STEVE INSKEEP, host.
This is MORNING EDITION from NPR News. I'm Steve Inskeep.
Today's Personal Health report explains how two dealt with potentially fatal cancer. It's a special challenge for doctors with cancer who are used to giving medical care, not getting it. They know better than most what their future might look like. Dr. William Tierney wasn't happy being suddenly known as the guy with cancer.
Dr. WILLIAM TIERNEY (Medical Research Scientist, Cancer Patient): You want to be normal and not be self-pitying and any more dependent than you have to be.
INSKEEP: For Dr. Elizabeth McKinley, the knowledge that she had cancer hit her at odd times.
Dr. ELIZABETH MCKINLEY (Assistant Professor, Medical and Biomedical Ethics, Case Western University, Cancer Patient): I find myself just weeping, you know, will I see my kids get older? Will I have terrible pain? When am I going to die? Is my husband going to be all right?
INSKEEP: Both doctors shared their stories about how they got through their cancer with NPR's Joanne Silberner.
JOANNE SILBERNER reporting:
After ignoring symptoms of recurrent pain, internist William Tierney was diagnosed with lymphoma at the age of 48. It was a particularly difficult type to treat, but he survived. During the illness he swore he'd take it easy. But it's only now, six years later, that he's telling his patients he's cutting back.
Dr. TIERNEY: There's something else I need to tell. I'm retiring from this practice.
Unidentified Man: I'm going to cry.
Dr. TIERNEY: Not a guy your size. You used to be a tough guy.
SILBERNER: The patient is a former motorcycle gang member who weighs in at more than 350 pounds. He's been with Tierney for 26 years. Tierney knows his patients depend on him and feels terrible about dropping them, especially since he learned the importance of depending on others during his own illness.
Dr. TIERNEY: We help people and their families through difficult times when people die, etc., and you have to be the one who's strong to lead them through it, to be the one that people lean on. And it's very difficult for physicians to just back off and say you take care of me.
SILBERNER: Tierney remembers in the midst of a chemotherapy cycle collapsing behind the lawnmower. His neighbor came over and said you're not doing that anymore, I'm doing it. Tierney only let him because he was so exhausted. He gradually learned that had to let people help him, not just for his own sake, but for theirs.
Dr. TIERNEY: A research colleague of mine, just, he was desperate to help me. I mean, he really looked stricken. He wanted to find something to do for me. So I used to ask him to drive me home from chemotherapy. I felt fine after chemotherapy. I mean it didn't affect you until days later. But I let him give me a ride home just so he felt he was doing something for me. It was actually a problem because I had to find a ride in that day so my car my car wouldn't be stuck at work.
SILBERNER: Cutting back at work was especially difficult. People still wanted to depend on him. Even in the weeks and months after chemotherapy, which left him feeling unable to think clearly. Once, he was out running with a colleague who was a co-editor of a medical journal with him.
Dr. TIERNEY: I was complaining that I just had so much to do. I couldn't get it done; my brain wasn't working; and he just said, well, you need to do less. And he was the one giving me a lot of push-back about the amount of work I was having him do for the journal. And I finally stopped in the middle of street and said, damn it, it's people like you that I have to tell that I can't do the work. You know, I can't just do yours and nobody else's. I can't do any of it well.
SILBERNER: Tierney learned even if people were depending on him, he had to prioritize. Ultimately, he realized with teaching and research and traveling to Kenya for an information technology project, he couldn't do well by his patients. They couldn't depend on him anymore, leaving him to make the difficult decision of leaving his hospital-based practice.
Dr. TIERNEY: The way I justify it to myself is that they need a doctor who has got more time to be a good doctor than I do. They need to get known by somebody who has more time and is going to be there for them when they need somebody, and that just isn't me anymore.
SILBERNER: The big lesson for internist Elizabeth McKinley was very different: how to hope. That's a lesson she sorely needed earlier this year when she waited with her radiologist husband in his office for a CAT scan of her bones to show up on the computer.
