In prior posts, I described coping strategies that sustained me during my treatment for acute myeloid leukemia. More recently, I noted factors beyond my control that nonetheless worked in my favor, including a privileged status, excellent care, and social support. Here, I describe additional factors that contributed to my survival.
One was generational timing. Put another way, my parents picked a good time to bring me into the world. As a baby boomer, I lived into my sixties before contracting a life-threatening disease that was incurable throughout much of the twentieth century. I am humbled by the fact that the stem cell transplant procedure that saved my life has only been available for a couple decades.
A brief history. The first successful bone marrow transplant occurred in 1968 at the University of Minnesota Hospital. A further advance came when French researchers transplanted stem cells from umbilical cord blood in 1988. The first successful cord blood transplant in the U. S. followed in 1995. The Blood and Marrow Transplant Unit at the University of Minnesota Medical Center has since become a leader in umbilical cord blood research and transplants. In the fifteen years before my diagnosis, they performed almost 1,000 such transplants and were routinely achieving successful outcomes.
As a beneficiary of this medical progress, my procedure began with a week of high dose chemotherapy and full body radiation that destroyed virtually all my diseased bone marrow and white blood cells. That paved the way for a genetically matched, umbilical cord blood transplant. The “transplant” is not a surgical intervention; it is simply a transfusion of donor blood that introduces new stem cells into the body.
Once there, the stem cells just “know” where to go to begin producing new bone marrow and all the cells needed for a healthy immune system. The umbilical cord came from one of the donor banks that have only been established in recent decades but are now available world-wide for patients seeking a cord blood donor.
In addition to this medical miracle, I also benefitted from some old-fashioned good luck. As a poker player, I have often pondered the parallels between playing that game and making life decisions. Both require acting with incomplete and imperfect information, and the stakes can be quite high.
If we draw on our rationality and intuition, we can assess the risks, calculate the odds, check our gut, and make the best decision at the time. In the case of my transplant, the “house” was offering odds any poker player would relish, but the downside was a 15-20% mortality rate from the procedure itself. So, I could expect to “win” at least 80% of the time, but otherwise, it would be game over.
That sobering scenario led me to take my time, do my homework, examine my options, get second and third opinions, and reach a measured decision to go ahead with the procedure. As good as such decisions may be, however, outcomes in poker and life are still subject to unpredictable and unknowable factors. For all our proactive efforts to control outcomes, it’s healthy to retain some humility in a universe that can still roll dice with our fate.