Camp Angel, Summer 2014

It's summer again. Among other things, that means... Camp Angel! The camp this year was held from Friday, July 11 to Sunday, July 13, 2014. Here's what we did:

 

The Campers were divided into 4 groups:

Foxes (3 counselors and 8 campers -- girls, ages 10 to 12), that lived in the Treehouse

Wolves (2 counselors with 7 campers -- boys ages 10 to 12), that lived in the Tower

Bears (2 counselors and 9 campers -- boys ages 8 and 8), that lived in the Fort

Bunnies (2 counselors, 2 junior counselors and 8 campers -- girls ages 7 to 9), that lived in the Covered wagons.

 

So, if you're wondering what the 'special visit' was on the schedule of the first day at camp, it was... a visit from the local Harley-Davidson riders club. They bought cool biker bandanas for us all too.

 

My daughter, Bunnie friend and a biker

Camp Angel is a wonderful opportunity to have kids between the ages of 8 and 12 (well, some older and younger ones sneak in) to get away from cancer in their families and have fun. Although there are no formal or oganized events where kids talk about cancer, you catch snatches of conversation between kids. They realize that they are not alone.

campers, counselors and some of the bikers

My duaghter, our camp photographer and me in front of a bike

The campers had fun around the fireplace and sleeping cool camp sites.

 

The towers, where the Wolves stayed

The covered wagons, where th Bunnies stayed

  

Bunnies and bears waiting for their turn on the pirate ship

 

First group of campers getting into dock

  

Bunnies making bunny ears!

 

coloring shirts on the pirate ship



Captain Steve makes the BEST pirate drawings for your T-shirt, AARRR!

Phoebe drives us onward to find treasures... or unsuspecting ships to attack!

Can we get the swim tests over with so we can jump in?

Getting ready for tubing on the lake!

Hey! Wait, that's not where your slug goes! It's your bait for the fish....

 

Who says bunnies can't fish?

Yay! I got another one!

We're all ready to party! Where's DJ Dan?

Let's go to the Y-M-C-A! Yeah!

Do the macarena!

Note to self: do not compete in a limbo competition with 8 year olds, you won't win!

Camp Angel is loads of fun. More importantly, it is a great example of how to turn tragedy into a blessing to others. In 1995, after losing her husband to cancer, Lolly Rose noticed that children were often sidelined when a loved one of theirs got cancer. It broke her heart. She founded these camps for children touched by cancer in a loved one to be able to come up for a weekend in summer and winter. She took her personal loss and transformed it into an outpouring of love and support for other families touched by cancer. The camps are free to the campers and their families. For more information, go to http://angelonmyshoulder.org/

In memory of a young cystic fibrosis patient...

My heart is heavy with grief. A young man with cystic fibrosis died in the intensive care unit today. I have taken care of this young man as a patient for about 5 years. During that time, he has had several close calls and has spent a fair amount of time in the hospital. I last took care of him during a 33-day hospital stay in which I rounded on him every day. We would sit and watch WWF raw on tv (his favorite show). We talked about how when he got out, we would go to Madison to see an actual wrestling match -- the one they televised and that we watched. I promised to go. That is a promise I can never keep. I had sat by his side when his marriage fell apart and he wept bitterly. I had reassured him when he thought he would die and together, we fought until he lived to fight another day. He trusted me with his life. I felt that I gave him good care. This last time around however, he came to the ER when I was out at a children's camp. He was admitted directly to the ICU and sent off to a university hospital the following day. Within 2 days of getting there, the team decided that continuing agressive care was futile and with the patient's decision to give up, support was withdrawn. He died within the hour of withdrawal of support. I do not doubt that the doctors there gave him excellent care. I do not doubt that the decision was made competently. I do believe however, that they did not him like I did. One of them told me over the phone that he had no 'quality of life'. I told him how this young man had celebrated the 4th of July with his family and ate a barbeque. I mentioned how he joked and laughed and enjoyed wrestling on tv. He was surprised. In the end though, my patient, my friend, died. I feel the loss. His death reminds us that CF is an ugly disease that steals away the youth, vigor and ultimately the life of these young people. It leaves behind weeping parents, spouses and sometimes children. I take care of adults with cystic fibrosis. Some days between waiting for one patient to receive a lung transplant and the always untimely death of another patient, I almost want to walk away from this work ... almost. But I will not. I will fight it on every front with the anger born of loss. I will aggressively fight for the lives of my young patients and purchase every breath and every day from this relentless disease. What else can I do?

Doctor, I made you a comic...

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Makayla Schwantes is a wonderful 7 year old girl who made me a comic. I think she is a wonderfully creative and intelligent little girl. Thank you Makayla! (Thank you to her parents for letting me share this).





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"I miss her something terrible."

A daughter brought in an 85 year old man for an office visit. He and his wife lived on their own. The elderly couple had resisted every effort on the part of family to move out of their house into an apartment in a senior center or in an assisted living facility. Together, the frail couple helped each other with their medicines, activities of daily living and went everywhere together. His wife had crippling arthritis and was in constant pain. Finally, after 2 months in hospice, she died.

