He has seen cancer from both sides now
'Delivering bad news is a lot harder now," said Joshua Kanter, a cardiologist at Children's National in Washington, D.C., whose work sometimes involves the smallest, sickest hearts. "I like to think I always did it well, but there's a visceral part of me that understands what a family's going through like I never did before."
That is, like he never did before July, when cancer was diagnosed in his youngest child, Judah.
The Rockville, Md., kindergartner, who just turned 6, has the most common form of childhood cancer: acute lymphoblastic leukemia. His prognosis is good - there is an 85 percent success rate - and when I met him last week, he was pinballing around his hospital room at Children's, his IV no impediment to his freewheeling energy.
Judah has been known to perform a "chemo dance" - hopping around singing "I'm getting my chemo! I'm getting my chemo!" - when arriving at Children's.
"He does tend to get a lot of attention and toys," said his mom, Mara Kanter, of his stays in the hospital. (Brother Noah, 10, and sister Yael, 8, come to visit occasionally.) "He enjoys talking to the nurses and the staff and the doctors. He does ask a lot of questions. And they just make him feel special and important."
Judah has gotten quite an education. He knows what his chemo drug, methotrexate, is supposed to do. ("Kill the leukemia cells," he said.) He knows that saline syringes make good squirt guns.
"That was really important to me, that we not dumb this down for him, that he be a real active participant," said his father. "I think it's made it much less stressful, much more comfortable for him."
In lymphoblastic leukemia, bad cells replicate uncontrollably in the bone marrow, crowding out healthy cells. Chemotherapy - Judah has had four intense sessions over six months, to be followed by two and one-half years of outpatient treatment - wipes out the rapidly dividing bad cells, giving stem cells space to create more healthy cells.
Kanter said that when it comes to having a sick kid, being a doctor is a double-edged sword. On the one hand, you understand a lot already. On the other, that makes it even easier to scare yourself.
"You did decide you weren't going to read all the literature," Mara said to Joshua.
"When you have implicit trust in the doctors taking care of you, I didn't feel that was necessary," he said. "The literature has a lot of reassuring stuff and a lot of scary stuff. And I didn't need that."
Judah's oncologist, Anne Angiolillo, director of the hospital's leukemia and lymphoma program, said it's an honor to care for any child, regardless of who their parents are.
"Think about it," she said. "These people leave home, pull out of their driveway and come to the hospital thinking their child just has bruising or is constipated or has a little ache or pain, and within hours, sometimes within minutes, they find out their child has cancer. Someone is putting their most precious life in your hands."
When it's a fellow physician who does that, she said, "it resonates even further in my heart."
Kanter has always understood in an abstract way the effect his words must have on concerned parents, but now he has a special appreciation of life in the valley of sickness.
"I don't know that I'm tangibly doing anything much different, but I'm definitely more aware," he said. "It's empathy. What's empathy? It's being able to put yourself in someone else's shoes and understand what they're feeling. I get it."
John Kelly writes "John Kelly's Washington" for the Washington Post, a daily look at Washington's less-famous side.
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