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Alumni Essays

When the Tree Mattered More than the Forest

Rayna M. WeiseRayna M. Weise

Despite being a cancer epidemiologist, I learned more about cancer than I ever could from textbooks, published articles, and my own research when my father was diagnosed with stage II bladder cancer. My father was resistant to a reduced quality of life that would result from standard therapy, radical cystectomy; he opted for radiation therapy only. A year later, he started to have severe abdominal pain. His cancer had spread. 

As I sat with him and his oncologist, my heart broke as he expressed a desire to do whatever it took—surgery, chemotherapy, lifestyle changes—only to be told that surgery was no longer an option and that he wasn’t healthy enough for chemotherapy. What ensued was what I saw as a failure to provide patient-centered care. While he was poked, prodded, and operated on, his health declined and it was difficult, if not impossible, to get any straightforward information from the hospitalist overseeing his care. Perhaps as a means to make room for other patients, he was transferred to, of all places, a rehabilitation center. By the next day he was in the ER with a blood glucose level of nearly 500 mg/dL. We contacted a hospice and decided to bring him home, confident we could provide the kind of care he needed. Only after we arranged this were we told my father had less than a few months to live. Though angry at the time, looking back I realize how hard it must have been for the physicians to admit “defeat.”

My two brothers had flown in to help and between them, my husband, my mother, and me, we were able to give him round-the-clock care and lots of love. The hospice nurses warned us that he was a “stoic patient” and that we’d have to watch carefully for signs of pain since he might not express his discomfort. I will never forget an exchange between us as I was giving him medications through his jejunostomy tube. He insisted that he didn’t need his scheduled dose of morphine, but when I pressed him quietly, he nodded ever so slightly so nobody else would know. Even in his final days, he wanted to spare us from his own suffering. 

If not for him, I don’t think I would’ve become an epidemiologist. He encouraged my interest in math and science. While other girls got dolls, I got chemistry sets. Instead of taking dance lessons, I took after-school math classes. He pushed me to excel academically and was so proud of me when I finished my MPH. (I was the first in the family to earn a graduate degree.) He was even prouder when I started my PhD at Hopkins, but I will always regret not finishing it sooner.  On the morning of May 10, 2011, my father passed away while he slept.  Two months later I successfully defended my dissertation.

Rayna Weise, MPH, PhD '11.



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