Tuesday, October 16, 2012

JoAnne - Closing Chapters - Dear Dr. Ustun

In the days following JoAnne's death, I swapped emails and talked with Celalettin Ustun, MD who served as her primary transplant physician. I wanted to make sure that it was included in the record. A pdf copy can be found in Dropbox.


Dear Celalettin,          June 21, 2012

Thank you for sending me the e-copy of the paper detailing JoAnne's ofatumumab experience. Several days ago I went online to track it down but found that I would have to pay $50 for a one-day access.  I figured that as contributing author, you would have ready access. During my career, I spent a lot of time reading, analyzing and data mining the medical literature so the value of the paper is not lost on me at all. I find it to be a very unique and poignant keepsake of our transplant voyage. I would like to get hard copy reprints to include in our family history and will make a note to contact you once the article is hard copy published. 

Now to the more important. Please accept my apologies for not responding to your voice mail message of condolence sooner. I listened to it in a timely manner, but have found it challenging to craft a proper response. The sadness and sorrow that came through in the tone of your message has left me quite humbled.

I often recall the first time that JoAnne and I met with you. She, of course, was at a critical and anxiety provoking crossroad in her life. We had talked to friends and colleagues with some familiarity of the University program. We had it in our mind that Linda Burns was the doctor for us. She was leaving for an extended period however, so we decided to meet with Celalettin Ustun, the physician relatively new to the UMn BMT program, assigned to us upon referral. As we gained a better understanding of how the transplant would unfold, we became more comfortable in your hands.

It did not take long for both of us to realize how fortunate we were that our paths crossed. In the final summation, I can say it no better than JoAnne and I saw it as a God given blessing that we were invited to travel the SCT trail with you as our guide. In time, we learned of your genuine compassion and empathy for JoAnne. We were comforted by your forthright approach to the challenges that seemed to endlessly confront her. Our spirits and confidence were boosted by your introspective manner and the way you would be considering the options for JoAnne's treatment whether we were in the same room together or after you had gone home for the evening or weekend.

In all honesty, I was not brimming with confidence when JoAnne began the transplant process. Early complications dimmed my outlook further. Over a few months however, I watched you and the BMT squad repeatedly rescue her from precarious settings. Our confidence grew and our outlook for the future began to fill with optimism. Even when that heinous Richter's Transformation descended upon her, we found hope and ultimately success against the cancer in your knowledge and skill.

On June 5th, JoAnne finally let go of the rope in her lengthy tug of war with CLL. She is at peace and no doubt smiling as she did throughout her life. It was a sad day for all of us who cared for her, and I am sure an additionally exasperating day for you. When I look at the statistics, the odds are very long that a beautiful young woman in her 40's should be stricken with CLL. The rarity of a Richter's Transformation at the point of her transplant seems almost incalculable. For it to be detected and effectively treated is highly implausible. And then to suffer demise at the hands of infection and GVHD. I will struggle for a time as to whether we should have opted for transplant sooner, but one must ask whether JoAnne's spirit and compassion were finally more desperately needed elsewhere. She had completed her mission on earth and resides now as a citizen of a better place.

You may be aware that during JoAnne's transplant, I maintained a blog so that friends and family could be kept up to date on her progress. It was also cheap therapy for me. I wrote a letter to Kathy and I hope that you have seen it. It conveys more of my feelings about the UMn BMT team. I also posted about the Captains of the Ship  I hope these messages convey the depths of our gratitude. There are numerous other messages and pictures as well. While you are a highly trained man of medicine, in our experience, you are first and foremost a kind-hearted human being. I am sure there are days when the challenges of your work and life can become discouraging. I recognize that you are a busy fellow, but it might not hurt to keep handy a bookmark to the blog. While the ending is sad, JoAnne waged a valiant effort against her CLL while surrounded and supported by the fellowship of loving, extraordinary people including you and your team. She lived a life that honored God and inspired others to more highly value life and living. There may be times when her memory can serve as reminder of the powerful and positive impact you have on lives.

On July 14, we will conduct a Saturday evening memorial service and reception to celebrate JoAnne's life. If your schedule allows it, please consider joining us. Additional details will be sent in the coming days.

In the interim, here is wishing you and your's God's blessings and continued fulfillment on your journey. Give your wife and those two bright-eyed young boys a special hug on JoAnne's behalf when you get home tonight. She was all about kids and family.

Peace,   

Kevin Petersen
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And the Beast Goes On 

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