The Patient Will See You Now
1/18/2012 9:56:48 AM
 NEW ORLEANS - When neurologist Stephen Deputy is asked to show his identification, depending on which ID he displays, the accompanying photographs show very different phases of his life. On his LSU Health Sciences Center badge, circa 2007, he looks like a surfer with straight, long hair pulled back into a pony tail. But on his Louisiana driver’s license photo, taken in January 2011, there appears a bald man with a thin face, the skin pulled tight across his cheekbones and a coy half-grin on his face. Neither of these photos looks like the man to whom they belong. For today, Deputy has a head full of unruly curls. Because the cells that produce hair grow rapidly, chemo drugs may damage them, causing hair loss and, as in Deputy’s case, sometimes causing the hair follicles to grow back with a different texture than before treatment. The change in his coiffure is perhaps the only visible indicator that Deputy has transformed into a different person over the last five years. The only constant feature on each is the look of confidence.

"I feel like a different person now,” Deputy said of his life since his ordeal began. "I’m a lot calmer, a lot more patient with people. Life’s not moving so fast for me anymore. I’m not just trying to get to Friday each week.”

Deputy’s journey began with the discovery of a little bump under his jawbone. The bump would get a little bigger, then shrink, then get slightly bigger again. He went in for a couple of biopsies, but those didn’t reveal anything worrisome, so he didn’t do anything more about it. Then, about two years ago, it stopped getting smaller. It got bigger… and bigger.

"It was really grotesque,” he said, rubbing the spot beneath his chin where this life-altering alien growth, which he dubbed "Lumpy,” had once resided. In April 2009, he went to an Ear, Nose and Throat specialist who scheduled him for surgery. "I thought they were just going to excise a large but benign tumor, nothing to really worry about.” But after the surgery, the ENT doctor told him that he was dealing with lymphoma.

"Boom,” Deputy said, snapping his fingers. "From that moment on, I’ve been dealing with this.”

By "this,” he means the battle of his life. His war against his cancer began with an original diagnosis of Hodgkin’s Lymphoma. In January 2010, he temporarily moved to California to receive chemotherapy treatment at Stanford University. But the cancer cells failed to respond to treatment and instead spread very aggressively. His doctors at Stanford changed his diagnosis to stage IV T Cell Rich Diffuse B Cell Lymphoma.

Deputy began radiation therapy, which shrunk "Lumpy” very quickly. Soon his neck was free of cancer cells. But a PET scan at the end of his treatment revealed that cancer cells had spread to his spleen, liver and bones. He was put on a different chemotherapy regimen, and for the first time in his fight, his cancer went into remission. About a month later, his doctors performed a bone marrow transplant, in hopes that his body would again be able to produce the cells to combat infection through his revitalized immune system.

He documented his journey on a CaringBridge web log, which became his personal chronicle of the ups and downs of his fight against cancer, as well as personal observations from what he calls his "weird new life.”

The fight changed him, both personally and professionally. As he typed out entries on his blog, he found that expressing his deepest thoughts and emotions was therapeutic. He also received much support from people who left comments on his blog, including people he had never met.

"I stopped self-censoring when I was writing,” he said of his blog entries. "I wrote from the heart. It helped me tear down emotional barriers and changed my life for the better.”

Additionally, he found support among his colleagues at Children’s Hospital. The first person he spoke to after his diagnosis was Alfonso Vargas, MD, a pediatric endocrinologist at Children’s. Vargas was able to provide more than just encouraging words of support, for he had waged his own war against cancer a few years earlier.

"I had a retroperitoneal (behind the abdomen and around the kidney) B-large cell lymphoma diagnosed in March 2004,” Vargas said. "So I and my family had plenty of experience with the process, the dietary and the infection protection programs. I received chemotherapy for six months and literally was working only from home in a tailored sick leave.”

Deputy relied on the advice he received from Vargas, which included admonition on the need for vigilance to avoid getting infections while his immune system was compromised.

As he grew accustomed to entering physicians’ offices via the waiting room, Dr. Deputy learned to bring plenty to read to help him pass time awaiting his turn with the doctor. He sometimes spent as much as two or three hours in waiting rooms, feeling as if his entire life was on hold while he took this unexpected detour through the other side of the healthcare system.

He began to see several contrasts between the worlds of pediatric and adult medicine. "I found that things aren’t always well coordinated for adults,” he said. "If you need to transfer information from one facility to another, you can help yourself greatly by bringing it to the other doctor yourself. Also, I found myself making my own phone calls to coordinate my care. In pediatrics, I like to think we coordinate care for the kids a lot more thoroughly.”

From a clinical perspective, he now recognizes the importance of a patient seeing his or her attending physician as often as possible, keeping the lines of communication open between patient or caregiver and physician. "Even though your doctor knows what’s going on behind the scenes, you still need to maintain that ability to talk with them, to ask questions directly.”

His appreciation for the importance of communication impelled Deputy to evaluate his own bedside manner. "I’ve tried to incorporate that into my practice more now, to be more attentive to peoples’ needs. Even though I know what’s going on with the child, I’m trying to recognize the stress and anxiety of the parents a little more and appreciate it from their perspective, not just the medical perspective but also from the social and emotional perspective of the parents.”

Being a cancer patient also gave Deputy a feeling of camaraderie with the adolescent cancer patients he sees at work. "When I see a kid who is doing chemo or getting a bone marrow transplant, I really feel empathy for them,” he said. "I tell them I’m their ‘transplant buddy.’ I tell them that no matter how bad their day is, if they can ride out their treatment, there are better things on the horizon.”

As Deputy sits at his desk beneath a window with a view of the eastern edge of Audubon Park, his horizon looks good, too. Asked how he is feeling now, he erupts with proud excitement: "Yeah, I’m doing great!”

He is currently in remission and is optimistic about his future. And by fighting, he lost his fear of whatever the future may hold. "Having my mortality shoved in my face has helped me to enjoy the present a lot more.”
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