by Tom Brokaw
Normal now meant the daily drugs, the on-again, off-again back pains, the fatigue, and the uncertain walking gait. I wanted to shed the new normal and get back to the old model. These results would be a barometer of whether that was possible.
There was no reason to believe the worst. My first tests had been so positive. Apart from the episodic, piercing back pain I was highly mobile and sleeping through the night, interrupted only by a soaking of night sweats in my upper right torso. The sweats were a nuisance and a little mysterious. They arrived in a burst about 2:00 A.M., soaked my T-shirt, and then shut down. What triggered them? They are not unusual in cancer cases and the exact cause remains uncertain, but given the diet of drugs and physiological changes in a cancer patient’s body the choices were many.
Nocturnal sweating was a minor concern as we made our way through the Sloan Kettering corridors. I was a little apprehensive. What if the earlier progress had stalled or other trouble signs had developed?
Dr. Landau arrived and in her steady, businesslike fashion got immediately to the point. It was all good news. There had been a 90 percent drop in M protein, one of the key indicators. Plasma cells, the central villain when they become cancerous, went from 60 percent affected to 5 to 10 percent. The PET scan showed bone quality just below normal. Dr. Landau finished the report card and said to me, “We don’t need to do a stem cell transplant. We can continue with drugs but we’ll harvest stem cells just in case. That begins next week.”
Her judgment is a vivid example of how rapidly treatment for multiple myeloma is changing. A year ago, with the same results, she might have chosen a transplant as the next step.
Now I had to hope standby stem cells could be harvested without too much difficulty. My aging veins wouldn’t support a venal hookup to the blood collection machinery so they drilled a small hole in my upper right torso and inserted a two-way catheter with colored caps—one for outgoing blood, the other for a return once the stem cells had been separated.
The catheter had the appearance of primitive jewelry or perhaps an award to a Masai warrior for bravery in the field. I felt neither brave nor bejeweled. I simply wanted to get on with it, four days prone on a hospital bed, giving and receiving a steady stream from the five liters of blood most of us have coursing through our system, red and white cells each with a specific assignment.
The weekend before the procedure began I injected myself with two drugs designed to loosen the stem cell platelets, the baby blood cells, and store them separately. Repeat the do-it-yourself injection the morning of the first procedure and take another drug orally. A breakfast heavy in calcium is recommended to ward off chills. Veterans of the procedure called to say, “Take lots of books and other reading material. There’s nothing else to do while you’re there.”
Not for the first time during various treatments and office waits for results, I was very grateful for the digital tablet. Seldom do I have four uninterrupted hours for newspapers, email, books, or online shopping. The downside? The drugs, especially a powerful one at the end of the day, leave you vaguely unsettled physically, one more reminder of the pervasive forces of the disease and the efforts to control it. The out-of-sight fight between drugs and rogue cells for dominance in your bloodstream can be exhausting physically and emotionally.
The drive to and from Sloan in the evening dusk showed off the city in its holiday dress. The red, silver, and green glow from decorated Christmas trees framed by apartment windows and elaborately lit entrances to town houses were welcome distractions from the clinical settings of my destination and reminders of better days.
Four consecutive mornings I checked in at the blood donor offices and took my place in a curtained-off bed at the end of a ward where cheerful Jane, a nurse originally from Puerto Rico, hooked me up to a blood machine designed to draw off stem cells, those newbies that have not yet decided whether to be oxygen-generating red cells or disease-fighting white blood cells. Four hours later I was on my way home and by midafternoon Dr. Reichel, the Argentine American, called to report that the harvest had been modestly successful and that she would see me tomorrow.
Three more sessions were required and by Friday noon I was en route to a welcome distraction: A French producer had enlisted me to narrate an IMAX 3-D all-digital depiction of D-Day, seventy years ago, June 6, 1944.
