen Macaulay | 5:42 PM ET | 01-12-2007

Pam's folly was her insensitivity, not her central idea. It IS legitimate to question the distribution of health resources. I am thankful for the care my parents have received in fighting their cancers, and I can assure you that if/when I get cancer, I will fight it with every resource I can muster. I also recognize that those of us who have insurance have little power to redirect the resources spent on our care to immunizing children in lesser-developed countries or other high-impact uses. Nonetheless, we cannot be blinded by our circumstances from seeing that the world's health resources are distributed unfairly. Trying to bring about change in the systems and institutions that distribute these resources is the responsibility of an ethical person. What Pam injudiciously phrased as a personal attack is really an indictment of all of us.

Sent by Travis H. | 5:45 PM ET | 01-12-2007

I am a daily reader, and I am thankful for Leroy, this blog and how he has provided me with insight on a subject I knew almost nothing about prior.

I won't take sides about what Pam said, although I think it was insensitive.

A twist on the point she may have been trying to make could be explored if you ponder this: If Leroy was given $10,000 and a choice between using it to continue his treatment, or to be used to continue the treatment of the boy he saw being wheeled out of the radiation therapy room, or to be used for research to cure cancer, what would he do. This question is unfair, and I don't want it answered.

The point is that we live in a world of limited resources, and the only common denominator we can tie things to is money. Some people can't even get a sandwich, let alone $15,000 worth of cancer treatment. Like it has been said above, it's all just luck, we don't choose these situations, but for a lot of us we are in a position to be assisted with these challenging situations.

Does the machine just roll on, even in the face of unsustainable resource allocation? Would/will our society make the choice to balance the equation between the "haves" and "have nots"? Because, if we want to, there will be a seriously harsh quality of life correction for the lot of us, when we finally act on our beliefs that every life has infinite worth.

Sent by Thom | 5:55 PM ET | 01-12-2007

I have two problems with Pam's comments.

One: she implies some lives are worth more than others. I just don't believe this.

Two: the time, money and effort being spent to save Leroy is not just saving Leroy. All cancer patients benefit from the knowledge gained by what works and what doesn't work. Cancer is still a medical mystery to some extent. Well, to a great extent. The work in colon cancer has benefited other cancers. Avastin is a great example.

It is my heartfelt wish that Pam remains ignorant and never knows the terror of cancer, nor the insult of being thought of as a life not worth saving.

Sent by Karen | 6:01 PM ET | 01-12-2007

I just wonder that if Pam had been in your shoes, would she have decided that her life wasn't worth expending resources? And chosen no intervention? Or if her child or spouse or favorite parent were seriously ill or injured?

And I wonder what she is doing to alleviate all of those terrible conditions that she lists?

Sent by Maggie | 6:04 PM ET | 01-12-2007

I certainly HOPE Pam is alone! What a horrible note. A single life is a precious gift to be cherished. That some of us are more privileged than others in terms of money and resources is certainly not YOUR fault, Leroy.

Sent by Diana Kitch | 6:05 PM ET | 01-12-2007

Ironic title. Pam judged us and we are returning the favor. If we were truly non-judgmental, I suppose we would accept that she has the right to her misinformed opinion. I do feel sad for her, if and when cancer touches her life.

Sent by Stephanie | 6:06 PM ET | 01-12-2007

Now, now, everyone, please calm down. When I first read her comment, I, too, was appalled. After reading Mr. Sievers' response, I felt much better! It was satisfying — as if wits were justifiably counter matched. As the day grows old, I have simply come to enjoy the term "our" Pam has referred to us - "privileged". "Cancer People" are indeed a privileged group. It is amazing how clear and precise life is viewed after diagnoses. Please do not be offended by Pam. Perhaps she has seen a little difference in us, but cannot quite grasp the meaning and is only angry about that.

I have been reading Mr. Sievers' blog for about a month now. I have been searching for someone who could express what I am really experiencing (for just over 2 years now). Diagnosed LUNG CA Stage IV 10/2004 mets to chest wall and liver. I am glad to say that I have found him! Job well done, Mr. Sievers. Thank You.

Sent by Sharron Polozola | 6:09 PM ET | 01-12-2007

Dear Leroy, I have been reading your blog since early summer. I was diagnosed with Stage 1V follicular thyroid cancer three years ago. Your comments help me articulate to others exactly how I am feeling. To address Pam and her insensitive comments. She sits with a cup of coffee, and first reads the headlines etc, then she checks your blog. Checking your blog is a conscience decision. If she does not like what she reads, don't click on your site. Sort of like watching TV... if you don't like the show, don't watch. Perhaps, Pam's mother forgot to teach her "that if you have nothing constructive to say, it is better to say nothing at all." My blood is boiling over her insensitive comment — guess that makes me more alive than ever. Keep up your good work, Leroy.

Sent by Elizabeth | 6:11 PM ET | 01-12-2007

I'm sure Pam is not alone in asking her questions. I have rarely left a doctor's office not wondering what I just got for my $30 co-pay and $200 insurance bill. However the cost of healthcare should not be tied to the person getting it. Everyone deserves to live a long, healthy life — regardless of where they came from. You cant tie the cost of the treatment to the worth of the individual — it is the wrong concern (at least not in any moral fashion, as she was referring to). My life was not more or less worthy of being saved (dx in my 20s) than Leroy's at his age or child of 5. We are all human, we all have things left to do in the world, and we all mourn the loss of the life lost. Its been said before, if you're not part of the solution, you're part of the problem. I am not a victim of cancer, I am a survivor of it, and I use my (hard earned, tyvm) knowledge to try to better the system by advocating for reasonable health care for all, better allocation of resources, and funding that could make cancer a memory. My question to Pam would be: What are you doing to change the system?

Sent by Chris | 6:14 PM ET | 01-12-2007

Has Pam ever stopped to pondered that maybe one of those privileged lives saved today by those unknown amount of resources devoted to cancer research may just be someone who helps prevent the suffering of the faceless masses injured by war, genocide and countless other social injustices?

Lead on Leroy.

Sent by Jessie | 6:16 PM ET | 01-12-2007

Nicely said. I'm not a "victim" - my husband is. I'm grateful she's not his care giver.

Sent by Joan Kelly | 7:05 PM ET | 01-12-2007

Leroy:

Your blog got stronger today. In a strange way you can feel the power emanating from this page. Pretty fascinating, if you ask me.

Sent by Ben Turkel | 10:53 PM ET | 01-12-2007

I'm sure today's posting with Pam's comment will bring a record number of responses. I will add mine. I agree that Pam is both thoughtless and ignorant — not what I typically expect of my fellow NPR addicts. I was not in Rwanda, but I have been in the feeding camps of the Ethiopian famine. I wonder whether Pam has ever actually had to make a judgment on what one life is worth? I hope not. It's a horrible decision to face. Horrible. When the value of a life comes down to the dollars and cents it takes to save it... or prolong it... or enrich it... we have reached a landmark low in the human journey.

In the same situation, faced with the choice between have resources devoted to prolonging her life, or being set aside as having received "enough" out of life and declared not worthy of having another day — what decision would Pam make? It's easy to pontificate when the subject at hand hasn't touched you (although I disagree with the premise of her pontification), but when it's you and the face in the mirror, none of us knows beforehand what we will think, know, or believe.

God bless you, Larry. Yours is the only blog I read daily — thank you for all that you touch and give to all of us.

Sent by Martha Wharton | 11:55 PM ET | 01-12-2007

Dear Leroy,

I started reading your blog some time ago when my cousin Johnny was battling cancer and it helped me to better understand what he was going through. Thank you so much for that! Johnny passed away on November 11, 2006. Since that time, I have continued to read your blog because you are so open and honest and have become so real. Now, I feel I know you and I care for you. That is the reason why I am writing to you.

There is a stark difference when I compare you to Johnny, who was diagnosed with pancreatic cancer in December 2005 at age 65. That is that very early on Johnny accepted God's will and was at peace with whatever God had planned for him. I recall his telling me he began each day with The Lord's Prayer and it kept him close to God as he prayed "They will be done?" It was so heart-lifting and inspiring for everyone who came in contact with him during the past year to witness the power of trusting in God. Seeing how Johnny's deep faith supported and guided him through the challenges he faced, I wish that you too could find peace and comfort.

Today at Mass the priest talked about "faith", which is a gift we wish for everyone. When he compared "faith" to "love", I thought of you. He said that just as we decide to"love" so to we can decide to have "faith". My prayer is that you will find "faith" in God and that it will serve as a source of strength and courage for you.

May God keep you in his care.

With love.

Sent by Ann | 2:28 PM ET | 01-14-2007

Mate, I didn't count them all, but I think there were at least 80 responses to Pam's letter, and I couldn't find one in her favor. And I imagine each letter would represent at least 100 people. So that's at least 8000 to 1. Consider yourself alone, Pam. And Leroy, keep hanging in there. Cheers.

Sent by Tom K. | 9:05 AM ET | 01-16-2007

Pam speaks with the arrogance of youth. Evidently she has little familiarity with cancer, perhaps because she has not lived long enough to know it intimately. She sips her morning coffee and disapproves of the efforts of cancer victims to live another day. Death is but an abstraction to her.

Pam, I hope you live a long, good life, one full of adventure and laughter and friendship and generosity, as Leroy has lived. I hope that you grow in wisdom and compassion with the years. And when the time comes for you to face your death, as you surely will one day, I hope that some callous and naive person will question whether anyone so privileged, as you deserve the resources to live longer. Perhaps then you will appreciate just how appallingly cold and small-minded your comments to Leroy are. You might even use that opportunity to respond with the same thoughtful reflection that Leroy displayed in considering your question to him, but that seems unlikely.

Sent by Ross Barker | 10:58 AM ET | 01-16-2007

Pam, please do not pretend you are concerned with lives of millions if you are not caring about single life. Please do not pretend an idealist and moralist. Sorry, but to me you are simply self-righteous.

Sent by Nella Rokicki | 11:07 AM ET | 01-16-2007

Pam — I feel sorry for you and sad that you would treat another human being the way you have treated/spoken to Leroy. You are sadly lacking compassion. I don't have cancer either and I hope I never do. But, if I am ever diagnosed, or heaven forbid, if someone I know and love is, I would pray they (or I) get the best cancer treatments possible, whether you like it or not. Leroy, thank you for your honesty and courage.

Sent by Carol | 11:11 AM ET | 01-16-2007

I have not read all the comments so I hope I'm not repeating. I'm a 40-year-old cancer survivor, diagnosed at age 31 who has benefited from the very care Pam derides. I am a physician who has treated thousands in my career and saved many lives — maybe someone Pam cares about.

Sent by K.A. | 11:15 AM ET | 01-16-2007

When I read Pam's "heartless" note, and Leroy's reasoned, honest and very human response, I was reminded of my grandfather's statement that such a person is "more to be pitied than to be censored." Fight on, Leroy. Legions are praying/pulling for you.

Sent by Gail Krejci | 11:17 AM ET | 01-16-2007

You guys are funny! I'll come back to that comment later.

Leroy, thanks again for what you accomplish in this blog. I lost my spouse five years ago and I know that if I am at peace with her death today, it is because she was extremely up-front with her disease. She was well educated about her cancer, especially helpful to the medical field trying experimental drugs when there is no more "known best next line of treatment."

Cancer patients are, in my eyes, admirable troopers, fighting for their life and teaching us all.

Her knowledge ("privilege") made her matter of fact about hope and possibilities, and most importantly, her skills to communicate helped all her loved ones to be as aware as they wished, ultimately we felt in control with her.

She educated us about dignity and generosity, in a word, about life.

Pam! She struck a nerve.

Why being affected by her comment? She obviously feels guilty about her own state of privilege, so she tries to spoil it for others.

Why did it work? Why did it bring so many justifications?

I saw a few Pams before. They are usually draining all your energy with their insecurities. At the time I was busy making sure that my spouse had every once of my strength, I decided to ignore the Pams.

Was I selfish? Who cares! In the big picture, we are all helping ourselves and each other but we cannot always take the time to be each others therapists!

Enjoy your day, Leroy.

Sent by Fra. | 11:19 AM ET | 01-16-2007

First, I want to thank you and all your friends for all their comments, questions and general supportive statements. As a nurse, they have given me a great many things to think about and to consider in my life both as a medical professional and a patient myself. While I do not have cancer my life has been touched, as many have by, someone we love living with the disease.

I myself was diagnosed a few years ago with acute heart failure a virus "attacked" my left ventricle and my life at 49 was suddenly and totally changed forever. I was told I had two choices: I could go home and "put my affairs in order" or I could opt for an experimental cardiac device that would "hopefully" retrain my heart to beat in a rhythm that would decrease the heart failure and increase my life expectancy. I am now the proud owner of a $68,000+ device and all the medical experts in my area are my guardians. I was in a clinical research study up until last week (3 ? years after surgery). The device has now gone to market! Now others will be able to lead a longer healthier life because of this study. In the mean time I have reunited with my daughter, I have lived to see my son start high school and show interest in girls, driving and looking for a job! I have seen my first grandchild born.

Would Pam put a price on my children still having their Mom (their Dad passed away 15 years ago)? Would Pam like to put a price on my grandsons smile when I walk into the room?

Was I privileged? Was my life "worth" this cost? I certainly have not lived a privileged life (I have a 1993 Ford Escort in my driveway as we speak). My life is not worth more or less than Leroy's, or Pam's for that matter. But when I was in trouble I'm glad Pam was not there tossing the coin in the air.

Leroy, God's blessings to you. You have given support to more people than you know. I hope that by giving strength you have felt it returned to you ten-fold.

Sent by Karen | 11:25 AM ET | 01-16-2007

Leroy — God Bless you! Your answer to Pam was, indeed, eloquent. My husband has small cell lung cancer and your blog and helped me so much to understand the cancer world we were tossed into. I am grateful to you for NOT GIVING UP and for my husband NOT giving up. We were ALL given LIFE and we are to fight the GOOD Fight. I cannot conceive Pam sitting there on her computer, drinking her coffee, deciding who should live and die — some people never fail to amaze me with their short sidedness. Pam should consider herself truly blessed that cancer has not darkened her doorstep — yet. Thank you for your strength, you'll never know the extent of which you life has touched so many and helped us all. God Bless you — Never GIVE UP!!!!

Sent by Joan Weaver | 11:29 AM ET | 01-16-2007

I was really shocked by the comment Pam made, and I suppose I'm trying to think about what it means to make such a comment, especially in light of what Leroy wrote. There are three features that strike me as particularly noteworthy.

The first involves empathy. I can just about understand someone posing such a question, or asking such a question, in a debate about ethics, which was theoretical in its nature. What is harder to understand is posting such a comment in the kind of space opened up by "my cancer." This space is, to me, an intimate one, where someone makes his experience available in an unusually open way. Hypothetical questions sort of don't belong here, and it seems to me that you would have to lack a very basic sense of empathy not to know that.

The second feature is its ignorance. As Pam settles down with her coffee and her computer, she has already benefited in countless ways from the privilege to which she was born and which operates explicitly at the expense of those who are not born to it. So have I, so have all of us, I'd guess. To isolate cancer treatment as if it alone — as opposed to your cup of joe or your laptop — represented the unequal distribution of assests is crass, simplistic, deluded. I'd rather money be "wasted" on cancer treatments than the wanton squandering of resources that is part and parcel of our privileged lifestyles.

