My Own Medicine: A Doctor's Life as a Patient

Editorial Reviews

The New York Times
October 13, 2002, Sunday
By Diane Cole

Through every account of a physician stricken by life-threatening illness runs a shellshocked scream of recognition. The feel of the surgeon's blade at their own throats suddenly reduces such doctors to the previously only distantly understood role of patient. Only then do they see just how cruel the lifesaving tools of modern medicine can be.

The details of illness always differ, but the basic lesson remains the same. Their patients were right. Bone-splitting surgery does yield excruciating pain; so-called common side effects prove uncommonly hideous. Worst of all, the callous, inexperienced residents who oversee hospital care are mirror images of the clueless physicians these suddenly enlightened doctors themselves once were. It's enough to make them want to change the system. Yet that system stays intact, even as more memoirs by doctors-turned-patients keep being written. At least one such memoir should be required reading for every medical professional. One good candidate is ''My Own Medicine,'' by Geoffrey Kurland, a pediatric pulmonologist at Children's Hospital of Pittsburgh.

What distinguishes Kurland's bracing confrontation with a rare form of leukemia is his humility in the face of uncertainty. As his metamorphosis from medical professional to medical case history begins, he is confident that he is suffering from nothing more than a broken rib, the fallout from his rigorous regimen as an extreme long-distance runner. The year is 1987, Kurland is 40, and the bright California landscape through which he jogs before and after rounds at the Sacramento hospital where he is then working matches his optimistic outlook.

Then he views his chest X-ray. A fist-sized mass of unknown origin has insinuated itself in the narrow space between his lungs. The tumor is probably benign, the surgeon assures him, yet these words of comfort arouse only discomfort as Kurland experiences the first of many insights that resulted from his unexpected role reversal. ''I'd used probably all the time with patients and their parents, thinking that it would suffice to allay their fears,'' he writes. ''Now I realize how wrong I'd been all those years. Patients don't want probably, they want certainly, even if it is unreasonable to expect it.''

That was just the beginning of Kurland's re-education. As he underwent a battery of diagnostic procedures that he himself was used to administering, he began to feel, understandably, like the baton in a relay race, being passed from one specialist to another. Even so, he learned how interminably long even the shortest wait -- for an appointment, a test result, a decision on what treatment comes next -- seems. Especially when his diagnosis was a potential death sentence: hairy cell leukemia, so named because of the fuzzy ''hair'' that surrounds each affected cell.

Today, hairy cell leukemia has a high remission rate. But in 1987, the chemotherapy regimen that is now a standard treatment was still under development, and the prognosis was a roll of the dice. Moreover, given the particular complications of his illness, Kurland had to undergo two grueling operations -- one to eliminate the chest tumor, the other to remove his spleen -- before he could even contemplate any further treatment. He was able to join a clinical trial of an experimental chemotherapy, and by the time his narrative concludes in 1990, Kurland had achieved a successful remission.

Kurland never asks for sympathy or pity. He reports his ordeal straightforwardly, always taking care to explain technical procedures in easily understood terms. Reticent about discussing his interior life, Kurland is far more comfortable juxtaposing his struggle against illness with his determination to stay in training for his marathons. Both, he points out, require staying power for the long haul. What comes through powerfully is his humanity, which his own bout with illnesses has clearly enhanced, and from which both his patients and his readers will benefit.

The New Yorker
November, 18, 2002

My Own Medicine, by Geoffrey Kurland
(Times; $25). While training as a pediatric pulmonologist, Kurland told a patient, "I know how you feel"; years later, when he was diagnosed with a rare form of leukemia, he discovered just how untrue this was. A self reliant type addicted to running ultramarathons, he was unprepared for the feeling of powerlessness that beset him. Taking a bone-marrow sample, for instance, is unpleasant enough, but his terror of being on the receiving end makes him plead for extra painkillers. The way in which serious illness alters one's sense of self and of life is compellingly expressed in this energetic, nervy narrative, as Kurland's illness and eventual recovery collide with a host of profound shifts—a big career move, the death of a colleague, an unravelling relationship with his girlfriend, and a deepening one with his parents.