When first approached I was reluctant because there have been so many D-Day productions, including three that I’ve reported on for NBC News. However, a preview of the French enterprise quickly won me over. The digital re-creation frees the producers from the same old grainy black-and-white film and allows them to put on the screen with heretofore unseen clarity the big picture and the smallest detail. For the first time, viewers can see the invasion armada from starboard to port, bow to stern. The Norman shoreline and countryside are faithfully reproduced, from Cherbourg to Caen, with the various German units, their size and mission, rising out of the digital landscape. Stylish portraits of General Dwight D. Eisenhower and the other principal commanders emerge from the screen at the appropriate moments.
To have a part in this enterprise, which was being produced for young people and to be shown in museums in the West, allowed me again to keep my condition in perspective. I wasn’t getting off a landing craft in heavy surf at dawn to face murderous fire with the odds short that I would survive fifteen minutes.
The narration went well, with the exception of my inability to nail the final nuanced syllable of “Bayeux,” the charming Norman city where I usually stay when I am in that part of the world. Finally, I got it right, or so the crew assured me. With a departing gift of vintage Calvados I was on my way to a family reunion for the holidays, thinking the tough December path was at an end.
Wrong again.
Walking into our home in the woods north of the city two days before Christmas I had my arms full of packages and in the dark failed to see a newly formed ledge leading to a flagstone patio. Suddenly I was falling, hard, face-first onto the patio. I was furious and frightened. I could feel the first steady stream of blood from somewhere. My glasses were smashed. Oddly, my head didn’t hurt as much as it seemed it should. I sat up slowly, bleeding down my jacket, grateful I had not been knocked out. My eyesight seemed intact.
My body was bruised but not broken. I made it into the house and called for Meredith to meet me in the bathroom. My face was a mess. A deep, jagged wound was open over my left eye and there were other contusions.
Meredith rushed me to a nearby emergency room—“Tom Brokaw, two six four oh”—where the staff ran some basic tests to determine if my vision and cognitive skills had been affected. Luckily, a plastic surgeon was on call and stitched me up so precisely—three layers deep—that three months later there was not a trace of an opening that went right to the skull bone.
By 10:00 we were back home and I fixed Meredith a stiff martini, grateful again she was at my side. Over the years she’s seen me through a serious helicopter crash, a deadly river-running trip, broken ankles, feet, and fingers, assorted parasitic conditions from the Middle East, and an anthrax attack on my office. Now cancer and a flagstone face-plant.
Her reaction is always the same: “We’ll get through this. A year from now will be much better.” One of her friends used to comment on Meredith’s steely resolve masked by her ethereal beauty. Over the years I’ve come to take it for granted, that combination of compassion and cool determination. She’s been a board member for Gannett, the media conglomerate, and for nonprofits such as Channel 13 and Conservation International. I’d get these glowing reports from others about her low-key but invaluable contributions on initiatives and her quiet refusal to be rolled on dubious proposals from management.
When I’d share that feedback with her she’d shrug it off. I’m the bombastic branch of the family. She’s the modest, still-water-runs-deep branch.
During my illness I kept waiting for her to suggest nothing more daring than a Barcalounger, but then she’s taken our daughters on a glac
ier trek in the Hunza Valley of northern Pakistan, our granddaughters to the Galápagos and on whale-watching excursions, and ridden horseback with girlfriends into the Montana wilderness. She’s so attached to these horse outings she joined an Icelandic horse safari across a long stretch of that North Atlantic country and also rode into the remote reaches of Patagonia. She completed the New York City Marathon in four hours while running her small chain of toy stores.
Three other friends dealing with debilitating health issues volunteer that their wives are performing the same heroics in much the same fashion. We three generally wind up conversations with a rare show of humility, acknowledging how lucky we are to have married such strong, capable, and uncomplaining women. “Awe” is not too strong as a description of our reaction.
What’s left unspoken is this: Would I be as helpful and generous if the roles were reversed? God, I hope so, but I also recognize that Meredith, as an expert bridge player, Scrabble fanatic, hostess, cook, benefit organizer, and businesswoman, is happiest when the job at hand requires a finely tuned detail gene.
