AFTERMATH

GIVE SORROW WORDS

NAHEED. ALENA.

Some sorrows are unfathomable, language incapable of expressing them. What combination of letters could possibly speak the unspoken thoughts of the mothers Naheed and Alena as they bid unhurried farewells to the serially dying parts of the creatures they birthed and nurtured for decades? The anguish has no beginning and no end, no relief, no ascent or descent, no respite, collapsing past, present, and future into one bottomless pit.

A new language needs invention to encompass the defenselessness, the vulnerability of these two mothers who, with utmost delicacy, eased their boys into the grave, one piece at a time, each over a period of sixteen months, tormented until their child’s last breaths about how to make the bewildering segmented departure less painful. Omar had seven surgeries to remove slices of arms and lungs, a cancer-filled shoulder. In Andrew’s case, first the limbs went, followed by the bowel and bladder, then his eyesight, and in a final insult, he could swallow no more. To dare to mourn with Naheed and Alena, one must own the sorrows of the universe. No linguistic hyperbole can do justice. Language itself becomes speechless, vocabulary held hostage by the raw agony of such incalculable scales. The infinite care with which Alena washed, scrubbed, and dressed the wasted, limp body of her twenty-three-year old, or the relentless, whacking, blistering, piercing, frightful terrors haunting Naheed in every waking hour, and in sleep, deplete the hubris of death, elevate the status of motherhood to where the stars lower their gaze. One spark of pain in the heart of these mothers eclipses the glory of the sun. Dust raised by their agitation conceals deserts, their tears forcing a river to recede, dragging its forehead obsessively in front of their grief.

Hota hay nehaan gard mein sehra meray peechay

Ghista hay jabeen khaak pe darya meray aagay

—GHALIB: EPISTEMOLOGIES OF ELEGANCE

Next to me, the wilderness is shamed into hiding in dust

The servile river grovels in the dust before me

OMAR AND ANDREW: WHAT WERE THEIR CHOICES?

Classic Greek canon places great emphasis on choice. In the Oresteia by Aeschylus, every character had a personal choice to make. Agamemnon did not have to kill his daughter Iphigenia. Clytemnestra did not have to kill Agamemnon in revenge for her daughter’s murder. Orestes did not have to kill his mother Clytemnestra to avenge his father Agamemnon. Everyone had a choice.

The Greek term pharmakon combines three meanings—remedy, poison, and scapegoat. Aeschylus uses the term in the Oresteia to refer to a drug that can either be remedy or poison; it gets rid of illness either by killing the disease or killing the diseased. When Agamemnon sacrifices Iphigenia, his act epitomizes the dual-edged pharmakon since it cured the problem of winds needed to drive his ships but ended up causing death of the whole family.

The pharmakon we offered both Omar and Andrew encompassed all three meanings. Prescribed to fight the tumor, chemotherapy and radiation therapy would serve as both remedies and poisons simultaneously. Basically, the treatment would destroy the tumor in one area as new ones erupted in a hundred others in brutal acts of ruthless, diabolical, vicious reciprocity. Of course, there was no hope of any improvement in survival. The poisonous side effects would land them in the hospital for weeks and months, with their mouth and esophagus one big, raw, open wound. The third meaning of pharmakon refers to the ritual of human sacrifice. By testing experimental drugs in humans, knowing little about the risks and benefits involved, yet, hoping to learn from observations made on the current subjects, were we not turning the societal demands, inner desires, conscious concerns, and capricious, arbitrary violence on Omar and Andrew in order to secure a better outcome for others in the future?

We gave those awful treatments anyway, because the alternative would be no less agonizing. Allowed to run amok, cancer is one of the most painful, horrifying diseases. The fundamental question for both Omar and Andrew related to making this impossible choice—succumb to the ferocity of cancer, or seek refuge in palliative treatments that temporarily control a growing tumor but come with their own set of excruciating side effects? Die from the disease or die from the treatment?

Which would you choose?

Why are these two the only choices?