Here was the husband in my office, bereft, tearful and lost. He had lost his wife of 64 years. That is more years than I have lived.

"We went everywhere together, doc" he told me.

He looked up to me with tears in his eyes, his voice cracking as he said almost in a whisper, "I miss her something terrible."

There is no medicine, no pill, indeed, no answer to grief.

It's the highlight of my year!"

This 51 year old construction worker came in for his annual physical. His hands were rough and grease-stained. He was large, muscular and plain of speech and dress. While I did his physical exam, we talked. I asked him how his kids were. His face lit up when he told me this story about his 16 year old daughter:

"You know what the highlight of my year is, doc?" he asked me.

"No, what is it?" I replied, thinking he would tell me about his annual fishing or hunting trip, or a vacation.

" Every year, my daughter's dance class puts up a production of the Nutcracker. The opening scene has some adults dancing the waltz at a party. I always participate so that I can be on stage with my daughter. She usually plays one of the wind-up dolls later in the play."

"You dance?" I asked, as I looked into his ears with the otoscope.

He laughed. "Not very well. But I wouldn't miss it for anything."

"This year, they are going to let the actors, including my daughter play more than one role and I get to do the waltz with my daughter in the opening scene. Imagine! I will be able to dance with my daughter this year!"

His face beamed.

"The high point of my life is spending time with my kids and the Nutcracker dance with my daughter is the highlight of my year."

I love listening to my patients' stories and my heart was warmed and touched by this seemingly rough, macho construction worker's tender spot.

"She's worth it!"

I was seeing an 83 year old male for follow up of recent health problems. I asked him how things were going. He pointed out that he was a little tired. His wife (81 years old) was formally diagnosed with dementia. She had had a recent hospitalization for an acute illness and had been discharged to a nursing home. At this time, my patiet's eyes flashed as he told me, "I didn't like the place! They had her walking with a walker." I got her home and in 3 days, she was walking on her own."

He told me that now she was home, he had to watch her carefully -- in case she turned on the stove, or left a tap running. He did all the cooking, cleaning and helped her get dressed. Concerned about his health, I explained as sensitively as I could that there were options: he could have home health come and assist him ("I won't have strangers coming into my home to care for my wife!"), he could place her in a nursing home or assisted living facility where he could visit her often ("I will never do that!"). In the end, somewhat exasperated, I told him that I was concerned about his failing health and strength. In the process of sizing up the task of his caring for his wife full-time, I explained that it was a lot of work for one 83 year old man to do. He fixed his gaze on me and simple said:

"She's worth it!"

Changes

I was returning from the country of Panama where I had gone to attend my nephew's graduation from law school. As I was going through immigration upon entering the United States, the immigration officer and me had the following conversation:

"What do you do?" asked the immigration officer.

"I'm a physician." he answered.

He continued to look through my passport and at his computer screen.

"You know" he said, "I used to go to my doctor and have enough time to tell him about what was wrong and things I wanted to discuss regarding my health. The last time I went, I waited about 3 hours for my appointment and it felt like it was all over in 15 seconds. He didn't have time to talk to me! He had to rush because he was only given so much time per patient. He did not want to listen to my questions. He asked me to make another appointment for those.

"I went to the Cleveland Clinic and felt like the doctor there took his time with me."

Healthcare is changing. Some clinics stay afloat by using a 'production' model -- physician's salaries are based on how many patients they see -- the more they see, the more they get paid. Other clinics pay their physicians a fixed salary, regardless of the volume of patients they see. In the latter model, there must be some honor system that physicians will not be lazy and skip out on seeing patients. They do get to take the amount of time they feel necessary to meet their patient's needs.

I believe in addressing my patients' needs. So I run late. Oh well.

What is the answer?

QR Code link to References to Poster

Welcome to the link for my poster at the ASM 2014 Meeting.

I can be reached for more information at aswani.vijay@marshfieldclinic.org. 

References to Poster presented at ASM 2014

1. Abedon ST1, Thomas-Abedon C, Thomas A, Mazure H. Bacteriophage prehistory: Is or is not Hankin, 1896, a phage reference? Bacteriophage. 2011 May;1(3):174-178.
2. Summers, C. 1999 Felix d’Herelle and the Origins of Molecular Biology. Yale University Press. Page 55, 64
3. Summers, C. 1999 Felix d’Herelle and the Origins of Molecular Biology. Yale University Press. Page 64
4. Raettig, H. 1958. Bakteriophagie 1917 bis 1956, Teil I and II, Gustav Fischer Verlag Stuttgart
5. Raettig H. 1967. Bakteriophagie 1957 – 1965. , Gustav Fischer Verlag Stuttgart.
6. Brussow H. Phage Therapy: Quo Vadis? Clinical Infectious Diseases 2014; 58(4): 535-536
7. Hankin ME. Les microbes des riviíres de l'Inde. Ann Inst Pasteur (Paris) 1896;10:175–176.
8. Twort FW. An investigation on the nature of ultramicroscopic viruses. Lancet. 1915;2:1241–1243
9. d'Hérelle F. Sur un microbe invisible antagoniste des bacilles dysentériques. C R Acad Sci Ser D. 1917;165:373–375.
10. Summers, C. 1999 Felix d’Herelle and the Origins of Molecular Biology. Yale University Press. Page 82-96
11. Summers, C. 1999 Felix d’Herelle and the Origins of Molecular Biology. Yale University Press. Page 114
12. Chanishvili, N. A Literature Review of the Practical Application of Bacteriophage Research.Nova Biomedical Books, NY.2012. Preface.
13. Summers, C. 1999 Felix d’Herelle and the Origins of Molecular Biology. Yale University Press. Page 125-144
14. Summers, C. 1999 Felix d’Herelle and the Origins of Molecular Biology. Yale University Press. Page 158

