DV Journal

“You look like Jack Skellington,” Edward Hesketh, then a defense attorney in Trenton, told me as he rested his hands on my shoulders at the Courthouse Cafe.

I was as pale as the Pumpkin King. Moments before, I had collapsed walking from the Mercer County criminal courthouse, where I worked as a beat reporter for The Trentonian, a daily tabloid in New Jersey’s capital.

Mustering what little energy and pride remained, I scraped myself off the concrete and clambered over to the cafe to meet a colleague. It was Dec. 14, 2016. I was supposed to board a plane in two days to visit family in Albuquerque for Christmas. I never made it.

The emergency room doctor placed her hand on my leg, a small gesture of comfort that made the world of difference, as she delivered the bad news: My testicular cancer, first diagnosed in 2015, was back.

Cancer is a leading cause of death worldwide, claiming nearly 10 million people in 2022. An estimated 2 million Americans were diagnosed with cancer in 2024, with more than 600,000 dying from the disease, per the National Cancer Institute.

The death toll leaves me consumed with an inexorable sense of grief and guilt as one of about 18 million cancer survivors living in the U.S.

When I was diagnosed with late-stage metastatic testicular cancer, doctors gave me little hope of living beyond two years. A doctor told me he thought he was looking at a scan of the lungs of a dead guy after he walked in on me spryly drinking a Starbucks latte on the first day of chemotherapy.

I was told I’d need targeted radiation to get rid of small lesions detected in my brain. Somehow, those resolved without any radiation, even though I was told it was unlikely the chemotherapy would cross the blood-brain barrier.

These are the ghosts of Christmas past that visit me every year around the anniversary of my diagnosis. They come bearing gifts of gratitude, fear, and whispering what-ifs.

Cancer almost killed me, and in the process, it pierced my pseudo armor of invincibility. Before I was first diagnosed in 2015, the threat of cancer seemed remote. I was a healthy young man, presumably with decades in front of me, living naively assured of a life that wasn’t underwritten.

Then the cold, hard reality set in when I read those words — suspected neoplasm — while exiting the emergency room doors. The lyrics of Lupe Fiasco’s “Adoration of the Magi” greeted me as I got back into my car to drive home: “Why you ready to die? You just a baby. Why them tears up under your eyes? You just a baby. Keep your head up in the sky. You just a baby.”

My parents flew into Philly, and I had an orchiectomy a few days later to remove the affected testicle. I was back to reporting a week later, intent on hobbling into habeas corpus hearings and Miranda motions.

I lived for the machinations of the Mercer County courthouse, and 22 months later, I almost died outside those steps.

I spent Christmas 2016 at Thomas Jefferson University Hospital in Philadelphia with my dad.

The nursing staff and some friends brought the festive holiday spirit to me. One of my favorite nurses, Andres, gifted me with a small blue checkered blanket that I’ve since clutched onto like Linus from Peanuts.

Friends put up a small fake Christmas tree in my hospital room and wrapped gifts for me. Some pitched in to buy a three-course holiday meal from Morton’s Steakhouse for me and my father.

Beloved friends I made burning the midnight oil at Marron Hall, the tinder box of an office that housed the Daily Lobo, the University of New Mexico’s student newspaper, visited from far-flung places during my two-week hospital stay.

I was discharged a few days before New Year’s Eve to continue outpatient treatment.

I wanted to celebrate my release, so I invited some friends over for a brisket and to watch the ball drop with my parents at my apartment in Croydon, Pennsylvania.

But as midnight drew closer, I experienced a debilitating bout of bone pain, a side effect of a Neulasta shot I’d receive to prevent infections from having a lowered immune system between chemo sessions.

The exasperated looks of helplessness washed over my friends’ faces as I was doubled over in unbearable pain. The on-call oncologist prescribed a painkiller. As my dad went to pick it up from the pharmacy, my best friend, Esteban, crouched down next to my bed and clutched my hand. A small gesture that made a world of difference.

It’d take several rounds of chemotherapy, including a “salvage treatment” at the University of Pennsylvania Hospital that was part of a clinical trial, plus an RPLND surgery performed by Dr. Joel Sheinfeld at Memorial Sloan Kettering, to remove large, benign tumors from my abdomen before I was declared cancer-free.

I memorialized the date — Nov. 16, 2017 — on a decorative cutting board that serves as a memento of my miracle.

