ADVICE FOR PROFESsIONALS

by Jone Geimer-Flanders, MD 

October 1, 2004 was a Friday and the only afternoon when I could close the clinic early without much hassle in getting call coverage and inconveniencing patients. I was closing early because it was my birthday and because I was my own boss for the first time…well, ever. I had scheduled a colonoscopy appointment that day with my colleague, gastroenterologist Dr. Seema Dar. Then the plan was to go out to dinner for my birthday. I reasoned that my husband had to drive me because of the sedation for colonoscopy. I’d be hungry, of course, since I was fasting, and we’d celebrate. It seemed the perfect plan.

I went in for what I thought would be a minor test to reassure me that the blood I saw was nothing more than something minor – hemorrhoids or something. Well, the colonoscopy showed a fairly large tumor in the lower part of my colon.

The plan to complete the test and spend a nice evening in a San Antonio eatery was replaced by phone calls to my sister and my best friend to disseminate the news, a trip to the hospital for blood work and CT scans, and – hardest of all – the very late evening talk with my daughter to tell her that her mother had cancer. All we knew for sure was that the tumor was large and I had to have surgery.

The next day was really a blur; I was still fasting and starting to have trouble concentrating. A friend of mine from training read the CT scan and started his report with, “Oh, Jone, I'm so sorry.” I spent the next few hours studying old textbooks and Internet web sites. It’s funny – now millions of feelings and thoughts go through your mind with this kind of news. To cope, I simply did what I was told and tried not to think. I had surgery, followed by six months of chemotherapy. Then I had another six weeks of chemotherapy and radiation therapy, leaving me weighing 89 pounds, frail, weak and thinking I'd never get any better.

At the beginning of the whole experience, when I was still hopeful and determined to sail through the cancer treatment and beat the disease, I decided it would be a good idea to sign up for the Lance Armstrong Ride for the Roses, a bike ride to raise money for cancer research and treatment. I used to do triathlons before medical school and even did a few after training. Ironically, I had read Armstrong’s book, “It’s Not About the Bike,” the May before my diagnosis. Although, as an amateur athlete, I really couldn’t relate to his situation on a personal level, I still felt I could understand some of the feelings he described. I got a lot more from the wisdom of the book during my treatment.

I had felt that participating in the upcoming ride would be my light at the end of this absurd tunnel I found myself in. I thought it would be perfect timing since it occurred in October, giving me eight months to be sick and four months to get better and train for it. Well, I did the ride; I don’t like to back out of things I commit to. But, to be honest, I rode without training effort and didn’t feel like doing it.

Let me describe the day.

You always hear these stories about cancer patients who battled back from their illness, brighter and more positive and enthusiastic about life, renewed, and full of attitude. Well, I missed that. I finished treatment and didn’t feel like a winner or a survivor. I just felt like I’d gotten really sick, almost died, but didn’t die. That was really the extent of my emotion. Quite honestly, I wasn't really all that happy that I’d gotten through it.

So, Sunday began. We got up at 4 a.m. (even though Austin is usually a 45- to 60-minute drive, we worried that the traffic might double the time) and arrived around 6 a.m. I registered and got my “goodie bag” with t-shirt, water bottle, and, of course, the tag that had to be affixed to the back of my shirt. There also was a small tag that said either “SURVIVOR” or “in HONOR of.” I picked up the survivor tag but put it in the bag.

I really didn’t feel like a survivor. I felt like I’d been dragged through the last year...in fact the only reason I decided to ride was that I knew if I’d missed it I’d feel even more like a loser. I was standing near the starting point with my bike, freezing in the 60-degree autumn morning, and sipping this great coffee provided by one of the Austin coffee houses. But my heart just wasn't in it. I thought to myself, “Just get through the next couple of hours, then you never have to do anything like this again.”

Lance got up and said some inspirational words and wished everyone a good ride. Then the ride began in waves, as some people were going 100 miles, some 70, 40, 25, or 7. I had signed up to do 25 – not too strenuous and certainly not too easy, either. The terrain was as expected.

San Antonio and Austin are part of the Texas Hill Country, so the first eight miles were pretty flat and after that it got hilly. I was so out of breath that I couldn't really talk comfortably.

Fortunately, the weather was really nice once the sun came out, the countryside was pretty, and I was in my head – thinking about the past year and the good things that had happened, because there were good things that happened. One, I got a lot of uninterrupted sleep! I also heard from people I hadn’t seen for a while and met a lot of great people in treatment – real survivors. I thought about the finality of death and the things that are really important.

Anyway, I stopped at rest stops along the way to get water, get off the bike seat, and hang out eating fruit. The rest stops were a party in themselves. The last five miles of the ride were very hilly. By this time it had heated up and become windy – not gusting, but more than a gentle breeze – so going uphill into the wind in my weakened state seemed insurmountable.

I resolved that I was not getting off the bike to walk; I’d press on to the end with everything I had, no matter what. Near the finish line I saw my husband Chris waiting for me. Nice. In the end, I think that’s the best you can hope for – that it is nice. Just like the past year when I’d be beaten down, sick, broken, exhausted and there was Chris waiting, watching over me, somehow getting me through.

Near the very end, riders would pass through one of two chutes. There was this sign in the middle of the road, just before the split, that read, “CANCER SURVIVOR ‘ RIGHT” and at that moment I had to choose. Do I go left with everyone else because I feel like nothing – a failure – or go right? Do I choose to be a survivor?

Well, I went right. And there were all these people cheering along the way, some obviously in treatment bald and broken-looking, but cheering and clapping. I just lost it. I started to cry, because I finally felt like I’d made it, finally felt the things that I’d read about people feeling, like a being better person for the experience.

Someone held out a yellow rose. I took it and held it up in my fisted hand as I crossed the finish line. A survivor.

Dr. Geimer is a graduate of the University of Osteopathic Medicine and Health Science in Des Moines, Iowa. She trained at UTHSCSA in both medicine and cardiology and currently practices preventive cardiology in the northeast San Antonio area. A member of he Comal County Medical Society, Dr. Geimer also is active as a physician facilitator in Texas Medical Association’s Communities of Practice.