WHAT IS PAST IS PROLOGUE

In 2005, Elisabeth Kübler-Ross published her final book, On Grief and Grieving, in which she suggested that families go through the same five stages of denial, anger, bargaining, depression, and acceptance, not necessarily in that order, as do patients given the diagnosis of a terminal illness. The problem turned out to be more complicated, however, as the bereaved suffer emotional bedlam in unpredictable installments rather than an orderly, stage-defined, specific progression, at all times attempting to readjust their place in a new world devoid of the loved one. Being part of the disquieting, vexing, confounding action as the disease flamed and burned its way with primeval savagery, all the characters seem larger than life, observations seem disproportionately significant, every question—no matter how inconsequential—worthy of an answer. The necessary issue ultimately relates to choice. And when the choice involves life-and-death situations, both the potential risk and individual responsibility demand intense emotional, psychological, rational, spiritual input. Was some choice—made under such intense pressure, caught in the whirling vortex of a rapidly progressive, unmistakably fatal disease—the right one? Would clarity come from looking back years later?

But then hindsight can also pose a problem, as retrospection tends to interpret events in rosier terms, to bring intellectual order to the impossible practical disorder of life. Consider the famous Robert Frost poem “The Road Not Taken,” which addresses this question of choice examined in hindsight. The last, most famous lines of this poem, “Two roads diverged in a wood, and I—I took the one less traveled by, and that has made all the difference,” appear to define the essential characteristic of the intrepid, bold, self-reliant, daredevil, quintessential New Englander. The ideal American, who goes against the grain, exerts individuality by choosing an unusual, risky, unknown, seemingly untrodden path. The key to the poem lies in the middle, where Frost describes the two roads. Being entirely covered with fallen leaves, they were basically indistinguishable. It is only when the poet looks back years later and reflects on the events of his life “ages and ages hence” does he decide that he made the best choice since “that has made all the difference.” Of course, it made no difference at all, but hindsight allows the poet to bring order to randomness, as if the decision that made the difference were rational, logical, evidence-based.

Although it posed the risk of rationalizing irrational events, I asked a few of the family members of the patients we have met in this book to cast a backward glance on the events. I had them read what I have written about their loved ones, about the gaping holes in our scientific understanding of cancer, about the draconian measures offered as palliation or treatments, about our failure as a society. Knowing all of that, I asked them how they might have reinterpreted or come to view the choices that were made differently. My hope is that given the benefit of reappraisal, reexamination, the information can be methodically re-reviewed, decisions made under intense pressure can be calmly and systematically sifted, reconsidered, questioned, alternate possibilities imagined. From this perspective, the what-if questions might finally be addressed, especially as related to what pain and suffering could and should have been avoided, what can be prevented in the future should such situations arise again and affect the living, understanding what choices would be altered, how to balance external contingencies with inner compulsions. The hope in reliving tragic situations is that it brings a modicum of relief to acknowledge the randomness of life—to concede that no matter how hard one tries, it is impossible to make any sense of the profound anguish their loved ones went through, to allow one to face the unintelligibility of disease, to face death. To accept that the only answer is that there is no answer.

OMAR

May 9, 2018

Naheed (Omar’s mother)

What I say with complete truth is that at no time… not for a second did I allow myself to believe or think that Omar would actually die… go away from me forever. He takes me to a sofa, sits down and in a casual tone announces that the doctor he consulted suspects something… some “grunge… or maybe a tumor.”

What happened to me from that moment to the very second that I realized the labored breathing sound was no longer coming from him and, in my hope-filled heart, assumed it could only mean that he had beaten whatever had been bothering him. That he was now better… he had been cured… he was alive… I cannot explain any of this rationally.

The truth of the matter is that “hope” as much as the cancer is an affliction… of the heart and head in the first case, of the body in the second. Hope latches on to you, crawls in and burrows deep inside your heart and your head. Once it goes, it leaves a cavity behind, a hole that can never ever be filled… and it is this hole, this nothingness, one needs to live with for one’s entire life… and it is this emptiness within this hole that we cover with the proverbial “patthar” [stone].

Omar would never have accepted any option that required him to accept his fate without fighting it every inch of the way. If it meant chemotherapy, radiation, experimental trials… he would go for it.

Do you remember how a few hours before he died he discussed a new therapy… stem cell or some other drug that you had discussed with him earlier?

And as for being told cold mathematical percentages of possible survival for treatments and experimental drugs… there was never a moment of doubt that he would be, must be, had to be counted among the survivors. And why not? Miracles happen, don’t they?

He might have had his own thoughts that were less happy, but he never conveyed them to me. Except for the single time when he asked me to learn to take care of my own finances… that was it… never after I told him that I would do no such thing and that he would be there to do it for me.

