The Tribune

By DR KENNETH KEMP

Over a hundred years ago, life was remarkably different from what it is today. Among the many staggering differences is that life expectancy for white Americans during the early 1900s was just 48 years old. Conversely, African Americans during the same time period could expect to only live to age 33. All the more disturbing is that one in four children died before the age of five. Former US President Theodore Roosevelt was horrified by this and spent most of his political career campaigning for the improved health care of Americans.

President Roosevelt’s unique sensitivity to healthcare can likely be attributed to the debilitating asthma that afflicted him throughout most of his childhood. Despite breathing struggles that would have brought a less courageous man down, Roosevelt served as governor of New York for two years before being appointed to serve as Vice President under President William McKinley. Just six months later in 1901, at the age of 42, McKinley was assassinated and Roosevelt became the youngest president in American history. With a commitment to improving health care, he served for eight years and to this day remains highly regarded as one of America’s greatest presidents.

Decades later and thousands of miles away, my patient (hereafter referred to as) Toni had no idea that she and President Roosevelt’s life would share anything in common. Born in Nassau in 1955, Toni spent most of her childhood summers in Abaco. On Saturdays, her grandmother, like most island grandmothers, baked bread and while it was still hot, she’d spread jam on top made from the guavas picked the week prior, ripened on the stem and bursting with flavor. Toni ate slowly and respectfully, licking the jam before taking each bite and smiling as her toes wiggled. Unlike President Roosevelt, Toni’s childhood was full of freedom and free of illness.

When she was 16, she met her future husband (hereafter referred to as Marvin) at the general hardware store where he worked. Marvin’s sister and Toni were friends and from that day forward, their lives became inseparable. They dated for two years before getting married. Eventually they had two daughters (and now three grandchildren) and for a while they even worked together in different departments at the same dealership.

As they got older, Toni remained vigilant about getting annual medical check-ups for both her and Marvin. This proved to be life-saving because when she was 27, Toni was diagnosed with kidney problems sustained during a fall but it fortunately improved without incident under the supervision of her family physician. Then, when Marvin was diagnosed with pulmonary fibrosis in 2011 and given five years to live, she became especially more mindful about monitoring their health and well-being. As the years passed, both Toni and Marvin grew more grateful for every year he proved the prognosis wrong. 2016, 2017, 2018 and then in 2019, it was Toni who was in for a sudden shock when during a routine medical check things took a dramatic turn.

While vacationing in Cat Island for her 64th birthday, Toni received a phone call from her doctor asking her to return to Nassau immediately for more tests, his lack of detail leaving her to imagine the worst. Two days later, she underwent a breast biopsy and it was confirmative for cancer. Toni was devastated and it was Marvin who held her hand and supported her from collapsing in a state of shock. Two weeks later, Toni underwent a right breast mastectomy and was discharged from the hospital the same day.

She had a drain inserted at her surgical site but was advised to move around as much as possible. So, when her sister-in-law invited her out for lunch a few days later, she happily accepted. It was refreshing to spend time with family out of the house. They were having a really nice day until the moment Toni stood up after eating and nearly lost consciousness. Her head started to spin. She was sweating profusely and became notably weak and light-headed, the fear in her eyes prompting her sister-n-law to call Marvin who was, fortunately, nearby. Meantime, as he was making his way to the restaurant, Toni’s feet were swelling by the second and turning the most shocking blue her sister-in-law had ever seen on a human.

They sped to the hospital. Toni’s heart was racing and she was desperately afraid of what was happening to her. It hurt to move. It hurt to breathe. Many things flashed through her mind but most of all, she thought of her children and began to cry. At the hospital, doctors examined Toni and her intense chest pain led them to believe that she had a heart attack. It wasn’t until she mentioned between breaths that she’d had a surgical procedure nine days prior that their expression changed.

Toni was taken to have a CT scan and based on those results, she can recall her doctor telling Marvin that she had more blood clots throughout her body than anyone he’d even seen clinically or read about in a medical journal. He told them to prepare for the worst because in all likelihood, she wouldn’t survive the night. The multiple pulmonary embolisms, or blood clots, that now littered her chest as diffuse as specks of sand on a beach created severe arterial blockages within her lungs. The situation couldn’t be more dire.

Certain cancers increase the risk of blood clots, while chemotherapy and surgery further increase this risk. Toni flat-lined before being resuscitated and transferred to the ICU. Marvin could barely get the words out, his throat was so tied in knots, but he asked, then begged Toni’s doctor if there was anything they could do to save her life. The physician said they could go in and surgically remove the clots using a catheter but there was a 50/50 chance that she’d die on the operating table. The risk was high, but Marvin and Toni agreed to the surgery because at that point, Toni felt like she had nothing to lose.

Contrary to all expectations, the operation was successful. Toni survived the night and another surgery a few weeks later when a vein filter had to be inserted. Her pulmonologist told her that God saved her life and it was an absolute miracle that she was still alive. Toni’s had 25 sessions of radiation and since then has been on chemotherapy meds and anti-coagulants.

Toni is grateful for the care she received from her oncologist and pulmonologist but she tears up when thinking about the overwhelming love and support she received from her husband - the gentlest and kindest soul that God ever placed on this earth. While all odds were against Toni’s survival, it would be Marvin who would go first. In 2022, during the COVID-19 pandemic, he developed a severe case of pneumonia. He outlasted the doctor’s prognosis by six years but succumbed to his condition in the hospital enveloped by memories of the scores of people who loved him.

Marvin and Toni were married for almost 50 years. Toni misses him dearly. She feels lost without him because they did absolutely everything together but every day she wakes up and makes it through the day knowing that in the words of Theodore Roosevelt, “courage is not having the strength to go on, it’s going on when you don’t have the strength”.

In 1880, President Roosevelt’s first wife Alice died from kidney failure just two days after giving birth to their daughter and just 11 hours after his mother died in the same house. Then in 1912, he was shot in the chest in a failed assassination attempt. At the advice of his doctors, the bullet was left lodged in his chest. But it was the scars of the day that his first wife and mother died that stayed with him until he himself died on January 6, 1919, at age 60 from a pulmonary embolism.

Toni says that the days don’t get easier but she knows that Marvin would want her to be there for their kids and grandkids as long as possible. Her take-home message to readers is to be vigilant about getting regular health check-ups. She also advocates that we live life to the fullest with the people we love and who love us back. In the end, she says, you’ll have absolutely nothing to lose with possibly a lifetime of happiness to gain.

This is The KDK Report.

• Nicknamed ‘The Prince of Podiatry’, Dr Kenneth D Kemp is the founder and medical director of Bahamas Foot and Ankle located in Caves Village, Western New Providence. He served as the deputy chairman for the Health Council for five years and he currently sits on the board of directors for the Princess Margaret Hospital Foundation in his role as co-vice-chairman.