How Steve Became Ralph: A Cancer/Stem Cell Odyssey (With Jokes)

How Steve Became Ralph

A Cancer/Stem Cell Odyssey

Steve Buechler

Contents

Praise for How Steve Became Ralph

Note to Readers

Preface: Lessons Learned

The Odyssey: From Diagnosis and Treatment to Recovery and Survival

1. Induction Chemotherapy and Hospitalization

Family Medical Update (file under not so good news)

News Flash: Sue Gets Time Off for Good Behavior

Update on Steve and Sue

Garrison Keillor’s Favorite Joke

Some Upcoming Medical Turning Points (and a serialized joke!)

Waiting Game

Waiting Game Part 2

Now for Something Completely Different

Something Completely Different Update

Why you want Homeowner’s Insurance

News: The Good, Bad, and the Ugly

News Flash: Steve Whines and Catches a Break

Holding Steady

Groundhog Days

Drama Queen

Countdown to Launch

2. At Home: A Welcome Respite

Home

Fun with Numbers

The Eyes Have It

Got Advice?

Decisions, Decisions

Decisions are a Process

3. The Hospital to Home Merry-Go-Round

Quick Update

Smooth Sailing

Really Quick Update

Holding Pattern

Oops!

Back on Track

Moving Forward

Full Speed Ahead

The Countdown Begins

Countdown on Hold

Countdown Resumes

4. The Stem Cell Adventure

Day -7

Day -3

Day 0: Three’s a Crowd

Hello, Neutropenia. Can Thrombocytopenia be Far Behind?

Twists and Turns in the Road

Day 14 Update

Jailbreak

5. Home for Good

Home Sweet Home

A Shadow of my Former Self

Day 39 Report

A Fork in the Road?

A Third Fork: The Road Taken

My New Shoes are No Joke

My Year in Review: By the Numbers

Mr. Hickman Gets the Boot

Day 92 Status and Reflections

Day 100 (A Somewhat Anticlimactic) Milestone

As Good as It Gets—with a Footnote

Tag Team Oncologists and an ER Adventure

Pot Pourri

Of Ducks, Lymphocytes, and Anti-rejection Drugs

One Step Forward, Two Steps Back: Doin’ the CMV Shuffle

A Little News is Good News

Retinal Recovery and a Spooky Retrospective

Day 180: Taking off the Training Wheels and Au Revoir?

6. Coda

Dumped by Yet Another Woman (Oncologist)

What a Difference a Year Makes

Vivid Imagination, Good Numbers, and Speaking Gigs

Some Writing, Retirement, and Recovery Milestones

My Victory in a 1K Survivor’s Walk

Briefly…

Ralph’s First Birthday: Still As Good as It Gets

Epilogue: Fashioning New Identities

Acknowledgments

About the Author

How Steve Became Ralph: A Cancer/Stem Cell Odyssey (With Jokes) by Steve Buechler, © copyright 2018 by Steve Buechler. All photos are used courtesy of the Buechler family. Quoted excerpts from The Wounded Storyteller by Arthur Frank, © 1995, 2013 by The University of Chicago Press. Reprinted with permission by The University of Chicago Press and the author, Arthur Frank.

This book is a true story about the real life of Steve Buechler of Eden Prairie, Minnesota. All names and locations are real, except when changed to protect the identities of individuals who wished to remain anonymous. Permission has been obtained where possible for the use of names in the book. This book reflects the opinions of the author and his life’s decisions. Written Dreams Publishing does not approve, condone, or disapprove of these opinions.

All rights reserved. In accordance with the U.S. Copyright Act of 1976, no part of this publication may be reproduced, distributed, or transmitted in any form or by any means, or stored in a database or retrieval system, without prior written permission of the publisher, Written Dreams Publishing, Green Bay, Wisconsin 54311. Please be aware that if you’ve received this book with a stripped off cover, please know that the publisher and the author may not have received payment for this book, and that it has been reported as stolen property. Please visit www.writtendreams.com to see more of the unique books published by Written Dreams Publishing.

Publishing Editor: Brittiany Koren

Copy-editor: C.M. DuPuy

Cover Art Designer: Sunny Fassbender

Interior Layout Designer: Amanda Dix

Ebook Layout Designer: Maria Connor

Category: Nonfiction-Cancer/Stem Cell Memoir

Description: A Minnesota man writes to his family about his cancer diagnosis and stem cell treatment.

