Monthly Archives: April 2019

Who Survives Cancer…. and Why?

When people are diagnosed with cancer, the question “why me?” looms large.  For those fortunate enough to survive, the question arises again. While definitive answers to who gets sick and who gets better remain elusive, the questions remain.

In 2016, I was diagnosed with acute myeloid leukemia. I didn’t spend much time asking “why me” because it didn’t seem like a healthy road to go down. After being successfully treated and recovering, I have the luxury of pondering the second question.  Why did I survive while others did not?

In transplant support groups, I often hear people say that everything happens for a reason. I think that is true in a narrow, probabilistic sense. Personal medical history, comorbidities, environmental factors, and genetic abnormalities can dramatically alter the chances of getting and surviving cancer.

But when people say everything happens for a reason, they usually mean that there is a larger, metaphysical reason for the differential survival of patients. As a sociologist, I understand the quest for meaning in the face of life-threatening illness and I respect belief systems that provide comfort and reassurance.

But I just don’t buy it. I don’t think there is an overarching rhyme, reason, or plan that explains life’s most fateful outcomes, whether “miraculously” good or horrifically bad.  Despite our impulse to find larger meanings in such events and after acknowledging how medical interventions can improve our odds, I think there is an irreducible randomness when it comes to surviving a lethal illness.

These thoughts were triggered when people gave me “credit” for surviving my disease. I have always felt uncomfortable accepting such credit.  Part of my discomfort stems from the coupling of credit and blame and the unintended consequences of such thinking.  For example, does crediting survivors for their “positive thinking” imply that non-survivors just weren’t positive enough?

As a patient, there were several coping mechanisms I relied upon throughout my treatment. But I will never know if there was any causal connection between those practices and my positive outcome. What I do know is that they maintained my sanity and preserved my identity during the most challenging experience of my life.

While acknowledging that outcomes may be unpredictable and somewhat random, sustaining ourselves along the way is a worthy goal in itself.  And if it does enhance our odds of survival, so much the better. My own story of what I did to sustain my self will be the subject of posts to follow.

 

Steve Buechler is a recently retired sociology professor and cancer survivor.  In 2016, he was diagnosed with acute myeloid leukemia and successfully treated with chemotherapy, radiation, and a stem cell transplant. He has since become a big advocate of writing stories as a survival strategy in the face of life-threatening illness.  His own story is available in “How Steve Became Ralph: A Cancer/Stem Cell Odyssey (with Jokes),” his memoir from Written Dream Publishing.

How Autism Shaped Me as a Writer

      In eighth grade, I discovered a new word I didn’t know existed: ‘autism’.

            Beforehand, I never knew what it meant, until I asked my parents about the definition one day. When I found out, my perspective on my childhood and the world around me shifted, rather than changed completely. Learning that word gave me a sense of clarity. It explained my prescription pills, the challenges I faced compared to other students, and why I couldn’t pay attention to my teacher in class.

For those unaware, autism is a neurological disorder currently found in 1 of 100 children. It is often categorized by an impairment of communication skills and difficulty in social interaction. While the severity of it is variable between patients, symptoms of autism include (but aren’t limited to) a delay in speech during early stages of childhood, anxiety in public spaces, repetitive behaviors/actions/movements, a poor ability of maintaining eye contact, heightened sensitivity and a lack of empathy. All of these symptoms are found on the autism spectrum, which catalogues a person’s autism spectrum disorder (ASD) on a high-functioning/low-functioning scale.

You might have heard of autism in Hollywood films such as Rain Man, Mozart & the Whale, Extremely Loud & Incredibly Close, or even TV shows such as The Good Doctor, where the autistic character is sometimes portrayed comedically as a socially-awkward yet talented savant. While there is some truth to savant syndrome and autism spectrum disorder being often linked, it is not the same for every person on the spectrum. Not every autistic person can be Dustin Hoffman and win every game of blackjack at a casino, or even find the bravery to break away from a planned schedule in their head. It is different for everyone, just as it was for me.

