Category: powerful spirit

Kids baseball game

Seeing Red

Joanne Dragun, M.D.

The crack of the bat. The roar of the crowd. It is baseball season and the formerly tiny faces in the big caps and over sized gloves who dreamed of this day await their destiny. The baseball draft will change lives forever and few will be called to greatness. When you are an all star athlete with profound skill, your eyes are on the hopes of a big and glorious future. When you are sidelined from your college team to be treated for cancer, the world tilts. What brings you back on course is a family devoted and your own internal fortitude.

The path of baseball star pitcher Dylan Simmons is close to my heart. While managing juvenile diabetes, Dylan was top in the sport and while recruited from high school, chose to succeed on all levels in life. College came first and so he excelled at a finance degree. During his Florida State journey, the lymphoma diagnosis hit. Hard. Nothing mattered now but getting well. Can you imagine being parents, both with careers in cancer treatment, finding your own child will battle a disease and right at the prime of his college journey? Scott and Tracey his parents sat the bleachers, traveled the journeys, supported the dream for years, then find themselves navigating a familiar terrain, but now for their own beloved son. The star baseball career sidelined with the hushed words and devastating diagnosis.

Dylan made his way successfully through a tough program of treatment and ultimately transferred to University of Pittsburgh where his star continued to shine at every level. The self proclaimed, …“diligent student with a passion for pursuing excellence in everything I do” with aspirations on and off the diamond, saw them come to reality when he was drafted by the Cincinnati Reds.

Dylan’s journey to professional baseball (and sure to follow more greatness, records and success) could be the culmination of this truly inspirational story. His brave and courageous parents and supportive and successful brothers could now see their aspirations for him come to fruition. But I do not believe that this draft, to a wonderful national team, with vision to recruit his talent, is his true life’s work. In his own words, “believing that with hard work and surrounded by good people, nothing is impossible”.

Dylan will inspire every little face of a juvenile diabetic with assurance that a lifelong disease is not limiting. How you stand up to it is what matters. That the children in cancer wards, like the one in home town Jacksonville where Dylan was treated, will envision their own success. That parents will have hope, as Tracey and Scott did, and siblings will converge to lift when another is challenged. Dylan Simmons’ greatness will be legend because he is an outstanding and talented athlete and Cincinnati does not even know yet how fortunate they are. It is his determination, leadership and courage in the face of adversity and power with God’s blessing on him that will reach heights never imagined.

We wish you all the success you so richly deserve. Your journey gives parents the strength to see power and courage in their own children- never victims always victorious. God bless you, Dylan, and your wonderful family. We will follow your career with anticipation and we will celebrate your every achievement, but mostly we will be grateful that you were given the gift to inspire others to reach for their own greatness within.

old couple walking while holding hands

First responders

Joanne Dragun, M.D.

The hospital cancer clinic is still buzzing with the hurricane effects. Employees and patients compare their disaster stories and pictures. It’s an unhealthy competition. Millie’s awfulness wins the day when not only is she receiving chemo and radiation, but her home flooded. Her husband, dog and cat were rescued by a son in a truck and are tucked into a small space with his family. The upside is more time with grand kids. The downside is they are all teens. Her husband clutches a flowered tote like a security blanket. “Everything is gone” he says. Their eyes are large and even removing masks this week found no smiles. “We worked hard our whole life, we didn’t deserve this”. No one did.

What happens next is what matters. The unselfish efforts to manage and comfort are center stage. The employees are collecting money for others with young families who are still sitting shell shocked. The embrace of post storm help is everywhere. What a wonderful and uplifting time in the aftermath. Telling the stories is critical to healing. By the end of the week, Millie is managing and wearing some funky clothes from a granddaughter her size. “I don’t even know who this band is”, she says of the T shirt. “It’s better you don’t”, I counter. Her husband bonds in the lobby with a male patient regarding how to manage their totaled cars. The healing is slow and labored, but one step at a time, everyone is getting through the day.

Josh is too young for cancer and too weak to empty the damaged house. His father flew in from Michigan to help. He is happy to respond and the formerly estranged son is grateful. The father’s strength is needed so much more than for the clean  up. As with getting through therapy or recovering from injury or loss, it is the gradual pace that reveals some improvement at the end of each day. Patience is imperative.

What can we do when faced with terrifying circumstances?  Even with challenges, there must be belief that you can overcome. If disaster strikes, have faith you will be saved. When hardships arise, believe that you will find a way through. If the situation is overwhelming, rest assured there will be a helping hand and often from unlikely sources.

