On October 10 Greg had a strange and singular experience. All of a sudden, after doing nothing more difficult and remarkable than getting out of the bathtub, Greg began to experience severe double vision—dysplopia for those inclined to medical terminology. He was seeing two perfect images side-by-side, images that would easily resolve into one if he just closed one of his eyes.
Greg had so-called “binocular double vision,” which often appears as a symptom of a number of serious conditions ranging from brain tumors and aneurysms to multiple sclerosis and myasthenia gravis. This, quite understandably, triggered urgent phone calls, a flurry of medical office visits, and an emergency MRI of the brain and brain stem. It was certainly a series of strange and discomfiting days.
But, it was the MRI that really brought the memories rushing back—dredged up from sixteen years ago—memories of other strange days and other anxious visits to hospitals—and memories of a most extraordinary doctor. This wasn’t the first time that Greg had to lay, still and quiet, mind racing with morbid scenarios, inside a clanking, claustrophobic tube. It wasn’t the first time that Greg (and Joan) would have to wait for results—both trying their best to balance precariously on a knife edge of fear—listening for a single phone call that could bring with it greatest joy (you’re cancer-free!) or deepest sorrow (I’m sorry, we found a shadow, a lump).
Every time Greg has to have a CAT scan or MRI, the experience is tinged with dread. Every whine of the tube, every mechanical clank of the whirling magnets is an awful counterpoint to his racing thoughts. Am I already dying as I lay here, arms flat to my sides, in awful semblance of a corpse? Am I just killing time until I get the bad news? Or will this machine, a marvel of medical science, tell me I have years to go before I must close my eyes for good? Lying supine in these machines brings one’s thoughts very close to the possibility of death, the metal and plastic tube a premonition of a tomb.
As it turns out, Greg would be fine. Death was not imminent. The machine delivered the much desired good news. There was no tumor, no cancer, just a simple “insufficiency” of blood to the sixth cranial nerve. Cause unknown—nothing to see here—move on. In six weeks it will be as if nothing had ever happened. But it did happen; and we were afraid, again, after all these years, of all those bad things that can befall a long-married couple.
This was all dwelling on our minds when, just a few weeks later, on an otherwise routine November morning, while filling out a medical form necessary for seeing a specialist about Greg’s double vision, Joan googled the name of the doctor who had removed Greg’s kidney after a diagnosis of cancer. Sadly, her innocent search uncovered the dark news that Greg’s surgeon, Dr. Andrew Novick, a world-renowned urologist at the Cleveland Clinic, had, unbeknownst to us, passed away, some eight years previously.
Deeply saddened by the unexpected news, we found our thoughts turning back to one of the darkest times in our life together. Fortunately for us, Greg’s brush with renal carcinoma had a happy ending—and we know all too well this is not the case for everyone. What we knew, for a certainty, was that sixteen years ago this extraordinary man, this most excellent physician, had saved Greg’s life.
In the summer of 1999 after a long and excruciating night in pain, Greg discovered a massive amount of blood in his urine—there is nothing like a toilet bowl full of scarlet to inspire immediate terror. An urgent visit to the doctor resulted in a “probable” kidney stone diagnosis. Greg was advised to watch for the stone to pass—but when no stone appeared, our then family physician, Dr. James Waugh of Kent, Ohio, following medical protocol, ordered an intravenous pyelogram. We both remember with utter clarity the call that came from him just the next day. Greg wasn’t home. Joan, unaware of what the test results were to show, gave the doctor’s office Greg’s cell number. Although something, perhaps a faint tremor of emotion in Dr. Waugh’s voice, told her that the news wasn’t good, she had to patiently wait to hear from Greg himself: “They found a shadow on my kidney.”
Appointments followed. Greg, we need to discuss treatment options. Greg, we need to schedule a CAT scan. Greg, the CAT scan shows a 10cm tumor. Greg—it’s renal carcinoma. Greg, you need surgery. Greg, I think you should go to the Cleveland Clinic. Greg, I think you should meet with Dr. Andrew Novick. Greg, he’s the best there is.
There are many things about that time in our lives to blog about: depression; sleepless nights; regrets. All the deeds left undone and words left unsaid. Above all one could write about how one day life is, well, normal, quite unremarkable. You wake up in the morning, get coffee, send the kids off to school, put in a day’s work. And then suddenly, a two-minute phone call changes your world—irrevocably. In the hours and days that followed, we were both consumed by an almost overwhelming fear of what might lie ahead of us.