Should the doctors have held out hope to Omar?… Yes. After all, it took nothing away from him. Yes… it meant painful treatments but it did not mean that there was no possibility of survival.

I feel that a patient must decide… with or without the family. Unless a patient is suffering beyond the limits of the human body he should be allowed to live in his own universe.

What researchers must do is what researchers should. They must work and work and think and feel like a patient or the family… they have to create new medications. New tools for isolating these cells and new concoctions to kill them. If the present laboratory is not equal to the challenge more research is needed… I was struck by how cells from one dish can jump into another in spite of stringent controls… how and why. Cancer is not infectious, is it?

In the end I think everything that happened to Omar had to happen but for the weak chemotherapy he was given by that first doctor. If any single mistake was made in Omar’s treatment, that was it.

June 15, 2018

Farid (Omar’s younger brother)

Dear Azra Apa,

Thanks for your message. Each of these questions is harder than the next, but I will try my best to answer them.

Was my brother ever told that his chances were zero? The answer to this one is a resolute “no.” We definitely weren’t told that his chances were zero. Not only that, the question of chances was studiously avoided by the vast majority of my brother’s doctors, down to the very end of the process. To be fair to them, this was a question I avoided myself in all my heated inner dialogues. It is not that I didn’t know that his chances were, in fact, exceedingly low. In fact, I was extremely surprised when he was given, at the very first meeting, a prognosis of 85 percent. Perhaps the doctor wanted to make him feel better? Unless her confidence was a matter of honor—the honor of medicine in the face of disease. In either case, it had the effect of momentarily boosting his confidence and casting doubt on what I had gathered.

We went on a walk, he told me not to worry: he was going to fight this thing, he said. Did he really believe this in his heart, or was this an act of fraternal compassion? Or is it that these two possibilities really cannot be separated? In either case, two months later, he was completely shaken upon being told (by his oncologist at NY Hospital) that the actual figure was 75 percent. In many ways, this figure was even more inaccurate than the 85 percent that was given to him at NY General Hospital since, in the in-between period, it had become quite clearly apparent that the methotrexate wasn’t working. Why, then, did the doctor give him that figure? Was this blatant lie an act of kindness? And why did it not achieve its effect? I remember Mursi asking him what the difference was between 85 and 75 percent. But in his mind, that 10 percent plunge in life chances required a categorical adjustment.

It is strange the effect that numbers can have. Numerically, at least, I knew more about his chances than did others, but still I was enraged beyond words when friends or family would say he was “dying.” I was enraged on his behalf and enraged because it was emotionally unrealistic even though it was manifest that the cancer was invading his body—cell by cell, organ by organ—to suggest that my brother was “dying.” Here was a man who produced a list of “100 Books to Read Before You Live”—because (as he said) “‘before you die’ is just too depressing.” This was also a man who insisted on going to see The Cherry Orchard—not a cheerful play exactly—knowing that his days were numbered. “No point in not living while I’m still alive,” he said when this choice was briefly questioned. Which is to say that this was a man whose idea of living wasn’t to be cheered up but to face life in all its intensity. Another reason why the bucket list wouldn’t have worked. My point is that he was in his prime—married to the love of his life, surrounded by loved ones in the place that he loved more than any other place in the world. He refused to be pitied or mourned preemptively by those who loved him. And yet, of course, he was very much dying, if that word has any meaning at all.

All this is to say that had his doctors refused him treatment, he would have fought back and refused their refusal. The thing is: at least for him, he—his life—wasn’t the only thing at stake. Also at stake was science and medicine, scientific progress, and the scientific method. To give up on himself was to give up on science—and that wasn’t really possible in his case. He wouldn’t have enjoyed his bucket-list world tour knowing not only that the end was coming, but also knowing that science had failed. Sometimes I wonder if one of the reasons that he didn’t follow the advice for a far more radical approach was because that advice was, in a way, an admittance of that failure.

I do think it would have been the ethical choice to tell him that his chances were nil. Perhaps the emotional pain of hopelessness would have been even more excruciating than that long succession of horrific surgeries? Still, I have to wonder why his doctors were quite so ready to operate if they knew that his chances were actually nil. I have to wonder even more why they couldn’t have told him clearly that a radical surgery or amputation was the only real chance for survival. Even if that chance was a fraction of a fraction, it would have helped to hear it from them. Did his surgeons really not know this? If not, why not? If yes, then why did they stick to their protocol? And why did they become so condescending—even aggressively mocking at times—at any point this decision was questioned?

