Crisis and Support Groups

“I claim not to have controlled events, but
confess plainly that events have controlled me.”
-Abraham Lincoln

He was almost eighteen: a tall, muscular, articulate boy who felt ready to leap into manhood. His mother brought him in because he needed a checkup before his coach allowed him to play football. He was a bit miffed that the rules had made him miss his first practice.

He had no symptoms. Well, maybe a cold the past few days. His throat felt sore. He was on no medicine; he did not smoke; he had not used illegal drugs.

I asked him to sit on the exam table. As soon as he opened his mouth, I felt concerned. He had thrush all over his throat and cheeks. Something we only see in people who have recently taken antibiotics or whose immune systems are compromised. Within five minutes I could see that this young man was in serious trouble. He had tiny bleeding spots in his eyes and all over his legs. His liver and spleen were large. He looked pale.  

When I finished the exam, I had to conclude that he had acute leukemia. There was just no other realistic possibility. I was young, fresh out of training, and a bit intimidated. I had to go out to the waiting room and tell his mother that her baby was seriously ill. What started out as a routine checkup was about to turn the family’s life upside down. Lucky for him that his coach had not let him practice: one tackle would have ruptured his spleen and could have made him bleed to death.

One of the most difficult things I have ever had to do. Made much easier because his mother was so surprised that she barely asked any questions. His father, a police sergeant who was already my patient, also behaved with considerable stoicism when I called him. The young man went in the hospital that evening. A bone marrow biopsy was done late that night. Within three days he was at the medical school’s hematology center, because he had a very resistant form of leukemia. 

The next few years were difficult. Two rounds of chemotherapy; his brain was radiated; numerous side effects. The leukemia recurred. He had a bone marrow transplant. It did not take. Another transplant was done, which was followed by severe graft versus host disease, where the donor immune cells attacked the organs that had belonged to him all of his life. He lost all of his hair (permanently). His skin developed many ugly sores which eventually scarred. The scars made him look like he had gone through many operations. He could not concentrate at school, the few times that he was able to attend.

His parents kept me informed of his progress. They handled all of the stress and expense with incredible equanimity. There was always this level of confidence; faith; commitment to stand by their son. I remember thinking that if this were happening to my child I would be in a psychiatric unit.

Ten years later he made an appointment to see me. He was finally over his numerous crises. Enough that his hematologists had urged him to go back to his primary care doctor. He looked much older than his age, and he was not as articulate. He had found a job where he made enough money not to depend on his parents. He even had his own medical insurance. He had many friends. He was virtually joined at the hip with his brother, who had followed in dad’s footsteps and become a policeman.

Other than for his appearance his exam was normal. I sat down after I was done. I faced him.

How did you get through all of this?  What made you want to go on?

“You have to,” he said.  

He smiled.  

“When you are in the middle of it you just go on.”

I told him that I did not think I would be that strong. 

He reassured me, with a look of supreme kindness.  

“Of course you could,” he said.

Then he took a deep breath and began to recite the names of people who had helped. Parents; family; dad’s colleagues; mom’s workmates; church; neighbors; medical personnel; even perfect strangers.  Literally hundreds of people who had banded together to save a life. The curious thing, he said: no one acted like they expected payback.

I was almost in tears when he got up and left the room.

I have often wondered since then what it is about some situations that bring out the best in people, and why there are times that our humanity fails us. We can rise to be angels. The question is why this urge is not hard-wired into all of us, all of the time.

 Maybe if we believed more in ourselves. Maybe if all of us had a firm conviction that yes, we can make a difference.  

Every day, with every breath, we have the potential to help to save a life.