But that dark time really isn’t the only subject of today’s blog. It is also about a man named Andrew Novick and our brief but life-affirming connection. By 1999 Dr. Novick had already been Chairman of the Department of Urology for fourteen years. During his tenure in the Department he led the urology program to the top of the national rankings (according to an annual survey conducted by the U.S. News & World Report). He had authored hundreds of research publications and held visiting professorships at academic centers around the world. Greg’s best chance of survival, we decided, would be to get treatment from the best.
The many trips we made to the Cleveland Clinic for testing that summer of 1999 are now mostly a murky blur to us, but the day we met with Dr. Novick—that day is crystal clear. It could have happened yesterday. His handshake was warm and genuine; his voice was confident and soothing. He explained the entire surgical procedure Greg would endure and what we could expect. Due to the size of the tumor, he said it was possible that the cancer had spread to Greg’s spleen and that the spleen might also have to be removed. As he spoke about the upcoming surgery, tears welled up in Joan’s eyes. Dr. Novick gently took her hand and reassured her, “Don’t worry; we’ll get him back to health.” That moment and those words were a turning point for Joan. Dr. Novick was not the kind of man to give false hope. If he felt confident of success, so did she.
When he had finished talking with us in his office, Dr. Novick suggested we go out to the main office and check the surgery schedule. August 9th was the first available date.
“Our first date was on August 9th,” remarked Joan.
“That was the day I met my wife,” Dr. Novick added.
We three decided that this was a good omen.
The day of the surgery, Greg had to be at the Cleveland Clinic at 7 am to be prepped for his radical nephrectomy at 9 am. It wasn’t until after 4:00 pm that Dr. Novick called Joan on the waiting-room phone with the news that the surgery had been successful. He felt confident that all the cancer had been removed. The tumor was self-contained, encapsulated on the kidney; “it was just sitting there,” he said. It hadn’t spread to the spleen. Greg had every hope of living many more years. And here we both still are, sixteen years later. Yet, sadly, Dr. Novick himself is not.
It is no small accomplishment to have the expertise and skill to perform a surgery like the one that saved Greg’s life. It takes years of study, hard work, and dedication. Such uncanny expertise mixed with personal warmth and extreme compassion; only one word comes to mind, extraordinary. What Dr. Novick did for us was no mean thing. It wasn’t just the surgery and the gift of his sure and capable hands; he also gave us a spark of hope, the courage to move forward into the darkness of an uncertain future. As it turns out, we could have many more years together. Greg would be able to see his children grow and thrive. For all these things we are deeply grateful.
In the years that followed we saw Dr. Novick just a few more times when Greg needed to go to the Clinic for his six-month check-ups. There were more CAT scans, all clanking and whirling, and more anxious waiting for results. After a while Greg’s cancer checkups and his CAT scans were done less frequently and more locally; we ceased making trips up to the Cleveland Clinic. Then, after a while, no more CAT scans were called for at all. Greg was cancer-free. We never saw Dr. Novick again after that.
During the nine years that followed the surgery, Dr. Novick helped create one of the most prestigious medical facilities in the world, the Glickman Urological and Kidney Institute. His urology program would continue to be ranked among the top two in the country. He championed the partial nephrectomy, a procedure which removes only diseased tissue and saves as much healthy tissue as possible. Always the innovator, Dr. Novick also pioneered a technique that used ice baths to spare kidney function. In recognition of his many accomplishments, he received the Ramon Guiteras Award, the American Urological Association’s highest honor, in May 2008.
On October 19, 2008, just two weeks before the Glickman Urological and Kidney Institute was to open its doors to its first patients, Dr. Andrew Novick passed away from complications of lymphoma. He was only 60 years old. It is impossible to determine how many lives he had already saved, how many more lives he could have saved—would have saved— had he lived. It is all so unspeakably sad and unfair—as life itself often is.
With his strong, capable hands Dr. Novick healed Greg—lifted him up as he lay dying. With his warm, compassionate voice, he gave Joan courage and hope when she needed it most desperately.
But he could not, in the end—all his skill and knowledge not withstanding—heal himself. His own cancer he could not cast out. We survived, and he did not.
Dr. Novick, Andrew, had touched us so closely; a relationship at once both unimaginably intimate and so clinically distant. Yet, we did not even know that he was gone—had been gone for eight years already. Something seems very wrong about that. There is a debt owed, but it is one that can never be repaid except in remembrance and gratitude. For the man who was there, the man who reached out his hand to help and heal: farewell good doctor, farewell.
Photo courtesy of Cleveland Plain Dealer