I am a surgeon who was diagnosed with malignant melanoma under my thumbnail on July 21, 2021. For those of you who have been following my cancer journey, you know that my life changed suddenly at that time. I underwent amputation of half of my dominant right-hand thumb, underwent a sentinel node biopsy, and now am receiving a year of infusions of a drug called Keytruda. As a physician, I tried to explain these procedures in earlier blogs to help other melanoma patients understand the process better. My life has also changed in many ways to a simpler life, focusing more on wellness and spiritual transformation. I am certainly in favor of all the treatments that are offered by conventional medicine (surgery, radiation therapy, proton beam therapy, chemotherapy, immunotherapy); however, there are aspects in our own lives that we can control to maximize our outcomes and health (exercise, diet, mental health, avoidance of carcinogens). So where am I now?

I am eating healthy meals that provide immune-boosting ingredients that provide my body with what it needs to decrease inflammation.  This diet helps me to fight cancer, heal better, counter side effects of chemotherapy, and hopefully help me to have a more successful outcome.  Two awesome resources for me have been the following:

• Meals 4 Health and Healing- The Heimerdinger Foundation (hfmeals.org)- an organization providing organic meals and nutrition education free of charge, for people facing cancer.
• Anti-Cancer, A New Way of Life– a book by David Servan-Schreiber, MD, PhD, that I now provide to cancer patients both in and out of my practice.

I want to explain the story behind The Heimerdinger Foundation and convey a few facts about cancer. Meals 4 Health was founded by Kathie Heimerdinger whose husband, Mike (former Tennessee Titans Offensive Coordinator), passed away from cancer in 2011. Through their experiences, they became acutely aware of the huge burden a cancer diagnosis is on the whole family, not just emotionally and financially, but how it upends the whole family. This organization helps caregivers focus on their loved one, taking away the burden of decision making, shopping, and preparing meals that aid in healing and provide nourishment. The Heimerdinger Foundation, each week in the area of Nashville, Tennessee, USA, serves approximately 800 nutrient-dense servings to nearly 100 cancer patients and their caregivers so that those going through active cancer treatment can focus on healing. I have been a part of this program, and my new diet is exactly along the lines of the meals served by this organization. I will go into more detail in Part 2. There are many ways to support this organization on their website (hfmeals.org) by way of donation or volunteering.

I want to communicate a few facts about cancer from the World Health Organization (WHO), and then I will focus on a few tips regarding my healthy, anti-cancer diet. The following statistics were most recently updated this month, February, 2022, by the World Health Organization:

• Cancer is a leading cause of death worldwide, nearly 1 in 6 deaths.
• Approximately 1/3 of all deaths from cancer are due to tobacco use, high body mass index (obesity), alcohol consumption, low fruit and vegetable intake, and lack of physical activity.
• Cancer-causing infections (human papillomavirus, or HPV, and hepatitis) are responsible for approximately 1/3 of cancer cases in low- and middle-income countries.
• Many cancers can be cured if detected early and treated effectively.

A disturbing trend in the United States is a 29.6% increase in cancer rate in adolescents and young adults, ages 15-39, from 1973-2015. (Journal of the American Medical Association JAMA Netw Open. 2020 Dec 1;3(12):32027738) We look at the cancer rate rather than actual numbers to adjust for population growth. Rates of obesity have increased considerably in this time frame among children and young adults.

The WHO states that cancer can be reduced by the following:

• Not using tobacco
• Maintaining a healthy body weight
• Eating a healthy diet, including fruits and vegetables
• Physical activity on a regular basis
• Avoiding or reducing consumption of alcohol
• Vaccination against HPV and Hepatitis B if you belong to a group for which it is recommended. (The HPV vaccine, or Gardasil, is helpful in preventing many of the head and neck cancers that I personally diagnose and treat regularly.)
• Avoiding ultraviolet exposure (use sunscreen when outside)
• Avoidance of air pollution and other chemicals that are known to be carcinogens.

The rising rates of cancer are concerning.  Cancer is more widespread today in the West and has been increasing since 1940. From the Anti-Cancer book, there are three major factors, among others, that have been in play the past 50 years:

1. The addition of highly refined sugar to our diet (causing inflammation, which negatively affects our immune system). Consumption of refined sugar has skyrocketed in the USA.
2. Changes in methods of farming and raising animals and, as a result, in our food (less of the healthy omega-3 fats and more of the unhealthy omega-6 fats).
3. Exposure to many chemical products that didn’t exist before 1940.

There are three principles to which I try to adhere in my diet. Certainly, there are days that are exceptions, particularly on infusion days, where I like to indulge more in a “comfort meal” and splurge on desserts! But overall, I have been strict.