The third noteworthy feature is that a writer, name of Swift, anticipated her post in his piece "A Modest Proposal." I recommend Pam read it to see just how diligently the worth of a human life can be appraised.

Sent by Melissa | 11:33 AM ET | 01-16-2007

Leroy, what a horrible message to send to someone struggling for his life. I suspect Pam has never suffered from a life-threatening illness. My God, what a horrific thing to say to a cancer patient. Can't one say that about any type of medical intervention whatsoever? I would ask Pam if she forgoes any kind of medical treatment in her life... either preventative or that which helps her recover from an illness. If she were to answer no, she doesn't ... then I would ask her why, after all those resources should be used for those "less privileged." Yes, she is entitled to her opinion, and yes, we are allowed to express our thoughts on her opinion.

I am so sorry you got attacked that way Leroy. Stay the course, we are all rooting for you.

Sent by Sher | 11:35 AM ET | 01-16-2007

Leroy,

I have a feeling that Pam's comment was not meant to offend you. She did take some amount of care to phrase it, and admitted that it may sound heartless. I do not think she is an unfeeling person, although others were quick to characterize her this way.

Had she been unfeeling, I doubt shed be reading each morning with her coffee, about the tragedies that befall the world.

Lets face it, we all see things through our own eyes, and it takes effort to look through another's.

Let's look through mine for a moment. I am a long-time nurse who has been with countless numbers of people at the end of their lives, those who were strangers to me and also close family members.

I have seen them struggle with treatment decisions, either for themselves or for others, and I have made decisions for my own dear mother. Just how much treatment do we opt for? For how long? How many different types of chemo do we try? When do we say, "Enough!" When do we acknowledge that the end of life is coming, and rather than prolong it, when do we begin to accept it, and live for the moment?

I have seen people I would love to have counseled to put their lives in order, take a trip somewhere where they've always wanted to go, rather than make daily trips to the hospital for treatment, treatment that will extend life for 4 or 5 months.

Unbelievably tough decisions, admittedly.

I encourage you to read "A Year to Live," by Stephen Levine. Great book to help learn to live each day to its fullest.

Warm regards.

Sent by Hillary | 11:37 AM ET | 01-16-2007

As someone who's come across this blog for the first time just today I feel compelled to comment.

Clinically, this is much ado about nothing. Pam's comments were clumsy, rather than hurtful.

Leroy's consumption of medical resources is from the pool of resources to which we all contractually contribute, to be used in the event of someone's affliction.

Rwanda and Somalia didn't contribute to this pool, Pam, which is why they're not benefiting from it.

Really, it's not much different than any other form of insurance. We don't judge the claimants. A loss is a loss regardless of size of the claim or the wealth of the claimant or whether they're smart or stupid, handsome or ugly.

So Leroy, this isn't about your personal value or worth and you need not take offense at Pam's comments.

Extend that privileged life of yours as long as possible.

However, on a different level most of us might agree with Pam. Why would anyone spend a billion dollars on a new football stadium when the same amount would purchase incredible relief for a million disadvantaged people in the third world? Why spend $100,000 on a sports car and not a dime on the homeless?

I won't even pretend to know those answers.

Sent by Michael | 11:40 AM ET | 01-16-2007

I do think Pam has a good point. What was cruel was misdirecting it to an individual fighting a battle with cancer. In this country, where supposedly all have equal opportunity, with more resources than any other country for health care, we do ration care. There are 44 million people in this country without health insurance and many more with terribly inadequate insurance, and they are looked in the eye and denied treatment for their cancer, simply due to the bad luck of working at a job without coverage.

However, this is not Leroy's decision to make or battle to fight. He is doing what any other human being, including myself, would do in this situation — he is fighting for as long and as good of a life as he can with all the resources at his disposal. But there are people who are making decisions that affect the availability of health care to Americans and to people around the world. And those of us who are not focusing our energies on a battle with cancer can tell decision makers that we want answers. Why do these drugs cost so much, with so much $$ going to profit and pharma CEO salaries? Why doesn't Medicare negotiate for drug prices instead of using our govt health care dollars for pharma profit? How could we shift more money from insurance company overhead into direct health care if insurance was regulated or Medicare expanded? How would world health and peace be served by shifting our government money from war to global health care?

I agree that Leroy can't affect these problems by getting or not getting a PET scan. And further more, no one with cancer should be expending their energy thinking about these issues — they are appropriately focusing on health, life, and family. But the rest of us shouldn't just throw up our hands and say that nothing can be done, it's just the system. We should ask why, in the richest country on earth, that spends more per capita on health care than any other country, but is the only developed country without universal health coverage, why every American cant have the same good care that Leroy has.

Sent by A.M. | 11:44 AM ET | 01-16-2007

I read your column everyday. It gives me strength. I have just completed treatment and have run up a lot of insurance bills. It costs way more than one can ever imagine. As I head back to work this week after six months of medical leave I feel grateful. I am heading back to a job I love, teaching. I feel ready to touch the lives of many students. I feel that my expensive treatment has allowed me to do this. I hope it is worth it. To Pam, I hope you never have to face such an illness. You just sit back and enjoy your cup of coffee. To everyone else be strong and continue to fight!

Sent by Geri | 11:46 AM ET | 01-16-2007

My only experience with cancer has been my husband's prostate cancer. One of the most easily curable and treatable. We are very lucky. Our only difficulty was with sexual function. Our insurance pays for shots and pills so that we can have a fairly normal married life. He is 72 and I am 64.

Apparently Pam would say that the money paid for his surgery and medication was a waste and should have been used to help someone she considers more unfortunate than us.

But how many cancer survivors are still alive because of money spent on treatment, and therefore are able to be healthcare workers, volunteers for Red Cross or some other charitable organization or any other myriad of opportunities to help those less fortunate than themselves in this country or elsewhere.

Why isn't Pam sending the money she spends on computers and all that enables her to read your blog, to Doctors without Borders, the UN relief fund, Darfur, or any number of other places.

My experience in life tells me that she might be a very judgmental person who does not herself, contribute much to the very problems she says would be better served by using money now used for cancer treatment and research.

It would be very interesting to know just how she does contribute to the "the growing numbers of innocent victims of genocide, war, hunger, disease, poverty."

An important question that I haven't seen asked in the comments is "Why is she even reading the blog if she can't relate to it on any level?"

Sent by Susan S. | 11:48 AM ET | 01-16-2007

Wow! I almost fell out of my chair when I read her comment. I am a 34-year-old woman and I was diagnosed with Stage 2 (T3N0) rectal cancer on 12/22. I found your blog while searching for information about Folfox - which I am starting week after next. Along with radiation. Then I am having surgery to remove my entire rectum — which means Ill have a colostomy bag for the rest of my life. And then after surgery I am looking at 4-6 more months of chemo. So, I guess you could say that many resources will be expended to guarantee that I live to see my 50s or 60s. I had what would be considered a privileged upbringing and live a nice life now. I work hard for what I have, but have always had the cushion of generous parents — if something happened to me. And now something has. My whole world has been turned upside down. I will not be able to have children because of this. I am going to have a colostomy bag at 34. Not fun things to think about when you're 34 and single! But I absolutely believe that mountains should be moved to make sure I live. I volunteer and have been involved in the fight against breast cancer since my Mom had it for the first time in 1985. (She got it again in 2005). I truly believe that the good we do for others comes back around and now it's my turn to reap the benefits of it. And I am going to take all I can get. And I think you should, too. This woman Pam is a fool and clearly does not "get it." Thanks for your blog and I'm going to keep reading!

Sent by Carrie | 11:51 AM ET | 01-16-2007

I have one more thought.

My mother died from colon cancer. The doctors gave up on her and didn't treat her. According to Pam's theory, there are underprivleged people somewhere that benefited.

Of course, this is ridiculous. No one chooses whether to treat illness or give an underprivileged person a better life.

The reason there is funding for any cause is a direct result of advocacy.

So, Pam feels passionately about the plight of the underprivileged. Her choice is to sit on her butt sipping coffee and sling guilt at someone for seeking treatment and announce their life is somehow not worth saving.

Heartless?? That is a complete understatement.

Sent by Karen | 11:54 AM ET | 01-16-2007

This is the first I have posted although I have been reading your blog for sometime.

My first thought after reading Pam's post was that she has never had a loved one with a serious disease. My mother died of lung cancer this past May at the age of 73. Before her illness I never realized how desperate one could be to see someone live. I am certainly much more empathetic with anyone going through this journey than I was before. I read your blog with the hope that you will be around a long time.

Also, I am a medical librarian, so everyday I see the value of medical research. Physicians do not practice in a vacuum. They learn from each other, from the medical literature and from their patients. Your physicians are not wasting money trying to keep you alive. They are also learning how to keep other patients alive. This is the process that has resulted in cures for cancers that once were death sentences. This is why we tried to get my mom into a clinical trial?because it not only offered hope but also the chance to help future cancer patients. Your struggle is not pointless. Hang in there.

Sent by Doreen Roberts | 12:08 PM ET | 01-16-2007

I may be in the minority here, but I understand the origin of Pam's question. I can understand her reasoning — how and why she drew that conclusion.

Further, I may be in an even smaller minority when I state I disagree with Leroy on the issue of "luck of the draw." It is unknown if our souls (or any other power) decides when, where, and what conditions/circumstances will await us when were born.

Once we are born, however, decisions and judgments are made every minute of every day regarding who lives and who perishes. We choose to call it things like, "distribution of wealth", "supply and demand", "market forces", and my favorite, "capitalized and free economies".

These aren't ethereal forces that coincidently decide people's fate. PEOPLE make these decisions. As human beings, we are ALL responsible for one another and the privilege and/or deprivation that befall us. We decide which causes warrant the resources that will provide salvation. Western civilization decided long ago that countries in Africa, the Middle East, Caribbean, Asia, etc. weren't worthy of the same treatments. This has existed for centuries and humanity has allowed it to be explained away by calling it happenstance.

Leroy, the answer to your question of "Who decides?" is all of us. Part of being a "lucky" U.S. citizen (or European) is being able to have the money and resources at the expense of others.

Sent by Michael McGalin | 12:12 PM ET | 01-16-2007

I found Pam's comment to be very interesting. I, too, am concerned about the few who waste resources while the many suffer. However, I don't think I would have ever applied that thinking to healthcare.

Firstly, if she really is concerned about the cost of treating cancer, Pam may wish, for example, to look at the profits drug companies make in the U.S. versus in other industrialized nations. I don't think the solution to that issue should be to let more people die so that we can save healthcare dollars.

Secondly, there are so many other areas of waste that are much larger, and have much less benefit to society than healthcare. Look at the cost of the Iraq war, for example, with lots of no-bid contracts that are not audited or checked in any way for fraud or the tons of dollars ear-marked by congress every year for pork barrel projects. Resources that could be used to better purposes without costing others lives.

If it were your child or spouse or parent who were ill, you might find it difficult to deny them expensive treatment and we are all someone's children, if not spouses or parents.

Sent by Jane | 12:14 PM ET | 01-16-2007

I am a cancer patient and I find Pam's comments offensive.

Its so easy to sit back and make comments about things you haven't experienced. I wonder if Pam traded places with us if her opinions might change.

Sent by Mary Scruggs | 12:15 PM ET | 01-16-2007

Has Pam ever stopped to pondered that maybe one of those privileged lives saved today by those unknown amount of resources devoted to cancer research may just be someone who helps prevent the suffering of the faceless masses injured by war, genocide and countless other social injustices?

Lead on Leroy.

Sent by Jessie | 12:17 PM ET | 01-16-2007

It seems as though these kinds of thoughts come to us when we see all the truly awful things that happen to people in other parts of the world — and here too! Leroy, you've seen it. Sometimes I feel a bit guilty for my "daily bread" plus so much more.

But all that is gone when my thoughts about "too many people" in the world and not enough money to fix the problems (never mind that money will not fix many of the problems!) when I think about: hmm, just which people would I eliminate? Not my family, not my friends, not my friends' friends. Considering that were all connected at some level, that pretty much eliminates the elimination.

Pam's thoughts perhaps provoke contemplation — but only in the abstract. Just as soon as medicine, housing, food affects people I know or even can imagine, compassion kicks in. As a previous commenter noted, Pam must not have anyone close to her who has faced such dire adversity.

Leroy, I hope the radiation and chemo haven't — and don't — diminish your hug-ability. I wish I could reach out and give you a hug of comfort and appreciation.

Sent by Gail | 12:19 PM ET | 01-16-2007

Leroy,

You have dignity and poise I can only aspire to have in my lifetime. Keep up with what you do every day. You inspire us all.

Sent by Rhonda | 1:44 PM ET | 01-16-2007

Message for Leroy...I, too, read your posts every morning and doing that reminds me to pray for you and for all those in need, struggling to survive every day.

Included in my prayers is my friend Jennifer who has cancer. She is only 29. Your blog helps me to understand better what she does just to get through every day. She is expecting her baby in April. During this time of pregnancy, she has not had chemo and the prospect of her resuming, let alone the time the cancer has had to evolve, is scary for all of us who love her. Like you, and many, many others, she exhibits courage beyond imagination.

I am sorry for the post from Pam. I am sorry for your cancer and for all those who suffer in this world. I use almost nothing of my health insurance and if the money I don't need goes to helping you, Jennifer, and others, Hurray! It is the least I can do... keep on, Leroy! More courage and strength and hopeful miracles to you! None of us can put a price on the life of another... in God's domain, He loves us all. Nobody is worth more or less.

Sent by Imani | 1:47 PM ET | 01-16-2007

I think many people would react as you did to Pam's questioning the cost of care for sick privileged people. With all good intentions for the overwhelming masses of grossly underprivileged humanity, it is a natural response on an impersonal level to think that spreading out resources evenly would be more just. Theoretically it seems so. In practice, the needs or the world are so great possibly no one would benefit.

It is a great starting point for several discussions. One is that by spending large amounts of resources on sick people in this country we have effectively used each patient in an experimental fashion. Patients try a variety new drugs and therapies, advancing the knowledge of the medical community and the treatment for all future sick people.

Another discussion is the allocation of resources to treat patients and the rising cost of medical care. One of my own views is that abortions to prevent unwanted pregnancies or the births of severely ill babies is positive on many levels, including the cost issue. And that the resources spent on extremely aged or ill individuals who would prefer to opt out is a waste. I would never advocate anyone be required to have an abortion or be euthanized because they have Alzheimer's or Lou Gerhig's disease, but I strongly feel the right to these choices. It is a belief in quality of life over quantity of life and my concern that resources not be forced on adults that don't want them.

My last of many other discussions I could prompt is the idea of who is a victim. Pain and sadness and suffering is just that no matter what age you are, where you live, the number of people you are suffering with or how lucky you have been up to that point in life. Why Pam would choose to put the word victim in quote marks is the biggest mystery to me of all.

Pam probably isn't heartless. I would question her logic and the depth of thought she has put into the matter. But there is a wide range of values in your audience and it's great you bring them into a forum that might prompt some thought.

Best of luck and thank you.