Dr. MCKINLEY: So I wasn't really looking at the images. I'm looking at his face. And I can see it on his face, you know. He starts to slow down, and his face falls, and he's obviously seeing something; and I'm looking at the picture and I can't see what he's seeing. And, you know, I kept going, Chip, stop. I can't -- what are you seeing? I know it's bad. What are you seeing? And the poor man couldn't talk to me for a while. He's sort of crying at the keyboard.
SILBERNER: Nine years after her initial treatment, McKinley's breast cancer had returned and lodged in her bone. She asked her oncologist how long she had to live. How about a broad range, two years to 40 years.
Dr. MCKINLEY: She looked at me and she said, that's too many. I said, okay. How about two to 20 years, and she said, that's too many. So I didn't go the next step because I just didn't want to hear the answer. I didn't say is it two to 10. And I think I didn't do that because I feel very, I feel, I feel hopeful.
SILBERNER: The hopefulness is hard-won. McKinley remembers during her first chemotherapy back in 1997, at home, feeling exhausted, nauseated and poisoned, her five-year-old son burst into her bedroom.
Dr. McKINLEY: He comes in, he jumps on my bed and he says, Mommy! Mommy! Are you dying? And you know, of course, instead of doing what he needed me to do, which was to hug him and reassure him and tell him that I was going to be okay but that this would get better, I just burst into tears and rolled away from him, and just said, just feeling, oh my gosh, the path of sorrow and destruction I'm leaving in my wake is too much for me to bear.
SILBERNER: But then her old college roommate came to visit, bringing Monty Python videos. McKinley started writing in a journal. She joined a support group, and she learned from a patient she treated for water on the knee that she could get through chemotherapy. He noticed she had a surgically implanted port, a semi-permanent device for delivering chemotherapy, and he started telling her about his.
Dr. McKINLEY: He kind of handed me his story, sort of like he handed me his hand, you know? He linked his story to mine. And it sort of pulled me up a bit. I know that sounds very weird, but I really felt incredibly supported by this man I'd never met before, and actually would never see again.
SILBERNER: McKinley says she's learned to get used to feeling depressed and frightened occasionally. She knows from experience she'll come out of it.
Dr. McKINLEY: I just feel like I am so much more able to deal now. Again, because I've dealt before, I know what it feels like, I know when I'm about to be overwhelmed by the feeling of hopelessness. And I have some skills to pull myself out of it.
SILBERNER: She's trying a new drug, Arimadex, that wasn't around the first time she had cancer. She keeps herself busy with her husband and children, and teaching medical students at Case Western Reserve University. She's hoping to start a clinic for cancer survivors, and she avoids things that remind her of her first chemotherapy. She got rid of the scarves she used to wear to cover her bald head.
William Tierney, though, has mixed feelings. He wants to remember being bald. He keeps a picture on his desk at the Indiana University School of Medicine of what he looked like during his chemotherapy; no hair, no eyebrows, no eyelashes, no beard.
Dr. TIERNEY (Cancer Survivor): I keep it there just to remind me occasionally to realize that I'm fortunate to have what I have, and to try to recapture some of the god things about having cancer, about wanting to take, to pay attention to life as it goes by and not keep putting off things until tomorrow that may never come.
SILBERNER: While the photo is on his desk, it's partly obscured by a marble paper weight.
Dr. TIERNEY: That's because it's ugly. You don't like the way you look without hair. I can see it. I can see it. I know it's there.
SILBERNER: At six years out, it's unlikely that Tierney's lymphoma will return. But he is more prone to other types of cancer. He's hoping for a 40-year remission.
Meanwhile, he's learned from his first cancer that it's okay to let other people take care of him, that he can't do everything. And it's better to think in terms of daily plans instead of five or ten years down the line.
Joanne Silberner, NPR News.
INSKEEP: Doctors Tierney and McKinley wrote an essay about what they learned from their cancers. It includes a list of concerns they call The Eight D's, and you get a sense of what they went through just knowing that the list includes both the words dying and death.
You can read excerpts at npr.org.
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