This week, in honor of Breast Cancer Awareness Month, we're presenting two stories from cancer survivors.
Part 1: Gail Thomas clashes with her oncologist while deciding how to fight her cancer.
Gail Thomas has several resumes: writer/actor/teacher/filmmaker/lawyer. She is a Moth StorySLAM winner and has performed with RISK!, Sideshow Goshko, the Liar Show. She teaches for the Story Studio. Voiceover credits include David Letterman, Beavis and Butthead and Angelo Rules. Her short comedy, My BFF, rated 95% funny on Funny or Die and audience favorite at New Filmmakers. As a speechwriter for the Tribeca Film Festival and the Gotham Awards, her words were uttered by Oscar winners and fancy people with great clothes. Gail is currently working on her fashion sense. Her website is www.gail-thomas.com.
Part 2: As a marathon runner, Pierce McManus prides himself on his toughness — but then he begins coughing up blood.
Pierce McManus relocated to Washington, DC from New York in 1992 to pursue a career in international diplomacy. When his budding ambassadorial ambitions fell through, he opted for a different route -- running marathons, fronting a sleazy rock band, and diving headfirst into a career in digital communications. Pierce is a fixture of DC's venerated storytelling scene and the co-host of the popular Perfect Liars Club. You can learn more about him at the curiously titled piercemcmanus.com.
Part 1: Gail Thomas
So it’s August 2009. It’s a bright, sunny day in Brooklyn and I have a doctor’s appointment. Normally, I would ride my bike but I can barely walk so I catch a cab.
It’s a week after my hysterectomy. Hysterectomy. I never thought I'd say that. My sex organs are gone. We didn’t really get to say goodbye. I didn’t plan to have kids but I thought, well, maybe, I don't know if the ovaries balanced something else out. I don't know.
But I’m not worried. It’s my post-op appointment and this is when my young, good-looking doctor is going to shake my hand and tell me, “Congratulations, we got all the cancer.”
I get to his office, he brings me in. He's wearing sort of this khaki slacks and a button-down shirt. He looks more like a teacher’s assistant than an oncology doctor. He motions for me to sit. He closes his office door, no handshake, and he goes and starts pacing back and forth behind his desk.
He's not as cute as I remember. I feel like I’m a graduate student that had just failed an exam or something. And then he starts speaking.
“Mrs. Thomas, it’s serious. The cancer has spread from your uterus to your ovaries. I’m not sure if we got it all. I don’t want to give you false hope.”
False hope? I'll take false hope. I'll take any hope you've got. Just bring on the hope. That’s good. I don't say that and he continues.
“Mrs. Thomas, it’s Stage 3A metastasis. You have a fifty-fifty chance of being alive in five years if you don’t do exactly what I say.”
Mrs. Thomas? I’m not married. My mom’s not there. And this guy just took my uterus, my Fallopian tubes, and my ovaries out of my vagina. I think we can be on a first-name basis.
And he keeps talking. He starts talking about treatment. He says six weeks of radiation daily followed by six months of chemotherapy. He says other things, more statistics, but all I hear is, “six weeks of radiation followed by six months of chemotherapy starting immediately”. He calls it protocol. Standard treatment. It sounds like a threat.
I finally speak and I say, “Well, I'd like a second opinion.”
He says, “Okay. As long as you start treatment first.” I don't think that’s how second opinions work. I think you're supposed to get the opinions and then decide.
Plus, research says that you should heal from surgery before you start treatment. Now, I don't have a medical degree but I do have a law degree, and I’m not good at confrontation but I’m really good at research.
And research also says that what’s standard treatment one year can be over-treatment the next year. It also says that every patient is different.
I have other reasons to be concerned about this surgeon. I have a fever that is so high that I’m not sleeping at night, and when I tell him this, he won’t give me antibiotics. He says, “Oh, it’s just menopause.”
I have so much drainage coming out of my body that I’m wearing adult-size diapers and I can’t walk the dog half a block without dripping.
And I don't tell him this. I woke up during surgery, just long enough, to hear him say, “She's not that bloated. She shouldn’t look like that.” I fell back.
