Early December In Chicago

Early December is a hopeful time of the year.

Thanksgiving has just passed and the spirit of holiday occupies the mind. Feasting is both a memory and a future prospect as Christmas comes in a little over three weeks and Chanukah also arrives soon. Expectations of gatherings with family and friends thrill, as do thoughts of gifts, peace and good cheer.

Besides, during the time between the holidays there’s always the chance that the weather will be nice – a big deal in Chicago.

December 01, 2003 began the same way for JA and me as had Mondays for the previous couple of weeks. It was chemo- and radiation- therapy day.

By 10:15 AM JA and I were at the radiation oncology center for his 10:30 appointment. There, quite unexpectedly, we saw JA’s good friend of many years George who was also being treated for cancer. The two old friends greeted each other warmly, shook hands, hugged and spoke about the lives they led and the lives they lead. Never once did their voices reveal a sound of sadness or resignation.

I remember George in some of my earliest memories. George was a real-live hero. The first I ever met.

Back in the day, and I am talking the 1950s, George worked for JA at “the shop.” He was an ex-fighter pilot who had a wonderful mind for things electrical, mechanical and manual. At JA’s business, George was the chief motor repair person. I remember vividly how he, in his blue company coveralls with yellow-stitched “A&G Electric” logo, asked me about the conduction of electricity in water. Quite a question to a five year-old. Obviously memorable.

The three of us used to care for the stray dogs and cats that JA, George and other workers adopted as pets. The animals had the run of the shop’s basement. Each day, they would at least stop by for a feeding and on their own choosing either leave or remain for the night. Winters were more likely to create guests; other seasons saw day visitors. Their choice.

George designed and constructed his own home. He dug the foundation, poured the cement, built the walls, did the electrical, plumbing, etc. A resourceful and knowledgeable person, George was MacGyver before there was MacGyver.

Years later, I would be at George’s workbench together with one of my best friends from medical school rebuilding an old VW Bug we bought for $150. After three years, it would leave Chicago and travel to Minnesota in my friend’s possession as he went into his General Surgery residency.

In the cancer treatment center, George was called in by his physician and several minutes later JA followed, called in by his.

Together we walked into the treatment area.

The radiation oncology room is a monument to the inefficient use of space. Larger than it needs to be, the room houses what looks like a standard x-ray examination table and a console straight out of a low budget 1950s sci-fi flick. Impulses to yodel, perform a forbidden experiment and confront extraterrestrials are simultaneously inspired.

The room is painted contractor off-white and the floor is a familiar faux marble-looking linoleum with skid marks that reminded me of the ones from my grammar school. As a kid growing up in the 50s and 60s, there were plenty of opportunities to get acquainted with the floor. Tuesdays were air raid days. When the siren would sound, we had to go and hide under our desks until the sound ended.

You’d think they would polish the floor. It does not look as if they do. They used to in my grammar school, though.

This procedure was just one of around thirty that JA would have over the next six to eight weeks. JA removed his sweater and shirt. A low step stool was placed next to the exam table. JA stood up on it, turned so his back faced the machine and hoisted himself to the table to lay down for his treatment.

Lung cancer patients are commonly treated with radiation therapy. To kill the cancer cells high energy rays of radiation are used. This radiation is similar to x-rays.

The x-ray tube was positioned above the top of his chest. When radiation is administered, it is important to get your aim right for two reasons. The first is so you get the cancer. Just as when you shoot a gun, you want to hit your target. The second is so you minimize the non-cancerous, i.e., normal, tissue that is killed by the radiation. This lessens the collateral damage. Inside the housing of the x-ray tube is a light bulb. The bulb illuminated an area on JA’s chest showing the target area. This is where an invisible rain of radiation will shower through and soak the cancer mass in his lung.

It had been several weeks since JA was officially diagnosed with lung cancer. I say “officially” because the cancer that had grown inside him was missed by his physicians years earlier. Despite the delay in diagnosis, his care team was anticipating a cure. Based upon all the information provided to us by his doctors and the assertions of his therapists, they’re expecting to treat his tumor with radiation and medication to shrink it to a size where it will removed surgically, thereby effecting a cure.

Lung cancer happens because cells in the lung grow out of control. These out of control cells can invade nearby tissues (local extension) or spread farther in the body (metastasize). Although any of the tissues in the lung can become cancer, there are basically two main types: small cell lung cancer (SCLC) and non small cell lung cancer (NSCLC). SCLC is rarer and more aggressive. NSCLC is more common and less aggressive. JA had NSCLC.

As he lie there, his chest exposed, the radiation oncology technologists in the room set the equipment to deliver the radiation deadly to his tumor and life giving to the rest of JA’s body.

Although the treatment only takes a few minutes and is painless, irradiating cancer in the chest, especially in the area where JA’s tumor was located, is not without potential side effects. The skin can burn, the esophagus which is the tube that travels from the mouth to the stomach can become inflamed, swallowing can become difficult and painful and in severe cases the esophagus itself can become permanently injured. Fortunately none of the side effects had affected JA.

From start to finish, from when we arrived until we left, it could not have been more than an hour. We exited the building. Most everyone was wearing gloves and heavy coats. Not JA. As long as I can remember, his hands were temperature-invincible. Even during Chicago’s coldest winters, I never knew him to wear gloves.

From the radiation oncology building We walked to the car in the parking lot and got in.

Together we drove the several miles to JA’s oncologist’s office which was located across the street from Rush North Shore Medical Center. Rather conveniently, the oncologist’s office was situated maybe three minutes from JA’s residence, assuming you missed making the one stop light and there was lots of traffic. Otherwise, the trip took less than two minutes.

I let JA off in front of the doctor’s office under the covered portion of the driveway. He went inside and I continued forward to park the car in the lot.

Next:    In The Doctors' Offices (or to read more about Skokie, click here)