A Life Well Lived

Posted by & filed under Beating the Beast.

Rodney Warner

Rodney Warner

I was treated for cancer, and seen for post-treatment follow-up, at six hospitals in five cities in three states. I had six treating physicians. Through good and bad, I enjoyed the company of my doctors. I learned their idiosyncrasies, like: Dr. Firshein’s dry sense of humor; the fact that Dr. Cooper wore penny loafers, khakis and blue oxford shirts every day and the fact that Dr. Salner could spend five minutes apologizing for the fact he was five minutes late.

I was living in West Hartford, Connecticut, when I received an allogeneic bone marrow transplant for relapsed Hodgkin’s disease at Tuft’s Medical Center in Boston. My treating physician there was Dr. Ken Miller. After about a month, my wife and I moved back to West Hartford and for a time I was seen by Dr. Miller and a local hematologist/oncologist, Dr. Peter Tutschka (pronounced TUSH ka). I saw Dr. Tutschka from about June 2003 to September 2004, when I moved to Pennsylvania.

Last night, while writing my previous blog, I learned that Dr. Tutschka died last year. I knew back in 2004 his health wasn’t great (due to heart problems) so the news wasn’t a shock. It has left me in mourning though, because he was a very special man of immense intelligence, skills and desire to help others. He was also one of the most interesting people I ever met. Over the span of his career, he probably helped save thousands of lives, maybe hundreds of thousands as time goes on.

According to his obit, he was born in 1945 in Czechoslovakia of German parents. As an infant, he spent time in Germany in a relocation camp and contracted polio when he was five. He came in first in a country-wide examination and was considered Germany’s top young scholar in 1963. Tutschka went to college, medical school and earned a PhD (he told me her studied the effects of stress on the immune system by doing “terrible things” to monkeys).

Dr. Tutschka was a pioneer in the field of allogeneic bone marrow transplants (BMT’s). He joined Johns Hopkins University School of Medicine in 1971 and later became head of the hospital’s bone marrow transplant unit. He told me he was at a conference in Europe where he had dinner with a friend working for a Swiss pharmaceutical company. The friend told him they had hoped a new drug called cyclosporine would be a miracle antibiotic, but it was a flop. Dr. Tutschka was interested in it and smuggled into the U.S., a sample with which he began to experiment.

In hindsight, it’s no surprise cyclosporine is a lousy antibiotic. Because of Dr. Tutschka’s research, it was found to suppress the immune system and has been used by thousands (tens of thousands?) of BMT patients.

If you’ve never had the pleasure of having a BMT, you may wonder why someone dealing with cancer would want to suppress their immune system. BMT’s are used for some kinds of blood related cancers. They’re for those of us whose cancers haven’t, or won’t, respond to chemo or radiation.

Our bone marrow is either destroyed or heavily damaged (by chemo and maybe with radiation too), dies off and is replaced by donor cells (either bone marrow or blood stem cells). These cells migrate into bones, ideally start functioning and creating cells of a new immune system.

Blood related cancer cells express certain proteins which make them especially vulnerable to donor immune system cells. You need to have these immune cells active enough to kill cancer cells, but they can misbehave and also kill healthy cells, like those in the skin and digestive system (graft vs. host disease). Right after the procedure, BMT patients are put on immune suppressant drugs and gradually taken off them (unless something bad happens, like the cancer progressing or an infection (dose may be reduced) or there are signs of serious graft vs. host disease (dose may be increased)).

After a BMT, your body is like a party and your donor immune system are the guests.  You want them to have a good time and maybe get a little sloppy (and kill cancer cells) but not so crazy that they start busting up the furniture (graft vs. host disease). Cyclosporine, and later drugs, is used to keep the guests in line. Without this control, it’s much more likely the patient will die of either the cancer, infections or graft vs. host disease.

Dr. Tutschka left Johns Hopkins and later went to the medical schools at Ohio State University and the University of Connecticut, then to St. Francis Medical Center in Hartford when I saw him. Over the span of his career, he either authored or co-authored over 200 medical journal articles.

While seeing Dr. Tutschka, we often had time to chat. We talked about cancer and BMT’s but also what it’s like to practice medicine and treat cancer patients. We talked about his time as a doctor in the German army (he said there was a draft and he really didn’t want to be in the army, and the doctors were not the most military group). I learned that not only was he a musician (able to play the piano and organ) but he had built (from a 16th century design) his own harpsichord.

We also talked about his experience teaching medical students and after learning how brilliant he was, how well he worked with patients and just the vast amount of wisdom in his head, I thought the world would be better off if he stopped seeing patients and just trained doctors, if he could just download everything in his head so other doctors might be nearly as good as he was.

It doesn’t work that way, and according to his obit, Dr. Tutschka wanted to do it all, treat patients, teach and do research (while building a harpsichord in his spare time).

There are people out there who are as smart and dedicated as Dr. Tutschka, but not nearly enough are as completed devoted to helping others as he was. He was an immensely gifted man who used those gifts to save, or at least prolong, the lives of others with grace and compassion. You couldn’t ask for a better doctor.