My Life with Cancer

By this time I was in mental free fall. Friends later said I handled it courageously, but they were wrong. American culture rewards cheerful stoicism, a quality that cancer patients usually display in public but find difficult to sustain in private, especially at the beginning. I collapsed in tears only briefly, but retreated into a fog of unshakable misery. My detachment alarmed Emily, who wisely resisted many well-intentioned efforts by family and friends to coddle me. She understood that their instinct to be protective was making me into a weaker person than I needed to be. So she lovingly but firmly pushed me back into some semblance of normal life. "Get off the Internet and get back to your real work!" she insisted on more than one occasion.

I slept only with the help of sleeping pills. After taking too many, I botched the disclosure of my condition to our three kids, then ages 14, 12 and 10, stumbling so badly over my words that Emily finally sent me to bed. Our family freely discusses everything but in this case we only told them the extent of the problem when we had a plan in place to try to fix it. They didn't want to know the details, and their self-protective lack of curiosity on this subject (and this subject alone) was a relief to me. We rarely talked about it with them thereafter, an unfashionable approach I would recommend. Physically, I felt OK; emotionally, I was in hell. A woman I knew who was dying of breast cancer told me that none of the pain she was suffering at the end of her life compared with that first month and the daze of diagnosis.

I fell back on what I knew—reporting and analysis—and undertook a furious round of investigative phone calls. Everyone agreed that it was critical to be examined at a major cancer center, where doctors would have seen my disease much more often than at other hospitals. (I was even told of studies showing the farther one travels for treatment, the better the chance of survival.) With the help of friends, I finally got an appointment at New York's Memorial Sloan-Kettering Cancer Center. It happened on my wife's birthday, the only present she wanted.

After receiving a second opinion on the lab results, the brilliant doctor who became my oncologist administered an excruciating bone-marrow biopsy, which felt as if I were on a medieval rack. The results confirmed that I was Stage Four, the most advanced, though the systemic nature of lymphoma may have made that less dire than in other cancers. He told me that my two-year odds of survival were essentially a coin toss, and that my best chance to improve them lay in four months of accelerated chemotherapy, followed by a bone-marrow transplant, an aggressive regimen previously used mostly for relapsed patients.

Many patients place full trust in their physician and never second-guess them. I was constitutionally incapable of that, so I hit him with a barrage of questions. Why this chemo protocol and not another used by a different hospital? Why not enroll me in a clinical trial? Why couldn't he tell me more? Even though I admired him, I continued reporting. With no standard of care for this disease, each expert I managed to get on the phone had a slightly different take on how it should be treated, which I later discovered is common with cancer.

I vacuumed up everything I could. (Cancer is unbelievably complex: lymphoma alone is made up of more than 30 different types.) I even became capable of decoding some of the doctors' medical jargon, which is like picking up a foreign language. The more I knew, the more frustrated I grew at the Catch-22 of oncology, which is that the most cutting-edge therapies are used only for the sickest patients, when it's often too late. Newly diagnosed patients get the old stuff, unless they get much sicker, when it's often too late for them, too.