You also have the ability to manage your situation by how you decide to approach it. To paraphrase holocaust survivor Victor Frankl, “The one thing no one can take away is the way you choose to respond to (what happens to you). Freedom is choosing your attitude in any given situation”. We forget this truth so it is worth repeating. You are actually the first responder.

I am not admonishing you to put on a good front or to be upbeat. But I am advising that you can be empowered. Here is a reminder that you are in control. Recognize your situation and permit yourself an appropriate reaction. Then set your intention just for the day. Months of treatment or recovery is too much to fathom.  Survival tomorrow is only possible because you were strong and determined today. I see the possibilities again and again.

By Friday, I give information and support to Millie that the therapy, though tough, is having a positive effect. They let go of the breath they have held. For her husband, I told him I intend to cure him of that large flowered handbag. They chuckled and touched hands as they left the clinic. Being grateful for even a small moment is a start.

aerial photo sunset

Another fine mess

Joanne Dragun, M.D.

First stated by Oliver Hardy to Stan Laurel in a comic short in 1930, this catchphrase made its way into all of their films. The classic team discovered a way to get into alot of mess but comically found their way through.

The world and even our own lives know about mess. Covid, cancer, injury, illness, family strain, economic strife, mental anguish, addiction, war and suffering, on and on are ways that can make living an exhausting endeavor. Some patients will sigh, “Doc, cancer is the least of my concerns now”. So how can we adjust for the chaos? Shall we all just dismiss it like “The pandemic is over”? Really? I know more people with covid now than over the past 3 years. We can’t just magically think trails away or ignore them.

In the short comedy film, the crisis is averted and eventually things can and do improve. (Aah the power of script writing.) But just as there is drama, be assured that there are events positively affecting our lives too. Even with many “fine messes”, there are ways, grand and subtle to bring us through. Here are a few examples: I am inspired by Jessie who smiles now but managed covid, colon cancer surgery and treatment last year. Sure there were terrible times, but this week she bursts with pride as she shows me a picture of her beautiful daughter heading off to college. Rich is a young very strong veteran with a heavy lifting job. The back pain he thought went with the territory. Multiple myeloma in the spine took months to diagnose. Ultimately he became addicted to percocet. Kyphoplasty and radiation for pain, allowed him to be weaned off the drugs. Not a cure or a sure fix yet, but a light in that terrible tunnel for Rich and his family. Jose was busy battling lung cancer when his family from Central American descended on his little home. He and his gracious wife helped to get them settled, apply for citizenship, put the kids in school, and the parents quickly found jobs. “Doc, if I can help them, even while I have cancer, maybe God will spare me”. An ulterior motive, but one that boosts his immune system by reaching outside of himself and his own drama to lift others.

There is no doubt that there are ‘fine messes”. There always will be. We are not unique to time or place, generation or location. Simultaneously we should recognize the many successes we have had. They build our hope and faith for a way through. Being miserable, tearful, despondent and hopeless doesn’t even feel good! A suggestion is to say positive affirmations to yourself constantly instead of ruminating on the drama. When you think, “What else could possibly happen?” Consider,”What else is in store for me?” If we can survive the worst pandemic, have improved survivals with cancer (18 million of you now), forge paths for our children and families that lift them up, there is every expectation that we will get through another “fine mess” and end up just fine too.

Note: While you are doing positive things for yourself, the flu shots and next covid boosters are available now.

adult biology chemical chemist

Stubborn

Joanne Dragun, M.D.

Stubbornness shows up so often in our lives- not just errant children or hard to color grey hair (what?). As I review Miss Margaret’s pet scan, we are both troubled by the small lung cancer still evident- mocking us months after therapy. My brain is recalling Lady MacBeth’s ‘Out out damn spot”, but my words are hopefully more comforting. If a cancer is slow growing, it will take time to resolve after therapy – so have patience. Miss Margaret feels great- it is just a stubborn looking spot that can take up to a year to resolve on pet scans. For Miss Sallie, her distress is how stubborn breast cancer can be with even “cured” patients requiring surveillance for a long time. She joins the 8 million breast cancer survivors, but is impatient. I advise not putting life on hold waiting for the shoe to drop. Live fully and with joy and give the cancer no power over you. Fred awakens early daily to scan the internet for new therapy for metastatic prostate cancer. PSMA therapy is coming but awaiting FDA approval. He thinks that checking news will make it happen (a government agency act quickly??) I advise- “Fred, you are wishing your life away. As long as you feel well, wake to have a great day. Therapies will unfold for you at just the right time. His stubbornness is disturbing to his wife who wants him to let go of the daily drama.