After my revelation, I became depressed. My entire world had been shattered, and I was convinced everyone considered me a freak, and I held this firm belief for a long time. Then I watched a wonderful film called Temple Grandin, a biographical movie about the life and career of Mary Temple Grandin (played by Claire Danes), a woman with autism who revolutionized the humane practices of livestock in slaughterhouses and ranches. Observing how Temple’s mother resisted having her autistic daughter institutionalized, encouraging her daughter to go to college and witnessing Temple become a spokesperson for autism inspired me. It made me believe I was more than a disorder, making me feel more hopeful for the future.

To this day, I’ve unfortunately haven’t had the opportunity to meet Temple Grandin herself, but my younger brother has. He’s attended one of her visiting talks and even requested that she sign a copy of her book Thinking in Pictures for me (Thanks again, Jacob!).

Believe it or not, I originally wanted to become a magician. I wanted to entertain people by pulling them into the wonder of an illusion, which is now the same goal I yearn to accomplish in each story I create. However, it wouldn’t be until tenth grade that I decided to try writing a short story for the very first time. It didn’t seem hard to me, considering I’d often spend my lunch hours in the high school library to escape. I had already devoured almost every book on the shelves, but I craved for more stories to read. There were more stories I wanted to experience, which is when I decided to write my own.

My early writing days are currently a blur, but what I remember the most revolved how to make a story believable. I experienced every symptom of an amateur writer trying to find their style; awkward grammar, complicated stories and writing too much exposition. Each story was harder to write, but each story grew bolder and better. At the same time, I opened myself further than I ever dreamed about. Over time, I slowly realized a writer cannot tell a story about life without experiencing it. If I wanted to make a conversation more believable, or an interaction in a crowd sound more real, in order for the reader to become more engrossed into the narrative, I needed to experience the same thing my characters would.

Creative writing requires patience and the will to let an idea flow to you naturally, which compelled me to practice my craft. At the same time, it compelled me to become more patient in anxious situations. Storytelling also requires making the fictional characters seem as real as you and me. The more I interacted socially, the more I could utilize the diction and mannerisms of a conversation into my dialogue, which in turn benefited my ability to recognize facial expressions and what they mean. Every leap into a conversation improved my writing style, and every interaction in a social setting allowed me to form lasting friendships over the years.

In some way, autism helped me become a better writer and a better friend. Granted, it doesn’t change the fact I still have autism. I become uncomfortable in loud places and sometimes need someone to tell me what they mean versus what they say, which can sometimes irritate my loved ones. Nevertheless, my family, friends and colleagues are very supportive of me as a writer and as someone with high-functioning autism. They gave me the determination to achieve.

In conclusion, I do not consider myself an autistic author, but an author with autism. Ever since my awkward days of high school, it was my dream to be published. Now that I’ve accomplished this goal, I hope to become a spokesman for the autism community. I want to prove to children with autism, Asperger’s or ADHD that the disorder never should define them. They can achieve important things, meet amazing minds and treasure friendships while finding a day of solitude as equally rewarding. Writing helped me overcome many of the obstacles of my condition, which can be the same for another person on the spectrum with their passionate hobby. If you’re a parent with an autistic child, my best advice for you is to encourage their interests and let them evolve into something beautiful.

To quote my hero, Dr. Temple Grandin, “If I could snap my fingers and be non-autistic, I would not. Autism is part of what I am.”

 

Nathan HoppNathan Hopp was born and raised in Green Bay, WI, and discovered his love for literature at a young age. He’s written countless short stories and flash fictions across several years, from vignettes submitted to magazines to short stories he posts online. His debut novel, “The Adventures of Peter Gray” was published in April 2018.

The epidemic of Overuse

Insanity is trying the same thing over and over again and expecting a different outcome.

The father and son duo who I  have seen three times since Christmas break have returned again.  The father is scowling because last time I refused to an order an antibiotic for his son’s allergies.  Of course the first visit I had relented  because the office was busy and the father practically demanded one. “ There are some fragile older relatives in the house. What I am kinda saying is we need that antibiotic.”

Flash forward a few months later they returned to see me again. The office was not as busy and dad was scowling about his son missing school yet again. The teenager had forgotten to take his allergy  medication. This time I educated them about overuse of antibiotics.  His father admits his mother has bad allergies. I recommended the teen take his allergy medication regularly and stay hydrated. The father is disgruntled I did not order an antibiotic. He mutters something about the antibiotic not lasting long enough last time.

