THE POISON I.V. PAPERS: II.

[This is the second of a series of occasional journalistic entries concerning
the recent fortuitous discovery of cancer cells in my abdomen, and my struggle
to put this shocking, new condition into perspective. The presentation will be
honest and in my own particular style. Phillip Danzig]

April 28 , 2004 I prepared for the consultation with Dr. Bruckner.  

It is my practice to seek the opinions of others, and I received a diverse and ambiguous spectrum
of comment::   Go with the most highly recommended doctor you can find;   Only select a
physician with whom you can communicate;  The patient's attitude is the major factor, so be
positive, dress well so your doctor will take your case seriously;   Your attitude doesn't count for
much, its all in the diagnosis and medication;  Take a holistic approach and eat the proper organic
foods;  Don't listen to what others tell you, for in the end, you are responsible for the management of your disease.

Bearing a large, 20 In. by 30 In. carrying case containing my CAT scans, Reports and liver
biopsy, I traveled by subway out to 53rd Street in 'Sunset Park,' Brooklyn to the Lutheran
Medical Center.   I walked through a blue-collar residential area, under the Brooklyn Queens
Expressway and into a forlorn Industrial Park that has seen better days.   The Medical Center is
housed in a large, 6 story industrial building undergoing continuous renovation and repairs.    Its
long hallways were unusually clean and shiny, even for a hospital.  'Five East,' the oncology
ward, is carpeted and has Van Gogh prints on the walls.

Dr. Bruckner is a stout man, with a close salt and pepper beard who rarely wears the white lab
coat common to his profession.  I gave him a sheet listing my priorities: 

1.   Cure liver cancer

2.   Locate, cure primary cancer

3.  Maintain control over my Crohn's disease

4.  Use modern pain management for chemotherapy side effects

5.  Note possible urinary tract inflammation

6.  Maintain nutritional management for my weight loss:  from 147 lb. to 117 lb. in one year

7.  Many fistulas are said to be present

Then I listed my five previous surgical operations and gave some biographical information,
including that I am a retired architect and mosaic artist.
Dr. Bruckner read the paper and said, "This is a competent list:  I ought to have you lecture my
class in patient communication."

I seemed to have caught his attention.

Next, Dr. Bruckner went over the CAT scans, Reports and liver biopsy I brought, but seemed
mainly interested in the liver X-ray. He held it up to the overhead fluorescent lights in the ceiling
saying,  "I've seen worse...."

Feeling relieved, I mentioned that I had heard that he had taken on a 92 year-old patient with
pancreatic cancer on whom several other doctors had given up.   I heard that she had lived
another five years !    I wouldn't mind living another five years, I told him  "I have several such
cases," he replied.    We discussed the absence of knowing the organ of origin, but the doctor
reassured me.   "The origin is either in the small intestines or the pancreas, and I treat both
malignancies the same way.   So it's not worth the time lost for further testing.    I use an
aggressive approach, using five chemicals,"  he said.

Sensing that I was in the hands of a confident physician, I stood up and we shook hands.  An
appointment was made for the first chemo infusion to begin a week later.

"Forget about the five years for the older woman,"  I said, "I will be looking to be here at 97 !"

I liked what I had seen of Dr. Bruckner, but kept my appointment with Dr. Ki Young Chung at
Memorial Sloan-Kettering, for a second opinion.  I had been told Sloan-Kettering was steep
into research, considering its patients as statistical specimens.  Located on 53rd street, Manhattan,
in the heart of "Bloomingdale Country,"its "minimalist" architectural decor was as far from
Lutheran as could be imagined.    Dr. Chung is a warm and patient profession, completing a four
year Fellowship at Sloan-Kettering.  I asked where he had studied before that and  he replied,
Johns-Hopkins, Baltimore.  A thorough man, he had already read my CAT scans, Reports and
liver biopsy before he called me into his office.  

He pointed out that my work-up was almost complete, but there was another test which could,
possibly, determine if the pancreas was involved.  "How efficacious is this test ?" I asked.  "It is
clearly determinative only 25% of the time."    I mentioned seeing Dr. Bruckner, who had said
that the test was not worth the delay.  Dr. Chung did not comment.  I said that Dr. Bruckner
planned to give me a slow infusion of five different medications.   "All at once,?" he questioned.
"Yes," told him, then asked, "What does the literature say about using five at once ?"  There is
nothing in the literature on using five chemo medications at once," he said.  "Our approach is to
use two or three at one time.  If they don't help, we move on to others."  Then Dr. Chung gave
me a short, but complete, physical examination:  chest, heart, belly, ears throat, weight and height. 
I noted that no doctor had taken my height in about 20 years, and realized with some small shock
that I had shrunken an inch and a half in that time !

So I had a choice:  continuing with Dr. Bruckner, off 53rd Street, Brooklyn, or change to Dr.
Chung, on 53rd Street, Manhattan.   I decided to stay with Dr. Bruckner.