Hardcover ISBN: 978-1-7335034-1-9 

Paperback ISBN: 978-1-7335034-2-6

Ebook ISBN: 978-1-7335034-3-3

LOCN: Catalog info applied for.

First Edition published by Written Dreams Publishing in December, 2018.

Green Bay, WI 54311

Praise for How Steve Became Ralph

"How Steve Became Ralph is an odyssey in every sense of the word. Buechler transforms a devastating cancer diagnosis into a literary quest infused with intelligence, mindfulness, humor, and hope."

—Carolyn Redman, Author of News From Lake Boobbegone

A thoughtful encouraging expression of one man’s odyssey beyond a diagnosis of leukemia. This is a courageous plowing-through months of testing and treatment supported by family, friends and health care providers. Punctuated by personal insights and small quips of humor, Steve Buechler delves into his physical, psycho-social and spiritual processes as he works with the health care community and a cord blood transplant. A good read for a health care provider, patient, or caregiver.

—Roxana Huebscher, PhD, RN, NP and Professor Emeritus, UW Oshkosh

"Steve Buechler’s How Steve Became Ralph is an unusual cancer memoir as it's not about death and dying rather about living and thriving. The book is filled with life lessons injected with ample doses of the author's quirky sense of humor. A compelling read!"

—Simi K. Rao, Physician and Author

Steve (or now Ralph) reminds us, healthy or ill, that life, with all its challenges, is worth living. It shows us the importance of seeing the glass half full rather than half empty, the necessity of setting real priorities in our lives and that keeping an open mind for all the goodness that our journey can offer, even in trying situations, can be ultimately rewarding to ourselves and others around us. It also underscores that patients have a major role in their healing process, which cannot be merely passive. More importantly, love from our family members and our friends, and even from our health care providers (and ourselves) can achieve the best possible results. Good reading to re-set perspectives and to help appreciate and treasure our lives, one day at a time.

—Gina Cunto-Amesty, MD

Note to Readers

When I was diagnosed with a lethal blood cancer, I was inundated with clinical, technical information about my disease and its prognosis. But what I didn’t have was an intimate, personal account of what it might be like to persevere and survive the ordeal. One goal in writing this book is to provide such an account to other patients, as well as their family members, friends, and caregivers. My story also offers medical providers a glimpse into the inner journey patients experience while under their care. And if you have managed to avoid the medical system as patient or practitioner, I offer the book as a cautionary tale and a compendium of some pretty awful jokes.

"The ill person who turns illness into story

transforms fate into experience…"

—Arthur Frank, from The Wounded Storyteller

This book is dedicated to Dr. Rachel Lerner and the doctors and nurses of the oncology ward at Methodist Hospital in St. Louis Park, Minnesota and to Dr. Nelli Bejanyan and the doctors and nurses of the Blood and Marrow Transplant Unit at the University of Minnesota Medical Center in Minneapolis, Minnesota. Their combined efforts saved my life, and this book is merely a symbolic down payment on a debt that I will never be able to fully repay.

Preface: Lessons Learned

People tell stories not just to work out their own changing identities, but also to guide others who will follow them.

—Arthur Frank, from The Wounded Storyteller

Much to my surprise, some routine lab work in the spring of 2016 revealed I had abnormally low white blood cell counts. My doctor referred me to a hematologist who recommended a bone marrow biopsy. I followed their advice but was not overly concerned because I had been in good health my entire life and had no symptoms. Given that history, it was hard to imagine that any serious illness was present.

My biopsy was on a Monday. The next day, I swam my normal fifty laps, saw a chiropractor, did some shopping, and ate dinner out. On Wednesday morning, I played in my weekly poker game with some retired guys and lost ten bucks when my eighty-year-old nemesis knocked me out of the tournament. It was the last time my life would feel normal for a very long time.

That afternoon, I was informed by phone that I had acute myeloid leukemia. On Thursday, I was admitted to a hospital. On Friday, I started chemotherapy. In a mere 48 hours, I went from feeling perfectly healthy to a week-long, 24/7, chemotherapy drip.

As if that was not surreal enough, the next day my wife was admitted to the same hospital with what proved to be a fractured femur. She underwent surgery to repair her leg, spent seven days in our hospital, and then was discharged to a transitional care unit for another three and a half weeks. We came to think of this time as our month from hell, though its ramifications would play out for many months thereafter.

