Sunday
Then: Care & Prayer
While you’ll learn later that I do not trust most doctors now, I firmly believe that everyone needs to keep searching for a doctor whom you trust unequivocally when fighting a disease.
I found mine in Dr. Bill Utz. Dr. Utz dropped the biggest disappointment on me on the worst day of 2001, December 27. That’s when we got data from the biopsy and scans. Nine days earlier, going only on my PSA score of 159 (it should have been about a 2) and what he had felt via a digital exam, he was pessimistic.
Me? A cliché applies best, so I’ll use it: "This couldn’t be happening to me."
Utz was one of the ‘Top Doctors’ in the Twin Cites as selected by fellow doctors for Minneapolis St. Paul magazine. I first saw him on December 20, following the call from my general practitioner about my high PSA. Utz did a digital exam, shook his head in concern, and my wife Carla fainted, becoming the patient instead of me. A nurse was dispatched to get a Coke to give her a sugar fix and she returned to the upright position.
Now it was the end of the worst day a week later, and Carla and I with friends Mary Melbo and John Witek sat in Utz’s office. We should have been a lot more stressed were it not for Nancy Ness.
The four of us had waited silently in Utz’s waiting room for nearly an hour to get the news about whether my cancer had spread to the bones, when his office manager Nancy Ness, the wife of Dave Ness, a work colleague of Carla’s, came out and sat beside Carla. With a nonchalant manner, she simply said: “Your bone scans were negative.”
Mary, John, Carla and I are all in agreement: the sound we made simultaneously added up to one big YELP.
The day before, grim faced and looming over me while finishing the biopsy, Utz had said he didn’t like what he saw and he suspected widespread cancer into the bones. (next destination for prostate cancer after the bones: the brain)
Now, at least, that grim possibility was behind us.
“I can’t cure you,” Utz told me when the four of us finally sat in his office that day, “At least not yet. But what I’m going to propose is somewhat radical. I’m going to give you a testosterone-blocking drug to shrink the tumor over the next five to seven months and then we’re going to do surgery.”
Carla and I, and Mary and John, himself a physician, looked at each other and had the same thought: That doesn’t sound radical at all; that sounds logical and reasonable.
Then Utz provided insight into the American medical community. Utz himself had trained at Mayo Clinic with his father who headed urology there. A little over 10 years ago Mayo began performing radical protatectomies on patients with cancer that had broken outside the ‘capsule’ of the prostate, a radical departure from conventional medicine at the time. And Mayo’s 10-year data indicated that these patients as a group did better than patients who previously merely received testosterone-blocking drugs or other therapies, with patients and doctors doing practically nothing else but keeping fingers crossed. This practice is called "watchful waiting", and it sounded mind-ripping to me.
We listened, and then Carla asked the obvious question: So why doesn’t every surgeon do this now? With professional courtesy, Utz described the influence of the Johns Hopkins clinic in Maryland. It long had ranked in higher stature than Mayo for urology, but its surgeons did not perform many surgeries on advanced cancer patients like me. In fact, Hopkins performed 25 percent the number of surgeries each year as Mayo. So, we left very comforted with the fact that Mayo had developed over 10 years outcome data on more than probably 12,000 patients with all stages of prostate cancer.
As we were wrapping up this session, with Carla gulping her Coke to stay sugared and faint-free, Utz turned to her, looked her in the eye with a laser-focus and said: “Carla, listen to me. He is not going anywhere. Let me say it again. He…is…NOT…going anywhere.”
I got a shot of testosterone blocking Lupron that day and I started to try to visualize the walnut sized prostate shriveling up.
Thus began the struggle over the certain impending surgery. A couple of weeks after the diagnosis, Carla said: “You know how much we admire Mayo Clinic for fixing my first bad hip replacement. And you know your father is going to insist that you go there for a second opinion.”
We asked Dr. Utz on the next visit refer us to the best of his colleagues at Mayo. He immediately said that would be Dr. Hans Zincke, one of his mentors, and the surgeon there known best for aggressively dealing with the most advanced cases.
