Category: Human Spirit

BOO!

Joanne Dragun, M.D.

As you push past the erupting Christmas decorations to shop for a Styrofoam pumpkin, are you enjoying the cooler temps and fall foliage? It is always my favorite time of year, kicking through the multi-colored leaves, enjoying the vibrant mums and the children’s excitement.

What was your favorite costume? Somewhere in an attic is there a cape, wonder woman bracelets or cowboy hat? Long before costumes for purchase, it was fun to cobble together with elaborate creativity an outfit to change your identity. I loved anything with makeup but actually won a contest at age 5 for the “crying bride”. There is a picture of me wailing on the ground in a beautiful veil and dress my talented seamstress mother made, but I was so shy and terrified that I sat down and wouldn’t move. Hmmm, I didn’t understand the irony.

Recognizing the character costumes today is a challenge, but what hasn’t changed are the the precious smiles on the trick or treaters’ faces. I fuss and exclaim how great they look and watch even the shy ones beam. Its a time we get to be face to face with many youngsters and if we allow, the masquerade can be a treat for us too.

For just one day, enjoy the frivolity. Carve and light a pumpkin. Maybe dress up yourself- I know your little dog already has an outfit. If there isn’t trick or treat where you live, consider volunteering at a school that has a party- always needed. You can really get out of your own head and drama when an entire town or neighborhood is being frivolous. Giggle, you owe yourself an opportunity for fantasy. Play a little- answer the door in a sheet, get a mask, take part. Whatever else the scariness is in your life right now, please do not let another holiday go by without joining in 100%. Remember a time when you too believed you could be anything- you still can. The cape is waiting.

No Time for Losers

Joanne Dragun, M.D.

‘Cause we are the champions… of the world! (Queen ’77). Stanley Cup, Super Bowl, NBA Finals, March Madness, World Cup, US Open, now World Series… Everyone loves championships! If your favorite person or team is involved, even better. People enjoy the distraction sports provides.

Mr. Martin discussed his time in D.C. when the team was the Washington Senators and moved to Arlington Texas in 1972. Without a team for 33 years, Washington finds themselves this week in the World series (with Huston Astros) for the first time since 1933! “Doc, worse than having a losing team was having no team at all. We were abandoned. I loved taking my kids to the game on family day. To see a team in my lifetime make it to the series is a gift from God!” His eyes sparkle, he puffs out his chest and 700 miles away in Jacksonville, he is rooting for a home team winner.

Mr. Martin didn’t expect to see this day because he has stage four lung cancer and has lived well for three years. Immunotherapy, found to be effective for his type, is keeping it under control and he is thrilled. Mr. Martin believes he was meant to live for these games. He ties his own wellness to their success.

There is only one issue that matters in this story: Mr. Martin has found an event that captures his imagination. This fills him with joy, lifts his spirits, boosts the immune system fighting his lung cancer. It doesn’t take an IV, hours in the chemo chair, beams of radiation, recovery from side effects or cost of healthcare. It is a shot in his arm of pure goodness and life that doctors do not prescribe.

I understand that not everyone will feel this engaged with the Series, but Mr. Martin demonstrates how easy it is to find a happy engagement in life and is available to us all. It may be a grandchild’s graduation, a son’s wedding, a spouse’s good news, the birth of a new baby, so many events in our own life that help us to celebrate with the champions.

Life didn’t throw you a curve ball so that you can strike out. Difficulties happen that give us opportunities to overcome and bring elation into the heart. There really is no time for losers, we can cheer the champions or become one ourselves. Each one of us must have awareness for the brave and proud unfolding of our lives and raise a toast to our spirits.

School Days

Joanne Dragun, M.D.

When Mrs. Hale arrives for a visit I know there will be energy and joy to spare. I ask after her mother and she tells how she moved in with her because, “Doc, 97 year old people just fall over too much so I have to keep propping her up!” 80 year old Mrs. Hale is the youngster and full of vitality. “Sorry I’m late, with school and everything”. I commiserate that it is difficult to navigate Jacksonville with the traffic and buses.

“Oh no, Doc, I am late because I have a job as a crossing guard! I go to my post at 7:30 AM and again at 2:30 PM and I just love it. The kids are great, I am watching them grow up and they keep me young!” This is really awesome. “I feel as if I am playing. I laugh, tell them how smart they look and get lots of hugs”.

