The Veteran and the Oncologist

The 80 year old veteran was seated in the clinical exam room with his two sons who had brought him across the country for a visit with the Chief of the Leukemia and Lymphoma Section at a major Center of Excellence.  The veteran and the doctor had hit it off famously as soon as the patient walked into his office for the first time and noticed a picture of a military officer in an Australian army uniform hanging on the wall.

The veteran had come at the insistence of his sons to receive suggestions for treating a rapidly progressing lymphoma. He had been given a bleak prognosis by his local oncologist and his children felt a second opinion was worth the three hour plane flight and expense.

When the veteran walked into the office of the doctor and saw the picture of the Australian soldier hanging on the wall he said “I served with that outfit in the Philippines during WWII in the jungles. Who is that gentleman?”  “That’s my father,” the doctor answered.  For the next few minutes they swapped war stories.  These were not gruesome battle tales but stories of young men from different parts of the world relaxing and playing together to relieve the stress of battling a common and evil foe in an inhospitable climate far from home. The doctor and patient bonded with the doctor hearing many of the same limited number of war year stories these veterans shared with their families. He was now hearing it from a “Yanks” point of view. They swapped stories about the US and Australian unit working together and ambushing a British beer convoy on its way to bring the English troops their daily beer ration. The Aussies and Yanks buried month’s worth of beer in the jungle and then traded it back to the Brits in exchange for favors.   They shared stories about drinking scotch in the jungle and how the doctor’s favorite scotch was the same brand of scotch the veteran’s father had loved as well.

After two days of evaluation, the veteran was told he should be placed on an aggressive regimen of chemotherapy usually reserved for younger patients. Before his first administration of the drugs the doctor walked into the infusion center and leveled with the veteran. “We have not used this cocktail of four drugs on many individuals your age. I think you will do fine but I have to be honest with you that we don’t have much experience with these medications in older men and women.  Are you frightened by this?“ he asked.

The veteran calmly looked at his children and the doctor and said, “I haven’t really been afraid of anything since August 8th, 1945. “   So began the tale never shared before. On August 8th, 1945 , the soldier just six weeks shy of his 21st birthday , along with 99 of his fellow soldiers in the 11th Airborne Division, were training for a low altitude  jump mission for volunteers only . They were training in the remote jungles of the Philippines, jumping from slightly over 150 feet in preparation for a secret mission.  On that August morning they were assembled and were ordered to pack their parachutes and be ready for a mission briefing. Their commanding officer told them that they were leaving that evening to jump into Japan to map the beach landing sites for the Allied invasion of Japan to soon follow. They were to maintain complete radio silence until they had completed their reconnaissance and transmitted the information. If they survived that portion of the mission, they were to reassemble and began a secondary series of missions aimed at sabotage and local destruction of communications assets.  As they lined up to board their planes, the commander of Pacific operations thanked them for their service to their country and that he did not expect any of them to survive the mission.

The men flew in radio silence throughout the night of August 8th, 1945 and in the predawn hours of August 9th jumped into Japan.  The veteran said that as he left the plane his body was shaking in fear and for the first time in combat he voided into his pants on the way down. “I thought that I would be shot and killed by enemy fire before I hit the ground. I never expected to be alive to celebrate my 21st birthday. “The troops met no resistance and went about their primary mission quietly and expertly still maintaining complete radio silence. When they assembled at their rendezvous point, and broke radio silence to transmit the information they had been trained to obtain, they learned that the second atomic bomb had been dropped on Nagasaki that morning. A truce had been declared.  For these brave soldiers the war was over. Three weeks later they were in San Francisco awaiting discharge and a return home.

The chemotherapy went flawlessly. The soldier tolerated the first round well and returned home to complete the therapy locally under the direction of the Center of Excellence. Eight years later he remains disease free. He has never shared another war story with me, his proud son.

A Treasure Lost – Surgeon, David Wulkan, M.D.

I lost a colleague this week to acute leukemia. He was diagnosed and treated at a world class Center of Excellence but succumbed to the complications of treatment so rapidly that those of us who worked with him daily had little knowledge that he was ill or gone until it was all over.  This 56 year old General and Vascular surgeon shared a February 17th birthday with me, came from a working class urban background and trained in the General Surgery program at the rigorous and demanding University of Miami Jackson Memorial Hospital Program. He completed his residency training several years after I completed my general medical training and then moved up to Boca Raton, Florida to join one of the premier surgical groups in the area.

My wife had the privilege of teaching one of his children at the pre-school level and knew his wife and children. We never broke bread together or visited each other in our respective homes. We didn’t go out socially together either. Despite this, I considered him a friend as I saw him on a daily basis while I made morning and evening rounds at the Boca Raton Community Hospital as we both strove to prevent disease and help others. He was warm, understanding, even-tempered, showed great judgment clinically and great understanding of his patients’ needs and concerns.

Surgeons are often branded as arrogant, cold, and volatile. Dave was like a teddy bear, just a very bright talented competent one.  We shared patients and they all thanked me for finding them such a special physician in their time of need. He educated me when I needed to be educated and he did it in a manner that conveyed the message in a professional and respectful way without making me feel like I should have known that.

I know the kind of hours he put in and the sacrifices his wife and children made with regard to time so that he could care for other persons’ loved ones. That is time one never recaptures.

My community has lost a treasure of a doctor and a wonderful human being. We will miss his kind and affable manner, wisdom and skill. My thoughts and prayers will be with him and his family and with the families of all those other caregivers who make it easier for their loved one to care for and help someone else’s loved one routinely.

I was proud to be Dr. Wulkan’s colleague and will miss him greatly.