That is never more evident than during the Christmas holidays, when, as we like to say in our family, it’s all about Baby Jesus and Meredith.
December 25 is her birthday as well and despite the conventional reaction—“Oh, dear, too bad; you must get short-changed”—the holiday is especially rich in our family as we celebrate Christ’s birthday and Meredith in all of her glory.
She spends weeks planning and preparing the Christmas Eve guest list and menu: country ham and homemade biscuits; oyster stew; fresh oysters and clams; endive filled with crab salad; game sausages from Montana; Christmas pudding from her own recipe; old-fashioned Christmas cookies and magnums of Champagne followed by Christmas caroling.
Every year, the same promise: “This is my last year. I can’t do all this work every year.” Yet, with the exception of her sixty-fifth birthday, which we celebrated in Hawaii, she’s back at it shortly after Thanksgiving.
The arrival of the first grandson, Sarah’s Archer, gave the occasion an extra glow. His girl cousins inducted him into the Christmas-morning ritual of opening presents and posing for pictures taken by the ubiquitous cell phone cameras.
I raised a glass to Meredith and all that she and the family mean to me in the best of circumstances, a compact that has been tested and strengthened during this cancer blindside. To keep from choking up I invoked some locker-room language to bid farewell to 2013, saying the New Year was welcome and bound to be better.
It did have a promising beginning. I was largely pain-free and the decision not to undergo a stem cell transplant meant we could plan some time out of the city in the coming months, joining friends in the Caribbean, visiting Sarah and Archer in Los Angeles. I’d already given up six months of my old life, and, unrealistically, I kept thinking I could reclaim it just around the next treatment.
In February I turned seventy-four with none of the old panache: “Bring it on—trips to war zones and bike trips in Chile. Fishing in the Bahamas and maybe a week in China.” For the first time I began to acknowledge limits and concentrated on a different kind of calendar: Will I be there when the youngest granddaughters, Vivian and Charlotte Bird, head off to college? How will being a single mom to Archer work out for Sarah in the long haul? The San Francisco branch, Claire and Meredith, so gifted and promising, let me see their full realization.
Selectively I reentered the public arena, interviewing my old friend Jane Pauley on her new book about the choices baby boomers can make for the back third of their lives. We first met when she was the Today Show ingénue in the midseventies. Now here she is, a kind of youthful grande dame of boomers, still slyly witty.
Jane told the audience, “Baby boomers are often misunderstood. We didn’t invent sex, drugs, and rock and roll, but we took it to scale.”
My schedule was carefully calibrated so I could be home by 8:00 P.M. or so. Some evenings were harder to leave than others.
The National Board of Review is a New York organization of film critics, academicians, publicists, and others in the entertainment business who know how to attract attention: put on an award show leading up to the Academy Awards. This year my longtime friend George Stevens, Jr., son of the late legendary director, was being honored for establishing the American Film Institute, producing and directing his own films, and presiding over the Kennedy Center Honors. I was privileged to pay tribute to George but I knew I’d have to leave shortly after. It was not easy. The room was in a giddy mood, with Meryl Streep and Emma Thompson lighting up the festivities with wicked takes on Walt Disney and women in high heels.
Bruce Dern stopped by to ask Meredith if she was still running marathons. Leonardo DiCaprio and Martin Scorsese did a comic riff. Steve McQueen, the director of 12 Years a Slave, was honored and gave a heartfelt speech.
Or so I read the next day. I was home in bed by 8:45, a long way from my early days in New York, when Jane Pauley would joke I stayed out half the night because I was afraid of the dark.
—
Just as I was beginning to plot a return to almost normal, during the summer months back pain made a return visit. Persistent and more aggravating than debilitating, it again became a constant companion, a reminder that maybe my track to recovery had more detours than I had expected.