Two days ago they returned after a few weeks gap. Now teen has a wet cough. He has been taking zyrtec  and allegra for his allergies. Teen reports green mucous and worsening over the past few days. Since he has a history of childhood asthma I relent this time to order the antibiotic. The father’s behavior is still very hostile and he scowls throughout the exam  declining the strep and flu testing.

Of course  I educate on staying hydrated and continuing his allergy regimen. The father asks if his son can play lacrosse. I state that as along as he has no fever and he is breathing fine, he can continue activity as tolerated.

The risk of severe diarrhea resulting in the diagnosis of Clostridioides difficile otherwise know as C. Diff plagues and kills many people across the nation each year. Recently the overuse of antibiotics have led to the discovery of a very resistant fungal infection cause by Candida auris. Medical teams and researchers are finding it difficult to manage the treatment as each regimen fails. A man suffered for ninety days in a New York hospital before succumbing to Candida auris. The unfortunate truth is that suffering could have been prevented had he not become resistant to typical regimens prescribed for his ailments.

I sigh with relief as they leave the clinic sometime later. All I can say sometimes you loose some and sometimes we win. The overuse of antibiotics and pain medications to mask symptoms is a common practice that the patients end up paying the price for sooner or later. As  new provider I sometimes find it challenging to educate my patients and their family members regarding the overuse of antibiotics. I attended a conference in New York a few weeks ago regarding gastrointestinal disorders. The common factor reported as the cause was overuse of antibiotics. I may not convince every patient I treat, but I shall make a greater effort to educate them about the  possible long term effects about using antibiotics prematurely.

We all need to make a conscious effort to promote probiotic use with antibiotics  and perhaps as a routine measure to prevent severe gastrointestinal side effects. The general public still believes the antibiotic is the cure of any ailment they present with. There needs to be more awareness and education in primary care settings , urgent cares and clinics.

sonaliSonali Dhir is a new nurse practitioner. She loves to travel and spend time with her family. She lives in New Jersey

Doctors as Detectives

During my prolonged treatment and recovery from acute myeloid leukemia, I spent many weeks in the hospital with a severely suppressed immune system as a side effect of chemotherapy. This condition is an open invitation to any infectious agents who happen to be in the neighborhood, and I had my share of them.  They included colitis, E-coli, the cytomegalovirus, and several others that were never definitively identified.

I was also on numerous medications, including prophylactic antibiotic, anti-viral, anti-fungal, and anti-rejection drugs as well as other drugs to blunt the side effects of these initial medications.  These drugs nonetheless produced some nasty side effects on their own or in interaction with each other.

The upshot was that on any given day, I would experience symptoms that included fevers, headaches, intestinal indignities, rashes, blurred vision, light-headedness, muscle aches, bone pain, and even persistent hiccups. It was on these occasions that I became acquainted with one of my now-favorite medical specialties known as infectious disease doctors.

I’d only known them as heroic figures in melodramatic movies about plagues threatening all humanity.  But on a more mundane and realistic level, they were also everyday heroes who often provided me relief from a myriad of infections and side-effects.

Their visits would be prompted by my report of unpleasant symptoms or obvious signs like spiking fevers. They would then begin looking for clues like detectives on the trail of a suspect.  They would consider all the medications I was taking as well as their doses and scheduling.  They would listen carefully to my recitation of symptoms. They would prioritize which medications were necessary and which could be eliminated or replaced with others. And they would order blood work, stool samples and other tests to nail down the culprits.

It would often take several days to grow and identify infectious critters in the lab, and sometimes a definitive diagnosis remained elusive.  Even so, their experience, their listening skills, and their hunches often led to solutions that relieved not only my symptoms but their underlying causes.

While it was unpleasant to weather so many infections and side-effects, I came to welcome visits from these doctor/detectives who so often cracked the case, identified the villain, and brought me relief so I could focus on healing and recovery.

Steve Buechler is a recently retired sociology professor and cancer survivor.  In 2016, he was diagnosed with acute myeloid leukemia and successfully treated with chemotherapy, radiation, and a stem cell transplant. He has since become a big advocate of writing stories as a survival strategy in the face of life-threatening illness.  His own story is available in “How Steve Became Ralph: A Cancer/Stem Cell Odyssey (with Jokes),” his memoir from Written Dream Publishing.