Sent by Lynn | 1:48 PM ET | 01-16-2007

It's appalling that people can be so "heartless" or "ignorant." I can't decide which best characterizes Pam. But I do appreciate your struggles and I appreciate your willingness to share the details of your treatment. I hope Pam never gets the dreaded diagnosis but odds are not in her favor. I had surgery for colon cancer last January & this week had the follow-up colonoscopy. I'm cancer free! A close friend has just been diagnosed with melanoma but in its earliest stage so she should be fine. One of my husband's co-workers just received a diagnosis of prostate cancer. So I hope someone out there isn't making decisions about whether any of us deserve to have resources expended on us! Actually, we need a national health care system to provide better treatment to more people. Take care!

Sent by Ann Donley | 1:52 PM ET | 01-16-2007

Pam appears to have triggered an enormous outpouring of support for you, Leroy. She poses the challenge we all face daily in dealing with cost versus value. The fact is every life is priceless but society or insurance or others believe it has a price tag and tries to justify limiting expenses. All we can do today and everyday is to reaffirm our commitment to life. Strange to be under the impression that it is moral to limit benefits to anyone or for anyone to give up because there is so much misery and suffering in the world. One day at a time, one person at a time, one medical advance at a time may be all we can ask for but it is how we learn and grow and perhaps find some victories. So Leroy, I salute you for what you are doing and everyone else like you for being part of the solution and for considering life priceless.

Sent by Rich | 1:52 PM ET | 01-16-2007

Do you see, Leroy how powerful you are to all of us out here in this unforgiving world? I truly have been blessed by this cancer "experience" with meeting all of these perfect strangers in this world of Internet. My life is changed forever by your words and their words. Thank you so much for helping me to learn about myself and others. It is humbling, heartwarming, and somehow I feel so fortunate because of it.

Sent by Marianne Dalton | 1:56 PM ET | 01-16-2007

Living is about hope, not just who is "worth it" "lived well, long, etc..."

We hope that our lives are worthwhile, that we love our families, our friends, maybe even make a difference in our jobs. For someone to think that another's life or trying to keep living is not a worthy goal, they must be very sad, hopeless, and without love in their life. Think about the replicant in the end of Bladerunner who loved life — any life — and you see the hope in the end of why you keep trying to live, well, better and enjoy it while you can. Good luck to you!

Sent by Fleur Duggan | 2:03 PM ET | 01-16-2007

Leroy and others,

I must join the few voices that have stated that Pam is not ignorant or heartless. She has asked a critical question that is simply uncomfortable for most of us to consider. Yet, she is not alone. Insurance companies already limit what they pay for certain procedures so the idea of limiting treatment and costs is not new.

Perhaps she could have used another word besides "cancer victim." I was diagnosed two years ago with stage III colon cancer, had surgery and went through chemo. Maybe I am unlucky, but have never considered myself a victim. My recent scans show spots in my liver and lungs although I don't know for certain what they are (but I have a good guess). At times I have wondered, and felt somewhat guilty, as others have said in these posts, about the costs of my treatments. Yet the question Pam raises must be asked. And it also hints at other questions: Why are healthcare costs so high in the first place? Who benefits from the high costs? Why is it that insurance companies can afford big buildings with their name on it and have TV commercials? How can drug companies afford those commercials? How much does a CEO of a drug company need to make?

I am just one among many of you who have cancer. We are just a few of the people who suffer in this world. Yet, the resources are there to help us all. This is not an either/or proposition. We cannot look at this as some have said, "life is simply unfair so I am grabbing all there is." That is a narrow and limiting mindset.

Pam, in fact, seems to express compassion. She sees the millions who suffer due to war, genocide, and poverty and then wonders how an affluent society such as ours can do better. If there is a marker of spirituality then it must be care for the marginalized. Am I, as one who has cancer in this country, marginalized? Some may say yes, but compared to the world the answer is no.

So the questions must be asked, what is reasonable in treatment? Where do we put our dollars? Leroy himself is asking about the quality v. quantity of life. These are not forbidden questions. Let's continue to ask and probe, even as we live and learn from each other.

I'll take my coffee black, and have it with Pam — and Leroy.

P.S. Leroy, my sweet caregiver wife loves you and may disown me for this post. I told her you would understand.

Sent by Jeff Blanton | 2:07 PM ET | 01-16-2007

Leroy,

Need I say anything more? Look at the amount of support that has been sent your way today. Keep up the great work.

Sent by Jane | 3:10 PM ET | 01-16-2007

No, Pam, you're not alone in asking this question. I am a senior citizen who has had hundreds of thousands of dollars spent on my health care over the past few years, paid for by insurance and Medicare. But when I think about it I feel guilty, because I realize that hundreds of children are dying each day because they can't afford the most basic of childhood healthcare. Of course, I'm as selfish as the next person, so I'm not complaining... but it is food for thought.

Sent by Martin Boyce | 3:13 PM ET | 01-16-2007

Whew! After the initial alarm of "Pam's" words, being calmed by Leroy's helpful insight & reflecting on all the responses, I finally recognized "Pam's" VOICE. I've heard it before — the voice of the indifferent or angry teenager in the classroom. For years I only heard the insensitivity & anger. Now I'm able to see & hear deep sadness & pain behind the words of many male & female PAMS.

Perhaps "our" Pam can only envision caring for those really far away, because she/he hasn't felt love up close. "Loved ones? Who are they? No one loved me, why would I care about one of them? Myself? No one cared or cares for me, why should I care to stick around?" Sadly, PAMS are everywhere — on the road, at work, in the store. This one just hurt more, by blurting out in the class of the hurting — this large community of "loved ones."

I will end my day with a cup of tea, and hope & pray that our adult Pam will soon experience what we have, the immeasurable value & love for "just" one person — one highly treasured person in great need of care. And can reach beyond the privileged computer we all enjoy to put that care & love into action.

Cancer warriors & loved ones march on!

Sent by Karen | 3:20 PM ET | 01-16-2007

When I was recovering from cancer years ago, having lost all my hair, gained a lot of weight, and with permanent numbness on some of my fingers and forever incessant ringing in my ears, a friend at work (whom I really liked) came up to me one day and gave me some advice.

I really shouldn't have gone thru the chemotherapy, he said. It's not natural.

I didn't know quite what to say. I had survived a cancer that years later led me to wear a yellow band (until recently). I had survived the radiation therapy and then subsequent tumors that started growing in my lungs and near my kidneys. And I had survived the chemotherapy that made those tumors recede. And this guy was telling me I had done the wrong thing.

His thoughts might have been legitimate. His motives were certainly not unkind. But I had been at death's door, and for that he should have just kept his interesting philosophical contemplations to himself.

Sent by David | 3:22 PM ET | 01-16-2007

You write, "There are great inequities in this world not everyone has access to the same resources. But that doesn't mean that anyone else gets to decide who deserves it and who doesn't." That last line — read it again. Does that mean you have moved heaven and earth to promote universal health care coverage? Are there any people out there angry at "Pam," but by their inaction, their voting record, their everyday actions, showing that really, deep down, they feel its perfectly OK for some to have good health care, and others not? Do you acknowledge at all that health care dollars are limited? The truth is, it is, under the current system and probably always, it is impossible to offer the best of care to everyone at all times. This is just a fact.

Who decides who deserves it and who doesn't [deserve it]? Why, if you don't advocate for equal health care access, then it is you, you who are deciding who deserves it — and who doesn't. And it's not about putting a crass monetary value on a person's life, but about privileged people being unwilling to live with a little less so that everyone has access to the kind of health care they themselves feel they have an inalienable right to.

"In the end, life is about loving people, especially in their times of need, and hoping that when you may end up in the same situation, someone will be there to love you." Yes, and I hope that the love you write of includes voting for, advocating for, health care for all, so that there is not only someone there to love them, but a host of caring professionals to treat them medically and offer hope to them. What are you doing to promote this? Can you imagine going through what you're going through if you were a single parent employed as a clerk at Wal-Mart? Or don't they "deserve" the kind of help you're getting? Who decides? YOU decide.

I wish there were unlimited resources. My own feeling is to do all that can be done for anyone who needs it. And I wish us all well as we deal with the illnesses we and our loved ones encounter in our lives. But I have learned that if you insist upon the compassion of others in your times of trouble, you had best be offering it to everyone. That's everyone. Straight, gay, poor, rich, support network, homeless, addicted, sober, witty, stupid, compassionate, blind.

Sent by Haley | 3:25 PM ET | 01-16-2007

I appreciate your response to Pam and what is, apparently, her indifference to the suffering of others, including yourself. However, I would say that no matter what seems to come your way, both in sickness and health, privilege and want... you have the words — and the heart — for it. Thank you so much.

Sent by Susan | 3:28 PM ET | 01-16-2007

Well, Leroy,

I am glad that you told us that you read all of our posts; I always wondered if you really did. You've already got so many responses to the Pam article. I sincerely hope that you hear from your entire cancer family. Looks like you've got a lot of reading to do this weekend.

Actually, I thought your letter was very calm and well spoken. I know I was in a rage! I also know that I could not have expressed myself nearly as well in response to such a cheap shot. I couldn't help but wonder as Pam reads her morning news over a cup of coffee, how she would react to the news "you have cancer." Bet it wouldn't be nearly as cold hearted, if cancer got up close and personal with her.

All I can say is that she is obviously blissfully ignorant to sit in judgment like that. She is probably one of those people who when they find out a friend has miscarried tells them that it is OK because the baby must have had something wrong with it and would have never lived a productive life.

Congratulations on your grace under fire. You are amazing!

Sent by Cathy Sewell | 3:33 PM ET | 01-16-2007

First of all, thank you so much for what you're doing with this blog. I download your radio time on my podcasts and listen to them for perspective and hope.

Pam's post made me angry and sad, as well. I'm currently being treated for endometrial cancer and my former partner is currently being treated for recurrent ovarian cancer. Are we fortunate that we have insurance that covers the expenses for this disease? You bet! Do I feel guilty over that "privilege"? Sometimes. What I most focus on is our 6-year-old daughter who has two moms with cancer! Are we fighting the fight of our lives? Absolutely. And I think if you speak to our daughter when she's older, shell be happy that the doctors are doing all they can to save her moms. She's already been an orphan once in her life, I certainly don't want that to happen again.

Is this privilege? Maybe. I just feel grateful for everyday I have and wish that everyone going through any life-threatening ordeal had the same chance. That doesn't happen. So all we can do is live our life to the fullest each day. And that starts by stopping all the judging of others that happens.

Be well.

Sent by Jamie | 3:37 PM ET | 01-16-2007

Wow, aren't we being a bit harsh toward "Pam"? Leroy made a reasoned and reasonable response. Now we need to accept that "Pam" is not a Frankenstein monster and we don't need to hound her from our community. She made an uninformed comment, NPR and Leroy decided to share it with all of us. We are surely mature enough to consider what has been said without hurling invective, aren't we?

Sent by Katie | 3:39 PM ET | 01-16-2007

Pam,

You want to explain to my children why I am going to die and that all the money I have paid into health insurance shouldn't allow me to have access to the available treatments? I am just guessing here, but I betting you don't have cancer. If that lightning bolt were to strike and you get cancer (and I hope it doesn't) something tells me your altruistic stance may change. It's nice to have the opportunity to sit in your warm home and pontificate about something you have no experience with. I didn't hear in your e-mail that you were heading off to the Sudan anytime soon.

Sent by Bob | 3:52 PM ET | 01-16-2007

Dear Leroy:

I am sorry that someone who has never been in "cancer world" has the nerve to pronounce judgment. Who knows how Pam would think if it were she who had cancer or a loved one, including a child?

You are putting your life out there for all of us to read, and to participate in vicariously. You can have cancer and grace or cancer and bitterness. You have Grace.

As for the new chemo, go for it. If the side effects are too debilitating, you can stop. When I went through breast cancer chemo at age 38, I was so, so sick. I was told to smoke pot, and refused. In retrospect, I should have done it, as it probably would have helped with the nausea.

You are inspiring for putting your feelings out there in public. You are not a hero, because you are doing what you have to do. I think heroes do things that are not expected of most people. I like to save the word "hero" for those people, which in no way detracts from your bravery and poise in volunteering to pose a part of your life for the general bottle-necking consumption of the public.

Lots of love from the tropics in St. Thomas.

Sent by Julie Evert | 3:58 PM ET | 01-16-2007

Regarding Pam's comments, her posting was simply insensitive and mean-spirited. One is certainly entitled to his/her opinions, but as one writer responded, perhaps Pam's mother never taught her "if you have nothing nice to say, don't say anything".

Best wishes to all of you.

Sent by Liz | 4:23 PM ET | 01-16-2007

WOW is all I can say. It is almost the same as saying if you just let a starving child go a few more days, we won't need to feed him/her. I am concerned that we spend so much money on things that seem to go on and on. For example, the amounts we are spending for one particular company in the Middle East that seems to get the most funding although they have just lost millions somehow. Or maybe that we have taken so much from Social Security to fund homeland security. I guess the key is the both share "security" in their description?

Maybe the best thing that can happen to Pam is that she becomes a victim of the big C. Or maybe she has children that she would think about leaving as her disease progresses. Or maybe she could argue with the doctors whether "just one more" treatment would work this time.

As a 3+ year survivor of stage IV oral cancer, I am glad they "invested" the money in me, for sure, as is my family.

Best Wishes always.

Sent by Ed Brown | 4:32 PM ET | 01-16-2007

My first reaction to Pam was, WHAT??? I've read many of the responses, including yours. Of course you are correct and your life/work experience goes well beyond what most of us could ever anticipate. But I must say that Pam's letter caused me pause. As one who has undergone treatment for cancer, I'd never considered the expense in terms of resources expended on my behalf. But there is something to reflect upon here, not from a moralistic or judgmental perspective, but from a one-world perspective. Am I putting back into the world through my words, deeds and actions an amount equal to that which I have received? I hope so, but I think I need to get busy and make sure I keep the scales in balance — love more, give more, create more, live with compassion. I'm working on it.

Sent by Maya Brand | 4:34 PM ET | 01-16-2007

I have had similar discussions with people about their perceptions of children with disabilities. In my work as a pediatric physical therapist, I see the joy each child brings to his/her family and their contribution to our society, even if it is a small and quiet one. Each life is important and no one has the right to judge, as you so eloquently say, the worth of that life. I can only imagine that Pam has not had a loved one diagnosed with disease or born with a disability. Playing God is a dangerous place to go.

Leroy, your impact on the world and all of us is priceless, and so are you.

Sent by Karen | 4:36 PM ET | 01-16-2007

I have been reading this blog daily for the last few months. My husband was diagnosed with late-stage lung cancer just over one year ago. He is a never-smoker and we have three young children. It isn't fair, life is not supposed to be fair, we are all faced with different battles and different situations and life is how we respond and travel on this journey.

Obviously, Pam's journey has been different than ours. I know that what we are going through has changed my worldview enormously. I still cry for those who suffer in other parts of the world and do try to help the "under-privileged" with both time and money — is it enough? No, but would I choose to do nothing for them or for my husband? Again, no.