An MRI was scheduled while I was negotiating an interview with Greg Mortenson, his first since 60 Minutes raised serious questions about his phenomenal bestseller, Three Cups of Tea, an inspirational account of building schools for girls in Afghanistan. There were also allegations of financial abuses and exaggerated claims of success. Mortenson was forced to resign from his foundation, pay back a million dollars, and rethink his life.
Since I knew Greg, his family, his work, and his accusers, I was in a unique position to conduct the first interview with him since the scandal broke. I warned him and his friends it would not be softball. It was not, and he rose to the occasion, admitting that he made mistakes, that he apologized to staff members who early on raised flags about the abuses. He also thanked Steve Kroft of 60 Minutes and author-mountaineer Jon Krakauer, who first raised the issues, saying they probably saved his life because he was forced to concentrate on his health, including a serious cardiac condition.
Greg, the son of Lutheran missionaries, was the classic victim of that ancient Greek disease hubris. He now recognizes that and wants only to return to building schools and educating young Afghan women, leaving the foundation and fund-raising in the hands of others. He was grateful for the direct questions and the opportunity to begin anew. I reminded him America is a land of redemption if you admit your mistakes. He is a young man with a big heart and a determination to change the lives of young women in one of the most gender-hostile places on earth, northern Afghanistan. He’s now back at it.
Once the Mortenson interview was out of the way I appeared for my MRI, which lasted about an hour. I had no sense of foreboding, which was a routine Brokaw approach. “Everything will be just fine.”
Wrong.
I had several compression factures along my spine, including an ugly one at a location called T12, in the midback area. Strung together, they were like an alarm system, but what were they signaling? Had the myeloma flared up? Were my bones more fragile than we thought? Did I imprudently lift objects that were too heavy?
Most important, why hadn’t the physician in charge of my physical rehabilitation picked up on the developing fractures earlier? Perhaps my threshold for pain was misleading. When I said my pain level was a two-three on a scale of ten, would others have identified the same pain as a five-six?
On every visit from September through December I acknowledged pain, but never at an acute level. Nonetheless, its persistence should have prompted a hands-on physical run down my spine to determine if there were sensitive areas. That did not happen, for whatever reason.
The Sloan specialist in charge of structural issues was a forty-three-year-old with a big résumé, a brusque styl
e, and apparently not much interest in face-to-face consultation, for I saw him only twice from September to January. He was another reminder of the importance of becoming proactive in your treatment.
At the same time I was losing height. Through my fifties I was an even six feet and then dropped down to five eleven. Now I was aware of standing next to old friends and feeling much shorter than in earlier encounters. In fact, I was. I measured five feet nine, just barely. That was alarming. Was I becoming a man shrunken by disease and an unstable spine? Good god, what next?
What next was a procedure called kyphoplasty, in which the patient is under general anesthesia while neurosurgeons or specially trained radiologists shore up the fractures with cement injected through a needle. I felt like a pothole on the highway of life.
There was some discussion of bracing the T12 fracture with a rod and screws but in a quick survey of other specialists arranged by Jennifer, the consensus was “stay away from that kind of invasion.”
In the pre-op discussion I was startled to hear the radiologist say that if they had detected these fractures in November, say, he could have cemented them in their infancy, which would have been preferable.
I had grown up with a father for whom pain was a personal burden, not to be shared with others. During his severe back injuries he’d come home at the end of a long workday, strip off his shirt, make some iced tea, and sit in a straight-back chair, staring blankly at the far wall, never whining. I was never that stoic but I did inherit some of his attitude.
Two memories: I severely wrenched my left ankle when it was caught on a sagebrush stem as we rushed by in an ATV during Montana hunting season. On the advice of a hunting companion, a brother-in-law who is an ob-gyn, I iced it that night, laced up my boot extra-tight the next day, and hunted again. By the day after that the swelling was alarming and Dr. Jennifer insisted I go to the emergency room, which I did, reluctantly. X rays showed I had snapped my distal left fibula, the slender bone leading to the heel.