Great news! You will live a long and healthy life. Sure, you’ll experience the normal afflictions – head colds, the flu, sprained or broken limbs – but anything life threatening? That won’t be your issue. Instead, you’ll keep ticking along until one day long in the future, you will simply die. Maybe a heart attack will take you out. Perhaps you will succumb in your sleep.
Wait. I’m sorry. As it turns out, this probably won’t be true for you or those you know. Instead, most of us will encounter something far more serious on the path of life. A quick look at basic health figures –heart disease deaths, cancer illnesses and mortalities, lives shortened by auto-immune diseases, car and motorcycle accident injuries, and need I mention COVID – should inform you that at some point in your life, we are likely to experience a health scare.
I define a health scare as an event or series of events that forces you to contemplate your own mortality, in some cases much earlier than you may have anticipated. It is something with a measurable possibility of turning into reality – a situation that will immediately interrupt and possibly shorten the quantity and quality of your life.
In July of 2016, just before 6 p.m. and about 30 minutes after coming home from work, my wife had the epitome of a life-and-death health scare. I watched her shut down in a period of less than five minutes as she experienced intense dizziness and nausea, vomiting and diarrhea. Thinking she had experienced an aneurysm, I immediately called an ambulance. It turns out I literally saved her life by doing this, as she had suffered an acute cerebral hemorrhage on the surface of her brain. About an hour later, my wife and I were told by doctors the following three things at our local hospital emergency room in Redwood City, California, several minutes before she was rushed by ambulance to Stanford Hospital in Palo Alto:
1) You may not live through the night.
2) Under no conditions should you let yourself fall asleep, no matter what.
3) As a precaution, immediately call your parents to say goodbye.
Yes, you’re reading that correctly, and I witnessed the subsequent emotionally charged phone call, sat with my wife for many days in Intensive Care, and helped her recuperate during the next six-to-eight-weeks. Her story is a lengthy, physically and psychologically painful one that still understandably harrows her to this day. Thankfully and miraculously based on statistics, my wife is now perfectly healthy.
Now let’s look at you. Perhaps you are in your 20s or 30s and this concept of a health scare, as well as my wife’s story, is foreign to you. Maybe you have witnessed folks in your family or friend circle experiencing their parents’ or grandparents’ health scares. But as you age into your 40s, that circle will close in. All of a sudden, you’ll hear the tale of a friend, and another, and then maybe at some point in the future: you. That’s right. This phenomenon of a health scare may no longer be an “other” thing but a “you” thing.
And finally, let’s look at me. At 59 years old, I have been healthy for my entire life. I feel strong and vibrant. I’ve completed endurance races like Tough Mudder, and since turning 50 I have run four half marathons. While my weight has fluctuated and my doctor has nudged me a few times during the last decade to take off 10 to 15 pounds – OK…20 pounds, I have never been more than slightly to moderately overweight based on Body Mass Index (BMI) measures, nor have I needed to take blood pressure or cholesterol medications. I get some form of exercise nearly daily as I have for decades, lean toward a plant-based diet and eat mostly organic foods, take a few supplements, and make sure I stay on top of doctor appointments. Yet although these actions may reduce the risk of heart disease and cancers, there are no guarantees.
Case in point, since late March, I have been going through my own health scare. While it is not nearly as serious or immediate as what my wife experienced during the Summer of 2016, it fits my aforementioned definition: an event or series of events that forces you to contemplate your own mortality, in some cases much earlier than you may have anticipated.
Starting late last December, my white blood cell count decreased lower than the normal range. My doctor suggested I get retested in 90 days versus the typical 12-month increment. But because she didn’t seem to think anything of this other than being an odd blip in the data, neither did I.
Fast forwarding three months to the end of March, my white blood count was markedly lower. And now my blood platelet counts were abnormal as well, as was my “absolute neutrophil” count and my red blood cell count. I received a nearly immediate email message from my doctor, who said she was referring me to a hematologist and that it would take a few weeks to get an appointment. “Holy crap,” I thought. “What is going on here and just what the HELL is a hematologist?” Then I looked up the definition of “hematologist” – blood doctor expert – and became more concerned. THEN I looked up the credentials of the specific hematologist she referred me to, and my heartbeat immediately increased and breathing shallowed. Every fourth word of her bio read, “Cancer. Lymphoma. Hodgkin’s Disease. Leukemia. Cancer. Cancer. Lupus. And oh yes, cancer.”