I am sorry to answer your questions with questions. As for all the other Omars, it seems to me that the ethical choice would be to inform the patient of their certain death. But if that death is all but certain, it behooves the institution to let them know that the course they’re following has no chance of succeeding. But more than anything, the ethical choice is to accept, at the deepest level, the fallibility of institutions and the imperfection of epistemologies that are cherished and defended aggressively. After all, it is this fallibility which explains why these protocols are even needed.

Love,

Farid

October 29, 2018

Sara (Omar’s sister)

One of my last conversations with Bhaya [brother] was in Brooklyn. We were standing at a vantage point, the vista of Prospect Park before us—he turned to me and said, “Do you think Heaven looks like this? I can’t imagine anything better.”

As his “Little Sis,” I probably read him differently from others; it is of course the prerogative of all younger siblings to be able to read through their older ones. I believe that Bhaya knew his prognosis, he knew the chances of survival were very small, and he knew the chances of imminent death were high. He knew that radical surgery was his best chance of survival. The complexity of human relations does not of course translate this knowing on his part in any linear way to the decisions that he made for himself.

This is partly because there is one quality of Bhaya that defined how he dealt with his illness and his loved ones through this time in his life—it is a very rare quality but one which defined who he was in a very profound way—the ephemeral lightness with which he could be selfless, loving, protective, generous. Please don’t think my brother was a saint; he was as exasperating a sibling as can be, but he was an exceptional human being in so many ways, and this was one of the ways. If we had acknowledged this quality vocally, if it had been part of our narrative about him and how he was coping, perhaps we would have given him a chance to have an honest conversation with us.

I wonder sometimes, what would he have chosen to do if we were the kind of family that spoke collectively and openly—imagine us sitting around a dining table, his family and friends there, and his family saying to him: “Beloved, think of yourself and not of us. Here are your options. Option 1: radical surgery. Option 2: palliative care. Option 3: multiple surgeries and chemo and radiation. This is what all three mean for you. We are here to support you in whichever one you want to do. We are here to support you if you change your mind. We love you enough to not only help you fight this, but to also support you if you choose not to fight this. You tell us what you want to do. We are here for you. Talk to us, please. Share your fears and thoughts.”

I would like to say to families, friends, doctors, nurses, and social workers out there—have that conversation. Nobody dies because of a conversation. Nobody chooses physical pain over death because of a conversation. No one will give up on life, because you have put choices before them. Please don’t be a coward.

Don’t do what I did, waiting for someone to bring up palliative care and even assisted suicide, for me to share the research and options I had explored for him, to give me a crutch, an opening to have that conversation.

For me, we all failed Bhaya. Collectively, we forgot the most important quality of love—selflessness and compassion.

July 10, 2018

Mursi (Omar’s wife)

It never occurred to us that Omar would die. We did not talk about him dying ever. If we knew how hopeless his prognosis was, we would have decided to have children. I did not want kids. He did. One month before his diagnosis, we discussed the topic and decided to have kids. But then he was diagnosed even before we got married, and then of course too much was happening to talk about it. If we knew he had no chance of survival, we would have thought about kids.

A second thing we would have done differently, had we known, is travel more. In 2008, after multiple lung surgeries, we decided to go to Greece for our honeymoon. Omar didn’t even want to tell the doctors because he did not want to be told not to go. They would have said his immune system was suppressed and it was too dangerous for him to travel. We had a wonderful time! He never complained throughout the trip even though of course there were days when he had pain, but the joy we had was unparalleled. We should have taken more trips like that.

Another thing is related to all the surgeries he had. After the very first one, we were told the cancer cells were already in the veins. That means it had already spread. Yet the doctors did not tell us what that spelled as far as his prognosis went. We were always talking about chances; one day it was 85 percent, and next time it had slipped to 75 percent. Even if they did, it did not register. Omar definitely, and all of us also, had all this hope. This one more treatment might do the trick. This is why we kept going. The later surgeries and pneumonia were terrible for him. At some point after the seventh or ninth surgery, we questioned why he needed so many operations. Thinking back, I can say for sure that if I was in his shoes, I would not have gone through so many surgeries. They were too painful.