Know who else is stubborn? Researchers. Antibodies targeting tumors are newly discovered and this week a new immune therapy for pancreatic cancer is being tested in mice. Thank goodness no matter what else is going on in the world, science still moves forward and docs and their mice never give up.

I admire stubbornness. Patients who demand the best treatment, second opinions, the newest research are probably also those who demanded attention, were obstinate and tenacious as children. All necessary traits to improve their outcomes. Over the years I have been impressed how those who think of themselves as wimps or shy eventually dig deep and become fierce, surprising themselves. This week we had several bell ringers who completed therapy- all with smiles, some with tears, but in every case wonderful brave people who were astonished at their own strength and fortitude. So when someone calls you stubborn, just say, “You say that like its a bad thing!” We know better. It is often just the right trait to bring you success- in life and health.

Set an Intention

Joanne Dragun, M.D.

We need a break. Help re-focusing. If you watch news, you may feel your head exploding. Let us find a way to a new refreshed personal path.

Prior to every yoga practice the instructor invites us to “Set an intention” or to “Dedicate our practice to someone”. Often my intention is to avoid falling over, but that’s not the idea. Let’s borrow this practice for ourselves and make a new life affirming action. Your morning has opportunity to be a true awakening not just to the day but to your life. Let the first idea become your intention- no pressure. Eventually this will become a habit that will return to bless you everyday.

If you start to do this daily, you may have 365 different intentions in a year or one that enters your consciousness daily. Its a simple way to send love out into the universe at no cost or effort to you. Maybe your daily intention can be to see beauty, or remember to take a cleansing breath or to practice kindness, to have more abundance, or to be grateful or to be a blessing or to put a problem or someone you love into God’s hands.

Every intention is as unique as the person thinking the thought. If this is too esoteric for you then begin by sending love to someone today. Starting your day with a selfless, outwardly directed thought will begin to open your heart and help you to visualize your life in a more deliberately positive way. Be generous with your thoughts. Believe that you are impacting the energy of the world with your mind because you are.

I have found in my practice that most families impacted by a cancer or life threatening diagnosis pray. I believe in the power of prayers but not every request is granted. We are not privy to all the plans and sometimes can feel disappointed. Setting an intention brings the power into you. It allows you to decide, then act on a focus today. Not just hope, but to be engaged with the thought enough to have an impact on the outcome.

Simple works. Instead of listing everything and everyone you care about, you get to think of just one action, person or blessing, knowing that you have another chance tomorrow. Everyone needs a reason to get up in the morning. Include in your reasons a special intention making this a wonderful and worthwhile day. Namaste.

Gifting

Joanne Dragun, M.D.

A lovely patient has been busy through chemo and radiation sewing beautiful masks. The fabrics are fun and fanciful yet keep toxic inhalations at bay. She even included some college teams. Her gift of love is extended not only to our staff and fellow patients, but she is mailing to Texas, Ohio and other cities in Florida. It is a great way to share the “we’re in this the together” time. Another patient is making meals she shares with an elderly neighbor. He helped her through her drama of diagnosis with his own strength with cancer history. Mrs. Charles gifts a large pack of precious toilet paper to another patient, Mrs. Evans who is in a wheelchair and unable to go anywhere except this therapy. The gifting and kindnesses go on and on (as is usual with cancer patients anyway) but more so now. This lifts everyone’s spirits.”Doc, its never about me- everything I do, even this therapy is for my family” Hank says. Malinda is a substitute teacher, unemployed. She is “manning up” accepting the risk  helping at the church to make food bags for children- her heart is breaking for them more than her need to feel safe.

What is it with these cancer patients? They are such a fierce group. “Doc, you concern yourself with my treatment but let me live how I need to”. Maybe these gifts from the heart are what is keeping them going- being needed, which is a prime motivator for life. So these feisty cancer patients and survivors are changing my own dialogue. I want to say “be safe, stay home until there is a better way to manage this disease, don’t put yourself at risk (there are patients who have lost the battle not from cancer but the virus). But instead they teach me everyday. I now think: Be strong, don’t cower, push back, remain tough as you had to for treatment, don’t be bullied, spread love which boosts the immune system like nothing else can.

So a new message is evolving: Continue to gift your spirit- even  with a phone call. There is so much rescuing to do. The pain will only heal with human kindness- not a vaccine or drug.

There will be a time when our formerly self-centered lives return to a new normal. But the break in our focus is so dramatic, devastating and gut wrenching that we will all be changed. People are waiting hours in line for food (“Doc, I’ve worked everyday since I was 14 now I can’t afford gas to come for treatment”.) There is no way this won’t have a lasting impact.