In the end, we selected Zincke and the Mayo Clinic for surgery for two reasons, one the place and our family history there and, two, a comment made by one of Zincke’s residents, Dr. D’Angelo. “One thing about this place. We do so many cases here, there are never any surprises.”
An uneasiness about telling Dr. Utz we’d selected Dr. Zincke for surgery turned out to be silly. Utz immediately embraced our decision. He also concurred with Zincke that we shouldn’t wait his initial call for five to seven months of drug-triggered tumor shrinking.
A story unrelated to my case confirms my admiration for Dr. Bill Utz. I was visiting longtime friend Jeff Heegaard in his office and dropping the shock of my diagnosis on him for the first time in early 2002. When Jeff asked me who my doctor was and I told him Bill Utz, I’ll never forget the look on his face: it was the most affirming, confidence building flash of expression I’d ever seen. “You’ve got the right guy,” Jeff said. Turns out his father-in-law, John Hartwell, was one of only about 100 cases a year of an especially virulent form of prostate cancer and Bill Utz was the reason the family said the outcome was so outstanding, and this despite the fact that Bill didn’t do the surgery. He sent Jeff’s father in law to MD Anderson in Houston to a surgeon who had done similar cases. Jeff related a story that Bill later also told me about the entire family and Bill praying together in Bill’s empty waiting room at the end of the day after he had first relayed the bad news. Bill also told me later: There is truly some divine intervention in that family because that fellow should not still be here.
Jeff also told me the story of he and his father, a physician, retreating to a restaurant after being told Jeff’s mother would probably not pull out of a sudden disease. Jeff and his dad, deciding the only thing to do to fill their time before returning to the hospital for the inevitable, was to pray. And, upon returning, Jeff’s mother began to come out of her horrible condition and within days was fully recovered.
I never asked Dr. Utz to pray for me, but I suspect he did. And it helped. And the truest words I’ve spoken in the last year, other than to my wife and kids, I said to Bill Utz: “I’m really glad you’re my doctor.”
An update:
I write this on December 18, 2004: I am still deeply saddened by today's funeral of Jeff Heegaard’s father-in-law, John Hartwell. John died at age 75 on December 13th, four years after being told by Bill Utz that he might have three months to live. ¶ 1:48 PM
I found mine in Dr. Bill Utz. Dr. Utz dropped the biggest disappointment on me on the worst day of 2001, December 27. That’s when we got data from the biopsy and scans. Nine days earlier, going only on my PSA score of 159 (it should have been about a 2) and what he had felt via a digital exam, he was pessimistic.
Me? A cliché applies best, so I’ll use it: "This couldn’t be happening to me."
Utz was one of the ‘Top Doctors’ in the Twin Cites as selected by fellow doctors for Minneapolis St. Paul magazine. I first saw him on December 20, following the call from my general practitioner about my high PSA. Utz did a digital exam, shook his head in concern, and my wife Carla fainted, becoming the patient instead of me. A nurse was dispatched to get a Coke to give her a sugar fix and she returned to the upright position.
Now it was the end of the worst day a week later, and Carla and I with friends Mary Melbo and John Witek sat in Utz’s office. We should have been a lot more stressed were it not for Nancy Ness.
The four of us had waited silently in Utz’s waiting room for nearly an hour to get the news about whether my cancer had spread to the bones, when his office manager Nancy Ness, the wife of Dave Ness, a work colleague of Carla’s, came out and sat beside Carla. With a nonchalant manner, she simply said: “Your bone scans were negative.”
Mary, John, Carla and I are all in agreement: the sound we made simultaneously added up to one big YELP.
The day before, grim faced and looming over me while finishing the biopsy, Utz had said he didn’t like what he saw and he suspected widespread cancer into the bones. (next destination for prostate cancer after the bones: the brain)
Now, at least, that grim possibility was behind us.
“I can’t cure you,” Utz told me when the four of us finally sat in his office that day, “At least not yet. But what I’m going to propose is somewhat radical. I’m going to give you a testosterone-blocking drug to shrink the tumor over the next five to seven months and then we’re going to do surgery.”
Carla and I, and Mary and John, himself a physician, looked at each other and had the same thought: That doesn’t sound radical at all; that sounds logical and reasonable.