Mrs. Hale found a way to have recess late in life. “You know I didn’t make it past middle school. We lived on a farm so I had to work and never got an education. It makes me feel real good to see these little ones so happy to go to class and to tell my mom everyday that I have to leave for school!”

She will likely live a long life, as her mother is doing, especially if she stays active. Mrs. Hale has a quick laugh, is young at heart and has stories to share. She reminds us that age is a state of mind. What a blessing for the children to see her smiling supportive face each morning. She is impacting their lives with her encouragement. This octogenarian found a way to boost her own immune system without chemo or doctors. She is smarter than most and schooling us all!

Discovery

Joanne Dragun, M.D.2 Comments

Whether it’s Columbus, Erickson or Indigenous Day, its a time to say “Yay for new adventures!” What Columbus has to do with not getting mail or the bank closing is a mystery but what matters is the concept of discovery.

Lets take a moment to personalize this idea of discovery. If I asked you to describe yourself in 3 words, could you do it quickly? You will surely not say cancer victim. You may include survivor, but I hazard to guess that you do not even elude to an illness. When did you discover yourself? Was it when you were tested by a life altering threat? Did you find that you are strong? When you went to school and were able to help a classmate who struggles. Did you admit you are smart? You may have worked out, lost weight and become more physical and self assured. Do you see confident? Have you taught, spoken, advised developed a plan and see yourself a leader?

At what time in your life did you enter into discovery of your own uniqueness and strength? Have you ever taken the time to consider how truly amazing you are? In 1492 Christopher Columbus did not discover a new world, he set out with profound bravery to expand the old world and in doing so demonstrated that exploration changes lives.

All the sacrifices, pain and suffering endured led to adventure and honor still recognized over 500 years later. Don’t think for a minute that your own trials and efforts will evaporate. Your strength, discovery and exploration of your legacy will last for generations to come. You will have constructed a life to be revered. Fortitude will be ingrained in your children’s children and they will have wisdom, laughter and love because you sacrificed, learned and grew. This is not to say they will never suffer, but there will be a strength they didn’t know they possessed. You are the blessed result of your own ancestors and their profound life discoveries.

The Nina, the Pinta and the Santa Maria may have been vessels of ambition, but your own personal discovery of faithfulness, hope and love are destined to last forever. Take a moment now to think of three words that describe you and in doing so discover your own new world.

That’s the Spirit!

Joanne Dragun, M.D.1 Comment

Fall, football and face painting have arrived! Do you have a favorite college or NFL team? We are “Jag-Adelphia” fans here, but Steeler and Penn State nations are strong in Jacksonville and of course U. Florida. Sunday afternoon I chuckled to see three senior men with ridiculous orange foam Denver helmets at the Broncos- Jags game. Its fun, its spirit, its excitement and it surely is fantasy.

Can you imagine if every conversation you had in a day revolved around cancer? It doesn’t deserve to consume our entire attention. Bright Gator orange and blue fills the waiting room and is the fall fashion here. Football is a common language across socioeconomic strata and regardless the stage of cancer, everyone has a team and are thrilled to represent.

When Ben arrives for treatment, he has switched his First Division Army hat for a Gator one. He never went to college but his two grandsons are enrolled. It is as if he is rooting for the boys to win, be successful, enjoy life. His face lights as he tells about discussing the game with them. It brings a common language to those generations apart.

Binge watching football, NFL and college in a week does have its own risk and too much couch potato time could cause a gain of 5 lbs. But if you think it is all frivolous, enjoy witnessing the buzz of the season. If sports cannot distract you, then give attention to a good book, music, walk in nature, look through old albums, sew, bike, draw, garden, volunteer at a school or nursing home, take an online course or spend time with a friend. Find something that helps you to forget even for a few moments that you or a loved one are being challenged. It will heal your heart from the ache of the diagnosis. It will calm your stomach from the gut-wrenching feeling which will purify your immune system. We cannot live in a constant state of angst. We need relief.

I am giving you permission to live your own fantasy- find something that lifts your spirits and keeps cancer from stealing your joy and time. Protecting your own spirit is what matters. Cheer yourself on to a healthy victory. If it includes a foam helmet or face painting- go for it. No judging!

What spirit lifting activities have you found helpful this week? Feel free to inspire others.