1. I avoid over consumption of refined sugar. No more sugary drinks or other sweets. I now for the most part only drink coffee (slightly sweetened with agave nectar which in plant based and has a low glycemic index), green tea, and filtered water.
2. I avoid over consumption of omega 6 fats by having a diet low in animal fats (less meat and dairy products).
3. I choose a Mediterranean type of diet, high in fruits and vegetables, with more seafood, and try to eat more organic foods, avoiding processed foods.

More to come in Part 2. Feel free to lend your support to Meals for Health (hfmeals.org) if you live in the Nashville area and are looking to donate your financial support or time for a good cause. My next infusion is next Thursday, February 24. Thanks for taking this journey with me.

For those of you who have been following my cancer journey, you know that my life changed suddenly last year when I was diagnosed with an aggressive form of melanoma, underwent amputation of half of my dominant right-hand thumb, underwent a sentinel node biopsy, and now am receiving a year of infusions of a drug called Keytruda. My last round of imaging studies revealed no evidence of recurrent cancer to date. My next infusion treatment is on February 24, 2022.

While continuing to receive my cancer infusions, I have focused not only on returning to work as a surgeon, but also on achieving more balance in my life. One such way for both me and my wife Kellee was to downsize our house. Sometimes it is good to share some of the uplifting moments in our lives:

We moved to our new home (built in the 1960s) 3 months ago. Kellee and I wanted to have a special painting commissioned to display prominently in the sitting area of our home, just inside our front entry. We asked our good friend and artist, Christy Frank (@christyfrankart), to create the perfect painting, in an impressionism style, incorporating our existing colors. She met with us in the space and began to create this special piece. I have posted some of the steps along the way in this blog.

There is some back story, in that Christy’s husband, Dr. Robert Frank, is one of the ear, nose, and throat surgeons, in my group. They have both been a part of my story this past year from my diagnosis through treatment. In fact, as I write this episode, I am on call for our practice for the first time since my diagnosis and surgery last summer in 2021. It took a while for me to work my way back to the office and the operating room to the point that I would feel comfortable in the event of a surgical emergency that would require my attention. I was scheduled to be on call over Christmas, but Dr. Frank graciously covered my call despite having a new 3-month-old baby daughter at home for her first Christmas.

Christy named this piece, Rejoice, to express the waterfall of emotions that she felt during the creation. In her own words, she shared to me and Kellee, “Your physical, emotional, and mental journeys that have been coupled with the immense spiritual component were at the forefront of my mind.” This was one of her quickest creations ever because of our personal connections.  She says she “could not put down that brush!”

I hope you all can appreciate this work now hanging in our home. As I drank coffee and sat in our sitting area this morning, I reflected on this work and how it will be a beautiful reminder to me for many years to come. As I see it every day, it will remind me of light and hope. Another word that comes to mind is “thankfulness.” It will help me Rejoice in my victory over melanoma and remind me of God’s grace. “Rejoice in the Lord always. I will say it again: Rejoice!” Philippians 4:4

For those of you who have been following my cancer journey, you know that my life changed suddenly last summer when I was diagnosed with malignant melanoma. I underwent amputation of half of my dominant right-hand thumb, underwent a sentinel node biopsy, and now am receiving a year of infusions of a drug called Keytruda. At this point, my most recent imaging studies revealed me to be free of recurrent disease, and I am scheduled to receive my next infusion of Keytruda later this month.

My Otolaryngology practice is picking up to a more normal pace of clinic, office surgeries, and operating room cases. I have developed a deeper relationship with my patients as I have transitioned from physician to patient and back to physician again. I appreciate all the prayers and support from so many of my patients that are following my progress through this website.

Yesterday, I met a new patient who presented with longstanding sinus problems.  As always, I reviewed her medical record, performed a physical examination, and made some treatment recommendations. As a physician of many years, sometimes I just have a “sixth sense” when something is not right with a patient. She had the look of anxiety and stress on her face. I stopped and made eye contact with her, and asked her, “Are you OK?” Tears began to flow from her eyes as she shared with me that her husband died suddenly this past November. He was in distress at home, and an ambulance was summoned, but he suffered cardiac arrest on the way to the hospital. She is now alone in Nashville, with no family close by. In addition, she is a cancer survivor, but has battled recurrence, and was scheduled for a whole-body PET scan the next day. My own health situation has given me a platform and testimony. I shared with her my battle with cancer and ongoing chemotherapy. We talked about how only cancer patients who have been there can really understand the anticipation and anxiety of the approaching date for imaging studies (MRI, CT, PET scans) that are part of routine surveillance and evaluating for recurrent disease. The waiting period prior to the study, the time spent in the scanner, and the waiting period for results can be agonizing. And then if the news is good, it is almost like a weight off one’s shoulders.

I asked her if she was a person of faith, and she said yes. I talked about our lives on earth, and how God helps us through our earthly suffering on the way to our eternal home where we will be restored with Him forever.  She has the same world view as me, and I believe she sincerely appreciated our “time-out” from her ENT problem. Sometimes, a doctor just needs to listen. Maybe we all should take the time to listen to others. Be kind because you never know what someone else is going through.