[15] Abedon, ST, Kuhl, SJ, Blasdel, BG, Kutter, EM. Phage Treatment of Human Infections. Bacteriophage 1:2, 66-85. 2011

[16] Summers, C. 1999 Felix d’Herelle and the Origins of Molecular Biology. Yale University Press. Page 206

[17] Ruska H. Über die Sichtbarmachung der bakteriophagen Lyse im Übermikroskop. Naturwissenschaften. 1940;28:45–6. Ruska H. Über die Sichtbarmachung der bakteriophagen Lyse im Übermikroskop. Naturwissenschaften. 1940;28:45–6.

[18] Pfankuch E, Kausche GA. Isolierung und übermikroskopische Abbildung eines Bakteriophagen. Naturwissenschaften. 1940;28:46.

[19] 14

[20] Sanger, F.; Air, G. M.; Barrell, B. G.; Brown, N. L.; Coulson, A. R.; Fiddes, J. C.; Hutchison, C. A.; Slocombe, P. M.; Smith, M. (1977). "Nucleotide sequence of bacteriophage ΦX174 DNA". Nature 265 (5596): 687–95.

[21] Thiel K. 2004. Old dogma, new tricks—21st Century phage therapy Nature Biotechnology 22(1): 31-36. See Table 1 on page 35.

[22] Smith, Hamilton O.; Hutchison, Clyde A.; Pfannkoch, Cynthia; Venter, J. Craig (2003). "Generating a Synthetic Genome by Whole Genome Assembly: ΦX174 Bacteriophage from Synthetic Oligonucleotides". Proceedings of the National Academy of Sciences 100 (26): 15440–5.

[23] Bruttin A, Brüssow H. Human volunteers receiving Escherichia coli phage T4 orally: a safety test of phage therapy. Antimicrob Agents Chemother. 2005;49:2874–2878.

[24] Davison, WC. 1922T he bacteriolysaant Therapy of Bacillary Dysentery in Children. American Journal of Diseases of Children 23:531-534.

[25] Spence RC, McKinley EB. 1924. The Therapeutic Value of the Bacteriophage in Treatment of Bacillary Dysentery. Southern Medical Journal 17 (8): 563-571

[26] Larkum, NW. 1929. Bacteriophage From a Public Health Standpoint. American Journal of Public Health 19: 31-36

[27] Schultz, EW. 1932. Bacteriophage: possible therapeutic aid in dental infections. Journal of Dental Research 12: 295-310.

[28] Straub, ME and Applebaum M. 1933. Studies on commercial bacteriophage products. JAMA 100: 110-113

[29] Eaton MD and Bayne-Jones S. 1934  Bacteriophage therapy: review of the principles and results of the use of bacteriophage in the treatment of infections. JAMA. 103(23):1769-1776.

[30] Eaton MD and Bayne-Jones S. 1934  Bacteriophage therapy: review of the principles and results of the use of bacteriophage in the treatment of infections. JAMA103(24):1847-1853.

[31] Eaton MD and Bayne-Jones S. 1934. Bacteriophage therapy: review of the principles and results of the use of bacteriophage in the treatment of infections. JAMA. 103(25):1934-1939.

[32] Krueger AP and Scribner EJ. 1941. The Bacteriophage: Its Nature and its Therapeutic Use. JAMA 116 (19): 2160-2167.

[33] Krueger AP and Scribner EJ. 1941. The Bacteriophage: Its Nature and its Therapeutic Use. JAMA 116 (20): 2269-2277.

[34] Kutter, E., and A. Sulakvelidze. 2005. Bacteriophages: biology and applications. CRC Press, Inc., Boca Raton, Fla. Page 396.

[35] Kutter, E., and A. Sulakvelidze. 2005. Bacteriophages: biology and applications. CRC Press, Inc., Boca Raton, Fla. Page 398.

[36] Rhoads DD, Wolcott RD, Kuskowski MA, Wolcott BM, Ward LS, Sulakvelidze A. Bacteriophage therapy of venous leg ulcers in humans: results of a phase I safety trial. J Wound Care. 2009;18:237–243