Kindness

Joanne Dragun, M.D.

There are so many ways kindnesses are manifested in the families I am blessed to treat. Relatives and friends pitch in to drive, cook, help with medications, set up appointments and find a myriad of ways to extend support. Right now I have a run on handbags!

Wait. What? Women come for their treatments and their husbands arrive carrying their handbags, some over their arm others dragging on the floor. I noticed this phenomenon more this week because of Mrs. Arnold’s husband. He is a big 6’4″ robust man who arrives daily with his petite wife for her therapy. After her exam she heads to the changing room and he dutifully picks up her tiny purse. He has no concerns for himself and I love it. He smiles at me and shrugs his shoulders.

“Mr. Arnold, I think it is time for you to get a bigger bag, one that suits you. This tiny flowered one can’t hold more than lipstick and a tissue”. He looks down and softly smiles. “Doc, you won’t believe it but now I put my cellphone in here too!” I think: now that is a self assured man! He is laser focused on one thing: helping his wife in every way. Hoping that carrying her bag, assisting her with a sweater, holding her chair will somehow contribute to her healing.

As Mrs. Arnold rounds the corner, he steps up to meet her and transfers the bag into his other hand while he gently holds hers and escorts her to the door. The big gruff man with the tiny handbag is a blessed vision of kindness. I don’t think he will get a bigger bag. I think this one is just right.

Recognize the simple acts of kindnesses that surround you everyday and enjoy the blessings.

Power Packs

Joanne Dragun, M.D.

Cell phones, remote controls, drones, even vacuums all battery powered. People use the phrase “energizer bunny” to describe high energy and endurance, but we are going nowhere without batteries. Some day they will be passe but until then we need to charge.

Could you imagine if we had to have a battery pack for each bodily function? We are living miracles and while we can marvel we can also be disappointed. Bodies are not machines. We are not designed for perfection. Diabetes, heart disease, kidney failure, cancer, joint pain so many ways we wish we could reboot.

You hope the more you are disciplined, work out, eat right, that sickness will stay away. “Doc, I gave up smoking thirty years ago! Can’t believe they found this lung cancer when I had a pacemaker!” Jesse says. He is right it doesn’t seem fair.

Amos says, “Doc this cancer plus dialysis treatment is a full time job!.” At 82 he isn’t frightened or disappointed. He is happy to have today. “Hey, well at least I’m still standin’.” I peer over my glasses and we both chuckle. “Oh yeah, except for my wheelchair!” Now that sense of humor will get him through and recharge him.

Martha drags her oxygen tank down the hallway. She is 100 lbs but the emphysema takes the energy she needs to eat a decent meal. “Doc, I can’t breath and eat at the same time so go ahead and stick the feeding tube in, I’ve still got things to do”.

Everyone talks about embracing the natural but look around. We cannot live without being plugged in and there are many reasons patients accept the burden of medical devices. I am reminded that a life worth living and a future worth anticipating is the real power.

Jesse, Amos and Martha aren’t working hard for themselves. The real power player in our lives is hope for the future. Jesse to see a new granddaughter, Amos to attend his grandson’s police academy graduation, Martha to care for her two little dogs. Your mind and body have the real power- don’t abdicate it to any disease.

Think about what gives you power and when you do, I am certain you will appreciate that it is a life with many joys and expectations. Staying fully charged will provide for your best life.

Great Expectations

Joanne Dragun, M.D.

The patient’s chart is sacred. Personal history of the disease, pathology reports from biopsy, and scans related to a new cancer diagnosis are just words until I give their meaning to the family. I hold the papers in my hands reverently. They contain life and death information. I understand the responsibility I have to the patient and family in front of me. I am just one physician, one small part of a process and diagnosis creating this heart breaking drama.

As I explain all of the details and plan of care, I know they are just words. The space between my voice and their awareness is a broad chasm and the only real substance within that space is one question. “Will I live?” The “chart” becomes heavy. It is filled with all their hopes, real fear, confusion, shock, disappointment and pain. I respect this. Patients hang on every word, facial expression, mannerism, smile of assurance and hand of comfort. Physicians understand this sacred trust.