KITTY C.

June 18, 2018

Conor (Kitty’s son)

As far as my experience, I can’t quibble with the medical element. My mom always had glowing reviews of you and the other doctors who treated her—or to be more accurate, who she worked with. My mom was an incredibly giving person and, as a friend of hers told me casually but poignantly, “She really gave you a good life.” This is absolutely true, and I realize it more and more every day—she gave everything she could possibly give to me. Indeed, she even didn’t want to burden me with the knowledge of her disease for the first several months she was sick, until my aunt Helen persuaded her to tell me. Even then, somehow she shielded me from the worst elements. Helen and I became sleuths who tried to put together the bits and pieces of the progression of her disease and her treatments, to try to form a complete picture of what was happening in her life. In the weeks after she died, Helen and I wondered, had she held out for me? Was she looking at all the chaos in my life saying to herself, “I can’t die just yet because he needs my support”? We still tease her to this day for the copious notes she left on funeral parlors and cremation services, as if, even in death, she had to carry her weight in the family. We always tried to take that weight from her, but to no avail.

Well, I believe our last days with her may have eased my mom’s passing into the unknown. No matter how much you try to give back to someone like this, it never feels like enough. My last moment with her was two nights before she died. She was lying in her favorite spot on the couch in our living room, thin and frail, curled up like a child. I sat with her and ate a late dinner as Eulalee, her aide, took care of the intangibles. This may sound dark, but I think of Eulalee almost as a midwife of death, a kind of shaman who steps in at the end and guides people through the fear and sadness of dying, helps them remain present and accept it, and even guides their loved ones through it all. Like my mom, Eulalee was incredibly giving. She knew exactly what was needed to ease the transition. After engaging with my mom in what limited chat she was capable of, I was getting ready to leave for my apartment and Eulalee told me to give her a hug. My mom was a fiercely independent person, and she often shied away from overt affection, so it was difficult for her to signal when she needed it. But I obliged. Since my mom was not able to even sit up at this point, I sat down next to her and reached my arms under her, feeling her boney back and weak limbs. I saw an elated smile on her face, a feeling of satisfaction as she exclaimed, “You’re so great! You’re so great!”

Was that enough for a lifetime of self-sacrifice and kindness to a son who was sometimes clueless of his mother’s own struggles? No, it’s never enough. But by showing this gratitude, I sent my mom the message that her struggles were not in vain. She was proud and happy that she had raised a partner who could be there in the moment when she needed someone most.

The next day, Helen visited her as she drifted in and out of consciousness. She was traveling, as Eulalee said. Helen, her sister and best friend, gave her the strength to embark on this mysterious voyage. She reassured her, “I’ve got the pearls”—some storied family jewelry—which gave them both a nice laugh in the waning hours. I called from work in the afternoon and spoke to my mom. She was so happy to hear from me. She had no idea where I was or what day it was, but she conjured up a setting where she imagined me in my element. She said, “You’re at the protest? Are there a lot of people there?” I was confused, but I went along with the fantasy and was happy of how proud she was.

The next morning, I got the call from Eulalee that my mom was in the throes of death. When I arrived, she was breathing heavily but not conscious in any apparent way. Helen and Eugene, my half brother (who has the same father), came up to the apartment, and we waited it out. Eulalee knew to the minute when it was coming and told me to lie in bed with my mom and hold her hand. Again, I obliged. I gave her some parting words as she drifted away.

To my surprise, I went into a rage that she had abandoned me. But as I write this, the loving kindness that she gave me is all that I feel. And I take solace in the freedom she must have felt in those last moments to travel by herself, like the bird she always wanted to be.

ANDREW

Alena (Andrew’s mother)

How do I even think about what happened, and did we do the right things? Do we know even now what would have been better? What eats me is his last radiation therapy. The radiation therapist came in and said, “It’s your choice. You can do it or not do it.” I was so confused. I asked him, “What would you do?”

Did he stop swallowing because of tumor or the radiation? I spoke to someone whose nephew was dying of cancer at twenty-nine. They told him, “You will have a month to live.” Right before the doctors told him, he was full of life. After that, he broke and died in twenty days. Andrew had no chance of surviving. Would he have died before sixteen months if he was told that? As a mother, I would take every day. Every extra minute he could live and I could see him. An older man I know in Israel also has glioblastoma, and he is alive, though in a wheelchair, six years later. I would accept a wheelchair for Andrew as long as he could live.