What price is it worth to give my children a few more months or years with their father? To me, everything. Does this mean I feel less about the rest of the world? Do I think we are more deserving? No, but what I have learned is that we each contribute to the world in unique ways and are all valuable.

Judiasm teaches that saving one life is like saving an entire world. The reasoning being that you never know who or what that one life is going to touch and what ripple effect it will start.

Pam, I understand your thought process and am glad you had the courage to bring this up, but I hope you take the time to read the responses and tell us what you feel now.

Sent by Alissa | 4:38 PM ET | 01-16-2007

Wow! What a firestorm of passionate commentary this has evoked! The systems issue of how to use resources in the most constructive and equitable way is a real concern. And the feelings of individuals to seek the care they feel appropriate is real. In my own life, after 4 rounds of cancer that has so far not threatened my life, I think a fair amount about the wonderful question Clarissa Pinkola Estes poses in one of her stories, "How Much is Enough?"

I know that in my own life, I have lived to see all the greatest things I dreamed of seeing: both children grown into loving, creative, capable adults a sweet empty-nest season with my beloved having time to care for all four of our parents at the ends of their dear lives and a sense (at last!) of a growing desire to turn this country and world around with love and collaboration instead of fear and threats. So I can die happy any time, and have written instructions to my durable power of medical attorney to make measured choices re: expensive health care in my case only.

I do not speak for anyone else. I love my life, but I don't want to take desperate and expensive measures for no real gain. Again, I do not suggest this should apply to anyone but me, but that is my choice. I want hope and help and healing for everyone whose life has been touched by illness or injury. And the supports required to help them integrate the changes and find their wholeness despite what transitions they have come through. And I think if we look at the systems issues with both care and rational concern, and at the human issues with empathy instead of judgment, we might find a middle way. That is my hope, and my prayer.

And I know change can happen. Years ago, when I first asked my beloved that even if I am brutally attacked and killed, to go to court to ask that the death penalty NOT be an option the court would consider, he did not feel he could do it. Now, after many years, he has found his way to believing he can do that for me, should the need arise. I hope he never has to, but it reminds me how we can — with enough time — fine our way through hard choices and can grow beyond our borders in the process. And that is what cancer, and being a step-parent have taught me best in my life. How to exceed the limitations that first felt set in concrete. I have learned new ways to think of life, of the universe, of facing everything from love and being patient when I react with fear. Long ways yet to go, but I know that in every gateway living and dying offers me, there is more to learn, and that I can face them with gratitude.

I wish you all joy, and ease, and absolute delight. Thank you again, Leroy for this remarkable forum. You are indeed a cherished person doing remarkable things with your time and light!

Sent by Sarah | 4:41 PM ET | 01-16-2007

Dear Leroy: There is a discussion to be had regarding what Pam says... However, it is not one of who is deserving of living a long and healthy life and who is not. What Pam is asking gets us to that slippery slope that is meant when discussions are had regarding who is "deserving" of care and what lines need to be drawn when parceling out limited health care dollars. A conversation that could go on much longer than this space allows.

ALL life has value and as such deserves to have the resources necessary to have basic needs met...including healthcare. If we approached everyone's life this way who is to say that resources wouldn't be less rather than more scarce? I could go on...

I don't know Pam, that is true. But I would be willing to bet "dollars to doughnuts" that if Pam were in your shoes, or a family member of hers were in your shoes, Pam might very well feel very differently. Each person ought to decide what is "worth doing" in terms of care, not their circumstances, privileged or not.

Be well.

Sent by Sandra Yudilevich | 4:45 PM ET | 01-16-2007

Dear Leroy,

Two years ago, I was diagnosed with Primary Central Nervous System Lymphoma and underwent intensive chemotherapy. Slowly my motor functions have returned and I am now able to lead a "normal" life. Every three months I have an MRI. I know that the cancer can, and most probably will return and so try to live each day as fully as possible.

I was struck with Pam's letter and your response as well as the responses of others to Friday's blog. Throughout my life, I have wrestled with the discrepancies of opportunities of the first and third world peoples and I am touched by the lives of those who struggle in poverty and violence.

Your story of the doctor in Rwanda is quite telling. Last year, I visited a small and very poor mission of a friend in Central America. One man, in particular, was anxious to tell me that he prayed for me daily. His daughter was also diagnosed with a brain tumor at the same time I was. She died for lack of medical care. What was striking about the meeting was his joy that I was alive and that I had come to visit.

For me touching the lives of the poor and those without access to medical care simply invites me to reach out to "one person at a time." My powerlessness to "do something" is humbling. The only medicine I have to offer is my hand.

What is the value of a life: mine, yours, others? The gift of affluence is that we can wrestle and work toward a more equitable society, "poco a poco" as my friends say. In the meantime, it is important for me to value the life of each person I meet daily and to see that person's life is as valuable as my own. To do so, moves the question of value of human life and resource allocation, out of the economic realm and invites us to rethink our actions and public policy through our own willingness to be changed.

Sent by Carol Ludden | 4:48 PM ET | 01-16-2007

OK — maybe it's time to call a moratorium on bashing poor Pam. If she is still reading this, she has perhaps gotten a sense of what its like to be on the other side of the cancer fence. Your perspective changes completely and irrevocably when you're first told that you have cancer. Your first thought isn't "Do I deserve to have my treatment paid for?" but "Please do whatever you can to cure me or allow me to live long enough to see my kids graduate/get married, etc."

Is the cost to keep me and everyone else with a terrible disease worth it? You bet it is. Is the cost reasonable? None of us in this forum is probably going to be a fair judge of that — we have a pretty vested interest in the outcome. And if insurance wasn't paying for it, would I attempt to try to keep paying it on my own — you bet, and for as long as I could - beg, borrow, or maybe even steal.

But I do have insurance, and at the risk of being a "troll" (I love that term!) to the insurance companies, all insurance is basically a gamble or lottery. You pay your premiums for your auto, homeowner, medical and life insurance, and usually the house (the insurance company )wins. This is a gamble or lottery that you really don't want to win because it means that there has been some catastrophic damage to your home, your car, your health, or if you're really unlucky, your life. Six months ago, I "won" the health insurance lottery and got cancer. No television personality or models delivered a big check to my front door, listing my maximum lifetime medical benefit on it, nor do they come and offer me congratulations with each monthly explanation of benefits statements. And I even get to pay for part of this big winning with co-payments and anything that the insurance company thinks is beyond "usual and customary." Some prize.

So Pam, I hope you can understand us a little better. I offer you a challenge that maybe the rest of the respondents can help with. If you still need to see with your own eyes where and on whom all that money is being spent on — we will offer to open your eyes by taking you to our treatment clinics. Meet us and our families and professional care-givers and see what we live with. If you really need an eye-opener, visit the pediatric cancer ward. At the end of the day, make it right and write out two checks — one to the American Cancer Society, and one to Doctors Without Borders or other international aid agency. It will be a start.

Sent by Bob Maimone | 4:52 PM ET | 01-16-2007

Your attitude, as always, is wonderful. Way to go!!!!

Sent by Joanne | 4:54 PM ET | 01-16-2007

Leroy —

There is only one word to describe Pam's comment: insensitive. Some folks just enjoy being provocative, I guess. But I've learned one thing in the past 51 years I've been alive: what goes around comes around. Pam has never had contact with a cancer patient in her lifetime... please! Come out from under that rock, girlfriend!

Thanks for your patience and generosity, Leroy! Your blog is very important to us.

Sent by Kathy | 4:56 PM ET | 01-16-2007

I think Pam's comment demonstrates the difference between knowledge and wisdom. One doesn't balance the inequities of world wealth distribution by quibbling about the treatment of one individual with cancer. Just as one doesn't enter into a discussion of the economics of treatment with a poor, ill person in the Sudan or India. There are appropriate forums for this kind of discussion. It shows a lack of compassion and empathy on the writer's part. So much so, that one hopes it is a matter of ignorance and not a form of sociopathy or mental disorder.

I'm sorry that you received this letter. I wish you well.

Sent by Jane | 4:58 PM ET | 01-16-2007

I guess Pam thinks that if my family and the insurance didn't pay for all my expensive treatments this money would go to benefit the poor in some blighted part of the world? Her question reeks of arrogance — the arrogance of one who would play God — whose life is worth living and how much is it worth paying for it? Since my diagnosis a year ago I have been amazed at the amount of warmth, good will, helpfulness and love that I have received from many people because of my cancer. Her attitude may be found among a certain small segment of the population, but she is the first person I have ever heard express it! I'm sure the many relatives, friends, neighbors, and co-workers of cancer victims (what's with her parenthesis, anyway) would vehemently disagree with her as to the worth of a life of someone they know. I appreciate every moment of life, and to me it is priceless.

Sent by Marcia Greer | 5:00 PM ET | 01-16-2007

I am a "victim" of cancer. Ovarian Cancer. My care costs hundreds of thousands of dollars. I know I'm fortunate to have good medical coverage, otherwise I would not exist today. I'm a mother and grandmother, and therefore feel that I have a very high purpose for survival. I don't feel privileged. Who with cancer does?

Pam is looking at this from a narrow point of view. She doesn't realize the significance of any discovery made through the care of any cancer "victim." Anything learned can help many that come after us. No discovery is wasted on just one. We're undergoing treatment, but we're also pioneering medicine for future generations. It's a very broad picture and cannot be looked at through a narrow scope.

Sent by Juanita Helms | 5:03 PM ET | 01-16-2007

Mr. Sievers,

Thank you for the My Cancer blog. I made it through Non-Hodgkins Lymphoma years ago, and I really appreciate your willingness to discuss how cancer affects all of our lives.

Perhaps if you are searching for a topic to write about one morning, you could discuss any literature you've found particularly insightful or helpful in regards to cancer? I have a degree in Great Books (yes, it exists!), so perhaps I am a bit biased in my belief that books can truly help you understand things in life. Gunther's "Death Be Not Proud" and Edson's play "Wit" come to mind.

Finally, a local reporter (and friend) has been following a New Hampshire woman fighting a rare form of cancer called cholangiocarcinoma. Like you, I think she captures not only the day-to-day struggle, but also the human, inspirational side of it. If you have time, here it is.

Regards.

Sent by Greg | 5:25 PM ET | 01-16-2007

Dear Mr. Sievers?Leroy,

First, thanks for sharing your journey through a hellish cancer valley with all of us. I'm praying you emerge at the rim of the canyon, arms outstretched, victorious, and poised to take a long leisurely, 50-year plus stroll, comparatively, through the rest of your life.

I've been reading your story for a while now, and I've mulled over some responses, but I guess it took Pam's baloney comments to move me to write. In response to her statement, "I'm certain this will be interpreted by all as heartless, but... blah, blah, blah."

I would tell Pam, you're right, your words are heartless, (not to mention your karma is now in the toilet!) but no, you're not alone in your question/sentiments, in fact you should have no problem finding a job with an insurance company, or better yet, the U.S. government, no wait, there's an HMO with a door with your name on it, I'm sure.

Pam's comments are amusing to those of us who have navigated the health system for ourselves and/or our loved ones. See how easily, how very naively, she slips from gratitude at not having an expensive health crisis: "I am not and have never been the victim of cancer and for that I am grateful," to her assessment there is something immoral about, "expending unknown amounts of resources extending the life of one adult victim who, it appears, has lived a privileged life up to this point."

Nice burn on you, Leroy, there at the end, especially the use of the word, "victim," (what was up with that?) and certainly when coming from, what appears to be, an especially privileged American — It's apparent that she hasn't ridden life's roller coaster down to the bottom?yet. I emphasize the word yet, because her turn will come. And if not her, it will be her parent, her baby, or her loved one that faces a health problem and then she will she the foolishness of her words.

Yes, I personally feel that our country is seriously remiss in not providing some type of universal health care to all of our citizens, but I have no qualms about treating patients as aggressively as necessary to extend their life until they decide otherwise. In the end, unfortunately, it is sometimes the insurance or the lack of it, that does decide who gets the resources and who doesn't. But some people even beat those doors down and win. I could use all kinds of examples and Leroy, I'll bet you will get lots of heart-ripping ones from your readers, of patients who were told, well, we could try this but, it's experimental, it's not covered, but we'll do this and this, and the odds aren't good, etc? and the person got the treatment, survived and went on to do some extraordinary living, some fantastic things with the time they fought for. Hey, that could be you! :)

Good luck and hang in there!

Sent by Mary E. (Mare) Fenno | 5:34 PM ET | 01-16-2007

By Pam's argument, any dollar spent in the states could be better spent elsewhere. Every time we eat at a nice restaurant, the money spent could save lives in a third-world country. The same can be said about treating allergies, buying a car, having heat and air conditioning in your house. The Pams of this world will never be satisfied. They are the same people who criticize the donations made by millionaires because they could have donated more. And confident in her moral superiority, Pam has probably moved on and will never participate in the dialog that she has generated.

When DHs melanoma first recurred, the surgeon we used asked us why we were bothering with the surgery. The end result will be the same, so why bother? I've always thought this was a quality/quantity question, but in Pams mind it's a quality/quantity/worth question. The surgery was over three years ago. There have been two surgeries since. And another baby. DH continues to work, and we still have dreams and hopes. And we enjoy every minute of our time together. (And we did not go back to that surgeon.)

I assume that Pam does not have medical insurance. The reason for insurance is so that the financial aspects of being sick are not a concern — so that we don't have to decide whether extending our lives is worth losing our homes or retirement savings. Thank you, Pam, for telling us that we are immoral by not taking that money spent on insurance and giving it to the less privileged. I guess that when we get sick, we should just end it quickly. Euthanasia would save lots of money that could be better spent elsewhere. And why stop with the people with terminal diseases? As long as there are less privileged people in the world, perhaps only the healthy/self-sufficient people deserve to live.

"Pam" has frequented other boards. Having lost my home in Katrina, I have been accused of leaching off the government, wasting taxpayer dollars, not working, not paying taxes. I have even had someone question my right to vote. Since I live in FEMA supplied housing, I have lost the right to replace the nice things that I lost to Katrina with new nice things. My decision to rebuild in the same location is constantly criticized. Building higher and stronger is not enough for some people. They expect me to walk away from my job and start a new life in some "safer" location, and to continue paying the mortgage on a slab. None of the "comments" are directed personally to me, but they feel like attacks on my character. People from New Orleans are attacked even more viciously.

This blog is set up with no topic being off limits, so I don't mind that Pam expressed her opinion/asked her question. I just hope that she sticks around to hear the answer.

Sent by Erica | 5:41 PM ET | 01-16-2007

Dear Mr. Sievers,

Since the Christmas season has just passed bestowing "Good Will to All," I was shocked, then angered to read the comment posted by Pam. Has she never read or at least listened to A Christmas Carol by Charles Dickens? The story deals extensively with two of Dickens' recurrent themes, social injustice and poverty, the relationship between the two, and their causes and effects.

The following quotations have deeply touched our family each year and are found in Stave 1: Marley's Ghost.

"If they would rather die," said Scrooge, "they had better do it, and decrease the surplus population" and "It's not my business," Scrooge returned. "It's enough for a man to understand his own business, and not to interfere with other peoples. Mine occupies me constantly."

My husband, age 58, was diagnosed with pancreatic cancer in July 2006. He fought cancer with everything he had until his last breath on September 20, 2006. This U.S. Army Vietnam veteran never gave up hope and nor complained about his lot in life.

