For weeks we’ve been anticipating our upcoming adventure to Nepal. Above + Beyond Cancer: A Spiritual Journey to the High Himalaya is our most ambitious project to date. We are taking a group of 19 cancer survivors and 17 caregivers on a journey up through the remote villages of the Khumbu. It will be a mind-body-spirit journey that will culminate in a technical climb of a 20,000-foot mountain, Imja Tse. Somehow, I always thought the adventure wouldn’t begin until we actually reached Nepal. However, life had something else in mind.
It will take 4 flights for us to reach Nepal from the United States. On our overnight flight from Detroit to Amsterdam on September 22, we had just finished our dinner. Dr. Charles Lozier, an internal medicine physician from Des Moines, and I were in the next to the last row of the airplane (in the “back of the bus” with the rest of the Above + Beyond Cancer gang).
An announcement came over the loudspeaker asking for a doctor to come to seat 25A. Charles and I rushed to the front of the plane. Dr. Laurie Kuestner, a vascular surgeon and another volunteer Above + Beyond caregiver, had also come to assist.
Morgan and Kathy Curry were seated in 25 A and B. They are a couple from Saginaw, Michigan who are on their way to Switzerland where they would be getting on a riverboat cruise. Thirty minutes prior to the announcement over the loudspeaker, Kathy had noticed that Morgan was having difficulty speaking and his right side was very weak. She alerted the flight attendant and the flight attendant called for assistance.
When we got to Row 25, Morgan was calm and quiet. His right arm lay listless in his lap. He was unable to move his right leg. As we asked him simple questions, he stammered as he tried to get his mouth to say the words that his mind was thinking.
Morgan was 77 years old and has diabetes and hypertension. He had no prior history of stroke or heart disease. Dr. Lozier took his blood pressure and checked his pulse while I spoke with Kathy. Dr. Kuestner discussed the treatment options in managing an evolving stroke. If we were in an emergency room in a medical center, we would do a CT scan of the head to determine if there was any evidence of bleeding within the brain. If there were no bleeding, then a bloodclot-dissolving medicine, TPA, would be given. For this medicine to be effective, it has to be given within 3 hours of onset of the stroke. After that time, it could actually cause more damage than benefit. As Dr. Kuestner and Dr. Lozier continued to monitor Morgan, I went with the flight attendant, Kristine, to give the captain a report.
Here’s the dilemma – we were not quite half way across the Atlantic Ocean. The captain informed us of our location and how long it would take to go to the various airports that are within reach. Should we turn back and go to the nearest airport (Newfoundland) or should we continue forward and go to the nearest European airport (Dublin) or continue on to Amsterdam? There was a serious and thoughtful discussion of these options among the physicians. Everyone was aware of the implications of the decision that needed to be made. Obviously, Morgan’s health was the most important concern. As we discussed the situation, the airplane continued to move eastward.
The captain came back to have a final pow-wow before a decision was made. In the end, Morgan and Kathy voiced their opinion and the decision became much easier. Morgan, speaking with some hesitation due to the stroke-induced aphasia, said that he did not want the captain to turn the plane around. Kathy agreed whole-heartedly. Everyone collectively accepted their comments and the decision was made. We would continue forward to Amsterdam. Morgan was still conscious, stable and without pain. Kathy was also amazingly calm and peaceful. We would provide Morgan with oxygen via facemask in order to increase the oxygenation of his potentially damaged brain and we would closely monitor his condition.
Morgan was sitting in the seat next to the window; Kathy was sitting beside him in the aisle seat in this 2-seat section of the jumbo jet. Initially, I sat on the floor at Kathy’s feet and held Morgan’s limp right hand. The flight attendants moved some of the adjacent passengers back to the seats that Dr. Lozier and I had been sitting in order to free up seats next to Moran and Kathy. As I sat next to Kathy and Morgan, we talked about their 5 children and 10 grandchildren. We also talked about his tool manufacturing business in Saginaw and the wonderful trips they had taken around the world. Eventually, Kathy moved over to the middle section so that I could sit next to Morgan. As we flew across the Atlantic Ocean in the middle of the night, I sat next to Morgan, holding his arm in a comfortable position and massaging his limp hand. During the next hour, his speech improved and he began to move his thumb a little. This gave all of us encouragement.
