A Lucky Life Interrupted (2 page)

As a child of the region and for a while a part-time resident of Minnesota, I always feel at home. Well before I became a public trustee, I shared the midwestern pride in the Mayo Clinic as one of the world's great healthcare facilities, known for its expert, coordinated care and patient efficiency. Our family will always remember how they put my father back together after a lifetime of serious back injuries brought on by his career as an operator of heavy construction equipment. He was a man who didn't know his own strength: One of his boyhood friends remembers him lifting a V8 engine off
a workbench with his muscles alone. He came home from surgery at the clinic and never had another day of difficulty, thanks to his physician and a tempered attitude about work.

On the Rochester mall, summer days are given over to folk artists and local restaurants that sell the house specialty from makeshift kitchens. I opted for a pulled pork barbecue sandwich and headed for my hotel room to prepare a report for fellow trustees on prospective new members for our board.

Shortly, I was summoned to the Gonda building on the Mayo Clinic campus. A new clock was ticking in my life and I didn't have a clue. In about thirty minutes I went from the illusion of being forever young to the reality that life has a way of choosing its own course.

Dr. Majka invited me into his Spartan, functional office, where he said his boss, Dr. Morie Gertz, would be joining us to go over some of the blood results from the morning tests. Dr. Gertz is chair of internal medicine at Mayo and a nationally recognized hematologist. During lunch, Dr. Majka had shared with him the differences between my morning blood count and one taken nine months earlier. Okay. Maybe a low white count, I thought, or a parasite collected on that recent trip to Africa.

Dr. Gertz, a brusque Chicagoan, entered and went right to the computer screen, his eyes flickering as he scrolled down the columns of numbers. As he called them out, it sounded like a math quiz to me.

“A spike in the M protein cells.”

As he finished his play-by-play, he turned in my direction and uttered the phrase for which I was completely unprepared: “You have a malignancy.”

Making no attempt to prepare me for what was coming, he plunged ahead, saying it appeared I had multiple myeloma, a cancer of the plasma cells in the bone marrow, adding, “You've known others who had this.” Frank Reynolds, the ABC anchorman (so that's what he died of, I thought) and Geraldine Ferraro, the first woman to run for vice president of the United States. She lived with it for twelve years when the life expectancy was much shorter.

“It is treatable but not curable—yet. We are making progress. Fifty percent of the progress has been made in the last five years, and I want to review your record overnight to make sure we've got this right.”

Life expectancy? “Statistically, five years, but you should beat that.”

I appreciated his unconditional, straight-ahead style. As a scientist in a difficult discipline, hematology, he was a numbers guy. He might have been absent the day his
medical school class took a seminar in “bedside manner,” but that was not as much an issue for me as it may have been for others. As a journalist as well as a patient I was looking for facts, not cheerful obfuscation, so I welcomed the “just-the-facts” presentation. Fact: Multiple myeloma is an incurable cancer, but as Dr. Gertz said, so much progress has been made in treating it with drugs and stem cell transplants that it is becoming a chronic condition, no longer wedded to the five-year life span prognosis.

Dr. Majka, standing behind him, was quiet, but I could see the concern in his expression. When he was first assigned to me several years ago, I learned that he was born in Buffalo, New York, and grew up in the area, beloved home of my late colleague Tim Russert, the legendary
Meet the Press
host and Buffalo's leading cheerleader. When I mentioned that he said, “Oh, I know. The two worst things for Buffalo were losing Tim and wide right in ninety-one,” the year the bad-luck Buffalo Bills lost the Super Bowl to the New York Giants on a missed field goal from twenty-nine yards out with just eight seconds left in the game.

Dr. Majka and I developed a bond from that moment on, also sharing a passion for pheasant hunting and fishing. He's an enthusiastic angler for walleye, the feisty and very tasty game fish of the upper Midwest. Fishing
for walleye in Minnesota lakes is the upper Midwest equivalent of a religious pilgrimage.

