Not feeling too good about science and medicine today

I've gotten a bit sidetracked so we'll have to wait on my follow-up on pharmacist's refusal and some posts I've been working on about curcumin in cancer and the concerns about lay persons making treatment recommendations about lymphoma treatment.

I just learned over the weekend that the brother of one of my best former student lab interns died during a battle with osteosarcoma. He was a 23-year-old athlete who, after a bike wreck and several surgeries, still decided to run a midwestern marathon last fall. After the race, he felt unusual femoral pain that turned out osteosarcoma. He had been beating the cancer and was well enough to coach an athletic event two weeks ago, but felt ill enough to go to the ER that afternoon. He died within a few hours of admission due to a Staph infection or gram-negative sepsis, probably secondary to neutropenia from his doxorubicin chemotherapy two or three days earlier.

My student, being who she is, was doing missionary work with homeless kids in eastern Europe when the call came. Her parents didn't even live close enough to the hospital to get there in time. And now they are left with this gaping hole in their family after the rollercoaster ride of the cancer diagnosis, the excellent response, and the sudden death.

I know that everyone involved feels terrible, including the docs who are probably second-guessing whether they should have been more aggressive with GM-CSF or whatever blood growth factors they use in these cases. They are a truly wonderful and generous family whom I have been very fortunate to know. As I put my daughter to bed the last two nights, I just couldn't imagine the pain of a father, and a mother especially, in having to bury a grown child at the threshold of the best life had to offer.

We deal with death all the time in my family as my wife and many of our friends are oncologists and surgeons. What still amazes me is how quickly an otherwise healthy person who is transiently immunosuppressed can die so precipitously from a bacterial infection. It makes me wonder why Big Pharma hasn't more aggressively tried to tackle this problem, or whether there are challenges that preclude them from doing so. It makes me want to take a tutorial from Tara or Revere or someone at our School of Public Health to learn more, and maybe even get into ID (infectious diseases, not intelligent design) research.

In time, I guess.

But my challenge today is what to write in a sympathy card to the parents and grandparents of this wonderful and vibrant young man. I met him once, two summers ago after his bike wreck, with slings and pins all over his arms and legs. He couldn't wait to get back on the bike and really minimized the extent of the injuries even though he was also on seizure meds for the head trauma he had incurred. He pumped a lot of life and activity into those 23 years, even coaching on the last day of his life.

My ever-mindful student was already apologizing that she wasn't sure if she could follow through on her plans to come back and work in my lab since we study the drugs that led to her brother's demise. What do you say to a family and a student, people who have really become dear friends, when they are faced with this senseless loss?

I know it happens everyday, to little kids and families here in the US and even more so in less fortunate countries.

What I want to do is take a flight to go see them. Hug them. Cry with them. But today, a card will have to do.

Anything I can think to do just seems so inadequate.

Note Added in Proof:
Tara's trackback is a lovely reflection on why those who work in these areas are motivated to do so. Thanks, Tara - I probably need to do a sabbatical in your lab.

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Dear Abel--
Im saddened to read this post. Knowing many lymphoma patients, I have seen patients saved by the drugs, but unfortunately, also have known several who have died of treatment related sepsis. In particular, this post reminds me of a friend named Rick who didnt die from lymphoma, but rather from treatment related infection. He was a good man. Part of the risk of being part of a high risk club, is that we all too often lose members. That said, I know far more members of this high risk club who have benefited from the treatments and are still here today because of them. I belong to the group that has benefitted, and I guess this is what Id stress to your young friend.

Like you, I certainly hope our scientist pals come up with less toxic treatments, more effective treatments, and better treatments for the unfortunate side effects of treatments.

anjou

My dad has lymphoma and almost succumbed to pneumonia/sepsis, so I can understand where you're coming from. My condolensces, hang in there.

By Evil Monkey (not verified) on 05 Jul 2006 #permalink

I work in R&D at the maker of some of the better-known blood growth factors; on the worst days, the prospect of helping to make deaths such as these more and more rare is what gets me out of bed in the morning.

And I never know what to say when confronted with untimely death.

Pieter-- extending a thank you for your research on blood growth factors from the lymphoma support boards-- many have been helped by your work

Thanks for the add to the blogroll.

Jeez, now that i'm linked-to by a couple of official Seed science-bloggers, I should probly blog about science more myself!

My sympathies to you and all concerned.

Several years ago, my father was under treatment for lung cancer, which seemed to be going well. Then he keeled over with a lung hemorrhage, while preparing for his 60th birthday party. (I was actually in transit to the party, and arrived to the news.)

The thing about "death by side-effect" is, they were already facing death from the cancer -- and sometimes the dragon wins.

By David Harmon (not verified) on 06 Jul 2006 #permalink

Mr. Harmon - and condolences to you as well. It seems to be even more difficult when one comes to terms with the likelihood of win or loss vs. the cancer itself, only to have a second complication cause death. An oncologist friend of mine successfully treated a woman with breast cancer only to then read about her dying in a car accident months later.

Take no one for granted - tell everyone you love them; hug a lot; and, as Warren Zevon said, enjoy every sandwich.

Thanks, Abel. Dad knew there was going to be "a" party, but the "surprise" element was that my stepmother had done her best to gather as many of his friends and relatives as possible... he being a well-loved man, that was a lot of folks. And all those people who'd come for the birthday, stayed to commiserate and share stories about Dad. Most stayed for the funeral and even the first few days of sitting shiva, too.

The thing is, it wasn't really clear whether the hemmorhage was from the cancer itself, or the effects of the radiation et al, and there had also been a couple of missteps in the treatment. So then and now, I consider his death as part of the battle as a whole.

"An oncologist friend of mine successfully treated a woman with breast cancer only to then read about her dying in a car accident months later."

Ow, that "purely sucks". It reminds me of (way) back when I was moderating the depression-support list Walkers In Darkness -- we had a very caring member who'd been battling suicidal depression for years -- but what "got" him was complications of diabetes. In my online eulogy, I complained that "death cheats". And yeah, it does. But that's how the world works, and there's no refunds, no exchanges.
(Remember Meatloaf's song, "Life is a Lemon..."? Both "Bat out of Hell" albums are oddly comforting in the face of such things.)

By David Harmon (not verified) on 07 Jul 2006 #permalink