That’s all I have for today! Soon to follow are some cancer-beating health tips. Peace to all of you!

My Cancer Journey Continues

Six months ago, on July 16, 2021, as a surgeon, I biopsied my own right thumb nailbed because I was suspicious for melanoma.  Just a few days later, on July 21, 2021, I received a call from one of our pathologists that melanoma was confirmed, an acral melanoma, which is an aggressive type. The tumor was also very deep, typically a sign of advanced disease and decreased survival rates. For those of you who have been following my cancer journey, you know that my life changed suddenly at that time. I underwent amputation of half of my dominant right-hand thumb, underwent a sentinel node biopsy, and now am receiving a year long course of infusions of a drug called Keytruda. As a physician, I tried to explain these procedures in earlier blogs to help other melanoma patients understand the process better. My life has also changed in many ways to a simpler life, focusing more on wellness and spiritual transformation. So where are we now?

Six Months Later and Some Good News!

This week was a big week for me. I underwent CT scans of my chest, abdomen, and pelvis. Lots of friends and family were praying for me because there were some small liver lesions that were found on my last set of scans. However, the great news, and answered prayer, is that those lesions were stable and unchanged! Overall, there is no evidence of any metastatic disease (recurrent tumor) in my chest, abdomen, or pelvis. My scans are clear…except for healing rib fractures related to the bike wreck I wrote about 2 blogs ago! I am doing well 6 months out from my diagnosis! All my lab work came back normal as well, with some values improving with my new anti-cancer diet and exercise regimen (more to come).

Infusion Time

After the imaging on Wednesday of this week, I had another infusion of Keytruda on Thursday.  This is my 6^th infusion out of ten planned infusions.  I had a blood draw and three separate IVs this week (one infiltrated), so my arms look like a war zone. And there is nothing like getting cancer therapy in the middle of a pandemic. I see many Covid positive patients each week in my own clinic, and one concern I had was potentially getting Covid from one of them, which would delay my treatment. But all went well, and I continue to tolerate my infusions well without any of the serious complications associated with this medication.

 Moving Forward

Unless you have experienced it, it is hard to describe how the diagnosis of cancer impacts one’s life. It is hard to describe the anxiety of the night before further testing, and the feeling you have laying there in the scanner wondering what the imaging is discovering. It not only affects you, but also the lives of those around you: your family, your friends, your coworkers. My wife Kellee and both of our families have felt the emotional impact of my diagnosis. Those of you who follow this blog continue to walk through this journey with me and support me. My relationship with my patients has deepened, and I have learned the power of the human body to adapt, helping me to return to the clinic and the operating room. God continues to give me the mental, physical, and emotional strength to ride out this stormy season of my life. He has drawn me closer to Him, to a different way of life more focused on things of eternal worth. He has given me this platform, and a testimony. I hope that my thoughts, words, and actions moving forward are pleasing to Him.

So many people have reached out and touched me with their love and warmth. Just this week, Sally, mother of our son-in-law, brought Kellee and I dinner after my infusion; and one of my nurses, Kerri, made some of my favorite treats as well. It amazes me the generosity that continues many months after my diagnosis.  I pledge to do the same for others going through difficult seasons in their lives.

Coming up, I plan to share some aspects of my anti-cancer diet.  I will also share some generalized medical advice, based on sound science, for those fighting cancer and for those interested in healthier lifestyles and preventing cancer.   I also plan to share some patient stories. Thanks for following my story in real time as it continues to unfold.

I have been writing this blog to give my perspective of a surgeon becoming a patient, to give some perspective to other cancer patients, to share my faith, and to allow my friends and patients to keep track of my progress.

Battling Bitterness

This past year has given me more trials and adversity to date than I have ever faced in life. As you know, I decided to share it all with you. You guys have walked with me through a diagnosis of malignant melanoma after I biopsied my own thumb, through a surgery in which I lost part of my dominant hand thumb, through ongoing immunotherapy infusions , through the process of learning how to see patients and return to the operating room, and through a major bicycle wreck with polytrauma including a pneumothorax. I am thankful for the unconditional love of my wife Kellee. I am thankful for the endless support of my immediate and large extended family; I could not have made it through this year without you. Thanks Pastor Jack…you are family also. Thanks for the love and support of Pastor Tom and my church family at Brook Hollow Baptist Church, as I consider you family also. Thanks to the other doctors in my medical practice and all the staff that have supported me so well. I love all you guys!

