The Other Side of Tomorrow

I was a 33-year-old internist. Life had been good to me. Success, happiness, and love all came to me. It seemed as if it had been too easy, perhaps all too easy. A beautiful, healthy baby boy arrived. Life could not have been better. I had the best of everything.

In mid-1989 my fortunes changed. Slowly, imperceptibly, I began to grow weak. The least physical exertion produced tremendous left shoulder pain. I also developed migraines 2 to 3 times each week. Like all young physicians at a medical university, I attributed these symptoms to stress and lack of exercise and sleep. Their persistence, however, forced me to see an orthopedist, who diagnosed left shoulder bursitis. The neurologist diagnosed frequent migraines with aura and started verapamil. The symptoms relented somewhat by late 1989 but soon returned in earnest. My weight dropped 10 pounds. I was perpetually weak and tired.

My wife's birthday was on January 31st and I had intended to take her to dinner. My body had other ideas. I developed hemoptysis, fever, and phlegm. A simple pneumonia, I thought, or perhaps even tuberculosis, either of which needed only antimicrobials to cure me. All I needed was a chest radiograph to confirm my diagnosis. But, as the radiograph emerged from the processor, my pulse quickened and the acrid taste of metal filled my mouth. A large mass filled the anterior mediastinum and left paratracheal area.

I dashed from one benign diagnosis to another. I took the radiograph from the view box and walked outside. My physician-wife was in the hall and asked me how it looked. I could not look at her; I could only mutter that it looked bad. We went into the reading room and placed the image on the viewer. Squamous cell carcinoma of the lingula, was …