There is something else: expectation. When Margaret asks, “How can I survive this?” The children wonder, “Will she be in pain?” The husband says, “What can I do, how can I help?” We will work together as a team with the patient’s own strength to carry Margaret and her heavy basket of grief. We are all called on to lighten her burden. Other physicians and our staffs will converge for her benefit. Expertise, wisdom, the newest protocols, as well as comfort measures will be brought to bear. She is not alone.

I ask Margaret, “What is your expectation?” She softly says. “I know I won’t live long but I want to live well”. This is important. She does not want months of therapy. Her disease is stage 4 of an aggressive cancer that will not be cured regardless the treatment.

And so, a plan is hatched that includes non-invasive immune therapy, minimal radiation for pain and palliative care to avoid stealing her time from her family. Margaret may only have a few months, but her wishes and her own expectation – not ours are what matter.

I have great expectations for Margaret- that she will craft her time, have loving people surround her and peace in her heart . She is in control and I expect us to follow her lead.


What expectations do you have for a life well lived? Please share and you will open another’s eyes to possibilities.

Teachable Moments

Joanne Dragun, M.D.

It’s back to school and we are all reminded that every age, every stage and every challenge in life provides opportunity for learning. Isn’t it exciting and rejuvenating to look for ways to improve our life, happiness and wisdom? A lovely relative who thrives on self discipline is always happy to share fitness and wellness ideas. It’s her fault I do yoga (oops I mean encouraged me to explore the peace in practicing). Running, triathlons, biking are as much a part of her 55 year old daily life as her nursing career. Why am I torturing you? Because this woman loves sharing what she has discovered and extending herself to benefit others. The petite powerhouse softly say, “coconut water”. She then offers: “hot yoga… oh and with weights”. If that’s not enough the word “vegan” also escapes.

Frankly having tried vegan for a week I found myself groveling at a fast food drive thru. What I love however is her need to share. She is unselfish in expressing how activities for her own wellness could be a blessing to others.

Since “Doctor” means “teacher”, I hope in some of my stories there are teachable moments. Think about this for yourself. Having lived with cancer or any major life altering problem and run the gauntlet, don’t you have many ideas to also share? Not in a “let me tell you how awful it is” way but what helped, inspired and lifted you? You are a wealth of knowledge. It is as if you went to grad school for cancer survivors! Share your best ideas, how you navigated, and where you found strength.

You will give inspiration to another who needs those words. The best teachable moment sometimes is just realizing that we are not alone. You can calm someone fearful. You can help someone smile who is depressed. You can encourage another who is resistant. You can open the eyes of someone who is rigid. You can let another see that they too can be a survivor and it is not the end of the world. You can be amazing and motivate them to believe.

It only takes a few words to share your power. You will then rejuvenate yourself and be reminded just how strong you really are- no weight lifting required.

Cone of Uncertainty

Joanne Dragun, M.D.

The cone of uncertainty describes more than Dorian. The now deadly hurricane is fierce and captures our imaginations as if everyone is in the Three Little Pigs story. The wolf is at the door in the Southeast; the cone of uncertainty, evacuations, decreased water and gas supplies (oh and chips!?) keep us riveted to the alerts.

People feel a similar impact with a cancer diagnosis. Will I survive, how long, will it devastate my family and me, can I afford the therapy- so many uncertainties personal to each. The “cone” extends from overwhelming you or moving you closer to cure, depending upon the disease and your ability to tolerate. Devastation can occur. It’s all terrifying. If you could evacuate to save yourself, you would. Having no escape but to plow straight through it often requires a rescue plan.

Doctors and patients alike cannot tolerate this uncertainty- we need discipline around the cancer process. We desire outcomes that are positive. We really want to rescue you and fast. So how can we all deal with this drama? Realize that you do not need to know everything now. Make a plan in case you are no longer here to help your family. Even if you don’t need it for years, it will give you calm. Then take a breath and know you are only being asked to cooperate with therapy and otherwise have no control. Give it up. Have faith that your physicians are preparing you and that is the best you can do. Just like the pressure stream swooping in all the way from the Gulf of Alaska pushing Dorian away from the Northeast, you may be rescued by a new drug or therapy just before devastation. I see this with immune and targeted therapy in many diseases.

The storm will be over. You will look back and be amazed at how you survived or you will decide you have had enough. Either way, you will not be uncertain. Your life is unfolding as it should. Acceptance is healing. Stand firm in the eye and above all, never doubt the certainty of your own strength.