Pastor Alistair Begg relates that “suffering in and of itself does not lead a person into a deeper relationship with God. In other words, suffering will either make us run to God or away from Him. In the midst of trials, we must ask ourselves, “Is this trial making me bitter and callous, or is it making me loving and gentle?”  As a human, I continue to feel the battle oscillate within me between bitterness and a Christ-like attitude. I will continue to trust in God that He has greater plan for me, and that He loves me so much that life altering circumstances are drawing me closer to Him. He is giving me a testimony to share with you guys.

New Year’s Resolutions

I would like to share my experience with New Year’s resolutions last year. Every year I would make some “New Year’s resolutions” and rarely take them very seriously. However, last year in 2021, I decided to put in writing my goals for 2021, which would be a first for me. Then, I shared them with several close friends to keep me accountable. As all of you know who are actively following my cancer journey through this blog (now several hundred), I have been completely transparent. So…. here were my goals for 2021:

1. Slow down and simplify
2. Daily prayer time
3. Limit information from phone
4. Daily exercise
5. Eat well and healthy (decrease sweets)
6. Read at least 12 books (one per month and not related to my medical reading)
7. Goal weight 215
8. Connect with friends

Well, I would love to say that through my own perseverance and discipline that I accomplished every one of those goals, but I cannot take any credit. I spent much time in prayer asking for the discipline to accomplish my goals. Folks, be careful how you pray, because sometimes your answered prayer does not always look the way we envision it. If someone had told me in early 2021 that I needed to work less, sell my home and downsize, focus more on wellness, and greatly simplify my life, I likely would have laughed at them. However, the diagnosis of cancer was the impetus that effected my behavioral change.

Mission Accomplished

For those of you who have been following my blog, you know how all those actions came to fruition. As I continue to undergo treatment, Kellee and I have moved, and I have lessened my work schedule. I cannot control everything about my cancer diagnosis, but I have worked hard on the activities I can control. I spend time in prayer and in the word of God daily, some days for hours.  I am eating healthy meals that provide immune-boosting ingredients that provide my body with what it needs to decrease inflammation.  This diet helps me fight cancer, heal better, counter side effects of chemotherapy, and hopefully will help me to have a more successful outcome.  I continue to exercise daily.  The diet combined with exercise helped me drop 17 pounds to 210, 5 pounds below my goal weight. I also read 14 books this year, 2 over my goal; but I could not keep up with my Kellee, who read 85 this year! Aside from spending more time with family, I made a commitment to spend time with my friends, some of whom I had gotten in the habit of just texting.  And you guys know who you are….just to name a few….Worrick, Dwight, Pat, James, Ronnie, Lee R., and Lee H.

2022

Moving forward in the new year, my wish is that this blog comforts just one other cancer patient or brings peace or comfort to any one of you!  Then, I will consider this endeavor time well spent! I have repeat scans this coming Wednesday, January 12, and another infusion of Keytruda next Thursday, January 13. Feel free to lift me up in prayer. You are a part of my story that is still being written!

As you know, I am currently receiving infusions of Keytruda for malignant melanoma of my dominant right thumb, for which I underwent partial amputation of the thumb and sentinel node biopsy of my axilla. I have been writing this blog to give my perspective of a surgeon becoming a patient, to give some perspective to other cancer patients, to share my faith, and to allow my friends and patients to keep track of my progress. Once everyone is up to date, I plan to write some blogs about healthy living and healthy habits that strengthen our bodies, decreasing overall inflammation and promoting immune system health to decrease one’s risk of cancer. But first, here is my firsthand account of the past 2 weeks, a story that is completely true, but one that could be hard to make up. 

Wednesday, November 17- The Bike Wreck

Although I have started to operate again on Wednesdays, there was no time available in the operating room on this particular day. Also, my son Gray and his fiancée Molly were coming in town for a few days, so I decided to take a day off work, and plan a fun day with them knowing that I was scheduled for my 5^th infusion of Keytruda the very next day. Gray’s friend, Jared Clements, was also in town with them.  Gray, Molly, and Jared are all in their last year of medical school at the University of Tennessee Health Sciences Center in Memphis, and all will be fine physicians in their respective careers.

Our day started off with beautiful weather and a 3-mile hike in the trails of Percy Warner Park. Gray, Molly, Jared, and me hiked together along with the dogs, Baylor and Bentley. Next, I had planned a road bike ride from our home in Nashville, through the beautiful West Meade area, onto the Richland Creek Greenway, and then over to Star Bagel for lunch. I rode with Gray and Molly. My wife Kellee, Jared, grandson Bradley, and grandson Jack met us there and we had a great lunch together. I kept commenting on “what a perfect day it had been so far” considering the weather, the hiking, the cycling, and the time with family. Oh was that about to change!