If you feel compelled and are able to help, I will not direct that you cower to the threat. Of course I want you to stay safe which may mean staying home. But we know that you are fearless and unlikely to listen to caution after these past months of peeking through the blinds.  Instead I encourage you to live that life of sacrifice and strength that helps you to fight this cancer battle and continue to be unafraid. You are needed. (Just wash your hands and wear a mask).

Kaleidoscope

Joanne Dragun, M.D.

Turn the dial, just a few millimeters. Change the direction: a green tree, a blue sky. Marvel at the prisms, colors, dimensions and complexity.

The simple toy is able to capture our imagination reminding us how each point of view is influenced by minor movements. In medicine as in life, each of us have unique perspectives and they change daily. It is helpful to recognize how a slight change in thought, knowledge, or circumstance will influence our choices. Since “the only thing certain in life is change” we should be open to all possibilities.

Just a few aging and healthcare examples: Many seniors have said, “I am never going into a home”. But now three cooked meals, socialization, care and attentiveness look better then loneliness and rigidly holding onto an outlived house. Patients often present with cancer and say, “never chemo!” But when the grandchild climbs onto their lap and holds their face in their chubby hands, their heart melts and they nod, “Do everything possible”. A newly diagnosed patient enters the center, looks around and sees others getting on with life not terrified or broken and now their spirit lifts with hope.

Doctors are taught to view every decision through a patient’s point of view but we bring our own prejudices and need for rescuing into the mix. This week Dolly is so frightened of side effects she almost says no to any treatment and her family are adding their own concerns to her fear. She doesn’t see a way out, but we implore Dolly to to trust in her own courage and a new prism of hope takes hold.

Even more complicated is recognizing that within your own circle of friends and relatives, even spouses, their viewpoint will not coincide with yours. I have had to tap into this awareness often in my career. Every single time I sit across from the person scared or suffering or questioning and open my own mind to their viewpoint. It takes practice and patience and we don’t always get it right. What I think I understood today will change for them tomorrow.

I offer to you this week just that wisdom. Realize the frame of reference for yourself and others regarding any situation is almost fleeting. Don’t get stuck. Know that you can change a view swiftly and without any effort. It is always available to you. Nothing is firm or fixed and options are everywhere. You are the one holding the viewer. Turn the dial and prepare to experience a new and wondrous change in life. Allow the magic to unfold for you.

Super Spreaders

Joanne Dragun, M.D.

Hands washed. Check. Wipes in the car. Check. Sanitizer in the small purse. Check. Keys and credits card handy so no routing around. Check. MASK ON. CHECK! Heading out the door today for any endeavor takes some planning that has now become habit. With numbers increasing in Jacksonville, it remains wise to continue precautions. (Even the RNC canceled. The President’s need for adoring fans is like a need for air- just not this air!)

“Blah,blah,blah!!!!” I hear it across the store aisles. A woman is tossing things into a cart while on the phone- no mask. Not even tucked like so many under her chin as if she had a chin lift (you do realize there is no point of entry there). She is shattering my peace. It is smart to get in and out or buy online and when you can’t, then make your trips quick, efficient, and distanced. The reason I was appalled is that she didn’t distance, talking like that spreads,  and she seems insistent on avoiding responsibility. If someone has a medical condition enough to avoid a mask, stay home please. Like a bee you cannot avoid (well, more like a murder hornet)  she kept following me, so eventually I overheard her conversation.

It was a tirade of complaints from one thing to the next. Her “chi” was very disruptive and brought to mind Peanuts’ “Pig Pen”. I wondered who cared enough to let her whine. It dawned on me that she is a super spreader of hot mess. People who complain constantly, or just want to hear their own voices and not listen, are infectious too. It was noxious stimuli for me.

I rushed out to the safety of my calm, peaceful clinic. I thanked God that demoralizing and aggressive chatter does not happen in my sheltered space. Here, people have every right to be disenchanted with their circumstances. They may be too ill to care for themselves and need to move from home, concerned for the children who may lose a parent, fearful of cancer and it’s treatment now adding to COVID job loss and money woes, so many issues surrounding this insult that vary with each individual and family.

Patients are sitting in front of me daily who have every right to cry, kick and scream their shock, fear, and anger. Instead what I do see is a serenity that is ethereal. It’s not all acceptance; they are here to fight or at least learn. At every turn there is hope and always the love and concern for others come through loud and clear. Above their masks, the eyes tell me all I need to know. Wide eyes, a crinkle of smile, a soft tear- all at the same time in this sacred space.