Yesterday, our primary care physician, an internist, informed me that pancreatic cancer is the ONLY cancer to show no signs of improvement in the last twenty years. She heard the report at a medical convention last fall. She's as frustrated as I am at the distressing news.

To Pam: Our plans for retirement have vanished. My husband will not collect Social Security, nor will he enjoy his hard earned pension. He will not see his sons marry and have families of their own. I do not have the comfort and joy of this gentle, warm and gifted man, AND I will never again wake up in morning to be greeted by his infectious smile. So Pam, don't worry, there wasn't a dime spent on him that he hadn't earned. I wonder though, if one day, some of funds he paid into social security will be spent on you or your love ones. I truly hope resources will be available if and when you require them.

To Mr. Sievers: Thank you and your family for sharing your life with your readers through this blog. Your writing demonstrates compassion, courage, generosity and intelligence. Wow! That sounds like straight A's on a report card. May your medical report card show exceptional results. Our family is rooting for you.

As Spock would say, "Live long and prosper."

Sent by Megan | 5:52 PM ET | 01-16-2007

Dear Mr. Sievers,

I read your e-mail from Pam today. The poor woman has no heart. Somewhere along the way she has become bitter and unloving. Please don't spend too much time trying to figure out why. You have been a great source of enlightenment for me. Eight months ago my brother in law was diagnosed with lymphoma. I wondered how he dealt with this other that what he actually said. Because of you I think I have a much better idea of what people stricken with cancer are faced with. I really felt inspired by your story about how this medical aid in your column today was able to cope in the death camp... by making a difference with just one person at a time. What a gift. My daughter, a nurse practitioner, has worked with hospice patients. She is young and beautiful — both inside and out — and she cares.

I admire her so much. She has been such an inspiration to me, as you have. It must at times be painful to open your computer each day and tell the world your personal innermost thoughts. But believe me, you have made a difference in the lives of your readers, and we love you for it.

Fondly —

Sent by Maureen Reville | 7:39 PM ET | 01-16-2007

Leroy,

I found Pam's evaluation of your situation incredible, even unbelievable! I couldn't believe someone could actually WRITE such an e-mail to someone who has cancer, from which they might even someday die.

There are at least several things we can say about the author of those comments:

1. She IS heartless — and apparently, is unconcerned about it.

2. She should never be in a position of attempting to alleviate someone else's suffering or attempting to counsel someone who is in need of understanding.

3. With the way she feels, one wonders why she would even read your blog day after day, since she obviously has absolutely no compassion for your situation, and doesn't understand or appreciate your fears, struggles, sufferings, etc.

4. Anyone who would write such a thing to you is certainly NOT your friend or ally.

The really sad thing is that Pam probably feels that she has just made an objective, clinical analysis of your situation, and doesn't perceive how hurtful and destructive such comments are to the person who is on the receiving end of them. It is evident that she has never deeply felt pain in her own life otherwise, she could never have written as she did, even while being blind to the unbelievable inappropriateness of her comments to you.

I also agree with you that life is inequitable, and that it is neither right nor fair to assign a ranking of "oughtness" to your tragedy, as compared to tragedies elsewhere.

I fully appreciate your anger at the same time, what is really sad is the utter callousness of the heart of the author of those comments. Although anger is an appropriate response to what she wrote, sadness at her hardness of heart is, as well.

In any event, don't waste time ruminating over what she said. It was totally inappropriate and wrong.

(I am reminded of a situation some years ago on a Christmas Eve when I lay convulsing on a breakroom floor at work, not knowing the reason for my convulsions [it turned out to be that the pharmacist had inadvertantly filled my prescription medication at 10 times the strength it was supposed to be], and being very alarmed by them, even thinking that I might possibly die. I mentioned to a co-worker, who happened to be in the breakroom watching TV, that I couldn't stop my neck from wrenching, and that I was on the floor trying to stop my neck from wrenching.

His response to my alarming situation was: Without seriously averting his attention from the television, he blandly and unfeelingly remarked, "Sounds like you might not have a very good Christmas!")

Sent by Greg Sheryl | 8:21 PM ET | 01-16-2007

A comment regarding Pam's statements. I can only say my response to her is filled with compassion for her lack of empathy, and a seemingly over abundance of apathy regarding her values of all living things. It saddens me to think there are those that have not discovered the truths in life and living, and therefore are imprisoned in the darkness of their own thought and deed. May she never have this insidious disease stare her or her loved ones in the face. Apathy has no strength, it diminishes the person, their stamina, their courage. Surely being apathetic would remove her from the survivors list should she encounter a disease as such!

Sent by Robin Waters | 8:25 PM ET | 01-16-2007

I read your blog daily. As a doctor, it helps me to gain insight and empathy into the issues, conflicts, and daily life of the patients, friends and family I have who have cancer. I was very sorry and sad to read the note by Pam. Your response was on-target. I am disappointed that she communicated her message, which was clearly a thinly veiled commentary on resource allocation toward the social/cultural/economic inequities of the world today, in a way that was directed so personally toward you. That was her ignorance, and insensitivity, on display. Shame. Thank you for allocating your own personal resources toward maintaining this communication with us, at a time when I know you must find those resources thinly spread. Bless you and know that, at least in my life, you're making a difference and you will be remembered. I hope you have many good days in your life.

Sent by Susan Porter | 8:27 PM ET | 01-16-2007

Pam, just what are you thinking about? Why should anyone over 50 be turned away from access to anti-cancer therapy? Pam, would you at least provide hospice camp access?

We cry or laugh but the Clinton medical plan borrowed from the British the notion that people would be turned away from care (after age 69) and directed to a hospice. In fact, the plan was that the doctor had to call the police first. In England, you need kidney dialysis after age 60, you don't get it in England. Yes, that means your dead.

However, Pam brings up a situation that has even reached my local Masonic Home. The cost of medical care and the great numbers that now require medical care will ultimately bring great reductions in the access to care. Yes, in a few years everyone will have to experience being judged as worthy of care or the death camps. I'm ashamed that my church is a leader in providing quality hospice "care."

I made my first comment by stating that a dear friend had been killed by her insurance company. The lack of access to follow-up care, quick access to CT & MRI and then treatment lead to her very quick, painful and medically unexpected death from a totally cancer ridden liver. Her liver had not been an issue before.

In my first summer (1971) at Rosewell Park, men were just beginning to reach retirement in significant numbers. We have made such great strides in medicine and personal care that the majority of men alive today will reach at least 75. Well, the system is getting crushed.

Part of the problem is the capitalist system. Our medical system is as costly as it is because nearly everyone associated with that system is sucking down really big bucks. The doctors don't even go to the funerals.

Finally, no American should be ashamed of the levels of technology and care that we can offer. Many Americans have been killed so that Europe has not again and again gone to war. We have been blessed with Washington and Jefferson. One to chop up the British, the other to compile an as yet unigue establishment of government by the people. It is a crazy world out there. We say the Shia have our support to throw off the shackle of the minority Sunni, but the U.N. establishes that a minority of 10 percent, rules 90 percent and the 10 percent is actively executing those who failed to tossed out the 10 percent. I refer to Rwanda. Outside the borders of the U.S.A. it's a crazy place. Let's be thankful to be here.

Sent by Joseph P. Lyons | 8:29 PM ET | 01-16-2007

I, too, was upset when I read Pam's blog comment as my oldest son has metastized cancer and is undergoing his second round of heavy-duty chemo and radiation. It started out as cancer of the esophagus and after the first rounds of both chemo and radiation; they found the cancer had metastized to his liver and bones. Now he is undergoing another round of both chemo and radiation but has been told he only has 6 months to a year to live. My son means everything in the world to me and I take great offense to Pam's words. I would gladly move heaven and earth to cure him even taking his place if I could. So Pam until you walk a mile in the shoes of a cancer patient or one of their loved ones you have no right to make those comments.

Sent by Jean Somers | 8:32 PM ET | 01-16-2007

A multitude of emotions as I read those words from Pam, but you described it best when you said her statements would be considered "ignorant".

Ignorance ? The lack of knowledge, education or awareness

Leroy, every morning I read your blog also. Every morning you give me hope, insight, empathy, understanding, and in the midst of everything, sometimes even humor. All of this... priceless. You can't put a value on it. Your "life of privilege" has given you a format in which to reach so many of us, and for that alone, without the so many other things you have done in your life, (most, which we are all unaware of) for this alone, you are invaluable.

I do however want to address the "morality" issue. On Monday, we sat in the doctor's office as he told us the tumors in my son's lungs have not only grown, they are now "numerous." He gave us four options. All experimental, except the fourth, (I guess this, too, is experimental), but the fourth option was "do nothing, let the cancer take its course".

Yet, how "moral" would it be for us to not fight for this life of 15 years? On the other hand, how "moral" is it to expose him to the drugs they will pump into his body, drugs that we don't know if the combination or the dosage is going to be the finality of his life. Yet on the same hand, how "moral" is it to not hold onto the shred of hope that maybe one combination of these drugs will save his life, in turn becoming the protocol for this "poor prognosis" cancer he has.

In anticipation of a correction being "the words written were 'the life of one adult victim,'" I have to address this also. How can the "adult" victim be of any less value than the "child" victim? (I'm using the word "victim" for lack of a better at the moment) Had it not been for the "adults" that may have gone down this road before my son, we would have no option, but option 4. These "adults" are invaluable to the medical community. Every patient is invaluable to the medical community. We have stepped across the line of morality in this "fight." Anyone that sits in a doctor's office and hears the words, "it is definitely malignant" faces a different morality than someone who has never come face to face with those words.

Is it our "moral duty" to become the test subject of these experiments, or more moral to save the time and money of so many researchers? So the question becomes, how moral is it to judge someone, or in a less confrontational way, how moral is it to even question the morality of one that has heard these words? I almost envy Pam, because she has never had to face this "morality" of life and death. I sincerely hope she never does.

I almost feel sorry for Pam. What she doesn't truly realize is that she is leading a privileged life if she is able to sit still every morning just to read headlines and news. Then to casually click over and read about your personal hell and not get out of it what so many others do its almost sad.

Is she alone? Probably not.

I remember reading Lance Armstrong's book, and there was a point right after his diagnosis when someone sent him a letter that read, "you don't know it yet, but we are the lucky ones." I can't say I grasp it completely, but I got closer to it when my son responded to a paper at school that asked him what he would change about himself and he replied, "Nothing." His brother questioned him saying, "You could have at least wrote that you wouldn't have the tumor" to which he replied, "I wouldn't be who I am today if I didn't have it."

Earth shattering words for a mom to hear, but at the same time, wow, to have a teen so sure and content with who and what they are. Priceless. Maybe we are the lucky ones.

In essence, ignorance is the correct word for Pam's remarks, she hasn't had to walk thru this harsh world of reality, therefore how could she be educated or have any knowledge of it. Is ignorance bliss? Truly, I think not.

Leroy, I have to say it again. Thank you. I know there are days that it has to be a struggle to write your thoughts down and sometimes in times like this, to be civil. You have blessed my life in many ways, you have picked me up from a puddle of tears at times and shown me that there are so many others that are fighting this battle too...were not alone. Sometimes, that's the best thing to know.

Sent by Rhonda | 8:35 PM ET | 01-16-2007

Leroy,

I am willing to bet almost anything that Pam is a Republican! Just a hunch.

Sent by Art | 8:36 PM ET | 01-16-2007

Pam could be very young. Teens often sound heartless because they've experienced so little. I've heard many express very judgmental ideas, which are hard to listen to, such as "It's a sin to be depressed," or "People should move on its selfish to mourn." They just don't know yet.

Sent by Connie Brown | 8:39 PM ET | 01-16-2007

Leroy, I started reading your blog this last summer and came across it while visiting the NPR site, something about the words "my cancer" made the pit of my stomach hurt. I've had a lot of cancer in my family and am reminded that it is never far away, from any of us. Since last summer, I faithfully read your blog everyday. I've sent the link to your blog to several people, mainly family. You have a way of writing that comes from, and touches the heart. Based on the things you have experienced in your professional life and the notoriety that you have received I think I tended to look at you, as an accomplished professional, on a higher playing field. However, your blog reminds me that no matter what, we are all just people. And that alone makes your fight worth it. Every cent spent on your care, or any cancer patients care is worth it. As I'm sure you've seen in your life's journey here on this earth there are really just people who sit in their towers while true life happens.

People who take the time to ponder, as that woman did, if the fight is worth it. To you I say it IS worth it. Look at the amount of people you touch everyday by simply writing your blog. More than you will ever know. Look at how many people you have educated and made feel better because someone else understands what they are going through. More than you will ever know. So if you're looking for a reason, or a way to know if what you are doing makes a difference, let me tell you, you do to me and others who read your blog. Perhaps this is what you are called to do for now. So man, keep fighting, keeping going and above all keep hoping. Because in the end, it's the fight that counts. Best of luck and I look forward to more of your words.

Sent by Tricia | 8:42 PM ET | 01-16-2007

Hi Leroy,

Congratulations on a gentle response to such a brutally uncaring person. Even though I feel I shouldn't be shocked and appalled by words like Pam's, I am still.

When I was diagnosed with my cancer, my mother told me that I would have to "put on a suit of armor, because people will say things." When I was going through chemo, my boss asked me, "What is it like to be dying young? Is it like they show in the movies?" I was also told that if I missed work or went out on disability, I would lose my medical insurance.

Well, neither happened. I made sure that I didn't lose my insurance (except for the mini breaks when the company missed a premium payment), and I am still here. It wasn't easy, but I am very grateful, and I have a new job.

There are a lot of awful things that happen to people in the world. Cancer is one. Where something can be done to help, it would be immoral to not do so. And money should not be part of the decision of whether to do something helpful or not.

Cancer is one of those things where in this part of the world something can be done, and it should. The determining factor should be whether or not the person going through treatments is willing to endure the pain and suffering, and all the rest that goes along with those treatments. Not money. I agree with another writer who said the real question was why treatments cost so much, and how can we make treatments available to all regardless of insurance or financial status.

Leroy, just ignore her and use your energies to keep on keeping on. I and everyone else here are pulling for you. I also want to add that I really appreciate your blog. You put into words what has turned out to be common to most who have experience with cancer. I used to think I was all alone.

Sent by Lilly T. | 8:43 PM ET | 01-16-2007

Dear Leroy, I have been reading your blog for quite some time now, and just read your response to Pam. I think your assertion that Pam is "ignorant" is off base and dismaying — she has posed a question about the allocation of healthcare resources that we all need to be thinking about seriously: from ethical and intellectual, as well as personal, perspectives. Obviously, her comment struck a raw nerve with you emotionally and that is understandable — but it is you who elected to turn your struggle with cancer into a public forum for comment, and you have assured your readers that no topic is off limits.

Pam's commentary is one of the more thought-provoking e-mails I have seen on this blog, and it is troubling to see you writing her off as "ignorant." I do not believe you set out to create just an online "support group" for yourself or others dealing with cancer — certainly there are already hundreds of those — but rather to do something far more unique. As a journalist, you wanted to live out your life doing journalism that is, writing openly about an extremely difficult subject and inviting others to do the same. Perhaps that is just not possible or wise as your disease progresses. I certainly could not sustain it myself in the face of the most personal of all experiences—facing ones own death. All best wishes to you and I will keep on reading.

