My “Near” Near Death Experience

Do NOT Be Afraid

Twenty-Five years ago, my “Near” Near Death Experience began. I had just been recruited as Professor of Ophthalmology by the Medical College of Wisconsin. The transition from my private practice had a number of hiccups and twists. It had been my routine (short sighted, as I later realized) to perform several outpatient procedures on Saturdays at my major hospital. On the Friday before one of those, I discovered something ominous. There was a distinct mass in my upper left abdomen. It was my spleen.

For a few months prior, I had noticed I was more tired than usual, but I passed it off on my hectic schedule. While I normally could run up and down the stairs (I usually took those instead of the elevator) I was winded more than usual. I also thought I may have looked a bit paler than usual. The recognition that my spleen was enlarged demanded an explanation, so prior to my outpatient minor surgeries the next day, I had a tube of blood drawn and sent to the lab. About 40 minutes later I was paged with the message “Panic values on Russell Gonnering”. Fortunately, I was near the end of the procedure and when I finished, I called the lab. Yes, the values were indeed a cause for panic. They didn’t realize than I was the “Russell Gonnering” (how could they have missed that?!). My red count was significantly low. So were my platelets. They were dangerously low. These are the small components of the blood responsible, along with certain proteins, for beginning the process of clotting.

I quickly called one of my friends and colleagues, Jake, who was a hematologist/oncologist. Another friend and colleague, Mo, a clinical pathologist, was also in the hospital. Mo was an extremely skilled specialist in bone marrow biopsy, and an hour later I was on the treatment table undergoing the procedure.

As I awaited that, I kept on thinking, “It wasn’t supposed to end this way”. I had too many plans, too much to do. But I was immediately faced with the weighty possibility that those were never going to be accomplished. Mo went over the preliminary results as soon as they were available-about an hour after the procedure. I had leukemia….The words were shattering. But Mo said there was a bright side. I will forever be thankful to Mo, who has since passed on, for giving me some hope…expressing some genuine humanity… at what had been an awful shock. Mo was like that. He was a terrific pathologist, and he was a wonderful physician and human being.

My leukemia was “Hairy Cell Leukemia”, so named because the cells looked like they had hairs sticking out all over. I imagined the members of the band, ZZ Top, and almost smiled. If one was to have leukemia, Hairy Cell was perhaps the most favorable.

It is one of the rarest of the leukemias and patients who contract this seem to be centered in an area around the Great Lakes. I found out later that at least 2 other physicians in Wisconsin, roughly my age, were facing this at the same time as I was. Strange…we had no other common link. I recall an episode a few years earlier where I had a weird viral infection. I came back from the hospital exhausted on a Saturday, fell asleep and didn’t wake up for almost 24 hours. I wondered if that had something to do with it, as the Epstein-Barr virus is found in many patients with the disease.

Then the hardest part of the day came. I had driven myself to the hospital in my ¾ ton Dodge Pickup with a manual transmission. After the bone marrow, even though it was done without sedation, I was in no condition to drive myself home. I had to call Sandy, my wife, to ask her to drive me home.

It as the day before our 29^th Wedding Anniversary. She answered the phone in her usual cheery self and proceeded to talk about the plans for the next day. I had to gently interrupt her to tell her the news and ask that she pick me up. I don’t know how she did it, but the strength and courage of that lady never ceases to amaze me. No panic. No going to pieces. Just a simple statement that we would get through this and she would be right over.

That weekend was, well, horrible. We had to plan so many things. I needed to find somebody to care for the patients I had scheduled for the next weeks. We had to tell our adult children (our youngest would leave for college in a few weeks). I had to tell my parents of the situation. I certainly could never have done it without the sure, strong support of Sandy.

I had a dream that night. I was walking, alone, on this stone road up to an imposing gate in a wall. Nobody else was around. The gate was closed. I got to the gate, but somehow it was communicated to me that it was not time for me to enter…

A few days later I entered the hospital for the start of chemo. I was to have an agent called Cladribine, a purine analog that would be taken up by the malignant cells and poison their DNA replication. The cells would die and burst, releasing a tremendous amount of protein and I needed to be continually hydrated with IV fluids to wash these products into my kidneys and out. I had a triple lumen PICC (Peripherally Inserted Central Catheter) inserted in my upper arm into my heart. No pain but had to be done under radiologic control.

I met many of my fellow physicians in the wheelchair as I was wheeled into radiology where it was inserted. A cardiac surgeon asked me if I was in for a kidney stone. When I said leukemia, he really didn’t know what to say.

Perhaps the hardest part was the reception by one of the nurses. I frankly can’t imagine how she kept the job she had. She proceeded to enumerate all the awful things that would happen to me over the next few days. I would probably get shingles. I may get a fatal bacterial infection, etc., etc. I was absolutely shell-shocked. Thankfully Sandy was not there to hear this. As bad as this nurse was, she had an angel counterpart, whom I would describe a bit later.

I started the chemo in the afternoon, and true to form, I was feeling much worse the next morning. My blood counts had dropped, the red cells and the white cells and platelets. Those were now around 15,000 and I could spontaneously start bleeding. The white cells—those that fight infections—were also dangerously low. And I needed red cells to carry oxygen, so I needed the first of many blood transfusions.

