Searching for something to blame

Blaming is not always rational, nor is it a productive use of time and energy. I tend to avoid it like the plague, given my profession and the way we were raised. But, as I watch my 32 year old brother slowly fade from a horrible, and perhaps, preventable disease, the anger stirs and I find myself searching my soul for something or someone to blame, asking how on God's green earth could this be happening to my only brother. Mom's tumor surfaced seemingly out of the blue. We discovered it; we dealt with it as best we could. Craig's cancer first appeared in the Spring of 2006 -- first meaning we had dealt with it successfully. I recall it vividly and remember how Craig treated us a bit like melodramatic nuisances for having been upset at the time. Why wouldn't he? His kidney was successfully removed and he was told he had a nearly 0% chance of recurrence after having gone nearly 2 years without any indication of a "storm a brewin". Yet, at the time of plucking his left kidney from its home, the doctor noted peculiarities. It was a shriveled up, raisin of a kidney with more major arteries than normal. What that means, who really knows, but the doctor's assessment at the time indicated "one very sick kidney". The other peculiarity wouldn't be discovered until the pathology came back: the cancer was Chromophobe, the more "benign" of kidney cancer types. An excerpt taken from the Kidney Cancer Association website: "Chromophobe RCC rarely metastasizes until very late in its clinical course, and surgical removal of localized or even locally advanced disease is usually associated with an excellent prognosis. Metastatic chromophobe RCC is quite rare, and no standard therapy currently exists."

YET, it scored a IV on the Fuhrman scale. Also taken from the Kidney Cancer Association website: "Kidney cancers are usually given a Fuhrman grade on a scale of 1 through 4. Grade 1 kidney cancers have cell nuclei that look very much like a normal kidney cell nucleus. These cancers are usually slow growing and are slow to spread to other parts of the body (metastasize). They tend to have a good outlook (prognosis). Grade 4 kidney cancer, on the upper end of the Fuhrman scale, looks quite different from normal kidney cells and has a worse prognosis. Generally, the higher the Fuhrman grade the worse the prognosis." This SHOULD HAVE (maybe, perhaps) ding-donged a bell, a triangle, a bass drum that the cancer COULD come back.

Fast forward to fall 2007 when Mom was diagnosed with brain cancer. I remember Craig expressly stating that he went in to get check because he "didn't want to put the family through that with him". I remember sitting on a wall after work talking with him about his test results, results that indicated "lesions" in some of his organs. I also remember talking with mom about it and wondering whether we should be concerned. Craig went to Thailand and emailed his doctor about the results. Enter the unproductive blame game entertained right now as I sit in the doorway of my brother's darkened room where he is sleeping in a hospital bed attached to oxygen, looking like a young man dying. So, a rant:

1) When a cancer patient asks about concerning "lesions" in his report, take the point-two seconds out of your very busy life to respond, so that he might have half a f***ing fighting chance to beat the cancer.

2) If you can't do it, find a medical intern who has the professional wherewithal to respond.

--Flash forward to February time period--

3) When a cancer patient comes in with random bleed after random bleed, torn tendons for no apparent reason, weight loss like a south beach diet gone awry, ghostly complexion and complaining of stomach pain, don't assume it's an appendicitis, pancreatitis or any other "itis". Don't wonder about the gall bladder, the "bladder" bladder, or the remote chance a killer batch of exotic worms were back with a vengeance. Perhaps, instead, take a looksee at his medical history and discover the words "RENAL CARCINOMA" and perhaps run a few tests to check whether it has returned. Don't let a patient float through a handful of doctors appointments, waiting until he's literally puking his guts out to the point of delirium before the big ah-ha moment hits you. Any idiot off the street would have wondered whether the cancer had returned given those symptoms.

Perhaps, we're to blame for not insisting Craig get checked with greater furor but, heyyyy, wait a tic, he DID get checked!!!! Yes, multiple times in fact! He was checked for everything but cancer. I'm surprised a pregnancy test wasn't run.

It's unproductive and of course I don't think any one individual could have prevented the cancer from recurring, or have predicted even probable death from it. But, instead of catching it at Stage IV after all the times he inquired about his health, plenty of people could have listened once and helped catch the "rare, but won't recur" cancer at Stage "anything but terminal". Maybe, just maybe, this would have given him a fighting chance to see age 33!

If Dr. F or any of the clinicians we've met these last 5 and a half months were on the case, we would be talking about Craig's trip to the Galapagos Islands and how healthy he's doing on the first round of chemo. It's unfortunate they came on when the cards were stacked so heavily against him.

I'm sad Craig's been robbed, and it hurts like hell to envision a life without him. As senseless as it might be, I can't help but see red at the notion that this could have been prevented. The thought won't eat me up, just surfaces every now and then.

~E