With shaky hands on my keyboard, I went online and explored the typical procedures hematologists follow, what they find most often, and how long people typically live after contracting the blood-related cancers and lymphomas I just mentioned. I was looking for a “get out of jail for free” card but couldn’t find one. Everything I read seemed to indicate that with any one of these maladies, I’d have slightly less than a 50 percent chance of surviving five years. Sweet Jesus! Now I was beginning to freak out.
Since I didn’t have a relationship with my hematologist and the first appointment was two weeks away, I scheduled a video visit with my regular doctor during an April vacation on the Sonoma County coast to gain more context and get her “read” of the situation. Our Bodega Bay getaway was in a quiet and spacious VRBO surrounded by ocean views well within hearing of pounding surf. But throughout the week, I was so distracted I barely recall anything about the time away other than my anxiety. Well, I remember how relieved I was to return home. During the midweek video appointment, while staring at a clear blue sky over the Pacific, I thought I behaved calmly, but my doctor kept suggesting I try and relax. She told me she was simply following typical procedures based on my readings, that she couldn’t guarantee I was fine, but reassured me that overall, the numbers didn’t trouble her. According to her, she was simply playing it safe and told me it was likely I had an unidentified lingering virus, or perhaps this was a genetic issue. It could even be I had a very slow growing cancer, which sounds scary, but apparently isn’t unheard of and is rarely life shortening. And she had already ruled out HIV, hepatitis, and mono.
In particular, my doctor zoned in on that absolute neutrophil number. As it turns out, 40 to 60 percent of our white blood cells are composed of neutrophil. She said my number, at 1.7, was below 2.0, the low end of the healthy range. But she wouldn’t be concerned about the potential for cancer unless that number crept below 1.0. In other words, I was only slightly “off.” I remember writing “above 1.0 neutrophil is good” in big letters as I took notes.
Armed with this largely reassuring information, I visited the hematologist two weeks later for a 60-minute appointment. Although I felt calm, given the last reassuring conversation I had with my regular doctor, the meeting itself was a complete blur. In a typically windowless and dimly fluorescent-lit examination room, the hematologist spoke so quickly and used such arcane terms that as a medical civilian, I largely couldn’t understand her explanations. At the end of our conversation, she told me the process we would follow moving forward, which included her ordering 17 additional blood tests for that morning and having me schedule a 14-day follow-up video appointment to discuss the results.
Off I went to the blood lab down the hall. Whoever took my 17 samples was a steely pro. Accompanied by the quiet strains of Michael Sembello singing, “Maniac,” along with the requisite visions in my head of Jennifer Beale rapidly pounding her feet on the floor as buckets of water poured on top of her head, the lab technician administered a single painless arm prick and then seamlessly switched multiple vials during the course of a few minutes.
In the days that followed, I opted not to look at any of the results as they trickled in, although it was tempting to do so. My wife continuously urged me to review the tests and email the hematologist with my questions. But I figured that would be a poor way to stay in the good stead of an overworked doctor trying to monitor my condition along with those of patients suffering acutely serious and often fatal health conditions. Instead, I only reviewed them early in the morning of my video appointment 14 days later. This turned out to be a wise decision. And that’s because many of my results – white and red blood cell counts in particular – simply cratered. For example, the absolute neutrophil measure my doctor said shouldn’t go below 1.0? It was now at 1.0, dropping from 1.7 in my prior blood exam. I quickly dug up my notes from the video meeting a few weeks earlier with my regular doctor. “Above 1.0 neutrophil is good.” Now I felt numb. Clearly, there would have been no benefit to my generating an incessant stream of fear-based thoughts during the many days preceding this next appointment that I now faced within a few hours.
And so there I was at 6:30 a.m. on the morning of the appointment, staring at my computer screen and trying, with no success, to maintain my center. My thoughts were all over the place. It wasn’t, “Why me? Life isn’t fair!” Instead, my internal dialogue was more like, “Holy CRAP! How bad is this going to get? How quickly is it going to get bad? How long will I live? What will the quality of my life be? How will this impact my family?”
My appointment, at 10:30 a.m., went mostly like the first one, with the hematologist delivering a rapid-fire monologue using clinical terms I didn’t understand. Except this time, she was more serious, spoke even more quickly, would not rule out what I called “the scary stuff,” suggested I would likely need a bone marrow biopsy, and told me to get a blood test again that day.