Sent by Cathy | 8:46 PM ET | 01-16-2007

Dear Mr. Sievers,

Your response to "Pam" touched my heart. I can only hope she learns love and compassion somewhere along her own life's path. Of course you are valuable. Life is precious, in all the ways you so eloquently described. What better way to spend money than to help people the best way we can? To help them to make the decision to fight an adversity, especially illness. And then to be with them and ask for grace and peace for them when all our science, all our money is not enough. I have been following your blog for quite some time and have wanted to tell you how much your words mean to me. I don't have cancer at this time, though I know someday I could. And I have friends who do now and you help me to be a loving friend. I believe we can each be a blessing to each other by caring, comforting, listening, and supporting.

Laughing and crying are part of a beautiful life even when it is painful. It's OK to be cranky now and then. Life does seem unfair. But, no one, not one person, should ever suggest that because you have had a full life that you should give it up! To save money for what? What could possibly be more important and valuable? You are as valuable to me, and to all of us, as any other thing or person in this world. Count me as one of the people out here who value you and want you to live your life the very best way you can.

And thank you for talking about subjects that must often be very painful for you. I'm an RN and thought I knew how to talk to people with difficult illnesses. Not so. Your columns have taught me a lot about how to be a comfort and support. You have my deepest respect. You go, Mr. Sievers, you are helping a lot of people!

You have my prayers for a recovery and for a life of peace.

Sent by Julie Antinucci | 8:46 PM ET | 01-16-2007

Dear Leroy,

Oh yeah, Pam's comments make me extremely angry! Definitely! The value of life (one life or 100,000) cannot be based on the cost of saving that life. It just doesn't work that way. Each life is intrinsically valuable thanks to our Creator. Should we try to save an Albert Einstein, but not try to save a small child or vice versa. No! We should try to save as many as we can with whatever resources are available at the moment. We should work so that all the best resources are available to as many people as possible at any given time, but when those resources are available, they should be accessed without making judgments as to who should receive them. We do not know the reasons for "the luck of the draw". Thank God only He can make those decisions.

Sent by Susan Snyder | 8:48 PM ET | 01-16-2007

Well, as also someone facing less than a good cancer prognosis, I would suggest that there probably are many "Pams" out there, and really, how could she possibly get it? Perhaps those of us that are facing our mortality square in the face can hope that her questions/comments are an effort to reach out and learn something from us. I would like to think so.

Sent by Jean | 8:54 PM ET | 01-16-2007

I read Pam's comment and as a recently retired oncology nurse it made me very angry. I would much rather spend the money on your care and fellow cancer patients than spend $50 million a year on a soccer player!! No one knows what they will do or not do until faced with the diagnosis and options. The human will to live is extremely powerful.

Sent by Sandy | 8:56 PM ET | 01-16-2007

As a widow who lost her husband to cancer a year ago, I can tell you that I would have paid anything to save my husband's life. I told whatever gods there might be that I would willingly give up everything and live on the streets if I could keep my husband. Every life is everything to at least someone.

When I think of the vast amounts of money being wasted on wars and plastic stuff that nobody really needs, now that is something to question, not the money spent to save a life. And for every person who is being treated for cancer there is plenty that the doctors are learning to might help save the next person.

No person can know what it is like to suddenly find out that someone you love has cancer. You can look at it dispasionately now, but if it happens to you, you will understand that it is certainly not money wasted.

Sent by Lynn Larson | 9:00 PM ET | 01-16-2007

Angry, you bet!!!!!!!

What, pray tell, does Pam think money should be spent on? Pam should count her blessings that cancer is non-judgmental, that it hits indiscriminately. Surely if it hit based on arrogance, ignorance and plain stupidity, Pam would have been hit by every cancer known to man. Of course she'd be hit by some that are yet unnamed but we wouldn't want to bother wasting our resources on the Pams of the world.

Sent by Maureen Francis | 9:03 PM ET | 01-16-2007

In regard to the previous commenter who sat at her computer in the morning with her "morning cup" and looked at the NPR Web site... like who is the privileged one in this scenario? She certainly is the privileged one and shortsightedly levels criticism at the cost of cancer care when there are world problems. Really. She's not rushing out the door to work, she's not busily getting children ready for school so she can go on to work. She's leisurely enjoying her beverage surfing the Web the first thing in the morning. I'd say she needs to examine her own privileges before attacking others.

Sent by Sally Paige Kahle | 9:06 PM ET | 01-16-2007

Dear Leroy,

I have been reading your blog since the summer, when my goddaughter, Joan Lynch told me about you. I have been waiting to comment, send a somewhat articulate note about my feelings etc. while reading your blog. As you can probably tell, I do not write well, but after reading Pam's letter, have to comment!!

I think Pam is playing the victim. I wonder how she would have responded if she or someone close to her had cancer. I think that sharing your life, challenges, disappointments, fears, etc. is something not many would do. What is a privileged life? You put yourself in dangerous, not privileged positions when reporting in areas in crisis. I think I lead a very privileged life because I have a family that I love and loves me, have friends that I treasure and know are there for me, have enough food (but eat too much), and live in a comfortable home. That to me is privilege. I have to end because I babble. I wish I could write like Joan, but hope you can understand what I am trying to say! I just cannot understand someone like Pam, and am grateful I don't know her!

Sent by Barbara Popovsky | 9:09 PM ET | 01-16-2007

I just found your blog today and have been reading some of the recent entries. I hope that you didn't let Pam's inane comment set you back too much. My dad was diagnosed with ALL (Acute Lymphoblastic Leukemia) right after Thanksgiving and given three months to live by a doctor who seemed to take a perverse pleasure in the diagnosis. The man's bedside manner was so atrocious that we could do nothing but laugh at it and wonder if this was all we could expect. Luckily, after three weeks, a friend directed us to M.D. Anderson in Houston for treatment. Since then, the prognosis has gone from a 5 percent chance of remission to 70 percent. Dad is going through the hell of chemo like you and so many others, but takes strength from the high standard of care and the wisdom of others who know were all together in the fight against this hideous disease. So let's ignore people like Pam and put our energies toward helping each other get well again. Thanks for the blog.

Sent by Chris | 9:30 PM ET | 01-16-2007

I think there is a common thread on all of these responses. We are people who no longer live in a protected, "I'm invincible" world where we can make such naive claims. As someone who was diagnosed with cancer at age 21, I have been surrounded by individuals in my cohort who have not been faced with their own mortality or the death of a loved one. And I used to get furious with their comments. But I have come to the conclusion that Leroy voiced: She is lucky to have not been touched by cancer. I wouldn't wish it on anyone. One the other hand, I'm sure that most of us have become more compassionate and understanding due to this disease. I know that I have. And in that respect, I feel very blessed.

Sent by Sarah B. | 9:33 PM ET | 01-16-2007

What may have been interpreted as meanness or ignorance in Pam's note, may be immaturity. If so, and if she is lucky enough and has experiences and health which allow her to live and grow into maturity, she may some day understand and experience that life still has meaning after many decades.

Though Pam may not feel "privileged", if she is having a cup of coffee (and I hope she was able to eat a breakfast as well) and getting on her computer — that indicates "privilege" she may not be aware of. If and when she needs medical care, will she forego it because someone, somewhere may be worse of? Of course not! And I hope care is there for her.

Thank you, Leroy, for your courage, wisdom, your openness and your gift in sharing the road with us.

Sent by Fran | 9:39 PM ET | 01-16-2007

My sister has metastatic colon cancer and is going through some of the same steps. First I listened to your podcast then logged into your blogs. I found that you have an approach very much like my sister's and this is helpful.

I did not think I would ever write to you, but am now one of the many who wants to give you support after the shocking letter you received and posted last week.

The lady writing is indeed cold-hearted but she also lacks a sense of proportion and logic. We live in North America and the treatment given here is in proportion to the rest of our lives and society. If this person wants to follow her argument to its logical conclusion, she should give away all of her belongings and move to the poorest country in Africa and live as the poorest person lives there.

She is not in any position to criticize the care of any patient while she drinks her coffee and surfs the net each morning. How can she live with herself?

I have found your ideas and experiences to be touching and helpful. Thank you for the effort you make.

Sent by Pat Harding | 9:46 PM ET | 01-16-2007

Argh, what a horrible thing to write to a guy who's so ill. Leroy, forget the naysayer who wants you to fade away without medical intervention. I (and plenty of others, I'll bet) are rooting for you. The idea of going without or being denied treatment because you're privileged is absurd. The writer should give back his/her education, food, bed and other comforts of life and start the stampede to alleviate the misery of the world.

Sent by Sarah Light | 9:49 PM ET | 01-16-2007

I am shaking and have chills after reading "Pam's" comments on January 12, 2007. I had breast cancer when I was 41. I am now 58. Cancer changed my life when I lost my best friend to cancer. She was 28 years of age.

Pam's comments are incredibly callous and ignorant. I really do not know what else to say.

I am a principal and in one elementary school, I had two boys who had cancer. Both survived but their lives and bodies were permanently changed at the tender age of 8 and 10.

Mr. Sievers, I commend you on your willingness to share your thoughts with us. I know I would not be able to do so.

I would assume that remarks such as Pam's hurt you very much. Her comments will always remain with me.

I am glad I am not a member of her family or a friend of hers. I wonder if she has family or friends.

Currently, my cousin is being treated for Stage IV Uterine cancer. A dear friend is being treated for bone cancer.

Could Pam possibly not know anyone who has this dreaded disease?

Please know my prayers and thoughts are with you as you deal with your cancer. Your dignity is most inspiring.

Thank You.

Sent by Mary M. Smith | 10:08 PM ET | 01-16-2007

Greetings from across the pond. I think Pam is missing the point. It's not an either or situation.

Both the US and the UK are wealthy nations — we could choose to tackle both issues — our own health and well-being as well as that of poorer nations. My country wastes an inordinate amount of money on things that offer no benefit to mankind. I won't comment on yours.

Tackling cancer and poverty are not mutually exclusive. From someone with advanced bowel cancer. And a belief in the kindness of strangers.

Sent by Ian Spratley | 10:11 PM ET | 01-16-2007

I'm trying to imagine how one arrives in the mindset where one would effectively say to people who are suffering that they don't deserve the help they are getting? I can't stomach or buy into the idea that the only conceivable way to help alleviate other forms of suffering in the world is to take resources away from people who are getting some measure of help for their particular brand of suffering.

The common ground here... the one sentiment I think everyone who posted in response to Pam has said or implied is that ALL life is precious.

If you take the arbitrary dollar assignments out of it, there are more than enough physical resources in the world to solve all of the problems mentioned. The sad part of our reality is NOT that there are not enough physical resources... but that not enough individuals are aware enough or care enough, or are in a position to solve those problems. Companies have greater resources available but exist for the purpose of making a profit. A lot of the existing problems don't have as great a profit potential as something like treating cancer in the U.S. does.

However, an interesting spin on this discussion is that curing or preventing cancer, diabetes and other such diseases, would free up tons of resources (both dollars and people) to conquer other (perhaps less lucrative) challenges in the world. Solving poverty may not have as big a profit potential, but some profit is better than no profit...and some long term profit is garnered from the goodwill and brand reputation boosts that come from doing good in the world. So, maybe the answer for eliminating world poverty is actually to pump MORE dollars into cancer research NOW to banish that disease from the long list of things that are wrong with the world today?

Doing good and helping others, wherever and by whomever it's done is certainly going to result in a better world for all. While none of us is going to individually eliminate poverty overnight, as a group, we have proven time and time again that we can accomplish anything we set our minds to. Individuals can make a difference in the thinking and priorities of the greater community including companies and governments). Why not set our individual minds and goals towards influencing positive changes in the world, WITHOUT robbing Peter to pay Paul?

There is plenty of opportunity to make truly positive contributions (not just "net" contributions where someone ends up suffering more so that someone else has to suffer less). After all as Mr. Sievers and many others have said already today, who among us is qualified to make the judgment of who should suffer more or less? Who on this earth can predict the contributions to humanity that one person will make over another or how needed that person is?

Pam, I'm fairly certain it's not you...and I know without a doubt that it's not me. Accusing living breathing suffering people of being selfish in seeking treatment is misguided at best. Despite that, your comments certainly elicited some thought provoking responses. Last time I looked 68 responses and counting. I hope the end result is that you have indirectly spurred people on to get out there and make truly positive differences in the world.

Mr. Sievers, thank YOU for using the power of words to make a positive difference in the world every single day. (Your wife seems pretty amazing as well). Keep on truckin!

Sent by Nichole | 10:14 PM ET | 01-16-2007

I read your response to Pam's comments that one life isn't worth endless expense to save. At face value, I have to agree. But there is more than one de-personalized individual at stake. When I think of situations outside of cancer (my own condition) I see examples of extraordinary effort and expense to save one person. Should we save the severely deformed baby when we know that not only the life of the child, but the life of its family will be negatively impacted forever? Should we prolong life when without medical intervention life would surely end, and extending life causes the dying person great pain and suffering? Should some AIDS patients get subsidized medications that cost hundreds or thousands of dollars per dose, while others have no care what so ever? There are a million questions, and no perfectly clear answers.

But sometimes it is clear to see that saving one life is worth the effort. Six-year-old Katie is a good example she was a charity case, saved from certain death with, not 1, but 2 full visceral (5 organs) transplants. And it wasn't even insurance money that saved her but donations of time and money from countless unrecognized individuals. Is her life worth the millions of dollars spent to save it? Well no, not if you are an actuary for the insurance industry. But this one little girl, a radiant elf of a child, has given hope to thousands, perhaps millions of people who know her, have read about her, or will benefit by the lessons learned in her struggle and success. So her life is actually an investment, not an expense.

There are other examples completely unrelated to cancer. Take the story in which the movie Saving Private Ryan was based... how many people died to save one person? Was that single person worth all of those other people? No, absolutely not... yet it may be argued that there was more at stake than one human life. How does this relate to expensive medical intervention? I agree it is a circuitous path of thought process... one I have ventured down many times. My bone marrow transplant easily cost a quarter of a million dollars. Surviving the 9 years since then has cost hundreds of thousands, not including lost wages. Am I worth it? Well, no... not if you compare my "value" to anyone else: the rancher's wife who died of the same disease I had, only because she was uninsured or the mother in Africa who doesn't even have access to medical services that would provide her with a diagnosis of the disease that is killing her. Life is indeed not fair.

So now I think of a tale my grandfather told me: An old man is sitting on the beach, which is littered with sand dollars that were washed up in the last high tide. Hundreds of these creatures are dying in the morning sun as the man notices a boy walking down the beach toward him. The boy repeatedly bends down to pick up a sand dollar and fling it as far into the ocean as he can throw it. When the boy gets close enough, the old man says to him "it doesn't matter, you can't save them all." As the boy flings another sand dollar he replies, "It matters to this one."

Sometimes I feel shame for the amount of financial resources used to save my life. There are so many people who are not as lucky to have health insurance, be able to choose the treating facility, to have been born in this country, or to even have survived long enough to get benefit from medical progress. But we are talking about my life? and saving it is worth it to me.