When it became apparent that our home would be unoccupied for a month or more, I sent an email to a small group of neighbors to inform them of our status and ask them to pick up our mail and newspapers and keep an eye on our house.

I quickly realized that this was an efficient way to keep not only neighbors but family, friends, and colleagues informed about our status.

Within a couple weeks, the list of email recipients grew to a dozen, then two dozen, and eventually fifty or so recipients. Over the succeeding weeks and months, these missives grew to over sixty reports detailing my cancer odyssey.

These reports were composed for a known audience. I was highly conscious that I was writing for others, and I deliberately included some wit and humor to lighten the impact of my otherwise dire news. One of the great benefits of writing for others was the supportive feedback I received from so many of my correspondents who responded with kind words, timely advice, heartfelt prayers, and good wishes.

It eventually dawned on me that these reports had become a kind of cancer memoir consisting of serial, contemporaneous accounts of my treatment and reflections on being a cancer patient. It also occurred to me that on a more profound level, I was writing for and to myself. Each day in the hospital brought a new and dizzying array of personnel, medications, tests, scans, side-effects, cautions, and complications. While I received excellent care, it was an overwhelming initiation into the world of cancer treatment that left me feeling highly vulnerable and utterly dependent on the care of strangers.

The best way I could make sense out of it was to write about it. Writing became my therapy. It allowed me to take the chaotic, raw threads of my lived experience and weave them into a coherent, meaningful narrative of what was happening around me and to me.

In short, composing these reports became a psychic survival mechanism. It was many months later that it dawned on me that there could be a wider audience for the story I had been telling.

There is a vast literature advising new cancer patients about what to expect as they move from diagnosis to treatment. While valuable, this literature is both highly generic and exhaustively comprehensive. For legal and ethical reasons, it outlines every conceivable complication and side-effect of both the disease and its treatment. The unintended effect, however, can be to overwhelm the new patient, setting in motion the very depression and despair that this literature seeks to alleviate.

My story, by contrast, is uniquely personal. I make no claim to have had a typical experience. At the same time, and as my doctors endlessly repeated, there are no typical cases. Every cancer patient’s experience is different. While unique, my story includes many experiences that may confront most cancer patients. My hope is that by reading my memoir, others will find some insight into their own stories, or those of their loved ones.

To retain the authenticity of what happened to me, I have not significantly revised or deleted any of the reports that I composed over my months of treatment and recovery. I mean to convey the immediacy of my experiences as they unfolded from day to day. The topics addressed sometimes stray into events that are not directly about my disease or treatment, but this simply illustrates how life in all its complexity does not stop just because of a life-threatening disease.

My emails periodically discuss my wife’s recovery from her surgery as well as her ongoing and courageous battles with several chronic diseases that predated my own diagnosis. They also refer to an incident that preoccupied our attention at the very time I was initially hospitalized, she was recovering in a transitional care facility, and our house was unoccupied.

On July 5, 2016, a major thunderstorm swept through our neighborhood and partially downed two sixty-foot trees, damaging our roof, gutters, and deck. Within the hour, our good neighbors transmitted pictures of the damage to me in the hospital. The portion of the trees left standing posed an even greater danger to our house with more storms in the forecast, so I spent a frantic 24 hours on the phone with our tree service to take them out.

After the immediate danger had passed, I spent the next several weeks negotiating a homeowner’s insurance claim from the dubious comfort of my hospital room while also weathering various complications and side-effects from my treatment. In some twisted way, I found that dealing with multiple bad things simultaneously kept me from obsessing over any one of them, and things proceeded apace. It’s all part of the larger story.

On Positive Thinking

Among the responses to my reports, several people gave me credit for having a positive attitude. It is, of course, a mainstay of the cancer literature that a positive attitude is important, if not essential to a successful outcome. I never quite understood, however, what that means beyond the clichés and bromides about keeping one’s spirits up, looking on the bright side, and the like. More unsettling was the extreme versions of the positive thinking gospel that encourage patients to see their cancer as some kind of opportunity, or in the saltier language of my lady chaplain, an AFGE. That is, another fucking growth experience.

My reservations about the positive thinking gospel had originated with Barbara Ehrenreich’s Bright-Sided: How Positive Thinking is Undermining America. She cites credible research that positive thinking does not in fact lead to more positive outcomes. Even more importantly, it can have serious, if unintended, negative outcomes. For one, the constant encouragement to remain upbeat robs the patient of the opportunity to express their fears, despair, or disappointments as too negative and thus harmful to