Assuming you’re not familiar with bone marrow biopsies, they provide more information than one can glean from blood tests, particularly a more thorough detection of blood cancers. Apparently, they hurt, given that in many cases technicians need to come close to sitting on top of a patient in order to dig into the bone and extract marrow, typically from a hip bone. In fact, many patients decide to go under general anesthesia for the process. For me, the pain of the procedure wasn’t the scariest part of a bone marrow biopsy. Instead, it was and is simply knowing I may need one.
Getting back to my hematologist’s recommendation that I get an additional blood test that day, because my brain wasn’t moving quickly enough to process all of her rapidly delivered information in one sitting, I responded very slowly, saying, “OK, I’ll get tested again in the next few days.” It seems I was starting to psychologically shut down. In response, she gave me an odd look and said, “I will move as quickly as we need to.” Perhaps she thought this was reassuring. For me, her change in tone and language did not induce peace of mind.
My wife, who was with me during the video call and sensed my urge to delay getting the next test, told me in a way that was inconsistent with her typically light and joyful demeanor to get the hell out of the house, drive the 2.1 miles to the lab and get the damned blood test. But I knew I needed to slow things down, get a hold of myself, take a long walk outside in the sunshine, and follow the rest of my typical daily routine. Grabbing hold of my reigns was supremely important. Given that I had already waited two weeks to see the hematologist in the first place, I could pause on getting this next test for a day.
After a predictably restless night of sleep, I left my house early the following morning and had my blood drawn by 7:20 a.m. The results came back by 9 a.m. The numbers were better – a LOT better. Whew! By midday, the hematologist responded in email that this was good news. Shockingly, she ended her sentence with an exclamation point, and wrote that we could take a breather on the bone marrow biopsy, for now. Instead, she told me to get tested again in two-to-four weeks. I opted to get tested in two weeks.
Fast forward 14 days to nearly a week ago, and my results were now worse than they had been, but not as bad as the test four weeks earlier.
And so here I am. As I write this, it is May 17, 2021, and I am in a health scare, just one blood test away from needing a bone marrow biopsy. My hematologist wrote me that in addition to keeping a watch on the white blood cell and absolutely neutrophil counts, “If your hemoglobin or platelets go down too, I would favor getting the biopsy.” But there now seems to be some more light in this tunnel. She also said it looks like my levels overall, although still low, are stabilizing. And now I get the luxury of waiting eight weeks for my next blood test.
That is the story for now. Or is it?
As a CEO I worked with at a start-up used to say out of frustration with employees who made excuses for not getting results, “So WHAT? So, WHAT are you going to DO about it?” My answer is: I’m going to try and GROW from this.
To start with, I’m learning yet again that what we tell ourselves – the meaning we extract from any situation, and how we choose to respond – is more important than the actual events in our lives, or in this case, the data we receive from blood tests. I know this sounds cliché. But there is a distinction between knowing things and living them.
I have a choice in how I move forward during these next many weeks. I can treat myself like I’m on an eight-week vacation until the next test: optimizing my nutrition, working out in a more balanced way versus burning myself out, getting enough rest, meditating daily, behaving with more kindness and compassion toward myself and others, focusing on joy, and expressing gratitude continuously. Or I can operate like I’m in an anxiety-laden purgatory. Think of the miserable Bill Murray holding pattern he chose to be stuck in through most of the movie, “Groundhog Day.” This is what I’ve been doing for the last six-plus weeks. I can keep going with this act: staying up too late, sleeping too little, drinking way too much coffee, sedating myself into numbness with red wine, needlessly barking at my wife and daughter, and becoming too easily triggered during my interactions with other people.
Although I’m not giving up coffee or red wine, I’m choosing the eight-week vacation option. There is nothing like a health scare to awaken one to realizing life is a gift. We don’t know when or how we’ll be thrust past the exit doors from which there is no return. Contemplating one’s mortality while we are very much alive is one way of ensuring we extract as much juice from the berry and serve as a resource to those around us while we are here. Sometimes a simple dollop of joy and kindness can go a long way with others. My wife excels at this.
Perhaps the biggest lesson is that I can behave this way well beyond the next eight weeks by relishing the present moment more frequently; reducing my tendency to judge, criticize and have opinions; letting go; generating more happiness internally as opposed to waiting for external circumstances to meet my internal expectations; and treating people with more compassion.
I have a long way to go on this path. But I’m thinking more opportunistically, feeling calmer, and behaving more kindly than I did a week ago. The consistent, in-the-background mental dial-tone of fear – of seeing the world through my lens of ‘what if,’ is beginning to recede.
My most sincere hope is that if (when!) you encounter a health scare, you can transcend your fear and contemplate how you, too, can grow from it. Your time is likely coming. Start training now.