Most respectfully submitted, to a man who is helping numerous other people deal with their own cancer or with the cancer of their friend or loved one. You are worth it.

Sent by Kate Pittman | 10:17 PM ET | 01-16-2007

Leroy,

I have read your blog for many months now and I have been touched by your candor, wit and strength as you move through this tough journey with cancer. Some of your posts have moved me to tears and some have helped me gather the fortitude I needed to take on one more appointment, one more call to a doctor, one more inquiry about treatment options for my mom who died of ovarian cancer in September.

Pam's comment struck me as both callous and sanctimonious. How easy to be able to comment on the value of providing cancer treatment to those in "comfortable" circumstances vs. spending the money instead to help those in war-torn, impoverished and other equally awful circumstances when you have neither a) had cancer or b) lived in those circumstances. What is curious to me about Pam's comment is that her solution to the inequity in our world is to worsen the circumstances for everyone. But I believe the goal should be to elevate everyone, not drag everyone down. Maybe thats idealistic, unrealistic even. If so, I am guilty as charged and happy to be so.

My mom battled her cancer for 2 1/2 years. Based on Pam's comments, I think she would have also considered my mom a "privileged" victim. My mom taught me some of my most important lessons about family, friendship and community. She taught my siblings and I a lot about community service and helping others. She volunteered both her time and money to numerous causes. As a GED instructor, she helped high-school dropouts get back on the education track that would open up opportunities in their lives. She spent her own free time helping some of them get into better housing situations, away from abusive partners, and into much-needed jobs. I imagine many of these individuals would have considered the value of my mother's life very differently than Pam. She was a best friend to her kids and others, and one of the best people I will ever know.

Leroy, as much as Pam's comment hurt me, I can only imagine what it felt like for you. Your response to her was thoughtful and dignified. Keep writing and fighting Leroy! And know that there are many people out here who think your life is precious and valuable beyond description.

Sent by Gina | 10:21 PM ET | 01-16-2007

Regarding "None of us can judge"

"As we go forward, no topic, no matter how painful, is going to be off limits. Because if we don't talk about it, who will?"

"Pam" posed a painful question, and instead of answering it, you got angry, dismissed her, and called her ignorant. She is likewise being insulted in the comments section of your blog.

I don't think it's fair.

I have a question for you as well. You have expressed previously in this blog, that you feel fulfilled with your life. If that is the case, then do you have the courage to let yourself die in order to save the resources expended by the attempt to save your life?

Our lives are very precious to us, for a reason. Are you truly satisfied with your life? Or is there more work to be done?

Sent by Jody Sol | 10:46 PM ET | 01-16-2007

Dear Leroy,

I think the mean-spirited note you received from Pam is appalling. The complete and utter meanness of it, the total want of tact... The ignorance of some people can really take one's breath away, even when you think you can no longer be surprised, eh?

I imagine you'll hear from hundreds of other listeners/readers who check your blog hoping for good news. You're brave and articulate, and your account thus far is so very real, and up-to-the moment because of the technology.

When I left America to live in Australia in 1990, I missed NPR for many years. To have it again, and better still to choose exactly what I want to hear or read or see is just a miracle. I love it.

I can't help but wonder why that lady finds she has to follow your blog if it bothers her to such a degree.

I hope you don't waste another thought on her pointless opinion. The way to ameliorate suffering is to follow that Sans Frontiers medic... focus on a manageable portion of the problem at hand, and then do your best. How firing such a salvo at you could be of any use must remain a mystery...

Best wishes.

Sent by Rachael Craig | 10:49 PM ET | 01-16-2007

I think you are amazing for having the energy (psychic or other) to chronicle your condition like this. And do you ever take a break from thinking about your disease. I imagine that this blog forces you to live and re-live it. How noble of you.

I had colon cancer surgery six years ago and then two years ago liver mets and then last month, after a year of no chemo, a couple of enlarged nodes in the chest. Surgery for that three weeks ago and now I am facing another round of those mousey Erbitux/Avastin MABs and the accompanying rash.

Amazingly, I feel pretty good. I exercise like crazy — fast walking mainly and I find I can lose myself in my business.

I've begun to eat more healthily (macrobiotic - in principal at least) and, after previously resisting chemo at every turn, I find that I'm actually looking forward to starting the treatment.

Anyway, thanks for your column. You often echo my thoughts and its good to have company.

Cheers!

Sent by James Singer | 10:52 PM ET | 01-16-2007

Leroy,

My sister just recently told me about your blog. It's frightening how insensitive (stupid — ha, no cure for that) people can be. I was looking for answers and found these two quotes:

BARRY LOPEZ:

"How is one to live a moral and compassionate existence when one is fully aware of the blood, the horror inherent in life, when one finds darkness not only in ones culture but within oneself? If there is a stage at which an individual life becomes truly adult, it must be when one grasps the irony in its unfolding and accepts responsibility for a life lived in the midst of such paradox. One must live in the middle of contradiction, because if all contradiction were eliminated at once life would collapse. There are simply no answers to some of the great pressing questions. You continue to live them out, making your life a worthy expression of leaning into the light."

BUDDHA:

"If we could see the miracle of a single flower clearly, our whole life would change."

Sent by Julie | 11:53 AM ET | 01-17-2007

I've been reading this blog for quite some time now, but have never posted before. The heartlessness of Pam's question inspired me to stop lurking and say something. My best friend is battling stage IV breast cancer and I can't imagine what she's going through, while continuing to remain upbeat and positive through it all.

Perhaps Pam, in her selfish thinking, didn't stop to consider that spending resources to extend the life of ANY one victim may end up benefiting us all. New treatments are tried every day. Research continues to hopefully bring us all closer to a cure someday. Pam, did you ever stop to consider that someday, someone will be treated with what may turn out to be a cure? Have YOU had a loved one battle cancer? Do YOU have any idea what hell they go through? No? Well, NOW who's living a privileged life?! Maybe someday you'll learn to appreciate the things you have rather than being so judgmental toward others.

Leroy, you continue to touch the hearts of so many people. I wish you the best.

Sent by A.T. | 1:04 PM ET | 01-17-2007

One cannot make a statement such as that without first asking themselves if perhaps they shouldn't own a luxury car, a larger house, or other luxury items. These items do nothing to extend life, just make it more pleasant. Who is one to judge treatments that consume resources when they own things that can be seen as just as pointless?

Sent by Derek | 1:31 PM ET | 01-17-2007

I'm always amazed at how some people can triage their compassion. By reserving it for those they think are the neediest or the most wronged, they grow callous towards others who are also deserving of sympathy and support. I just don't understand how someone could be so angry about one injustice that it sucks the compassion out of them regarding any other injustice they encounter. Compassion should never be rationed like that.

Sent by Andy Carvin, NPR | 1:42 PM ET | 01-17-2007

Leroy,

Thank you for taking us on your journey. I have so much respect for you and so appreciate the insight and understanding you've given me regards to life with cancer.

Regards to Pam, I can only be sympathetic: she sounded like someone who sees much injustice in the world (there is!) and limited resources serving a limited few (in relation to the world's poor).

I am just so grateful for the access to healthcare I have and can only hope others will someday have the same access.

If I get cancer, I hope to face it (with lots of pain meds!), rather than fight it — but that's my choice. If my daughter had cancer, I'd want her to fight it tooth and nail.

So keep up the good fight, while it is your choice.

My best to you.

Sent by Adrienne | 1:47 PM ET | 01-17-2007

I sincerely hope that Pam never does become a victim of cancer... she would then have to admit she had no idea what she was talking about.

Sent by T.F. Pavlik | 5:39 PM ET | 01-17-2007

Dear Leroy,

I am writing about Pam's letter. I do believe that the only way she could have written that letter is by never having lost a loved one to a disease or experienced one herself. As she indicated. How sad for her.

I am not saying that to lose someone is a good thing, obviously, but what it does for your self is beyond words. To know loss is to know the preciousness of life.

As I stepped off our back porch the other day I had this overwhelming feeling of sadness — the war, the loss of our nephew, Darfur, my Grandmother's illness. And I realized in that moment that there was so much value in human suffering. To feel a little of what our neighbor might be experiencing.

I have had that same cup of coffee as Pam in the morning. However, I read your story through tears and just so wished you something other than you had.

I think of you often.

Sent by Chere Secrist | 5:44 PM ET | 01-17-2007

In reference to Pam's note, I don't know if she is heartless or ignorant, but she is definitely missing the point. Cancer is one of the miseries, one of the bad things that exist in the world. It may not be worse than war, famine and etc. but it is of the same ilk. Treating your cancer is an attempt to heal one of the world's miseries. Even on a small personal scale, this has value. It creates good in the world. And in a larger sense, it might one day lead to a cure or a more meaningful course of treatment for others. Neither the failures of diplomats and politicians nor the inevitability of natural disasters can take away from the work of medical doctors and cancer researchers (and yes, even the cooperation of hopeful patients like you) in working to heal their part of our broken world. Healing is all good.

Sent by Carolyn West | 7:16 PM ET | 01-17-2007

Bravo, Leroy, on your response to Pam's note.

Love to you and good luck with your treatments.

Sent by Cheryl Szydlo | 8:34 PM ET | 01-17-2007

Leroy, We are — all of us — fighting the beast, brave souls simply trying to live. I am an ovarian cancer patient and am honored to be fighting along side of so many others such as yourself. We need to network... if one is not fighting this battle the loneliness cannot be imagined. Each of us fights this battle alone in the corners of our mind and inside our deepest thoughts and realizations. I wish you the best.

Peace.

Sent by Dian | 11:36 PM ET | 01-17-2007

Dear Leroy,

First of all to Pam: I cannot believe that you can be that heartless. Tell us we misunderstood your question or we misinterpreted your comments. Tell us that you would say to your doctor if you were diagnosed with a terminal disease "Hey, don't give me any drugs to fight this. Use the money for something else, because I really have no reason to live. No loved ones to think about, no children to see graduate, no grandchildren to see born yet." TELL ME YOU'D GIVE UP THE TREATMENT. TELL ME! BE ON OUR END (a caregiver or a cancer victim) AND RE-READ YOUR WORDS. What are you, lawyer, financial analyst, fatalist, TELL ME! I think before EVER again putting your "finger-to-keyboard" (modern day pen-to-paper), you should make sure your brain is engaged before putting your fingers in gear! Make sure you drink that second cup of coffee to wake up your brain! People like you and like my loved one's family make me sick and makes me glad that I have evolved so much past your smallness of thinking.

Leroy, I have just discovered your podcast and then blog column here on NPR. I've caught up on all the things I can. I am assuming you have stage 4 lung cancer with metastases and you beat a different cancer earlier in your life. I'm sure I will do more research on your work as a reporter. Since finding your blog yesterday, I am starting to relive all my memories of taking care of Melody all over again. It is painful but yet necessary because I have to move on in my grieving process. Discovering your blog has made me realize that I am not well and I have sought the help of a support group, which I joined yesterday.

OK... I am a caregiver survivor in Chicago.

I met Melody in March of 2002 and clicked right away. We moved in together November 2003, we broke up November 2004. She was diagnosed with stage IV Lung Cancer April 2005. I moved back in to care for her for 18 months while her family (who lived in Florida) did NOTHING for her. After the first initial diagnosis, 2 siblings and her mother came here for about 4 days, and then after that... virtually no communication from them to her for the next 15 months. Her daughter moved to Chicago when her mother was diagnosed, but she was moving here from Florida anyway. Even though she lived basically across the street from us, she wasn't that much help because she is 27 with a 3-year-old and no automobile.

She would watch the cat while I spent weeks at a time staying overnight at the hospital and going to work after the doctors made their rounds in the morning, clean the apartment a bit, or her mother's laundry a few times, but no real help. Melody died October 20th last year and to this day, not ONE of her 2 sisters, 1 brother, her daughter or her mother has called to say "thank you" for anything. The only call I received was from 1 of the sisters (2 days after Melody died) threatening me with jail time if I had done anything to her accounts or if I had stolen anything from her. Hell, I was the one that kept things in order while she was busy fighting for her life. Melody and I had the best and purest relationship 2 people can have. As with most caregivers that are loved ones / spouses (let's face it, even though we were broken up... I still loved her. The title on the relationship after the diagnosis was secondary and besides, when she broke up with me for no good reason, she had a brain tumor in the right frontal lobe that hadn't been discovered yet), the loss we feel is very deep and doesn't go away. It lessens in time but nevertheless, will hurt for a long time to come.

Unfortunately, even though Melody had her will all typed up and ready to go in her computer, she never printed it out, and made it legal. The family has lied to me about the will, and even though I do not need the stuff that she intended to give to me (computer... I have 5 of them, a printer, DVDs and CDs), it would have been nice to at least have a couple more things to remember her by.

I do have a painting that she did for me (she was an artist), her old pots and pans she gave to me when she bought new ones, a teddy bear that I gave her on Valentines Day 2003 that she took with her to the hospital all 14 times she stayed there, a heating pad that still has her scent on it, a bottle of hydro morphine that she never took (she hated opioids) a handful of pictures and memories. Although I never did anything for her for my gain or for the praise of others, (there was never money involved and Melody always let me know how much she appreciated me putting my life on hold for so long), it would have been nice to be acknowledged, from the people who I let off the hook, for all that I sacrificed (I was passed up for 2 raises and a promotion at work because of all the time missed, the time away from my daughter, and my whole life basically) to take care of their family member.

So here is the question I pose to you and every one of you that are a victim to this terrible affliction. Do you have your house in order? Have you said everything to people that you want them to know. Have you made peace with your enemies and people that you feel badly towards? Is your will clear and concise? Have you left nothing to interpretation after you are no longer here to explain what you meant for your final wishes? Just because everyone is together in oneness of mind now, doesn't mean they will be after you are gone. I have found out that grief takes on many different forms (anger, selfishness, guilt) etc. My mom has said that she was going to leave it up to my sister to do the little stuff, to which my sister said NO. EVERYTHING has to be in writing. We (my family) are very close. We have no issues with each other and genuinely like each other. No matter how close you all may be, do not let anything slip by that might cause a riff in the water. Of course, this is good advise no matter what health condition you are in, but for some, action should be sooner rather than later. Remember, you aren't doing it for yourself you are doing it for them!

I don't know you Leroy, but I love you already. Positive thoughts are being passed your way from Chicago!

Sent by Michael | 4:01 AM ET | 01-18-2007

If we did not fight cancer with all of the resources we enjoy in the U.S., wouldn't we be squandering the opportunities afforded to us by the nature of our good fortune?

Sent by Andrea Clay | 11:08 AM ET | 01-18-2007

What if the extensive resources in our privileged country had not been used to investigate HIV AIDS? The HIV positive mother in Africa would not have medication to prevent transmission to her baby. The expensive treatments cancer patients (many of whom are not privileged) receive become a source of information for the vast research that is conducted to understand and treat this disease. As a third generation cancer patient I was diagnosed earlier and have lived longer than my mother and grandmother, thanks to the treatments their generation of cancer patients were given. I am grateful to live in a country that I can have this help. I know that ultimately the knowledge gained from the treatments of those of us who are privileged to have them, will benefit all of mankind.