Then Utz provided insight into the American medical community. Utz himself had trained at Mayo Clinic with his father who headed urology there. A little over 10 years ago Mayo began performing radical protatectomies on patients with cancer that had broken outside the ‘capsule’ of the prostate, a radical departure from conventional medicine at the time. And Mayo’s 10-year data indicated that these patients as a group did better than patients who previously merely received testosterone-blocking drugs or other therapies, with patients and doctors doing practically nothing else but keeping fingers crossed. This practice is called "watchful waiting", and it sounded mind-ripping to me.
We listened, and then Carla asked the obvious question: So why doesn’t every surgeon do this now? With professional courtesy, Utz described the influence of the Johns Hopkins clinic in Maryland. It long had ranked in higher stature than Mayo for urology, but its surgeons did not perform many surgeries on advanced cancer patients like me. In fact, Hopkins performed 25 percent the number of surgeries each year as Mayo. So, we left very comforted with the fact that Mayo had developed over 10 years outcome data on more than probably 12,000 patients with all stages of prostate cancer.
As we were wrapping up this session, with Carla gulping her Coke to stay sugared and faint-free, Utz turned to her, looked her in the eye with a laser-focus and said: “Carla, listen to me. He is not going anywhere. Let me say it again. He…is…NOT…going anywhere.”
I got a shot of testosterone blocking Lupron that day and I started to try to visualize the walnut sized prostate shriveling up.
Thus began the struggle over the certain impending surgery. A couple of weeks after the diagnosis, Carla said: “You know how much we admire Mayo Clinic for fixing my first bad hip replacement. And you know your father is going to insist that you go there for a second opinion.”
We asked Dr. Utz on the next visit refer us to the best of his colleagues at Mayo. He immediately said that would be Dr. Hans Zincke, one of his mentors, and the surgeon there known best for aggressively dealing with the most advanced cases.
In the end, we selected Zincke and the Mayo Clinic for surgery for two reasons, one the place and our family history there and, two, a comment made by one of Zincke’s residents, Dr. D’Angelo. “One thing about this place. We do so many cases here, there are never any surprises.”
An uneasiness about telling Dr. Utz we’d selected Dr. Zincke for surgery turned out to be silly. Utz immediately embraced our decision. He also concurred with Zincke that we shouldn’t wait his initial call for five to seven months of drug-triggered tumor shrinking.
A story unrelated to my case confirms my admiration for Dr. Bill Utz. I was visiting longtime friend Jeff Heegaard in his office and dropping the shock of my diagnosis on him for the first time in early 2002. When Jeff asked me who my doctor was and I told him Bill Utz, I’ll never forget the look on his face: it was the most affirming, confidence building flash of expression I’d ever seen. “You’ve got the right guy,” Jeff said. Turns out his father-in-law, John Hartwell, was one of only about 100 cases a year of an especially virulent form of prostate cancer and Bill Utz was the reason the family said the outcome was so outstanding, and this despite the fact that Bill didn’t do the surgery. He sent Jeff’s father in law to MD Anderson in Houston to a surgeon who had done similar cases. Jeff related a story that Bill later also told me about the entire family and Bill praying together in Bill’s empty waiting room at the end of the day after he had first relayed the bad news. Bill also told me later: There is truly some divine intervention in that family because that fellow should not still be here.
Jeff also told me the story of he and his father, a physician, retreating to a restaurant after being told Jeff’s mother would probably not pull out of a sudden disease. Jeff and his dad, deciding the only thing to do to fill their time before returning to the hospital for the inevitable, was to pray. And, upon returning, Jeff’s mother began to come out of her horrible condition and within days was fully recovered.
I never asked Dr. Utz to pray for me, but I suspect he did. And it helped. And the truest words I’ve spoken in the last year, other than to my wife and kids, I said to Bill Utz: “I’m really glad you’re my doctor.”
An update:
I write this on December 18, 2004: I am still deeply saddened by today's funeral of Jeff Heegaard’s father-in-law, John Hartwell. John died at age 75 on December 13th, four years after being told by Bill Utz that he might have three months to live. ¶ 1:48 PM