And he won’t even talk about side effects. Doesn’t he know that there's more to my life than just living? What about my bike? Can I ride my bike after chemo? And what about my other organs? How would the bladder feel about this? What about the heart? How does it affect the heart?
I walk out of there in a daze and I’m thinking about my friend D who had gone through aggressive cancer treatment, and I don't know if I would want to live like that. I walk through his waiting room and I notice that the chairs are dingy and the tables are kind of… it looks like a garage sale. Is this young surgeon my only hope? Did I just choose him because he's good looking? I've made that mistake before.
I don't have time to cry. I get home. I’m CEO of Gail’s biggest decision ever and I've got to make the right one. I hit Google.
Doctor Google is equally scary. Side effects include nausea, fatigue, dizziness, more cancer, more nausea, uncontrollable flipping eye movements that’s from the nausea medication. And sex? Apparently, and the doctor didn’t tell me this, apparently radiation sort of tightens everything down there, and not in a good way. I may be older than my surgeon but I’m not ready to give it up. I still got to boogie. I’m single but I’m scared.
So I’m a frantic Googler by night and I’m a good patient by day. So I agree to go to meet the radiation oncologist. He's got droopy eyebrows and a little gray in his beard. He comes into the room and he's holding my chart. He looks at me and he looks at my chart, and he looks at me and he looks at my chart as if he's trying to decide between the two of us.
Then he sits across from me, I don't know, about four feet across from me but it feels like he's holding my hand. And he says, “You know, there's a chance that you don’t need any treatment. There's a chance that you actually have. Your lymph nodes were completely clear. Twenty-six clear lymph nodes.”
He said, “There's a chance that what you have is two early-stage primary cancers, one that was on the surface of the ovaries and one that’s on the surface of the uterus, which means Stage 1 and no treatment necessary.”
Huh. Two cancers is good news. I guess that’s why you need a medical degree. But this is hope. This is real hope. I’m more confused but I am now really officially hopeful.
So I go home and now research is exhilarating. It’s a life-or-death matter. I’m Super Google Gail. I’m on, I’m up late 3:00 a.m. every night and I get more opinions. I go to my yoga teacher. He says eat a raw onion every day. You won’t have any friends but you won’t get cancer.
My Dominican handyman stops by with an aloe vera plant. And my brother is like Rambo. He's like, “Do it all. Do it all. Just do it all.” He's an MBA so he knows.
But I’m scared. What if the doctor is right?
So I agree to radiation but first I have to go to what they call simulation appointment. I get there and it’s a large room once more with the same garage-sale furniture only there's boxes, so it’s also a storage closet. They lay me down on this… they’ve got those silver, tin, steel tables. I lay on that thing and the nurses put this mold around me because they have to get the same size as my hips right so that the radiation goes into the same place thirty times.
Then they pull out this little tattoo device and they go zit, zit, zit. It’s like triangular little tattoos around my pelvis to make sure that the radiation goes to the same place thirty times. It feels wrong, but I tell myself, well, this is the price of living.
The morning of my first radiation appointment it still feels wrong, so I call and I say I’m not going to come in today.
And I do more research. Now, I’m going to get more pathology reports. I get four total and the third out of the four ones from a very prestigious hospital agrees with the last doctor. It says, “Two early-stage cancers. No treatment necessary. The lymph nodes were clear. It didn’t spread.”
I’m so happy. This is the one. I’m thinking I’m going to go with this one.
So I call my surgeon, my young surgeon and I tell him the good news and he won’t listen. He says, “Six months of chemotherapy followed by…” he switched the order now, “followed by six weeks of radiation starting immediately.”
And then he goes on vacation and I meet more doctors. Then I break up with him. I send an email because I don't like confrontation, but I get out of there.
By now I have found Dr. C. Dr. C is tall, thin. He has almost shaved, just a light bit of gray hair and he has kind eyes. He makes eye contact and he calls me Gail. And he nods and he has this little twinkle in his eye when he speaks and he listens to me talk about my fears and my concerns.
He tells me, “It’s your decision. You have time. It’s up to you.”
And he doesn’t laugh when I say, “What’s the least amount of treatment I can do without seeming suicidal?”