Sent by Linda S. Newson | 11:24 AM ET | 01-18-2007

Pam,

I don't actually think you are alone in that question. I think basically, you are asking the question, "How can person A have so much when person B has so little?" There are two points that you need to grasp which may (or may not) help you in understanding this conflict.

1. The world is not fair — a fact which, (ironically, given your focus) most people who face cancer are intimately aware of.

2. Humans, when given the choice, will generally elect to spend their resources to protect their own life and the lives of those they love, first. This is as true of families in the U.S. as it is in Zaire. It may not be strictly logical in a global sense, but let's face it, humans are more emotional and less logical that we like to admit.

If this inequity is bothersome, then the question arises: What are you going to do to fix it? No one is stopping you from making choices in your own life to help people in Sudan, Somalia, Indonesia, etc. Your desire to remedy this inequality is admirable. Going about it by criticizing people who are drawing up all their strength each day to be there for their loved ones is a waste of your energies.

Please try again.

Sent by Beverly Neubauer | 11:43 AM ET | 01-18-2007

Wow! Here we are 160+ comments later. Pam, or whoever you are, you should be proud of exciting the emotions of so many that felt the need to post a comment. I think that her posting was a good thing for anyone here. Pain, suffering, wanting to give-up, anger, sorrow, crying, you name it and anyone who has experienced what cancer brings, whether it is themselves or someone they love, has felt these emotions. It's not a quantifiable or calculable experience, although Leroy is doing his best to at least describe some of what it is about. Which is appropriate, I believe.

I think that Pam's question was viable. Not many here deny that, but it was her delivery and lack of information/ unawareness (defined as ignorance) that most have responded to most with emotion, which is understandable and real. We are human, we make mistakes and we feel many things. Of all the things I've learned through Leroy and the participants here, it is that raw human nature is only our true selves. If we deny all feeling, good or bad, our lives will be lonely. We all only have a quantified amount of time here, how is it best spent?

Sent by Phil | 1:17 PM ET | 01-18-2007

Thank you, Leroy, for putting yourself out there for all of us. My daughter in New York told me about your blog. I was diagnosed April 2006 with primary peritoneal cancer. It is sort of rare and is similar to ovarian cancer. It is being treated the same way. The prognosis given was 48 months! I finished chemo in August 2006. My numbers are good. I am still waiting for results of my last CT Scan. (Damn, the waiting is hard isn't it) I may have defused the bomb, I may have won this skirmish for now. What is so scary is the knowledge that once cancer enters the body, it can come back or appear anywhere else as a different cancer. Can I win this War?

My husband and I are the caregivers of his mentally challenged sister-in-law who was diagnosed with breast cancer around the same time I was diagnosed. She had her left breast removed. We were very lucky we found it very small and no lymph node involvement. I sometimes wish I had her mentality. She gives no thought to what she went through or why. She doesn't obsess about what can happen.

I am thanking you, because you have given a voice to my thoughts, feelings and deepest fears. I don't voice these because I am trying to protect my loved ones. I want to be strong, up, and optimistic darn this chemobrain! For them and for myself.

I will continue to live my life the best I can and take it a day at a time. My prayers, good thoughts and best wishes to you. You have inspired me more than you will ever know. We do need more honest and understanding people out there like you.

Thank you and keep up the good fight! We all need people like you, who are able to express what the rest of us can't.

Sent by Trish & Bonnieta Holmes | 1:47 PM ET | 01-18-2007

Dear Pam, I am a 35-year-young Catholic woman of great faith and value for life and my husband is a 36-year-young man and we were diagnosed 41 days ago with anaplastic astrocytoma (look it up!)

I do not subscribe to reading these types of thing, but my husband — a huge NPR fan — sent this to me — most likely to read the other entries but then I came upon yours.

Firstly, you are very lucky to be able to hide behind the anonymity of submitting a comment on a blog. I would like to invite you to come to MSKCC - Memorial Sloan Kettering Cancer Center in New York City and repeat what you have just said.

From what you have written your ignorance, arrogance, selfishness and ungratefulness speak volumes of the insignificant way you have chosen to live your life. I have just a few comments on your entry in response to your question "Am I alone when I ask this question?"

Every morning, (This would lead me to believe you are well aware of what has been happening in the world EVERYDAY.) while drinking my first cup of the day, I sit at the computer and read what NPR has to offer (Do you ever stop to think of those who do not have the privilege and means to enjoy a cup of coffee every morning sitting at a computer?) I start with the daily headlines, the growing numbers of innocent victims of genocide, war, hunger, disease, poverty. (Does your level of ignorance preclude you from knowing these are century old atrocities that people have been fighting against for years? More importantly I am interested to know what have you done to aid in these fights? ) And then I move on to this blog (Why do you, if you find it so offensive?) I am not and have never been the victim of cancer and for that I am grateful (There is always tomorrow my dear!) I'm certain this will be interpreted by all as heartless (So you knowingly continue to post this and made the conscious decision to hurt and upset people?), but amid all the death, destruction and sadness that comes with being born at the wrong time in the wrong place (I have great interest to know what you consider to be the "wrong time and place to be born" and for whom? It would appear you are speaking of yourself), I question the morality (Whose morality are you questioning? And with what authority do you have to do so?) of expending unknown amounts of resources (Are these resources yours that you are speaking of? If not then, then who are you to be questioning the morality of the use of these resources? (I am sorry but did I miss it somewhere in your comment you mentioning that you are God?) extending the life of one adult victim ( For a person so concerned with "the growing numbers of innocent victims of genocide, war, hunger, disease, poverty" I ask you what ONE life is not worth fighting for ? would that be You and those who share your views? Or would it be the people of YOUR choosing? ) who, it appears,( I ask what is your basis for this assumption? ) has lived a privileged life up to this point. (Please quantify and qualify your basis for this?)

Life is a privilege and how you conduct yourself throughout the course of it will be your measure. It would appear to me that you have not embraced your privileged and that is very, very sad.

Am I alone when I ask this question?" (I challenge you to personally ask this to everyone who has been touched by cancer.)

Sent by MFord, Cancer Fighter | 4:57 PM ET | 01-18-2007

Sent by Larry Benfield | 11:44 AM ET | 01-19-2007

Hi Leroy,

I sent you the below message a few months ago when I started reading your blog. You might have thought my message was sad and I am a religious fanatic, but neither is true. The message presents a possibility that life is infinite and the truth is I am not religious at all! I think life is more then just one time around the block. I write you again now because you are weighing advanced treatment vs. quality of life. Please read a little of this book before you decide.

I wish that before my brother died of AIDS and my father of Cancer they had the chance to read the book, Final Gifts. Two Hospice Nurses wrote the book about the remarkable things they have witnessed. It is not a religious book, but it is spiritual.

My Mom called me and said I had better come home quickly because my father was failing. I booked the next flight home, but due to a connection delay, I finally got home about eleven that evening. My Mom was sitting on the couch alone, she explained, that friends had come over but had left about thirty minutes ago. I could hear my Dad's labored breathing in the bedroom. I walked back to see him, he was on morphine and I did not think he could hear me but I told him I was home. I want back to the living room and sat next to my Mom, we started talking. In less then five minutes, my father stopped breathing.

I mentioned to the hospice nurse what a coincidence it was for my Dad to die right after I got home, as if he was waiting for me. She said, you would be surprised how often these things happen and mentioned this book to me.

You may not want to read this book because it will make you cry but I made a promise to myself that I would suggest it to anyone I thought might die sometime in their lifetime.

However, just in case you don't read this book, below is the final message, it is a quote sorry I cannot remember the author.

Life is eternal and love is immortal, and death is only the next horizon, and a horizon is only the limit of our sight.

Sent by Mike Jones | 4:01 PM ET | 01-19-2007

Saving only one "victim's" life? Whatever is spent on saving or helping one "victim" helps the medical community learn how to help others down the line, thus saving more than one life. The science of medicine is an ever-evolving process and lessons learned now can help many others in the future.

Sent by M.C. | 4:23 PM ET | 01-23-2007

One way we all like to be treated is having others respect our concerns/ideas/questions. Each of us wants to ask a question and not be told "YOU ARE unintelligent, ignorant, or a moron."

I think one has to take another person's basic needs (such as feelings) into consideration and comment ones own needs (feelings) back without judging.

You can comment your own needs without judging by paying attention to wording. "You are IGNORANT", sends the person a feeling of being bad or wrong. It says, "there is something wrong with YOU." Instead, say how you and ONLY you feel, like "I feel very hurt." THEN you can share with them your ideas and hopes (remember the basic needs)"what about ______ and ______.".

This creates a cycle that helps you be listened to and honored without judgment and equally for the other person. Nice trade huh :) This technique is one from the None Violent Communication Foundation. Check them out to learn great ways to communicate easily with others.

Sent by Mark Longo | 5:14 PM ET | 01-23-2007

Dear Leroy,

I have been following your blog for many months. It has been incredibly helpful to me — your insights and perspectives are inspirational. I have a very rare terminal cancer. I am a patient at NIH and I have two small children (3 and 1).

I have always felt better after reading your blog but when I read Pam's words I was SO UPSET! I almost wish you hadn't posted it because it upset me so much, but I have been thinking about it and not only is she incredibly ignorant, but she's just plain wrong. I have a few comments 1) if you asked my children, my parents, my siblings, or my friends how much my life is worth — they would all tell you that they would give their last dime if they thought it would save my life (of course my 3 year old and 1 year old don't have much disposable income at this time). But that's just me, my second point is this: 2) when Pam or one of her friends or family members gets cancer, how are the doctors going to know which treatments to use on her - chemo? Surgery? Radiation? A combination? They are going to know, because they have been experimenting on all of us.

In her scenario, there is one adult victim — that's not the case — there are thousands of us, all over the globe, and the doctors are working to find a cure for the benefit of society. Cancer is an equal opportunity disease of the young and the old, and the rich and the poor, and of every nationality. Thank God for the "information highway" that is allowing our doctors here and in Europe and in every other country around the globe to communicate and bring us closer to a cure.

Because my cancer is very rare I have asked the doctors at NIH why they bother with it and their answer has always been that if they can crack this one, maybe it will provide answers to other types of cancers (besides, if they didn't do the research no one would because its not in the best interest of the drug companies because it is so rare). We're paving the way for Pam and her friends and family and if she doesn't appreciate, if all she sees is one adult victim she's not just ignorant, she's stupid. Sorry, I normally don't judge quite so easily but I can accept her comments gracefully, I just can't.

Thanks so much for being here. I feel that you are a part of my life and I think about all the other cancer patients that benefit from your blog and I feel somehow connected to them too.

Kindest regards.

Sent by Tannis | 5:36 PM ET | 01-23-2007

One has to wonder if Pam were diagnosed with cancer, whether she would suddenly have a huge change of heart and mind?

I imagine she would. It never hits home until it becomes your own personal problem. I just hope she never has to find out.

Sent by Brenda D. | 12:09 PM ET | 01-24-2007

I have just found your blog. I was diagnosed with Stage III diffuse large B cell lymphoma in Aug. 2006. I chose not to enter into the chemotherapy fun and games. I have been using the alternative medicine route. The protocol is one I have chosen for me. My last ct/pet scan showed that 85% of the cancer has left my lymph system. There are no signs of cancer anywhere else in my body. I know that you probably will not post this, but I just wanted you to know that I will pray for you and your recovery. My son set up a blog site for me to journal what I am doing. The site is www.bettytillis.com. It is wonderful to see how you are dealing with your malady and the consequences of your treatment. Bless you. You are an inspiration to all who suffer from Crazy Cells regardless of what medical treatment is chosen.

Sent by Betty Tillis | 1:24 PM ET | 01-24-2007

Thank you for your blog. You're providing an essential connection for many of us who have experienced parts of the cancer world through our loved one's unexpected journeys there. It's an essential link because it seems the uninitiated can't truly comprehend, or empathize about, the cancer world, which is kept isolated — in your words, on "the other side." Thank for spending your time and strong ability to articulate what the cancer experience can mean for patients & the people who love them. It may sound corny but I am sincere when I say your blog provides inspiration, insight & strength to me while dear friends face cancers overwhelming decisions and challenging complications. I think that enables me to support them better and I cannot thank you enough.

Sent by Marilyn | 10:36 PM ET | 01-24-2007

I am sorry Mark (Longo), but I reject your basic premise, which is that all viewpoints are of equal value so long as they are expressed without trying to intentionally hurt another's feelings.

The syllogisms used by Pam are based on such obviously faulty premises (I count at least four in the paragraph quoted by Sievers and the comment by Pam was longer than the portion quoted by Sievers if I recall correctly), that it is pointless to try to discuss it with her. It's like trying to "discuss" race with a bigot. No matter how long and how logical your arguments, you eventually come to the conclusion that Pam's or the bigot's conclusions are based not on factual premises, but on what they think.

Pam is either (a)stupid or (b)cruel. Because I took her comment at face value that she was not trying to be heartless, I concluded that the answer must be (a)stupid.

Very truly yours.

Sent by Thomas J. Clarke Jr. | 2:59 PM ET | 01-25-2007

Perhaps Pam has not had a direct threat to her life or the life of someone she loves. Her comment is not just heartless, it is thoughtless. It makes me wonder how she values her own life. Would she pull the plug at the moment she received a "bad" diagnosis? How can we justify what we spend on healthcare for neonates? For those is jail and death row? For those with traumatic brain injury? For the obese with multiple medical problems? You see, the moral issues are seemingly too complex! One must focus on the heart of the matter and that is the sanctity of life...

Sent by Suzanne | 12:37 PM ET | 02-05-2007

Leroy,

While reading your blog, and the comments, I was shocked and angered by the comment left by Pam about your supposed "victimhood". I was even more shocked to see my father's name as one of those responding in support to you as he drew on our personal experience of losing his wife and my mother 10 years ago after a very long and drawn out battle with breast cancer. I echo him as I say that she fought to the bitter end, and I hope you do to. She deserved every cent poured into her care, and every day that she survived, and so do you. Shame on you Pam, I pray that you never have to experience for yourself or watch as someone you love begs for even one more day, but sadly that seems to be the only way that you will truly understand Leroy's will to live.

Sent by Rebecca Tabbutt | 2:52 PM ET | 03-13-2007

My friend at work heard your show and told me about your Blog. My brother was just diagnosed with Cancer 12/06. I knew something was up 2 weeks prior to the diagnosis. His lung cancer had spread to his brain and if it wasn't for the intense headaches or the eye sight issues, he would have never known. Stubborn man, he wouldn't go to the Dr. They got the tumor 12/23, and they did radiation to get smaller tumors that were starting. He's now into his 2nd treatment of chemo for his lungs and we found out his PET scan results Thurs (3/8). He's got two in his left lung, one in his right, a tumor under his arm pit and 4 in his stomach. If it wasn't for the eyes and headaches, we may have just gone along all fat and happy never knowing this. He's giving chemo a shot, but I'm going to see if the treatment you are receiving is available in AZ. Thanks for your information, because you just never know who will benefit from it. I certainly wouldn't have. Oh, by the way, my brother will be 50 in May.

Thanks again.

Sent by Cammie Kryka | 2:54 PM ET | 03-13-2007