The Two Kinds of Decay

The Hematologist

My disease has two steps: the immune system secretes antibodies into the blood. Then the blood delivers the antibodies to the peripheral neurons.

The antibodies destroy the neurons. First they eat away the cells’ myelin sheaths, then they eat away the cells themselves, which heal more slowly, if at all.

And so I had a nerve doctor and a blood doctor.

The stereotype for hematology/oncology specialists, or hemoncs (pronounced almost like he-monks)? They are the self-styled St. Judes, patrons of useless causes.

My hem-onc was special. He was from Norway. And he didn’t mind sitting in my wheelchair if it were nearer my bed than the armchair.

He told me that he and one of his terminal patients played a game every day he visited the patient at the hospice. The hem-onc brought music recordings with him, and he’d try to stump the terminal patient, who knew a lot about classical music. Like, with the slow movement of one of the less famous of Mozart’s piano sonatas. And the terminal patient, who had a lot of records with him, would usually guess correctly what the piece was, and then he would try to stump the hem-onc.

The hem-onc visited his terminal patient first thing in the morning, then visited me, and then saw the rest of his patients.

He had a daughter about my age, and their relationship was not good, and it troubled him. She was a lesbian, and he didn’t know how to talk to a teenaged lesbian daughter.

Talking to me was easy for him. He knew how to talk to people with blood diseases.

One day he told me his terminal patient, the one with all the classical records, had died.

How many other terminal patients did he have? How many deaths had my hem-onc witnessed? Did he feel like a failure when his patients died? And by that metric, what case isn’t a failure, in the end?

What metric is used instead of immortality to judge the success of a hem-onc?