STRESS (fracture)

It's official. We had our follow-up appointment with Dr. Femino today and I have a copy of the biopsy report in my hands, which clearly states, "NO EVIDENCE OF NEUROBLASTOMA." I suppose it is also worth mentioning that there is no sign of tuberculosis, staph, salmonella, swine flu, or any other such ailment. It is, quite simply, a stress fracture and--to state the obvious--that heals without chemo or radiation or antibodies or any kind of treatment. That's the kind of medical problem we will take anytime, anywhere.

I don't know if I can adequately convey what it's like to go from having the possibility of trauma, i.e. stress fracture, essentially ruled out just over a week ago--that hope taken away--to absolutely confirmed trauma this week. Not to make a bad joke, but talk about trauma.... Oy! Yet, if I am being honest, I would tell you that--as grim as I considered things could be for Andrew, for us--I never fully bought into the possibility of relapse. And that has to do with my dad.

I haven't written about my dad here since his death, but the fact is that I think about him a lot, I miss him--especially at times like these--and I talk to him as I feel I need to. Needless to say, I have been doing a lot of talking lately.... Of course, there are many reasons for this, but the greatest has to do with the bond that I feel exists between my dad and Andrew. This is something that occurred to me at my dad's death and that I spoke about in my eulogy at his memorial service. In light of the last few weeks, I wanted to post the text of that speech here, because this is where I placed my faith while we awaited these results:

Sunday was the one-year anniversary of Andrew’s cancer diagnosis and start of treatment. It marked the day that he became a survivor and began his fight, all at once.

Sunday was also the day that my dad died at the hands of that same unforgiving disease. What might have been a time of… not quite celebration, but perhaps accomplishment and cautious optimism, was rendered, instead, a time of complete sorrow and loss. And yet, it was not a surprise. I knew on the Thursday before, when I heard from my brother about my dad’s deteriorating condition, that Sunday would be the day. I don’t know how or why or for what purpose, but such was the connection between my dad and my son.

If I attempt to reconcile the events of Sunday—to somehow relate them into a shared sentiment—it would be that of relief: Relief that Andrew has responded so well to treatment and is without disease on this anniversary; and relief that my dad, too, is no longer ill, no longer in pain, no longer suffering. He died peacefully, surrounded by family and friends.

For those of you who might not have known my dad, he was the epitome of “role model.” In fact, I would say that is the description you will hear most in connection with him. Certainly, his example is the one that I aspire to and try to emulate each day. It is no easy task, as he set quite a high bar: He was a loyal and adoring husband for 45 years; he was a loving and supportive father to his three children, giving us every opportunity and advantage in life; he was the “stand-in” father for many other children—foreign exchange students and neighborhood friends—who weren’t his, but whom he loved and cared for as if they were; he was a tireless professional and compassionate physician, going above and beyond in the care of his patients and bringing life and joy into the world; he was a passionate collector and student of art, immersing himself in a chosen medium or style or period until he had completely exhausted and satisfied his curiosity; he was a devoted son; he was a thoughtful sibling; he was an admiring grandfather. He was respected by his colleagues and peers. He was actively involved in the enrichment of his community. He gave service to others, always placing their needs ahead of his own.

My dad possessed so many fine qualities: Integrity, humility, grace. He did not like to call attention to himself; he worked in the background of our family, preferring to give the front of the stage to my mom. But my dad was endowed with a calm strength and a sense of control that provided a firm foundation for all of us. He was passionate about his work, pursuing it with diligence and purpose. He had an innate curiosity and was constantly learning. He was generous with his time and his knowledge. He was poised and practical and without pretense. But, perhaps most of all, my dad was kind—just genuinely kind.

I spent the majority of the past year speaking with my dad a lot--almost daily, in fact. Granted, these were not the most enjoyable of conversations; the subject matter was arduous and uncomfortable, centered largely on Andrew’s disease and treatment. Our talks were mostly medical jargon and numbers and statistics and anatomy and biology lessons. In July, we traveled together to Chicago for a conference—just the two of us, off on an adventure. It was something we had never done before. Again, it was not pleasure: It was two solid days of cancer lectures and discussions. Of course, now, those circumstances become irrelevant; I am so grateful for that time and experience—after all, time together is time together, and that, in particular, was a time when my dad shined. He was in his element there, eagerly attending the presentations, taking notes and adding his own commentary and observations. He was interested in meeting the other families and kids there and in learning about their situations, listening attentively to their stories and offering his advice or sympathy or whatever was called for. It was impressive and inspiring to watch him work.

What I cannot stress enough about the past year is how much my dad helped me to navigate such a difficult time and hold myself together. Throughout that time, he was a resource and an asset, teaching me the necessary science and medicine; he was a guide and a mentor, encouraging me to be a better advocate, while also providing critical perspective; and he was a bed of comfort and support during the most challenging and dire moments. Despite his own sadness and distress over Andrew, my dad never faltered in supporting me, remaining calm and strong and steadfast. His insight and expertise were invaluable and I will never be able to thank him enough for what he did for me and my family during that time.

When my dad fell ill and was subsequently diagnosed with his cancer toward the end of last year, my instinctive and overwhelming reaction was to seek treatment for him and I scoured the country looking for experts who could help him. Perhaps that was my way of trying to repay him for what he had done for me with Andrew’s treatment…? It was also a byproduct of the “wartime” mentality that I have been in for the past year: There is no surrender. When you are battling cancer, it does not occur to you to not. Yet, my dad had other ideas: Quietly and without fuss, he opted not to treat. It was a concept so foreign to me that I simply could not understand, and certainly could not accept. But, in essence, my dad chose to die in the same way that he had chosen to live.

In truth, I only understood and accepted his decision when I finally saw him again this past weekend, dying. It was then that the wisdom, the integrity, the strength and the courage of his decision became clear to me. My dad knew better than any of us what was in store for him. I recognize now that I have witnessed one of the bravest acts of my life and I am so, so proud of my dad for showing it to me. It is one thing to duck death, to cheat it here or there where you can, and to bargain and barter for more time: But it is quite another to simply accept it, walk toward it with a quiet and unflinching resolve and embrace it. And in that regard, I am grateful to the cancer: It was relentless and unforgiving, and it was mercifully quick.

And now, I am back to Sunday, January 18th. For me, I can’t help but believe that there is great meaning in my dad passing on that day. His concern for Andrew was almost all-consuming: Even in his illness, with his health rapidly declining, he would get on the phone with me only to ask how Andrew was doing. Theirs was a profound connection and, certainly, there is no separating them now: They will forever share that day.

My own belief is that my dad took it upon himself to clear whatever debt it was that Andrew might have owed. Perhaps he entered into some grand existential exchange; perhaps he chose to embark on a path where he will be watching over and sheltering Andrew; or perhaps he made some other arrangement…. Regardless, it gives me tremendous comfort to consider those possibilities.

It also means that, though I miss my dad—achingly, every day—I gain a certain peace when I look at my son and know that my dad is—and will be forever—quite present and close.

Thank you, dad. I love you and I miss you.

That is how I believe Andrew will stay safe. Stay healthy. Stay cancer-free. And, as the fortune cookie said, Live a long, prosperous life....

Good night.

Paul