Then he talks to the radiation board at the hospital on my behalf. They talk about me. They talk about my individual case. Not a statistic. Not everyone. Just me. And then they decide that I don't need to do radiation.
And then he tells me that he's heard of a study in Italy where you only need three rounds of chemotherapy, three months, half of what the original bully surgeon wanted me to do.
We compromise. I didn’t do any radiation. I did some chemotherapy. That was ten years ago. I’m cancer free. I didn’t have any nausea, no side effects, and I don't even think about it much anymore, except when I’m getting dressed and I see those little tattoos because they're permanent, those little tattoos.
But when I do I don’t think about that garage-sale treatment room or my condescending surgeon. I remember that I actually stood up for myself and then I found allies that I could trust in a partnership.
So I see Dr. C now every year just to say hi. That’s it. One of my recent visits I actually told him that I was starting to share this story and, as he was leaving, he turned to me and he said, “I don't usually tell my patients this but I’m a cancer survivor too. And if I hadn’t gotten a second opinion, I wouldn’t be alive today.”
I guess he learned to stand up for himself too. thank you.
Part 2: Pierce McManus
When I was a child, my parents bestowed upon me a rather unfortunate nickname. They called me Boo-Boo Boy. Say it one more time, Boo-Boo Boy. Because every nick, cut, scratch, cold, illness, malady, real or imagined, would send me into complete hysterics quickly followed with a desperate search for some sort of parental consolation.
My father was a grizzled New York city police officer. My mother was an old-school devout Catholic. Basically what I’m trying to say is parental consolation in any form was in very short supply in the McManus household.
“Here comes Boo-Boo Boy,” my father would say whenever he saw me approach with tears in my eyes.
In retrospect, I know that nickname Boo-Boo Boy was a thinly veiled attempt on the part of my parents to toughen me up. Quite frankly, I don't blame them. I was a pudgy, bookish lad with more imaginary friends than real friends, a propensity to burst into tears at the drop of a hat, and all the athletic skill of a wet sponge.
I loathed being called Boo-Boo Boy and I made it my goal over the years to put as much time and space as I possibly could between him and me.
By the time I hit my forties, I was pretty sure I had completely shaken the stigma of Boo-Boo Boy. I was living in Washington DC. I had a successful career in advertising. I had this swinging Mad Men bachelor lifestyle that accompanied a career in advertising, and I had finally discovered a sport that I was actually good at. Distance running. Marathons.
I went from being a kid who would cry at the first sign of pain to pursuing a hobby that required a high pain threshold. Yeah, take that, mom and dad. And when I say I was into running, I mean I was really into running. I was really good at it too, like Boston-Marathon good. And in the fall of 2010 at the Philadelphia Marathon, I qualified for my sixth Boston Marathon.
Life was good. The world was my oyster. I had a great job. I loved my swinging bachelor ways, and I loved the counterbalance and the mental discipline that running offered. I would say I felt invincible.
If we've learned anything from the Old Testament, Shakespearean tragedies and mid-1990s Nicholas Cage films is that the minute you begin to feel invincible, is the exact moment you should begin to watch your back for the unfathomable comeuppance that is waiting for you right around the corner.
I ran smack dab into my comeuppance four months after that marathon when I woke up one morning, made my way to the bathroom, hopped in the shower and proceeded to cough up blood everywhere. I do mean everywhere. My bathroom looked like the murder scene from Psycho.
Naturally, anyone in their right mind would exit the shower, dry off and call a medical professional. I did not. I was ridiculously hung over. I had spent the previous night at the annual advertising bacchanalia known as the ADDY Awards and I had raised all sorts of Cain into the early morning hours.
Truthfully, as I surveyed the crime scene that was my bathroom, I could hear the voice of my mother. “See all that? God is punishing you for your poor choices.” So I told no one.
Six months would pass before I found myself in a doctor’s office. I'd gone downtown for my annual physical. “Everything looks good,” my doctor told me, “but is there anything else you need to tell me?”
The truth was my life had begun a complete tailspin since that first coughing-up-blood episode. I was tired. I was lonely. But most of all, I was scared I couldn’t keep it a secret anymore.
“I've been coughing up blood,” I told her. Things really took off from there.