Unfortunately, his improvement was short-lived. Over the next two hours his expressive aphasia worsened slightly and his arm became limp and lifeless once more. Morgan remained conscious, calm and pain free. He was able to drink water and eat a little bit. After another hour he started fidgeting in his seat and he said that he needed to urinate. Dr. Lozier and I were able to move Morgan to a small wheel chair that they keep on the airplane and transport him to the bathroom. It was a very tight fit as Morgan, Dr. Lozier and I all squeezed in to the tiny lavatory. Morgan’s right leg was lifeless. I held Morgan upright in a standing position as Dr. Lozier assisted Morgan with his zipper and eventually his water began to flow and Morgan got the job done. He said, “That was the most difficult pee I’ve ever taken!”
We returned Morgan to our seats and settled in for the remainder of the flight. Morgan and Kathy remained calm although you could tell they were concerned about what would happen once we arrived in Amsterdam. Although Morgan was calm and peaceful on the surface, at one point he asked me, “Am I going to die?” I told him, “No, Morgan. I think everything is going to be ok.” We left it at that. I sat next to him and prayed that my prediction would prove to be true.
Sitting in seat 24B, right in front of Kathy’s original seat, was Margaret. Margaret was an African American nurse from the University of Michigan. She had a wonderful caring and compassionate presence. At one point in the evening she asked me about my fleece and the “Above + Beyond Cancer” logo on the front of the jacket. I told her about our organization and the purpose of our journey. Her eyes filled to overflowing with tears. She told me that her daughter, Veronica, had died of cancer at the age of 22. Veronica, or “Bubbles” as Margaret called her, had been diagnosed with stage IV kidney cancer at age 21 and had lived only 8 months after being told she had cancer. Even as her illness stole her strength, Bubbles continued to be a source of joy and positive energy in Margaret’s life. Margaret misses Bubbles more than her heart can bear, but her faith in a life after death provides her comfort.
As Margaret continued to shed tears of remembrance, I decided to share with her the story of Chris and the prayer flag project. I opened my backpack and removed Chris’s flag from the inside pocket. Chris was a patient of mine who died at age 21 of a malignant tumor that started on his tailbone. Margaret read the words that Chris’s dad, Joel, had written on the prayer flag that commemorated Chris’s short life. Chris’s life had parallelled Bubbles’ in many ways. As Margaret read, tears streamed down her cheeks, landing on Chris’s flag, creating small dark spots on the green fabric. “Thank you,” she said. “Thank you for sharing this story. I know how important it is to remember.”
I removed a blank prayer flag from my backpack and Margaret created a flag in memory of Bubbles. I will carry her flag, along with Chris’s flag and the flags of hundreds of my patients, to the summit of Mount Imja Tse during the next two weeks. Bubbles will help inspire all of our Above + Beyond Cancer team as we journey to the top of the 20,000 foot peak near the base of Mount Everest.
Our plane landed in Amsterdam nearly an hour ahead of schedule. All the passengers were instructed to remain seated until the paramedics could come on board and wheel Morgan off the plane. Dr. Lozier and I briefed the paramedics on what had transpired during our long and sleepless night. Then, we said our goodbyes. The farewell was short on words, but long on emotion. Kathy gave me a hug and kissed me on the cheek. “Thank you,” she said. “I don’t know what we would have done without you two.” Morgan smiled and I squeezed his lifeless right hand one more time. “Good luck, Morgan,” I said. “I’m sure that everything is going to be ok.” Once again, I silently prayed.
After the Curry’s had left the plane, Charles and I reflected on what had transpired. The intensity and depth of this serendipitous relationship was still palpable. The events we experienced remind us that life will unfold on its own terms, regardless of what we have planned. It invites us to be prepared for what this upcoming journey in the mountains will teach us. Be here now.