I wish I knew what gave him a better quality of life—to treat or not to treat him? When given a choice, until the last day, Andrew said, “I want to live and will do everything to beat this cancer.”

Azra, I have to tell you, no one was honest with me. No one told me. But even if they had, what would I do?

Even my friend who stayed with me the last night said, “It is time to let him go.” I couldn’t. I always had hope. When he asked me, “Ma, is this it?” what did I say? He was still walking, getting radiation treatment, but walking with a cane. We were coming out of the apartment. He just turned to me and said, “Looks like I just got the bad lottery ticket. I’m not gonna make it.” I said, “No one knows. Perfectly healthy person could get hit by car and die.”

His father was more accepting.

Andrew did not lose hope. Even when he failed the swallowing test, he wanted to take it again.

I keep thinking about this: If he had no chance to live and telling him would take away his hope and kill him faster, could we give him placebo instead of that terrible treatment with chemo and radiation therapy? At least he would have kept thinking he was getting treatment, not lose hope, and it would not kill him faster. Why make his life more miserable with those poisons?

When he started with the terrible headaches after the first round of surgery and chemoradiation therapy, we called NY General Hospital and were not getting any satisfactory answers. They told us it is probably a sinus infection, he should take antibiotics. He had no relief and the headaches were killing him. We called a few times, and they made us feel like they didn’t want to be bothered. When I called a few more times in a row that he was having terrible headaches, they seemed annoyed. Finally, they told us to go to the ER. By then, he was throwing up and almost losing it. In the ER, scans showed tumors all over. When Dr. C. found out Andrew had metastases all over, she was very upset. Then we went to NY Hospital, and she never called once to follow up to ask about what happened to Andrew, was he even alive. We just never heard from them again. It still bothers me to think of how they treated Andrew. Sure, we need hope, but we also need more compassion. It’s great they follow the books to do things, but compassion is not in their books.

And what of NY Hospital? His oncologist just disappeared after he came once, joked a little, and left. That was it. After that, he just never bothered. For more than three months, Andrew was admitted, going through hell, but the oncologist, he never came.

Kat (Andrew’s sister)

Because Andrew never accepted he would die, I cannot. Looking back, his condition was so brutal. He was receiving special pills from California with THC. He was taking a very strong dosage. He did not like taking it because he would wake up high and drowsy, and anyway, we couldn’t tell if it was helpful at all. Only twice I saw him scared. Once after the first surgery when he was in rehab. One morning when I arrived, he started sobbing, “Why is this happening to me? Am I going to die?” I did not know what to say. Should I say, “Yes, you are dying”? Instead, I said, “We are all dying.” At the end of Andrew’s life, Charles and Rebecca wanted him to acknowledge that he was dying. Sheher did not. Andrew liked attention but not pity. He did not want to admit dying because then people would pity him. That was Andrew.

The second time, he was depressed for a month or so when things started going downhill. Mom moved in with him and wanted to be there all the time. He was trying to negotiate his personal space. He felt she was taking away his privacy and independence. Once when he felt better and they were having lunch, I talked about something in the future, and Andrew said, “You know I am always going to have to deal with this.”

He showed sadness and disappointment every time doctors told him bad news. He would always respond by saying tomorrow would be different. He understood how much it would hurt me and Mom so he made it seem like it was not as bad as it really was. The thing that hurt us the most was how he was abandoned by his oncologists both at NY General and Special Hospitals.

Sheher (our daughter)

(Opening remarks at the Fifteenth Harvey Preisler Memorial Symposium, November 14, 2017)

On my mother’s side of the family, we have the sweet custom of being welcomed into the world at birth with an adult whispering the Azaan, or the Islamic call to prayer, into the newborn’s ears. When I was born and being handed over to my mother’s older sister for this ritual, my father intercepted. He snatched me from the nurse and repeatedly whispered into my ears, “Quantum gravity, quantum gravity!” Believe it or not, the first letter of the alphabet my dad taught me was G, for “glavity,” as I pronounced it. This was my dad: a scientist to the core, one who harbored an unmatched respect and appreciation for seeking answers to the wonders and mysteries of the universe through a serious commitment to the pursuit of knowledge.