No talk of hunting and fishing in this meeting, however. The quality of life during treatment? Uneven. Cause? Unknown.

I had often wondered how I would react to this kind of news. Don't we all.

Now I know. Family first.

Our family had just finished some estate planning and financial evaluations. My earning years might be greatly reduced, but there's enough to get through this and keep the family commitments. As a working-class kid who found success in a profession that paid some big numbers, I am always of two minds: Yes, we live very well and I like that. I don't want money to define who we are, but with this news I was happy to have its company.

I worried my Irish gene might kick in and I would tear up at the news—the maternal side of the family are Conleys, originally from County Mayo—but I was surprisingly focused on the practical questions, not the personal worries. I did not have an “Oh, my god, I'm gonna die” moment. Not one, somewhat to my surprise. I later did remember Bill Paley's lament in his nineties, “Do I HAVE to die?” Paley was used to having everything his way—CBS, great wealth, world-class art, women,
power—so his question was understandable. I was more in the spirit of my friend Jim Harrison, the writer who manages to be at once gruffly verbose and quietly insightful. We're the same age, and in an essay on his mortality he wrote, “As I aged, I expected to think about death far more than I do,” explaining that after some severe health issues he's determined to go out with a bang—writing harder, fishing harder, and treating three-a-day naps as a Buddhist Noble Truth. That was a truth I came to treasure.

There were those fleeting moments of wondering, Is this payback for having a good life, despite imperfect behavior and decisions from time to time? Retribution from whoever or whatever has the power I keep hearing those television preachers invoke?

Over the years friends have often referred to “Brokaw's lucky star.” I'd have to reach them and say, “Turns out that star has a dimmer switch.”

Those were the random thoughts that appeared and disappeared just as swiftly as I tried vainly to understand this alien invasion of my bone marrow. Life has built-in risk and reward rhythms and the human body, that complex construct of brain cells, blood cells, bones, organs, nerves, and dermatology, is a biological marvel until it turns on you, and if you give it enough time, it will—dammit.

I had more immediate concerns: how to tell Meredith, still in Montana, when I have more tests and a board meeting the next day. I have a script for JFK that needs work.

As Majka and Gertz left I kept plumbing my reaction. Did they just say I have a form of incurable cancer? There had been no advance signals that something was wrong, apart from that persistent back pain, which I attributed to the two falls I'd taken while fishing and the long airplane rides to and from Africa.

(At one point earlier in the year I had even consulted a Montana chiropractor highly regarded for dealing with cowboy and skier back issues. I suspected he'd be surprised to hear the real villain is cancer.)

It was a left brain—right brain exercise as I tried to work through the consequences of this startling and wholly unexpected news.

Left brain: I've got to get back to the hotel room and finish rewriting that documentary.

Right brain: C'mon, this doesn't happen to me. At NBC I am jokingly called Duncan the Wonder Horse for my ability to juggle many projects at once and still indulge my passion for the outdoors. Does this mean no pheasant hunting in South Dakota this fall? No bike trip to Australia in the spring?

At the time of the diagnosis I was, at seventy-three,
just short of the life expectancy of an American white male. That statistic has percolated up to almost seventy-six years.

Seventy-six for an American male was a number on an actuarial chart that includes men who are obese, smokers, and inheritors of deadly family genes. I took my guidance from more than a few friends still going strong in their eighties or even nineties. Life expectancy was not so much a measure of how long I had to live but, rather, what was still to be accomplished.

Is it too late to learn to sail solo? Play chess? Get a short story published?

Most of all, I've had a life rich in personal and professional rewards beyond what should be anyone's even exaggerated expectations. I fully expect it to go on not because I want to write more books or appear on television more. I want more time with our family and in a contemplative, reflective environment. This will force the issue. Time to stop running for the plane and time to reorder priorities. Is that possible given the momentum of my life up to this point? I'll have some help from the next generation.