You will encounter thoughtless people like that shopper many times now. I hope we all remember that many many more of us are being brave in the face of challenge, far beyond a capability we thought was within us. Positive, uplifting words are necessary now more than ever. Gentleness, a loving spirit, and show of courage are also contagious. Let us all be super-spreaders of the very best kind.

Big

Joanne Dragun, M.D.

We all recall the wonder-filled upbeat movie “Big” with Tom Hanks. The title reflected transforming into his grown-up body while still a child. The concept of living big with a child-like wonder can inspire us all. Dancing on the keyboard, falling for the pretty girl, though shy, making bold and wild ideas come to life in toys… living big! Lately, we’ve been doing the opposite. I listened to a meditation recently. The guide had many suggestions to keep things simple and contemplate small, taking time instead of just barreling through life. I am not having any of it. We are done living a scared, tight, small existence. We only get one life and while a virus has upended our peace, we can still be bold.

When Norman came to see me this week, the tattooed motorcycle rider was used to living in a big, gregarious way. The new diagnosis of cancer at only 45 years knocked him over. His whole perspective on life changed with one scan. There is a disconnect between his activities, travels, work, family, and friends, and this new threat. “Shoot me now, Doc! I guess I am dying. How’d you like that for a kick in the head??” This lifestyle change is more than he bargained for so early in life.

 I remind Norman that he didn’t ride his Harley cross country until he practiced around the block. Ramping up to “big” takes effort. “Norman I want that life for you as well. You can still live large, unafraid, fearless. Right now we need to manage the confusion and terror. You can’t get out of the rain until you build a roof, so let’s get started on therapy to protect you”. No one, regardless how tough is not afraid of cancer- double negatives for emphasis. During therapy, Norman needs hope for the future. Eventually, he will improve and there will come changes but he will have time to acclimate to them.

Lives have changed everywhere this year. Every one is not getting back to normal with covid either- there are jobs, businesses, and health changes for many- even psychological stress. Our child-like wonder has vanished. So its time to think of new normals and give ourselves the chance to be fierce and excited about our futures again. We are not here to live small, mousy insignificant lives. No matter the stressors- you are in this life to make a difference, love your family and friends, engage with passion and deliberateness.

The next day Norman came for the simulation to start the planning for radiation. He rode his Harley, walked in the door as if he owned the place. Gone was the downward cast eyes and quiet frightened demeanor. He was big, bold and brash and I loved it. “Bring it on,” his attitude said. That power will give him strength for the battle and surely impact his immune system. If he succeeds it will be all him and he will go on to live and love a big life.

Thanks Norman. You were just the shot in the arm we all need now. You will inspire others and we will all embrace a full future without timidness or fear. It’s important for us to live big lives in honor of those who miss having those years. Let’s all make the most of rejuvenation after the recent months of fear, and engage big and expect bigger.

See No Evil

Joanne Dragun, M.D.

The great thing about murder hornets (oh come on Joanne) is that we know what they are and we know what they do. There is even video of them ripping off the heads of bees- not good. However, I respect them. They are not hiding in plain sight, waiting to wreak havoc by the careless rub of the eye or scratch of the nose. (Yes, keep washing hands).

Florida is lifting restrictions quickly and as ‘stay at home’ is over this week, many are having to find their shoes and squeeze into something other than sweats. Release from captivity comes with responsibility. Respect that someone you encounter could be immunocompromised or lives with someone who is. Just because we cannot see this virus doesn’t mean we can be complacent. All along I have been in favor of living strong and brave but wise.

The virus is a lot like cancer in its surreptitious way. Skin cancer we can see, but the million of other cancers per year hide under that beautiful exterior, wreaking their own havoc on unsuspecting organs. Patients are always fascinated, if not horrified, when we review scans and can actually see inside the body. It helps them to arm for the battle.

This week’s literature tells us people are avoiding hospitals, procedures and screenings. Physicians are concerned people will miss the chance to get care early in disease stages when curable. Healthcare centers are safe and have every protection so have no fear. What isn’t safe is this cancer risk because of covid, 30-50% of cancer will go undiagnosed this year. Survive the pandemic to have an uncontrolled cancer? Don’t do it- be smart.

Pandemics end in 2 ways- they kill everything and then have no hosts or they mutate, become less lethal and highly infective (like this one) and we learn to live with them. Don’t wait for a vaccine- it may never come. So please take control of your life and get the care that you need. 99.97% will not be impacted by this virus but 2 million will be diagnosed with cancer in 2020 (better news- there are 18 million cancer survivors). Lets focus on what needs attention.  Let the murder hornets and virus go- it is time to take care of yourself. Continue to be smart when you go out and now maybe even add some non-toxic bug spray.

Source http://www.cdc.gov/cancer