A Doctor Battles Cancer and Discovers What It's Like to Be on the Other Side of the Needle

Illness is a doctor’s daily fare, a constant but fascinating foe to be approached with a great deal of intelligence and carefully controlled emotions. That changes dramatically when it is the physician’s own body that becomes afflicted. Needles, probes and IVs, once the tools of his trade, take on threatening and violating qualities. The hospital, formerly a familiar and friendly workplace, becomes alien and cold. That has been the experience of 26-year-old David Hong, the only child of a foreign service officer father and a music professor mother, both now retired. Hong was born in Hong Kong and spent most of his youth in Asia before coming to the U.S. to attend New York’s Columbia College, where he met his wife, Mona, a music teacher. Hong did two years of graduate work in molecular biology at Texas Tech University in Lubbock before entering the University of Texas medical school in San Antonio in 1980. It was there, in February 1984, that Hong was diagnosed as having leukemia. Except for about 12 weeks spent at home, he has been confined to New York’s Memorial Sloan-Kettering Cancer Center. In his room Hong and Assistant Editor Bonnie Johnson talked about how this past year has changed his perspective.

I think every doctor should spend a few days in a hospital as a patient just to see what patients have to go through. When I was a medical student performing the same tests I’ve had, I would say to my patients, “It will stop hurting very soon. I’ll be as quick as I can.” But I was detached from it: “Oh, the patient is in pain but not too much.” You’d always say that. When you’re the one getting poked, though, it hurts more than you’d suspect.

I began to feel symptoms in October 1983. Despite a normal diet of very healthy food. ‘I started losing weight, and within three months I had lost more than 25 pounds. I was also very fatigued. In November or December I began developing fevers. I felt like I had a prolonged case of the flu.

I was in my last year of medical school, and we were allowed to take electives at other hospitals to see how medicine is practiced elsewhere. I spent the month of January 1984 here at Memorial. It was during that time that I really began to fall apart physically. The fatigue had become so profound that when I got home from work, I would just sleep until dinner. Then after dinner I would go right back to sleep again. I tried to diagnose my own problem. I had a couple of tests run on my thyroid, but the results were normal. I read up on ail kinds of obscure diseases, but it never crossed my mind I might have cancer.

When I got back to San Antonio at the end of that month, I went to the student health service and they ordered a battery of standard blood tests. I looked at the smear under a microscope with a pathology resident who was a good friend of mine. He adjusted the focus, and I said, “Joe, this is a leukemic blood smear.” He turned pale, and his voice had a perceptible shudder. He said, “Let’s not think leukemia yet. It could be a long-lasting case of mono or a very atypical form of flu. Let me take the slide up to a faculty pathologist, and we’ll look at it again.” But even before that consultation, I didn’t believe there was much question as to what the diagnosis was.

I decided immediately that I wanted to be treated at Memorial. During my month here as a student, I was extremely impressed. I felt I would get the best care. I checked in on Feb. 8, just 12 days after I had left.

I knew very little about leukemia at first. In medical school you touch on all subjects but not in great detail. My instinct was to hit the books immediately, but I had very ambivalent feelings. I was afraid of what I would find, yet eager to find out more about my disease. There’s no exact term for my particular kind of leukemia. It’s been called chronic myelogenous leukemia, or CML, but it’s an unusual form with a relatively poor prognosis.

Before, when I thought about the possibility of having a disease such as this, I believed I would be able to handle it in an intellectual sense and, because of my background, I wouldn’t be scared. It wasn’t like that at all. It’s not necessarily advantageous to be a physician, because if you hear a bad result, you know the implications. In my case I knew enough to scare the living daylights out of myself, but not enough to reassure me.

I asked a lot of questions when I first came. I had an IV, and I knew what IVs were for and I knew what this medication and that medication were for, but I’d still ask questions. That was my way of expressing my fears. Early on I was paranoid about whether they were dealing honestly with me, but I’ve become a lot more trusting. I realized nobody was trying to deceive me.

I’ve had the same primary physician in charge of my case since the beginning, but I’ve had many residents and interns. I feel very envious of them. There is the feeling that life is leaving me behind. It’s painful to be in this room for months at a time, look out of the window, see people and cars moving and to understand that I’m not part of that anymore.

Our next step is to try a bone-marrow transplant. The marrow is where all your blood is produced. I’ve had six different types of chemotherapy, and so far we’ve been only partially successful. We’ve never eliminated the leukemic cells, though we’ve always reduced their number. Eventually they come back. The object of a transplant is to use very high doses of chemo to eliminate all the bone marrow in my body—including, we hope, the leukemic cells, but also the normal cells. Healthy marrow from a donor will then be grafted into me. Ideally we should all have identical twins for donors. A second choice would be a sibling. But I have none; so my mother is my donor. We’ll begin the preparatory chemotherapy in a month or two. The reason for the wait is that my liver has sustained a lot of damage from the chemo I’ve had so far. They have to give my liver a chance to recuperate before they can try again; so I’m going home this week.

The first thing I’d like to do when I’m healthy enough is take a trip with my wife. We deserve some time alone. A prolonged critical illness will damage even the best of families. Many things have been positive about this experience though. It has taught me to appreciate my family a lot more. My wife and parents are here all the time. As for friends, some who I thought would visit twice a year are here twice a week donating blood for me; others I thought would be close, kind of disappear into the wind.

Though I treasure each day I’m given, there are times when I get very depressed. This past Christmas was one. Everybody was out, decorations were up, and I couldn’t help thinking: “Is this the last Christmas I’m going to see?” In elementary school I had to write an essay: What would you do if you had six months to live? I wrote that I would want to visit all my friends and relatives one more time and then travel and see parts of the world I’d never seen. I’d probably say the same thing today. But I don’t know if I have six months—or six years. Should I recover from this, I would focus my efforts on finding a cure for leukemia and other cancers.