After lunch, we had planned to cycle back home on the same route, and we walked are bikes across the street, clipped into our pedals, and just started to head out. Somehow, while on the sidewalk, I must have become careless and allowed my front wheel to slip off the edge of the sidewalk at low speed. It slipped off right at the intersection with another sidewalk, leaving my front wheel in a low spot, abruptly stopping my bike at which time my rear wheel pitched upward, launching me over the handlebars in a complete 360, and landing on my side on the concrete with a hard “thud” and my bike on top of me. Immediately, I heard (and felt) my rib crack, knocking the breath out of me. Considering my severe pain, and inability to breathe, my family called “911” and an ambulance was summoned. I was transported to Vanderbilt University Medical Center with shortness of breath. I quickly became a patient on the Trauma Service there, with scans revealing a fractured 7^th rib, a right pneumothorax (collapsed lung), bilateral pulmonary contusions (bruised lungs on both sides), and a mediastinal hematoma (bleeding into my chest near the heart area). If a pneumothorax (collapsed lung) becomes severe enough that the lung continues to collapse more, then a chest tube is placed. Initially, there was just a small amount of air outside my lung but inside the chest cavity. But I progressively developed more pain and shortness of breath, and my repeat chest x-ray revealed further collapse of my lung, so my team of physicians consented me for a chest tube. An incision was made on the right side of my chest after some local anesthesia, and the tube was inserted through the soft tissues, over a rib, and into my chest cavity with a rush of air.  It was connected to a container that allows air to escape out and over time the goal is for the lung to re-expand and seal the leak.  I spent the next two days in the hospital with the chest tube. It was able to be removed on Friday night, November 19, and I was discharged home. The situation at that time was pain with hardly any movement, worsening pain with a deep breath, and severe pain with a cough or sneeze. I was unable to lay flat for the next 2-3 weeks. Obviously, the bike injuries caused my Keytruda infusion to be postponed.

Saturday, November 20 – The Wedding

My niece, Katherine, was scheduled to get married to Andrew the day after I was discharged from the hospital. It had been twice postponed secondary to Covid restrictions, and the big day was finally here. My sister, Andrea, and her husband, Ray, live just down the street. Their kids, Katherine, Charles, and Caroline have grown up with my kids so closely that they are almost like siblings. Our family is so close to each other, and there was no way I was going to miss her wedding, even though I had been in the hospital less than 24 hours prior to the wedding. Despite the rib fracture and chest tube dressing, I donned a tuxedo, took some Ibuprofen, and went to the wedding and dinner reception afterwards!

Thursday, December 2- Infusion Time

Well, two weeks after it was scheduled, I finally received my 5^th infusion of Keytruda. I had f/u CT scans while I was admitted to the Trauma Service. Overall, the scans were good news.  For my right upper extremity, there was no evidence of any cancer in my arm and no enlarged lymph nodes. My chest and pelvis were notable only for the traumatic injuries.  The abdominal CT did reveal a few small liver lesions that look to be more chronic; but to be on the safe side, a repeat liver protocol CT is scheduled in 6 weeks to make sure they are stable…prayers accepted!

Saturday, December 4- The Race

As everyone knows, I was in training for a triathlon when I got the diagnosis of cancer.  I have continued to train as much as I can because the exercise seems to combat the fatigue that I get on Keytruda. Months ago, Gray and Molly had signed up for the St. Jude Half Marathon in Memphis, Tennessee, and I had signed up for the St. Jude 10K. This event is a huge fundraising event for pediatric cancer research at St. Jude Hospital in Memphis. Despite the Keytruda infusion 2 days earlier and the painful breathing from the fractured rib, I was determined to finish this race.

For some reason, I have always been able to tolerate pain very well. One of my hobbies is horses.  I have been riding horses for over 50 years. We sometimes take our horses on vacation with us and trail ride. A few years ago, while riding in rural Tennessee in the Big South Fork National Recreation Area, I was thrown when my horse Highland slipped on a wet, rocky trail, and I broke my distal radius.  I kept riding the rest of the week on vacation, seeking care later when I got home.

Kellee was our support team, and her sister, Kristin, and Kristin’s boyfriend, Robin, both made the trip to Memphis with us to do the 10k as well. So, I ran the 10K along with the support of Molly’s mother, Robin, who ran along with me and helped encourage me. I wound up finishing pretty high in my age group. Gray and Molly both ran strong and outstanding half marathon races as well.

Suffering

In conclusion, I think about the last two weeks and the last 6 months, and I do think “suffering” is a good description for some of my experiences.  And what does that mean to me? Through all my suffering this year, I have continued to experience God’s presence in my life.   Psalm 27 of David, verse 1 states, “The Lord is my light and my salvation- whom shall I fear? The Lord is the stronghold of my life- of whom shall I be afraid?”

Some of my earlier blogs have mentioned moments that I feel are providential. I have not experienced God in an academic and impersonal way; for me, I have experienced Him in a real, experiential type of way. The comfort of His presence has drawn me closer to Him, closer to my family, and closer to my friends. Kellee and I have had a major reset in our lives, have simplified our lives, and have focused on our personal relationships with God through our hope in Jesus Christ, not the empty hollow promises of all the secular, worldly, influences that claim to bring us happiness.

Thanks for being part of my journey!

As you know, I am currently receiving infusions of Keytruda for malignant melanoma of my dominant right thumb, for which I underwent partial amputation and sentinel node biopsy of my axilla. After much physical healing, it was now time to start the process of learning to adapt and perform my duties again as an ear, nose, and throat surgeon. I loved my job and my patients, and I was determined to rebound and resume the awesome privilege of caring for patients. Much of my time between my second and third infusions was spent adapting to work in the clinic. Next, between my third and fourth infusions, I focused on my surgical skills and a return to the operating room. By the way, my body continue to strengthen and heal with a vigorous exercise regimen; I seemed to be regaining energy; and I was tolerating the Keytruda infusions much better. I continued to remain free of the more serious side effects such as pericarditis, electrolyte abnormalities, low platelets, pneumonitis, colitis, pituitary abnormalities, skin rashes, or elevated liver enzymes.

Otolaryngology Clinic

My right thumb had been amputated back to the first joint, but I had still had the ability to oppose my thumb to my fingers. Therefore, with some retraining, I knew I could regain my dexterity. However, this is a process with a significant learning curve. My remaining thumb was still healing, very swollen, and very tender. I began wearing compression sleeves to decrease the swelling and help the skin be more formed around what was left. It was also very sensitive to touch, and I practiced all sorts of desensitization therapy, such as immersing my hand in rice and moving it around, applying all sorts of different textures, and even brushing it with a toothbrush! The good news is that I am somewhat ambidextrous. I had always been a switch hitter in baseball and preferred to play in the field left-handed. In my surgical career, I had always removed the right tonsil with my right hand and the left tonsil with my left hand.

During my first week back in the office, I started practicing donning and doffing gloves and simply played around with typical office instruments, noting which ones were more difficult and when I might want to go left-handed.

The next week, I began to work some reduced hours in the clinic in conjunction with my nurse Carrie Reich, RN, and one of our nurse practitioners, Kelly Strimaitis, FNP. I began seeing patients with them and learning to adapt in the clinic. Kelly worked with me as my nurse for years, and then I had mentored her as she progressed through NP school and specialized in Otolaryngology. She is trained in endoscopy, and together we performed both flexible and rigid endoscopy, where I realized that I could hold and control the scopes well with a variety of different grips.

By the third week, I began to see some patients on my own. It surprised me how quickly I was adapting and before long I hardly noticed anything different. What WAS different was my relationship with my patients. Many had heard I had been out on medical leave, expressed their love and concern, and were by this time reading my blog. There was a lot of genuine and sincere discourse, deeper than the usual more superficial conversations, and I was asked to share my testimony over and over. There were a lot of hugs, a lot of tears, and a lot of prayers. It was always so special when a patient would tell me they had been praying for me. Occasionally a few patients asked if they could pray for me…for the healing of their own physician… right there in the exam room!

Return to the Operating Room

Well, I began to have some anticipation, albeit somewhat nervous, about a return to the operating room. Was I ready? Would patients feel comfortable? Was I ready to undertake the awesome privilege of putting a patient to sleep, allowing me to make an incision on their body?

The process began again much like it did in medical school and residency. I began to practice injecting on the skins of oranges, to simulate human skin. Lindsay Reynolds, LPN, arranged with one of our suture reps to procure for me a tying board which allowed me to tie knots and practice sewing with all types of sutures. I practiced with the surgical instruments, and even simulated deploying some of the implants we use in sinus surgery.

Well, the day arrived, and I had only planned one operation. I gave full disclosure to the patient regarding my health condition and informed consent. She needed a revision sinus procedure, and she said she felt completely comfortable with me. In the holding room, she said she had read my blog, and she asked me to pray with her, so I did. As I prayed, both of us began to shed some tears, and we had a shared moment together. Her operation went flawlessly!!!

Over the next 2 weeks, I had more days in the operating room with multiple cases per day. It was very emotional for me to make the return to the operating room. There was an emotional reunion with many OR nurses…nurses with whom I have worked for many years and who had been texting words of encouragement and praying for me. One group had given me a wooden cross, which has been in my pocket for every infusion procedure, in every office clinic, and during every operation I have performed. My nurses and nurse anesthetists are all very experienced, supremely skilled, and have done thousands of cases with me. I have trusted them with my own procedures over the years and with my own family members. I have enclosed some pictures of many of them.

If you’re wondering how all those operations went, they again went flawlessly! It is hard to explain, but when I returned to the OR, my thumb was still a little tender, and I was extremely careful with each and every move that I made. I seemed to be even more delicate with the tissues, and seemed to concentrate even harder, with intense focus. I made sure not to overbook my time and had no schedule pressures. It was absolutely incredible how perfect these cases went, even with a few moves that needed some adaptation.

Next up…I am scheduled for my fifth infusion but suffer a setback.

After my second Keytruda infusion for malignant melanoma of my dominant right thumb, for which I underwent partial amputation and sentinel node biopsy of my axilla, I continued to have time for physical, emotional, and spiritual recovery. As I began to focus on returning to more normal activities of daily life, I was determined to keep more balance in my life moving forward.

Physical Recovery

It had been just about 6 weeks since my operation. I continued to read voraciously and spend time in prayer. Kellee and I closed on our new home, a downsize, and began preparations to move, with the help of Damon Martin, who owns Martin Delivery Company and who also has quite the testimony to share. We enjoyed discussing how adversity in both of our lives made our faith stronger. If you ask him why he wears a big wooden cross around his neck, he will be glad to share it with you. We are both mutual friends of Pastor Jack Foster, who officiated Damon’s wedding ceremony. I was able to get back on the Peloton first, followed by my road bike. For my second trip out on the road bike, I was joined by my nephew, Charles West. Charles was training for a Sprint triathlon at the time and was back in Nashville for the weekend. He had traveled from Atlanta, GA, where he lives and works in equity research for an investment bank. He has since completed his triathlon, and we rode on a brisk pace for 11.3 miles on a beautiful afternoon ride. Kellee and I continued to spend a lot of time with family, namely son Gray, his fiancée Molly, daughter Alex, son-in-law Brad, grandson Bradley, grandson Jack, and all the great grandparents of Bradley and Jack: “Pops,” “Mommy Gayle,” “Choochoo,” “Niffy,” and “Gaga.” 

Little victories continued to bring me joy. It was very emotional for me to return in person to worship at Brook Hollow Baptist Church. I was moved to tears as Chandler Nicole Sherrill, with her sweet smile, led us in our first song. I enjoyed a return to “Friday Night Lights” at Montgomery Bell Academy, where I played football (Class of 1983). Tommy Owen field always brings back great memories where I watched so many family members play, including my son Gray (Class of 2013), son-in-law Brad Bars (Class of 2010), his brothers, Blake (Class of 2012) and Alex (Class of 2014), and my nephew Charles West (Class of 2016). I also appreciated my time spent with Jennifer Brantley, a cancer survivor, who helped me set up this blog you are reading.

Spiritual Recovery

I continued to experience peace as I focused on more heavenly issues. Unexpectedly, I received a call from Dr. Bill Sherman, one of my former pastors at Woodmont Baptist Church. I have always loved him, and we have always had much in common. We are both graduates of Baylor University, and he played varsity football there. As a matter of fact, he was an all-Southwest Conference safety for Baylor three years in a row and played in the 1953 Orange Bowl. When the storied New York Giants football franchise (where my son-in-law Brad played for 2 years) invited Dr. Sherman to come play pro football, he sent them a letter stating, “Thanks for the offer, but God called me to preach!” before heading off to the seminary. Dr. Sherman and I both love the Baylor Bears! He is a gentle giant, a man of God, and I listened to his sermons for years. His entire family has always been so close to our family, and multiple family members have battled melanoma over the years. I was so happy to hear his voice, and I explained over the phone to Dr. Sherman how the diagnosis of cancer had changed my life and my relationship with God. He responded with a simple but profound statement: “Lee, sometimes we do not realize that all we need is Jesus until all we have is Jesus!” That statement to date seemed to be a recapitulation of my battle with cancer up until now.

“It is good to wait quietly for the salvation of the Lord.” (Lamentations 3:26 NIV)

Author Larry Crabb, in his book Waiting for Heaven, states, “Perhaps in this verse there is no clearer statement of the Lord’s desire that we are to wait in difficult circumstances without yielding to the temptation to prioritize making a hard life easier.” Crabb, like me, came to this realization sitting in a hospital infusion ward with chemotherapy dripping into his veins. This verse in Lamentations was written by the prophet Jeremiah, who was trying to encourage the Israelites after their nation had been crushed and forced into Babylonian exile. Jeremiah himself was no stranger to intense suffering. He was mocked by fellow villagers when he was called by God, was forbidden to marry, was beaten, was forced into hiding during the reign in Judah of King Jehoiakim, was kept in a prison, and eventually carried away to Egypt.

I will leave you with these words by Crabb, reflecting on another Old Testament character, Moses, who left a life of luxury in the court of the Pharoah of Egypt, to remain faithful to God. Crabb states,” The path to happiness, to the joy and hope-filled well-being of a Christian’s soul, leads BOTH through some level of affliction, weariness, and angst, sometimes to nearly unbearable levels, AND to the awareness of a deep thirst that will be fully satisfied only in the next life, a thirst that stirs joyful, persevering hope.”

Next up…my third infusion and how I made my “comeback” to work, both to the office and to the operating room…from surgeon to patient to surgeon again!

Just 3 weeks after my first Keytruda infusion for malignant melanoma, it was already time for my second one. It went flawlessly, and again I developed some flu-like symptoms for a couple of days followed by 7-10 days of fatigue and muscle aches.

Going Public:

The Sunday after my first infusion, I decided to go public with my cancer diagnosis. Our office has been in the middle Tennessee community since 1973. I had cared for many patients over 23 years and performed literally thousands of operations. Our office, Allergy and ENT Associates of Middle Tennessee, was telling our patients that I was out on “medical leave.” The unknown of that statement left many patients seeking more information. Over the years, I had cared for generations of families, treating them as if they were my own. I have prayed with them, shed tears of joy and sadness with them, walked them through cancer treatment, and probably given my personal cell phone number to way too many of them. I have become part of their lives. My wife, Kellee, puts up with countless phone calls and house calls all weekend long even when I am not on call. I am still on old school physician, always compelled to be a caregiver, 24/7. So, I decided to make my diagnosis public, the Sunday after my first infusion, with a social media post. The response was overwhelming! I received so many kind words and prayers of support and eventually made the decision to start this blog of my cancer journey.

A Patient Story:

I will leave you with this story of my relationship with one of my patients. It exemplifies my relationship with many of them. I have his permission to tell this story. When I went public with my diagnosis on social media, one response was from Andy Garrett, who said, “Doc, you saved my life in 2007 with skills that were God given. Prayers work and you are in mine.” Andy Garrett is a patient who turned into a close friend. Over his career in law enforcement, he worked his way all the way to the top, becoming the top ranked officer, Commander, of the large Metropolitan Nashville Davidson County Police Department Central Precinct and later becoming Chief of Police in Mt. Juliet, Tennessee. He is the kind of guy, like many law enforcement officers, who would take a bullet to save a complete stranger. One day back in 2007, I was seeing Andy for a separate problem, I think related to his ears. As I was leaving the exam room, kind of an aside, he stopped me and said he had a mild sensation of a lump in his throat on the right side. Other than that, he really had no other symptoms. Many of you who have read my earlier blog posts know that something in my head compelled me to take a biopsy of my own thumb to make the diagnosis of melanoma, which I felt was providential moment from God. In Andy’s case, there was a similar feeling, and again I feel it was a providential thought from God. Some call it the art of medicine, or a physician’s gestalt. But even though he was not very symptomatic, even though I had finished documenting his office encounter, and even though I was almost out of the room, my gut, or God, said to stop what I was doing, turn around and investigate further. I took a look at his throat with a head light, and it looked normal. Next, I told him to stay put, that we were going to investigate further. My nurse of many years, Lindsay, topically decongested his nose. I performed a procedure on him called flexible fiberoptic nasolaryngoscopy, in which a flexible scope is inserted into the nose, and then slowly navigated through the nasal passageways, behind the nose, past the soft palate, to the destinations of the tongue base, epiglottis, and the larynx (or voicebox). As I looked down his throat, I saw a subtle area of his right tongue base that did not look normal, which led to a tough conversation with this handsome, athletic appearing man, always dressed impeccably in uniform. I was concerned about throat cancer. After informed consent, I arranged to take a biopsy soon thereafter in the operating room, confirming the diagnosis, which we caught much earlier than most tongue base cancers. He underwent a tough treatment protocol, including both chemotherapy and radiation therapy, but remains cancer free to this day!

Not long after my good friend and patient Andy had been given a clean bill of health (after which I have seen him for years), something else happened in my office, something so powerful that I hope you keep reading. Our office had been a provider for a Medicaid plan that eventually went bankrupt and left many medical offices, including ours, unpaid for many services rendered ( I think almost $200,000 dollars for our practice). Eventually, years later, we had written the money off our books as a loss. I guess the insurance company was liquidated, and they tried to repay some of the debt. We got a check in the mail for about $2500 that was unexpected, and had nowhere to post the money, because the accounts had long been written off. I spoke to our Administrator and to Dr. Scott Fortune, my longstanding business partner, and we decided that our staff had really been working hard at the time and to simply give the money to them. We had about 25 employees at the time, and I personally walked around putting a note on each desk, thanking each of them, and giving them each an unexpected $100 to brighten their day. While I was walking around passing out those notes, Andy Garrett showed up at our front desk unannounced, and asked if he could slip something on my personal desk, which he did and then left. I never saw him that day, but after I passed all those $100 gifts to my employees, I walked right back to my office, where there laid an envelope labeled, “Dr. Bryant.”  I opened it, and inside Andy had written me a note that said, “Thanks Doc for saving my life…. I promise I will never waste another day!” I was moved to tears! And with the note was a restaurant gift card for guess how much…$100. Sometimes in life, you get what you give!

Thank you, God, for Andy, and for all my patients who have become part of my life over the years!