Every Christmastime, I make sure to re-watch “It’s A Wonderful Life” and reread Charles Dickens’ “A Christmas Carol,” because I resonate with the characters’ struggles in those holiday classics.

George Bailey, the strapping young man who was going to conquer the world. Scrooge, work-obsessed miser suddenly re-awakened to the gift of life. The Cratchits, representing love from family and friends that encircled me during my crisis. Tiny Tim, the rickets-afflicted young boy whose fate seemed all but sealed.

Clarence, the guardian angel whose gift of foresight shook George out of his stupor of self-pity.

I found my angels near and far. They were at Jefferson and UPenn, from the Rio Grande to the Delaware River, the Daily Lobo to The Trentonian.

“Remember, no man is a failure who has friends,” Clarence writes to George at the end of “It’s a Wonderful Life.”

Cancer didn’t kill me, but it left me wounded. I have tinnitus, a slight ringing in my ears, and peripheral neuropathy in my feet. Torrents of panic have sent me to the emergency room a few times, thinking my cancer returned. I had one a few days before writing this piece.

During my most recent visit, an orderly brought me a cup of ice-cold water after I got the all-clear from the doctor. He asked me if I felt better. Much better, I told him.

Friends and family of cancer patients often feel helpless. They can neither cure their loved ones nor control their outcomes. They’re left juggling their own fears, grief and anxiety while supporting the people fighting for their lives.

Sometimes I wonder who has harder roles to play — the person in the chemo chair or their loved ones sitting co-pilot. All I know is, in these moments, it’s nice to have hands to clasp the same way my loved ones held mine.

Small gestures make a world of difference.

The opioid epidemic is the one of most serious public health and safety challenges facing our commonwealth, as reflected by the fact that in 2021 we lost an average of 14 Pennsylvanians each day to an overdose.

Overcoming this crisis requires a multi-pronged approach to support those struggling with addiction. But the goal should always be to stop addiction before it takes root, and as a certified register nurse anesthetist, I believe that requires reevaluating our approach to pain management and looking at where we can lessen the use of opioids or prescribe alternatives where those exist.

Among the tools that could have a real impact on weaning patients off opioids are non-opioids. I know that sounds obvious, but the U.S. Food and Drug Administration is close to approving the first non-opioid pain treatment for managing serious pain.

Non-opioids address pain outside of the brain, eliminating the risk of a patient becoming addicted to the treatment. To-date, the drawback of non-opioids has been that they were not powerful enough to effectively treat severe pain. But successful Phase III trials have been really encouraging to many of us in the medical community.

Non-opioids for severe pain could significantly reduce the number of opioids that patients are prescribed, and in turn drastically cut down the rate of opioid addiction occurring across our country.

Such a monumental advancement in medicine warrants action, so it’s encouraging to see some lawmakers — including many in our region — are already taking steps to ensure these treatments are accessible to those who need them once they are granted final approval.

In Congress, the recently introduced Alternatives to PAIN Act would make non-opioids more accessible to seniors, a demographic which typically has a heightened reliance on pain management treatments, by ensuring that non-opioids are covered under Medicare, the federal program that tens of millions of seniors receive their health insurance coverage through.

Not only would non-opioids be covered under the Alternatives to PAIN Act, but the bill also would make sure they don’t cost more than generic opioids. This provision is necessary: No patient should be forced into using more harmful and addictive treatments because they’ve been priced out of accessing healthier alternatives.

State legislatures across the country are joining the effort to leverage non-opioids alternatives to their fullest potential. Some states are considering bills that would cover these alternatives under their state’s respective Medicaid program, while others are pursuing investments in educational materials that inform patients and doctors about the existence of non-opioids, as well as the dangers of opioids.

Pennsylvania’s General Assembly has yet to introduce legislation on non-opioid access or education, but there’s still time to do so. It’s urgent that our lawmakers in Harrisburg make this a priority.

Our commonwealth has been hit especially hard by this crisis, which is why it’s imperative that every Pennsylvanian dealing with severe pain has access to these groundbreaking new treatments once they become available to the public.

Each patient who can avoid an unnecessary reliance on opioids could be another Pennsylvanian spared from opioid addiction further down the road.

It’s crucial for Pennsylvania’s legislative leaders to proactively embrace these opportunities to make a lasting impact on saving lives within our commonwealth.

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