Up Close. Personal.

At the tail end of summer, my oldest brother Scott, leader and back-bone of the family, was diagnosed with multiple myeloma, a cancer of the bone marrow and blood. He had a broken rib, nausea, and was losing weight, the tell-tale signs of what was lurking inside of him. Scott, never fearful of medical procedures, took the deep, penetrating needles and probes in stride, always replying to the nurses and doctors with a nonchalant “okay.” As a very specialized medical technician himself, he understood what they had to do, and to a fault, would not allow himself to be the difficult patient.

In September, while The Captain and I were floating around Greece, he was hospitalized for a couple of weeks. Nausea dogged him and he was still losing weight. The oncology team took more samples, and did more tests. There were some hopeful options, but then he developed an infection in his arm from an IV needle puncture. It led to a long course of antibiotics. Chemotherapy would have to wait until his immune system wasn’t so compromised.

While the around-the-clock infusion of antibiotics did its work, Scott was home, trying to live something akin to a normal life. He worked, and attended his daughter’s volleyball games. In October, fair weather for the Savage Family Regatta let him compete in a fun, yet serious sailboat race. I watched him racing, and winning, and said to ‘Honorary Brother’ Jeff Clark, I feel like this might be his last race. He denied it and we shook it off as unthinkable. Those four weeks passed by in a flash, and yet he continued to shrink in size and and he became visibly weaker. His breathing was labored.

Scott returned to the hospital on October 24, 2023, never to again feel the sun on his face, or breath the outside fresh air. Cancer-laden fluid was surrounding his lungs. Chest tubes were inserted to drain off the pool of contaminated blood that prevented him from breathing. Unit after unit of blood tranfusions were hung to keep him alive. To add to the ongoing train-wreck of problems, his kidneys shutdown. A port was inserted in his neck, and then replaced with a tunneled catheter, to allow continuous dialysis. Soon he was in the ICU for one of several trips there to get his vital organs back in sync.

From early in his stay, I went down to the hospital most mornings to encourage him to eat, and to be present for the treatment team’s daily rounds. Lynn, his wife of 37 years, would come after work. Various family members were in and out frequently, offering support. We all shared text messages and our observations with my wife, The Captain, who watched the charts and test results like a hawk. I can’t imagine how much worse this experience would have been without a skilled surgeon and critical care provider on over-watch. She had explanations for what was going on, and gave us clues about when to be worried, and when things were looking up. She wasn’t afraid to call attention to indications when the teams from the various services were slow on pick-up.

In mid-November, the oncology team offered an older, more generalized chemotherapy to shrink the tumors that were now identifiable inside his body and circulating in his blood (leukemia). For several days, the chemical concoction entered his system, drip by drip from a plastic bag hanging on the IV pole at the head of his bed. We watched his white blood cell count tick down to zero and prayed he didn’t suffer some kind of infection. A week later, hope peaked around the corner as his count began to creep back up. Somewhere after Thanksgiving, Scott’s kidney’s got back in the game and he was taken off dialysis.

In the midst of the holiday season, Scott began suffering from the effects of chronic undernourishment. Lynn and I just could not get him to eat enough. His sense of taste was dulled and he felt full after just a couple bites. His weight continued to decrease and his mental acuity was diminished. One morning I was present for the Occupational and Physical Therapy assessment and I witnessed my big brother tumble over the edge into incoherence. The therapist introduced himself and asked Scott his name. My brother said, “Scott Savage,” then the therapist asked what month it was, and Scott, in his best cooperative patient voice, said “Scott Savage.” Then for several more questions, the answer was “Scott Savage,” as if it was the most obvious thing in the world. Something was very wrong. The nurses and doctor were alerted and scans were made. Was it a stroke? Was the cancer in his brain? Later in the week, The Captain, monitoring from her over-watch position identified his condition as a Thiamin deficiency. After a family meeting with the care team and social worker, he was started on IV vitamin B1. The next day, Scott was back on track and a feeding tube then became a feature of Scott’s daily life.

With the coming of the new year, the now laser-focused attention on nutrition resulted in Scott recovering enough to be transferred to the rehabilitation hospital, with the idea of getting his next round of chemotherapy as an outpatient. For eight days he was no longer a bed-ridden invalid, but rather a man who could sense an end to the inpatient experience. The optimism and progress was short-lived. After two days of nausea and weakness, Scott was transferred back to the main hospital for more tests and a higher level of nursing care. It was the setback we all feared.

New scans and new symptoms showed the cancer in more critical locations. Scott was now jaundiced, dry-heaving frequently, and breathing was labored. Cancer was now found in his skin, liver, and feared to be rampant throughout. His organs were shutting down. It was time to gather the family one more time. After an emotional conversations with the oncologist, Scott asked to be change to a ‘do not resuscitate” status. Time was getting short, and several folks had to fly in from distant locations. We all thought and hoped we had more time, maybe just another day, but when he let go of the rope, he went very fast.

In the early morning hours of January 20, 2024, my brother Scott succumb to the ravaging effects of cancer.