Pittsburgh Magazine
January 2003
By Cindy Hsu Han

A Patient Doctor

Control and self-sufficiency defined Geoffrey Kurland's life as a physician and die-hard runner -- until he discovered he had a rare form of leukemia. My Own Medicine: A Doctor's Life as a Patient ($25, Times Books, hardback) offers Kurland's introspective story of his three-year journey to remission. A pediatric pulmonologist at Children's Hospital of Pittsburgh, Kurland treats children with life-threatening diseases. The irony and the unique perspective that come with being a doctor turned- patient give Kurland's memoir its emotional strength. Throughout the book, Kurland juxtaposes the helplessness of the patient and the bravura of the doctor. When he finds himself about to get his first bone marrow sample drawn, he recalls the first time he performed the painful procedure on a brave little boy years ago. He learns how wrong it is for a doctor to tell a patient: "I know how you feel." Kurland's journey to death's door and back takes him from Sacramento to the Mayo Clinic to Pittsburgh. Accompanying Kurland along the way are his doctors and colleagues, his parents, his girlfriend and his running shoes. In fact, the race as a metaphor for Kurland's approach to life and battle against disease is obvious to both himself and the reader. By the end of the book, Kurland finds himself running a 100-mile race out West, looking ahead.

Pittsburgh Post-Gazette
October 8, 2002
By Wallace Chuma

In the patient's shoes

Doctor's book tells how his battle with illness changed his professional approach

Reversing roles in not always something readily accepted, especially if you enjoy a privilege of sorts. You want to be in control, to have things go your way. You cannot let go without a fight.

Save, perhaps, for the intervention of fate.

That was the case of Dr. Geoffrey Kurland, 56, of Regent Square, a pediatric pulmonologist at Children's Hospital. After treating patients for 14 years he woke up one night in 1987 with a fever. It led to diagnosis of a rare form of leukemia that at the time had only a 40 percent survival rate.

In his debut book, "My Own Medicine: A Doctor's Life as a Patient" (Times Books, $25), published last month, Kurland narrates a grueling account of how his diagnosis with hairy cell leukemia 15 years ago presented a new experience in his understanding of disease, medicine and patient care.

A 1973 medical school graduate of Stanford University, Kurland developed a fever while practicing in Sacramento. He was admitted to the hospital, where an X-ray showed a fist-sized mass on the upper part of his chest.

"Then, quite suddenly, I realize who I am, into whom I have transformed ..," he writes.

"I am no longer the doctor. I am the person with the disease."

He was treated at the Mayo Clinic.

A bone marrow biopsy revealed hairy cell leukemia. The chronic lymphocytic leukemia gets its name from the abnormal shape of the white blood cells with hair-like projections. It can strike males and females, mostly between the ages of 40 and 70.

Hairy cell leukemia causes enlargement of the spleen, so Kurland's spleen was removed. This stabilized his blood count. The number of disease-fighting platelets had dropped to 60,000, down from a normal 150,000 to 300,000. Six weeks later, surgeons removed the mass in his chest. Just two months after joining Children's Hospital in 1988, he started a 14-month regimen of chemotherapy, which cured his disease.

The illness "had a profound effect on me. I became a different somebody," Kurland said recently at a book signing in Oakland. The experience was chilling, and the writer described his fears and concerns as surgery after surgery was performed.

"My Own Medicine" is rich in detail, enhanced by the author's skillful handling of the narrative, taking readers back and forth and connecting the different worlds of Pittsburgh, Sacramento and Stanford. He also carefully explains the medical terms.

Perhaps one of the greatest lessons is that people have less control over their lives than they think.

The book depicts a man who, faced with the painful reality of his own mortality, acknowledges his condition and gears himself to face the challenge.

"Sometimes you have to lose control in order to gain it," he said. The greatest lesson from his suffering was that he should trust some people. "Even the best of physicians have to be willing to let other physicians care for them. It's important to trust other people. It's usually hard because most physicians want to be in control," he said. The experience also affected his interaction with patients. Although he acknowledged that he was "a good physician" even before March 1987 (the diagnosis), he learned something about being a patient.