A week later, I made my way downtown for a CT scan to identify the source of all that blood. “We’re going to inject you with some dye,” the nurse told me. “That helps us read the scan better. But there's only one small side effect. It makes you feel like you're wetting your pants.”
As I lay in this giant metal tube for what seemed like forever, I was just completely terrorized not at the notion of what the doctors might find but out of fear that I had actually wet my pants. When the scan was complete, I was very relieved to discover that that was not the case.
But what I did discover shortly thereafter was six missed phone calls from my doctor and one very urgent voicemail. “Pierce, you need to call me right away.” It’s never a good sign, guys.
The scan had revealed a large mass in my right lung.
“I've made you an appointment with a pulmonologist this afternoon,” my doctor informed me.
Three hours later, I found myself in another examination room in downtown DC. The doors swung open, a doctor entered and, without introducing himself, he raised his finger to his chin, he looked me up and down and said, “Hmm, you don’t strike me as the cancer type.”
Two weeks later I am diagnosed with cancer. Leiomyoscarcoma. It’s a soft muscle tissue cancer with a 50% life expectancy, depending on which medical journal you read. But here’s the thing. It’s typically found in the uterine lining of older women, not in the lungs of healthy marathon runners.
“You’re one in a million,” my doctor tells me. I smile at the notion of winning Cancer Powerball.
I make the long walk home to my house that morning and I’m in complete shock at the news. And as much as it pains me, as much as I don't want to return to my Boo-Boo Boy ways, I call my parents. It goes right to voicemail.
I make my way finally into the lobby of my condo building and, just out of sheer habit, I check my mail. I reach into the mailbox and I pull out a large postcard.
“Congratulations! You're accepted to the 2012 Boston Marathon.”
The race is six months away. I wonder if I’m even going to be alive in six months’ time. My grandfather went from cancer diagnosis to death bed in the span of three months.
Then, in that moment, I am overcome with something I am not accustomed to. Sheer, unmitigated anger. Fuck that! I am running this race. I am going to be in Boston for the 2012 Boston Marathon. I’m not going to let cancer and I’m not going to let anything stop me. I just needed to get my doctors on board with this plan.
Things did not get off to a good start when I met my surgeon. “You will lose part of your lung, that is for certain. There is a good chance you will lose all of your lung.”
Things only went downhill from there when I met my oncologist. He described a series of radiation treatments that would happen after the surgery.
“But I've got the Boston Marathon,” I told him.
“Oh, Pierce. There will be other marathons. You need to focus 2012 on getting cancer free.” Clearly, this plan was not working. I needed a Plan B.
Plan B meant a second opinion, so I gathered all my materials and slides and I sent them off to Sloan Kettering Cancer Center in New York City. Due to the unique nature of my diagnosis, they completely expedited my case and in a week’s time I was sitting right across from one of Sloan Kettering’s top thoracic surgeons.
“I hear you run marathons,” he said. “My daughter runs marathons too.” I knew immediately that I was in great hands.
A year to the day of my Boston Marathon qualifying run in Philadelphia, I had surgery at Sloan Kettering. The doctor described it to me as having a lung transplant with my own lung. The challenge was being able to remove the tumor without having to remove any parts of my lung.
I woke hours later and was miraculously informed that both my lungs were still intact. That’s where things got really weird. Because further analysis of the tumor would indicate that I had been completely misdiagnosed. I did not have leiomyosarcoma. I had the equally rare and kind of bizarre glomus tumor, which is a benign tumor typically found underneath fingernails.
“Don’t worry, Pierce,” my doctor told me, “you're still one in a million.”
I was in the hospital for four days and I was released on Thanksgiving Day 2011. I wound up spending the next two months recuperating under the watchful eye of my mom and dad in my childhood home.
“We were worried about you, Boo-Boo Boy,” my parents told me. “We’re happy to have you home.”
A few weeks later at a follow-up appointment with my surgeon, I said, “You know, doc, I've got the marathon coming up. When can I start running?”
He says, “Running? We didn’t operate on your legs. You can start running whenever you want.”
So I started running. In four months’ time I made my way to the start of the Boston Marathon. I savored every minute of that race and I still savor every minute.