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Reflections on a Bone Marrow Transplant
I am 63 years old and have been living with chronic lymphocytic leukemia for more than 7 years. Two years ago, progression of symptoms and a worsening hematologic profile despite chemotherapy forced me to make an important personal decision regarding whether or not to receive a bone marrow transplant. As a physician, I knew that transplants for chronic lymphocytic leukemia were controversial and not based on rigorous, controlled studies. It would be risky and difficult, but there was still so much I wanted to do, including living long enough to play an important role in my grandchildren's lives. I chose to go ahead.
After 10 months of chemotherapy, my response was good enough for me to qualify for an autologous transplant. At first I rejoiced, but joy was replaced by anxiety and doubt. Many of those around me—including my physicians, friends, and family—assumed that I, as a physician, had more insight into the proposed therapy than I actually did, heightening the isolation of my decision.
In December 1998, I was admitted overnight for the bone marrow harvest, and the following day I was readmitted to the transplantation service. My room was small and had a special air lock to prevent hospital-borne infections. My wife and any other visitors had to wash and put on a mask and gloves to enter the room. I could leave the room and wander in a tiny hallway only if I put on a mask and gloves. At first, I did not realize how physically and emotionally isolating this space would become.
My therapy started immediately with a double-lumen Hickman catheter. Many of the staff addressed me as “doctor,” which made me feel special. Initially, I played the role by checking the doses of medications, but quickly I found playing doctor-patient to be a struggle. …
