E. C., New Jersey, USA
As we grow old, our life's experience becomes vast, and we tend to organize our recollections both metaphorically, often as a long journey, and in chapters, or adventures, by which we mark the trail. In my life's journey, as the decades have come and gone, the trail markers have concerned events of education, enlightment, marriage, war, law practice, children, grandchildren, deaths of parents and friends, all milestones of sorrow, delight, and everything in between. The adventures have included books, courses, travels, the Army, cases tried in court, and prostate cancer.
In 35 years of trying cases in court, I met hundreds of physicians and surgeons and studied what they could and could not do for their patients. In the last decades, an explosion in knowledge and technology expanded medicine and surgery geometrically. I learned that medical practitioners who stay on the expanding surfaces of that explosion can do more for their patients. I also learned that, for the most part, physicians are dedicated, hard-working, and devoted to doing good. Obviously, some have acquired more skills and are more devoted than others.
Like Dante, one day on the road of life, I found myself in the midst of a dark forest. In my case, darkness fell when my urologist called to say a needle biopsy showed I had prostate cancer. A partner of mine, one of the best lawyers and finest men I ever knew, had died prematurely from prostate cancer the year before.
"Do you do the operation yourself?" I asked. "Yes," he replied. "How many do you do in a year?" I asked. "Oh, perhaps twenty to thirty." "How do you do this operation?" I asked. He explained the 6 to 8 inch incision in the abdomen, the loss of blood, two to three days in the hospital, two weeks with a Foley catheter, the chances of urinary incontinence and sexual impotence, and much more. I had come to like this man, appreciated his knowledge, candor and dedication, but knew I needed to find a level of surgical experience and technological resource greater than available through his care. Indeed, I did not know what was available. "I must learn more about this," I said. "Learn as much as you can," he advised. I detoured off the main road, seeking that knowledge.
I found a superabundance of information about prostate cancer and its treatment. I learned there are urologists who perform the operation hundreds of times a year; that the operation can be done with very small incisions, within the body itself, employing optical fiber technology; that these so-called "laparoscopic, minimally invasive" techniques had been further enhanced to an amazing extent by surgeons who had become skilled in the use of computer-aided robots. I learned that Columbia University, where I had gone to law school, was emerging as an exponent of these techniques. I called one of the urologists at Columbia Presbyterian who referred me to Dr. David Samadi. What luck!
With his name, I found remarkable volume of information on him. I made an appointment and saw him within a few days. I found him friendly, astute, curious, and reassuring. "You will be fine," he said, after examining my body and my biopsy slides, "we will be friends for a long time, don't worry." Not worrying is easier said than done.
I called a close friend from my law school days who has many contacts at the Hospital and told him I believed I had found in Dr. Samadi the best of everything I had learned I needed. "My only problem at the moment is that Dr. Samadi seems too good to be true, and a lifetime of practice observing mankind's follies makes me suspicious whenever I get that feeling." "I checked," he said a few days later, and the word is that he is what he says." I had done all that I could, and now my only worry was my cancer.
A few weeks later, my wife, Sally, and I drove to Columbia Presbyterian Hospital near the George Washington Bridge for the big operation. All the members of Dr. Samadi's team introduced themselves to us, and told us their roles in the operation. When the time came, they assembled around the waiting station, and we walked into the operating room together. The best I can do to relate the reassuring and calming effect of this kind act is to say it is like running out onto the football field with your teammates, or marching past a reviewing stand in the infantry: we were all committed to for each other's care.
My team took me into the operating room at 10 a.m., I woke up in the recovery station with Sally at about 1 p.m., and went to my hospital room at 4 p.m. Two of my sons dropped by and gave me a big boost. I called my mother on the phone, and went to sleep. It had been a long day.
The next morning, with five very small abdominal puncture wounds and a Foley catheter and leg bag under my clothes, I walked down by myself to the entry level where Sally picked me and drove me home. The catheter was removed 4 days later. The pathology report came back with the very good news, "negative margins" and my PSA dropped to zero.
I found myself back on the main road of life. The fearsome adventure of having prostate cancer and finding a cure was mostly behind me. The forest had thinned, and I found myself emerging into a grassy meadow, with the Sun beaming down, walking along with Sally at a healthy pace.
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