A wonderful caring and attentive student nurse started the transfusion and about 30 seconds into it, I realized something was very, very wrong. I started getting hives. I was having a transfusion reaction. She was concerned, but protocol indicated most of the times things improve, so she didn’t stop it. It got worse and I pinched the line and said it has to stop or something very bad will happen. She stopped.

I called Mo, the wonderful clinical pathologist who had done the bone marrow biopsy. He listened to my description and said they would wash the cells, pretreat me with prednisone and all should be fine. Bless you, Mo! You were right. No further problem with any of the multiple transfusions I had.

However, another of the pathology staff came up to my room later, when Sandy was present, and told me I should not have had that reaction (but I had!). He wanted to give me the next transfusion and be there to observe what happened. I thought he was joking. He was not. Not every physician was like Mo. I imagine he was right at home during COVID. I of course refused his idiotic request.

There were some very dark days that first week. I started to have fevers at night and thought they were related to an infection. As it turned out, they weren’t. Later I found out they were a normal result of the chemo, but nobody thought to tell me, so I kept wondering if every fever would be the end. Fortunately, as horrible as the day nurse was my first day, the night nurse was a true blessing. She would give me an ice pack, and the fever would decrease. She would sit with me and talk. She was wonderful, and I told her and administration that fact.

I found out that I had high titers of Toxoplasmosis in my blood—probably related to the pet cats we had when I was growing up. That organism was probably still in my body but held in check by a normal immune system. But my immune system was not normal…As an ophthalmologist, I knew that if there was an organism in my eye, and it escaped immune control, it could be very serious.

There were some bright spots, though. I read the 23d Psalm: Though I walk through the valley of the shadow of death, I will fear no evil. As I read those, I realized, “Hey, I am IN the valley of the shadow of death now, and I really don’t fear it! I may not want the process of death to be messy, but I don’t fear death itself!”. That was, and continues to be, an incredibly liberating realization. Death had lost its sting, as I knew where I would go. Unless you are actually there, it is just words. BUT I AM HERE TO WITNESS IT IS REAL!!!

I also had an “interesting” interaction with, I firmly believe, an angel. It was @4 AM and a blood-drawer came to draw the innumerable samples I had. No wonder I needed transfusions! Why do they do it at 4 AM? She was an ebullient Black lady with a smile a mile wide. She saw the Bible on my table, and we engaged in conversation. I don’t remember the exact content, but I do remember I felt a profound sense of peace after the visit. The next day I wanted to thank her, but when I described her, there was no phlebotomist who matched her description. Not on duty that night. Not employed anywhere or anytime with the hospital!

The week of chemo finally was over, and I was discharged. Ceilidh, our little Border Terrier, would come up on the couch and literally sit with me for hours. She seemed to somehow know what was going on.

I didn’t suffer horrible nausea or loss of hair or anything like that, but for years, I felt something was just off. Sandy would try to find food that I liked. I had this craving for Dinty Moore Beef Stew, but when the plate would arrive, I couldn’t eat it. I was prescribed an anti-fungal that literally needed to be taken with Cola. Imagine that. I lost about 30 pounds. I was re-admitted twice because of high fevers. No cause found. Eventually it was chalked up to just an effect of the chemo, but each time I thought it was some deadly sepsis.

Multiple visits. Multiple blood tests. Multiple repeat bone marrow exams went on for a few years. I went back to work six weeks after I was discharged. I didn’t really start to feel “well” for about 2 years. There were some lasting effects: I lost all my earwax! Those cells just died and never came back. One of the antibiotics I was on destroyed part of my hearing. Not much, but enough to sometimes be annoying. And always, in the back of my mind, was the realization that I wasn’t really “cured” but was in “clinical remission”. Hairy Cell Leukemia is never really cured…I have abnormal cells still lying dormant. But I have come to grips with that.

It has been 25 years. I wouldn’t be honest if I said that it didn’t leave its scars, physically and emotionally but on balance, I probably got more than I lost. First, I know what it is like to be on death’s door and not be afraid. Psalm 23 and the whole of the Bible is true, and those who do not take advantage of the Gift of Salvation are really missing quite a bit. I know that when I am facing that Door again, and unless we are Raptured, I will be there again, I will not be afraid. I hope I can convey all who read this of that fact, for it makes all the difference. Believe me.

Secondly, I am so very thankful for the love of Sandy and my family. Many people were praying for me, and yes, I could feel it. It made a difference. Never, never, NEVER discount the power of prayer!

Thirdly, the experience really helped me as a physician. When I spoke with a patient who had a serious disease, I really knew what they were going through. Sometimes there was nothing I could do to help them, at least physically. But I always had something to offer. Even if their bodies were broken and could not be repaired, I could share my firm knowledge that to those who know the LORD, there is always hope. It’s not a myth. It is more real than anything we experience here in our earthly existence.

Lastly, as time goes on the magnitude of the experience tends to dim. I guess it is only human. So, I must constantly remind myself of the Goodness of the LORD and thank Him for loving us so much.

This is a change from my usual substack, yet it may be the most important one I have ever written. If you find yourself facing that Door and are confused and maybe scared, call me: 262-389-8702. I’ve been there….