"Only when you are confronted with a similar experience can you understand what it means to be a patient," he said. "I learned and understood the things that my patients used to tell me."

Pittsburgh Post-Gazette
Sunday, October 13, 2002
By Irina Reyn

The relationship between doctor and patient is often a conflicted one. In Leo Tolstoy's "The Death of Ivan Ilyich," the ailing protagonist leaves a doctor's office confused:

"All the way home he was going over what the doctor had said, trying to translate those complicated phrases into plain language and find in them an answer to the question: Is my condition bad?"

Now comes a book for those who wonder what might happen if the tables were turned. Geoffrey Kurland, pediatric pulmonologist at Children's Hospital, illustrates in harrowing detail how a devastating illness transforms him. He becomes a physician whose understanding of pain must transcend medical textbook definitions.

Kurland, who's also a professor of pediatrics at the University of Pittsburgh, first found out about his illness while serving on the staff of a Sacramento, Calif., hospital. A routine X-ray turned up a chest mass that eventually led to a diagnosis of hairy cell leukemia. For the then 41-year-old Kurland, a long-distance runner trying to qualify for a 100-mile race over the Sierra Nevada mountains, the news is a shocking wake-up call. He realizes he must begin a race for his life -a three-year treatment designed at the renowned Mayo Clinic (where his father is a researcher) in Rochester, Minn.

Kurland quickly discovers that his own experience with life-threatening illness -- he treats children with cystic fibrosis -- does not provide him with ample coping tools when faced with his own diagnosis. "As I realize the lack of control I am confronted with, I see, much to my embarrassment, that even though I am a physician, my illness, if that is what it is, is very much a mystery to me."

Like any other patient, he must first find out what hairy cell leukemia is. The bone marrow contains a variety of red and white cells, along with platelets necessary for combating infection and aiding in blood clotting. When the normal cells are crowded out by identical white blood cells with abnormal protrusions (hairy cells), the body becomes vulnerable to potentially fatal infections.

Readers who have felt frustrated before their physician's unruffled manner will learn that illness can transform the most experienced of doctors into frightened, uncertain patients. The strongest sections of this book detail Kurland's struggle with the infantalizing nature of being a patient with a serious illness. He must give himself over to numerous medical professionals, move into his old bedroom to be taken care of by his parents and organize his movements around a healthy platelet count. He must learn to give up the clinical control of a physician and how to allow others to direct the course of his therapy. Most starkly, he brings across the alienating quality of cancer treatment, particularly for a man unaccustomed to sharing intimate feelings with others:

"The sense of aloneness in the face of my illness ... is palpable and overpowering," he writes.

Kurland's battle with the disease offers a hopeful prognosis -- his leukemia has been in remission for 12 years -- that will no doubt prove inspirational for readers. Yet, while they will be able to identify with the very real emotions exhibited here, Kurland clearly has been granted the kind of state-of-the-art treatment that might not be accessible to the average patient..

For example, would a patient who was neither a physician nor a relative of a physician at a top medical institution have received the same kind of prompt, high-quality care from top experts in the field? Kurland admits that he never had to wait for CT scans or appointments; his connections also allowed him to enroll in an experimental treatment program that proved effective for forcing the leukemia into remission.

Yet at its best, this memoir proves that illness is the great equalizer -- in the end, we are all patients.

What Critics are Saying

Bernie Siegel

. . . no longer a tourist in the land of cancer, here shares his experience as a native. I admire his courage.(Bernie Siegel, M.D., author of Love, Medicine & Miracles and Prescriptions for Living)

Abraham Verghese

The story of Kurland's battle with a disease that almost took his life, is compelling and poignant . . . unique . . .(Abraham Verghese, author of My Own Country and The Tennis Partner)

Oliver Sacks

Taut, dramatic, and intensely real . . . very well-written.(Oliver Sacks)

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