Tuesday, July 28, 2015

Day 10 post-Cells: A Visit from The Guy

On my 21st day in the hospital, I had a surprise visitor.

It was a Saturday. Morning rounds happened a couple of hours later on weekends than they did during the week. I expected to see the on-call fellow ("my" fellow was off that weekend), and the attending physician. At around 11:00 AM, the knock. "White coats", I could tell that much immediately. There were two of them, but instead of the attending doc, who I was expecting, it was the principle investigator of the trial. The Guy.


The Guy and the on-call immunotherapy fellow strolled in and stopped at the foot of my bed.

The Guy was often among the big crowd of doctors I would see on Mondays during "grand rounds"; due to the rash, and the Rh drama, I'd seen the flock many more times than maybe what is typical.  TG usually was just one of the pack, and the attending doc would do all of the talking.  TG wrote the book, literally, on immunotherapy.  He's been working on this for decades. 

So, there he was, The Guy, standing at the foot of my bed on a quiet Saturday morning, grinning.

Me:  Wow, you look happy.  Good Morning.

TG:  Good Morning Mrs. Ryan.  I wanted to tell you again how excited we are about your cells.

Me:  Yeah...me too. <still not grasping what these people are talking about>  So.  Someone told me that I'm the first to have cells that reacted against KRAS ("crass")?

TG:  K-RAS ("KAY-rass"), he corrected.  You are not the first to react, but you are the first who had many cells returned to you that reacted against K-RAS.

Me:  <pondering that comment...> Tell me about K-RAS...if you have time.

TG:  It is a gene mutation.  It is a mutation from your normal DNA.  We know that it is involved in colon cancer and many other cancers.

Me:  So what have you learned about my case in particular?  Anything, yet?

TG:  No, no.  It's far too early for that.  Far too early.  We don't expect to see results for months.

Me:  Ah.  People keep saying that.

TG:  You should visualize those wonderful TILs attacking all of the tumors.

Me:  Oh, I do!  I have been doing that for a long time.

TG:  Good!  Good.  Mrs. Ryan, you are a pioneer. <pats the foot of the bed, then heads for the door>

Me [in my head]:  ...ima what?!  What did he say?...pioneer?!

Me:  HURRAY for pioneers!  The only problem with being a pioneer is all of these arrows in my back.

TG:  <stops, turns toward me> Mrs. Ryan, we are going to pull those arrows out of you, one by one.

Me:  That would be awesome.

Then he and the fellow left, and I had a moment of wondering whether or not I had just hallucinated the entire story. Hmmm...nope. Don't think so! Holy beans. 

The Pioneer himself called me a "pioneer". What in the world?...

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