The Brokaw grandchildren bring all of that into sharp focus. Two teenage girls, two elementary school girls, and a new addition: a boy, born recently to our youngest, who picked out a sperm donor and delivered an irresistible
child perfectly reflecting his American and Chinese ancestry.

As parents we are so consumed with the new experience of first having and then raising children, we often miss or rush through their unique stages of development. As grandparents we have the time and the eye for appreciating their physical, intellectual, and personality changes.

I don't want to give up my front-row seat for one of life's most rewarding experiences, the coming of age of Claire and Meredith, Vivian and Charlotte, and their prince, Archer.

In the meantime, Meredith: How do I break the news to her? We have been married for fifty-one years. I don't want to tell her on the telephone. I'll have to live with this for forty-eight hours and then deal with it when I return to the ranch. Not going to be easy.

As I made my way back to the hotel I kept checking my emotions. No “Why me, God?” I'm still a lucky guy. I have the best medical care. We caught it early. Unfairly or not, I have access to whatever resources I need.

I was a little surprised by the calmness I felt as I walked across one of the sky bridges connecting downtown Rochester and the hospital complex. In retrospect, it was a by-product of ignorance. For me, the diagnosis
was at the beginning a bewildering intrusion that I didn't fully appreciate. I could not anticipate how completely cancer would take over my life, how my body and psyche would change. It was already attacking my healthy cells and bones, drilling a hole in my right pelvis, but apart from that persistent backache I had no physical sense of the gravity of the situation. It seemed somehow abstract, a series of numbers on a computer screen unrelated to my anatomy.

I stumbled emotionally for a moment. That morning a young IBM representative had interrupted my coffee to share his memories of growing up in Yankton, my hometown. His father had worked for my dad on a large dam outside of town, building and maintaining recreation areas. He said, “In our family we thought your parents were simply the best,” adding with a laugh, “I delivered the newspaper to their house and your mother was always completely paid up.”

Mother and Dad are both gone, but their reputation and legacy live on.

Dr. Majka called to confirm the next morning's appointment and to say, “I have to tell you I came home and spent a lot of time reviewing how we reached the diagnosis. I couldn't believe this has happened to you.”

He wasn't foretelling my death. He simply projected how my adventurous life would be curtailed. I was
touched but told him I was handling it well and appreciated his early detective work that led to the diagnosis.

Later, Dr. Gertz said, “Andy is the best. He's an internal medicine guy and there's a thousand ways he could have read those blood numbers but he nailed it.”

Andrew, always modest, explained to me that the greatest challenge for a physician is what he calls “evidence-based medicine,” EBM, in which a physician relies on a large body of statistics. Instead, he says, let the evidence presented by the patient sitting before you lead you to a conclusion, and resist a diagnosis based primarily on a mass of numbers.

Although at first he thought I had an internal hematoma from the falls while fishing, he kept connecting the dots and had come to the conclusion that it was multiple myeloma. Without his timely analysis I would have returned to Montana, still complaining of back pain brought on by two compression fractures in my lower back, beyond the scope of a conventional X ray.

I've now talked to two prominent physicians who have MM but whose diagnoses were delayed because they interpreted their back pain as the result of aging athleticism. Their orthopedists agreed. Months went by before they got the blood profile that confirmed the real villain.

Dr. Jo A. Hannafin, a top surgeon and director of orthopedic
research at the Hospital for Special Surgery in New York, knew instantly she might be an MM victim. During surgery she lowered her head and felt a bone snap in her neck.

It could not have been that she was out of shape. In addition to her MD and PhD she is the first woman elected president of the American Orthopaedic Society for Sports Medicine, testimony to her wide-ranging research on athletic injuries, her skills in the operating room, and her record as a three-time national rowing champion.

MM is a low-population cancer, according to the official statistics, but I told Dr. Hannafin that I kept running into people—mostly male—who shared the condition. One MM patient even showed up in the outdoor plaza when I was doing the
Today
show with a sign: “Mr. Brokaw—I have multiple myeloma, too.” We talked about our common condition and different treatments.