International MPN News, Science & Opinion

The Long and Winding Road (Feb.)

To Practice or not to Practice? That was the Question

by Harvey Gould

              After Dr. Demon’s diagnosis of myelofibrosis, and securing confirming second and third opinions from Stanford doctors who respectively headed up its MPN treatment and bone marrow transplant departments, we headed home. In the course of our consultations with the Stanford doctors, one of them confirmed what we already knew, that though my liver was fine, it could be assaulted by complications from the disease. Because of that possibility he recommended that I stop drinking. However this was the same doctor who’d downgraded my prognosis from a median five years to three to five—sounding a bit like a judge meting out his sentence to a convicted felon.

As we left, my wife Karen said, “Do you understand the doctor just said you may be dead in three years, but you should stop drinking?”

“Yep. I heard him.”

“Screw it. Let’s go home, have dinner, and have a drink.”

We did—and still do.

After going through bouts of grief and depression, including the “why me”and the “woe-is-me” syndromes and visualizing my own funeral (not that I’m a drama queen or anything), I came to terms that whining aside, my disease wouldn’t just magically disappear.

With confirmation that my exhaustion wasn’t imaginary, I had to question whether I had the stamina to continue my career as a trial lawyer. Though TV shows depict a lawyer getting into trial within days after a case arises, then coming up with the smoking gun answer to the case in the course of the trial, and the case going to verdict within a day or two, real life doesn’t work that way. The work-up can take anywhere from one to two years and the kinds of cases I was handling would last anywhere from two to six weeks with tens of millions of dollars at stake. At the time I was at the height of my career, a senior partner in a law firm, the chair of our trial department, and handling major cases. Health aside, I had another fifteen years of successful and rewarding practice ahead of me.

But health no longer was “aside.”.During trial I’d work sixteen to eighteen hours a day seven days a week. After court was concluded I’d meet with witnesses, sometimes research and prepare written arguments on some issue the judge might have requested be submitted the following morning, and organize exhibits in preparation for the examination of adversary witnesses. Weekends were spent doing more organizing of upcoming testimony, researching and writing motions on issues that had arisen in court, meeting with and preparing witnesses for their upcoming testimony, and more. Though trial lawyers wear suits and appear relaxed and civil in the courtroom, trials are warfare, the pressure is intense, and the experience is physically and emotionally exhausting. You’ve got to be at the top of your game to give your all to the effort for the benefit of your client. They deserve no less.

What forced me to decide whether I had the right stuff to continue to handle the rigors of trial work was that I had a major case scheduled for trial about two months after my diagnosis. I then knew that the exhaustion I was feeling was not because I was being a lazy slacker and it wasn’t a simple matter of getting myself mentally reoriented for the upcoming battle. I had an organic explanation for my exhaustion. Adding to it was that, by then, I was experiencing night sweats and muscle cramps.

I stopped wearing a pajama tops because between the long sleeve and the collared neck, I’d sweat through it quickly. Instead I started wearing tee shirts and kept five or six next to my bed nightly. Four to five times a night I’d wake up cold and wet because I’d sweated through the shirt I was wearing, heavily at the nape of the neck, but also part way down my back and chest. I’d peel off the shirt, and put on a fresh one. The constant waking didn’t help with the exhaustion. Then there were the cramps.

Like an evil twin that would wait for me to fall asleep after putting on a fresh tee shirt, cramps would awaken me, on average, three or four times nightly. They would attack different parts of either leg—the most common areas being the instep, the calf, behind the knee, and the inner thigh. Sometimes, unwittingly, I’d bring one on by stretching a leg; sometimes they’d come uninvited. When they’d hit, often the pain was immediate and breathtaking and I’d fling back the covers, and if one of our cats happened to be sleeping next to me, him or her, and me out of bed in a shot.

The pain would be so intense it would take anywhere from one to three minutes just to stretch my leg to a full extended position, in the interim panting from, and feeling my heart racing in reaction to, the pain. Then, I’d limp down the hallway and for fifteen to twenty minutes, walk in a circle, periodically stumbling over Jesse, one of our cats who likes to be “in” on all that’s going on, feeling the pain ebb and flow, at times with shots so intense that I thought Thor was nearby overhead, tossing his thunder bolts at me, and laughing.

Ever so slowly, the pain would ease and I’d return to bed, feeling my muscles fluttering or twitching, fearing I was about to face another onset, but that wouldn’t happen for another hour-and-a-half or so, not long after I’d finally managed to calm down enough to fall back asleep. So, my nights weren’t so much filled with sleep, as filled with brief episodes of sleep, in between bouts of night sweats and cramps.

The upcoming trial was at a court about an hour’s drive from my house. In years past, I’d drive up to three hours daily each way without thinking about it, sometimes returning home at midnight and getting up at 5:00 to do some work for the upcoming day, and getting to court by 9:00. This time, the exhaustion was weighing me down. My wife and I discussed the possibility of her driving me to court daily, or us staying at a nearby hotel. Finally, I accepted that I was fooling myself, looking for ways and means to avoid the cold truth. I didn’t have the stamina to give my all to the effort and the client deserved better. I was no longer capable of withstanding the assault every trial brings and of being able to push the limits, as every good trial lawyer must.

Eleven times I picked up the phone to call my partner to tell her I couldn’t handle the case. Ten times I put down the phone. I knew when I made that call I’d be ending my career as a trial lawyer, and soon thereafter would have to withdraw from the partnership because of my inability to do the work that was my contribution to it. The eleventh time, I let the call go through, my heart thumping, this time not from physical pain, but from the emotional turmoil I was feeling. “Hi, Vicki. It’s Harvey….”

I’d just turned a hard curve on the long and winding road.

Take me back to the Contents

© Harvey Gould and MPNforum.com, 2012. Unauthorized use and/or duplication of this material without express and written permission from this blog’s author and/or owner is strictly prohibited. Excerpts and links may be used, provided that full and clear credit is given to Harvey Gould and MPNforum.com with appropriate and specific direction to the original content.


Comments on: "The Long and Winding Road (Feb.)" (2)

  1. My goodness you can tell a good story- I felt like I was right there in the situation you were living. Are you sure it is only your wife that is Irish?!
    Thank you for sharing your experience- it is both interesting and informative.
    Maureen

    • Harvey Gould said:

      Thanks Maureen. As for only my wife being Irish, if you continue to read my columns
      you’ll learn that much later into my diagnosis, in 2006, while in Ireland, I received twelve units of blood spread over six or seven visits when my Hemoglobin dropped into dangerously low territory. As a result, among other things, I wrote to the Irish Prime Minister (the Taoiseach) asking that he recognize my status as a “full-blooded Irishman”. I do hate to ruin a story so you’ll have to read continued columns to learn his response…

      Meanwhile, I’m delighted that you find the information interesting and informative. It’s kind of you to say so.

      Thanks,

      Harvey

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s

%d bloggers like this: