Pearson Timothy R. - Night reflections: a true story of friendship, love, cancer, and survival

R OBERT T . W INN, M . D .

WITH

T IMOTHY R . P EARSON

Humanix Books

Night Reflections: A True Story of Friendship, Love, Cancer, and Survival

Copyright 2016 by Humanix Books

All rights reserved

Humanix Books, P.O. Box 20989, West Palm Beach, FL 33416, USA

Library of Congress Cataloging-in-Publication Data

Names: Winn, Robert Thomas, author.

Title: Night reflections : a true story of friendship, love, cancer, and survival / Robert Thomas Winn, MD.; with Timothy R. Pearson.

Description: West Palm Beach, FL : Humanix Books, [2016]

Identifiers: LCCN 2016017794 (print) | LCCN 2016029922 (ebook) | ISBN 9781630060701 (hardback) | ISBN 9781630060718 (ebook) | ISBN 9781630060442 (e-book)

Subjects: LCSH: Winn, Robert Thomas, Health. | LeukemiaPatientsBiographyUtah. | CancerPatientsUtahBiography. | LeukemiaPatientsFamily relationships. | Husband and wife. | BISAC: HEALTH & FITNESS / Diseases / Cancer. | HEALTH & FITNESS / Womens Health.

Classification: LCC RC643 .W546 2016 (print) | LCC RC643 (ebook) | DDC 616.99/4190092 [B]dc23

LC record available at https://lccn.loc.gov/2016017794

No part of this book may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopying, recording, or by any other information storage and retrieval system, without written permission from the publisher.

Cover photo: Getty Images 186837005

Interior design: Scribe Inc.

Humanix Books is a division of Humanix Publishing, LLC. Its trademark, consisting of the words Humanix is registered in the Patent and Trademark Office and in other countries.

ISBN: 978-1-63006-070-1 (Hardcover)

ISBN: 978-1-63006-071-8 (E-book)

To the countless patients and their families who have battled cancer together; to the many gifted researchers who have persistently advanced the science of treating leukemia; to the devoted staff of the trio of hospitals in which my beloved Nancy spent the better part of a year; to my late mother, who taught me the ideals that led to my own career in medicine, showed me how to unearth the goodness in others, and exposed me to the beauty and power of the written word; and finally, to the anonymous donor who altruistically gifted his bone marrow to Nancy and, in so doing, gave her a chance at life.

A diagnosis of acute myeloid leukemia is a shocking, disorienting, terrifying event. Only a month ago, your life was unfolding as usual. Only one week ago, you sensed something wasnt quite right, noticing just a bit more fatigue and a few unexpected bruises. Only a minute ago, you heard your doctor declare that you have leukemia. Without therapy, you are told that you will likely die in a few weeks and that the only alternative is to receive intensive chemotherapywhich itself could kill you. If, following initial therapy, you are fortunate enough to enter a complete remission, you are advised that you will need further treatment to keep the leukemia from recurring. Later, you will have to make a decision between receiving additional chemotherapy versus undergoing a bone marrow transplant, one of the most crucial and anxiety-producing decisions in all of clinical medicine. Simply, it could happen to any of us, and it did to Nancy Winn.

In Night Reflections, Robert Winn, himself a physician, describes the roller coaster events following his wifes diagnosis of acute myeloid leukemia. The book is medically and scientifically accurate. More importantly, Dr. Winns story is remarkably open, unguarded, and intimatea personal journey of discovery, friendship, love, and ultimately survival. Dr. Winns willingness to candidly explore and expose his own vulnerabilities provides an honest look into the tumultuous and sometimes chaotic events experienced by a caring husband and family as a loved one faces a potentially fatal illness. I believe that almost any physician, staff member, patient, patient family member, or friend will come away with new insights and understanding after reading this moving memoir.

Nancy Winn was blessed to have a supportive husband and family. She was also fortunate to be treated in the current era rather than a few decades ago. Medical advances have been significant in many ways. Although the treatment of acute myeloid leukemia still leaves much to be desired, there has been noteworthy recent improvement in outcomes. Today, the risk of dying from a complication of chemotherapy has dropped remarkably, mostly due to the development of better ways to combat infection. With this advance and the development of new chemotherapies and refinements in their use, cure rates with chemotherapy alone have increased from 15% to almost 50%. Outcomes with bone marrow transplantation have likewise improved over the last several decades, and cure rates of 65% are now regularly reported. The credit for these advances goes to the scientists and clinicians who developed and tested these new approaches. But enormous credit should also be given to the countless patients who willingly participated in the clinical trials that were required to test these new approaches and demonstrate their effectiveness.

Nancy Winn did not have a matched sibling to serve as a donor but rather received her transplant from an unrelated volunteer donor. The first transplant from a matched unrelated donor was reported in 1980. It was obvious from the very beginning that if unrelated transplants were to become widely available, a very large donor registry would have to be created. Remarkably, today over 25 million normal individuals have agreed to be typed and entered into an international registry to provide bone marrow for individuals they have never met and to do so for no financial or other reward. While Nobel prizes and honorary degrees go to leading scientists and clinicians, there are many other heroes in the fight against leukemia, including past patients, volunteer donors and societies, and supportive, loving family members like the Winns.

Frederick R. Appelbaum, MD

Director, Clinical Research Division, Fred Hutchinson Cancer Research Center

Head, Division of Oncology, University of Washington School of Medicine

President, Seattle Cancer Care Alliance in Seattle, Washington

When my wife, Nancy, was diagnosed with an aggressive form of acute myeloid leukemia, our lives changed forever. Overnight, our world went from the normality of daily life to one tumbling and careening out of control. For the next two years, we existed under the dark uncertainty of a life-threatening disease and amid the roller coaster of tests, treatments, and hospitals. My escape was my medical practice, and my only comfort was the unwavering support of our families, friends, and our community. Heartbreakingly, I simply began to cry whenever I was asked about Nancy.

Since it was so much easier for me to write than to talk, I began composing letters on many of the evenings that I sat quietly and resolutely beside my acutely ill wife in the soft, flickering nighttime lights of her hospital room. My middle-of-the-night updates became the way for me to share our journey with our friends and family. And over time, I came to learn that these late-night reflections depicting our struggles and travails touched the hearts of friends and acquaintances alike.