The truth mattered to my father more than anything else. This is what has motivated me at a deeply personal level to devote myself to multimedia journalism as a venue to uncover the secrets of science, technology, and medicine. My childhood is filled with memories of evening excursions to the Lincoln Park Zoo, the Shedd Aquarium, and the countless at-home experiments and science fairs my father and I participated in together. And after studying premed and working in Dr. Siddhartha Mukherjee’s lab for the last few years, I’ve found my calling in science journalism.

Following my father’s footsteps, my biggest hope is to improve the lives of others. That is what my dad devoted his own life to. He grew up in Brooklyn, the child of parents who had migrated from Eastern Europe, escaping the Holocaust. He took an IQ test in high school: it was off the charts. He didn’t have to take any science courses during his last two years of high school because he knew the syllabi better than his teachers did. And at fifteen, he made the decision to dedicate his life to cancer research. He never looked back.

What a cruel twist of irony it was that as he was directing the Rush University Cancer Center in Chicago, he was cut down in the prime of his life by the very disease he had dedicated his life to curing. I was only four when he was diagnosed and eight when he died. My parents took great pains to never mention the c-word in my earshot and yet most of my memories of Dad are related, at least in part, to the presence of this nameless “other” in our lives.

Even though I was too young to know what was going on at any tangible level, I had some sort of instinctual knowledge that something was terribly wrong. I could sense my mother’s struggle as she was navigating through stages of optimism, pain, dread, despondency, and eventually hopelessness as my dad underwent a seemingly endless stream of experimental treatments. These stages are what most cancer patients and their caregivers experience.

Another example is Andrew, one of my best friends. In the spring of 2016, he developed numbness and tingling in his arm, which made him exercise more vigorously. One afternoon, while visiting family upstate, he felt weakness in his right arm. He was driven to the NY General Hospital emergency room. Within days, Andrew was quadriplegic: a nine-centimeter tumor was found in his neck. During the emergency operation, neurosurgeons couldn’t completely remove the glioblastoma multiforme that had already enveloped several upper vertebrae.

The year that followed was characterized by a mixture of hope, fear, anxiety, panic, pain, more pain. Too much pain. Andrew received round after round of chemotherapy, radiation therapy, immune therapy, more surgery, placement of a shunt, and then more chemotherapy and more radiation and more immune therapy. Throughout all these treatments, Andrew experienced indescribable agony and discomfort from the side effects, yet the tumors continued to multiply. He lost his battle on August 25, 2017. Andrew was twenty-three years old. What struck me the most throughout his ordeal, during which our friends and family never left his side, was his positivity and selflessness. He never lost hope that he’d get better, and spending time with him—even in the ICU—felt like we were just hanging out. He rarely—if ever—complained and always went out of his way to ask everyone else about themselves and shifted the focus away from himself.

Some of the best times of my life involve traveling through Europe with Andrew and our other two best friends, Rebecca and Charles. We had a great time clubbing in Berlin, visiting Versailles and the Louvre in Paris, fighting over bunk beds in London. Throughout his illness, we sat with his mother and sister, his grandmother and father, at NY General Hospital and at NY Hospital, laughing with Andrew, crying among ourselves in the waiting room, choking over food at night thinking how Andrew could not even swallow his own saliva, and staying up night after night in a cold sweat, dreading the worst.

Andrew and I shared December birthdays. Alas, neither Andrew nor my dad will be with me to celebrate my twenty-fourth this year. Picking up a yellow rose petal from Andrew’s grave and handing it to my mother for safekeeping forever, I realized that both my childhood and entry into adult life have been marked by the intrusion of this “other”: cancer. I have been forced to look at life itself through a prism of psychological and physical suffering caused by this deadly disease, for which there seems to be no solution. For me, life can never be business as usual.

I stand here today and entreat you not to forget what Harvey Preisler and Andrew Slootsky went through and what thousands of cancer patients are going through every day. I am deeply humbled by the courage and nobility of endurance I witnessed firsthand in my father and in Andrew. Let us pledge to work together at all costs to help all cancer patients.

I HAVE TOLD the stories of men and women facing death. These remarkable souls continued to inspire and humble their caregivers by their poise, their dignity, their grit, right to the very end. Death is not a failure, pervasive societal denial is. Greek gods could not accept mortality. Humans do.

Immortals are mortal, mortals immortal,

one living the others’ death, and one dying the others’ life.

—HERACLITUS