A Prayer For the Mayor

By HOWARD BERGER

TORONTO (Sep. 17) – Divine intervention for Rob Ford is still necessary, as it would be for any person diagnosed with cancer. But, perhaps not to the extent that was feared prior to Dr. Zane Cohen’s medical update Wednesday at Mount Sinai Hospital.

Dr. Cohen was adamant in renouncing media speculation that Ford had undergone a biopsy of lung tissue. According to Joe Warmington of the Toronto Sun, Ford, himself, created the confusion by believing that an endoscopic scan of his lungs yielded results that required biopsy.

Had this been true, it would have indicated metastasis (or the spread) of malignant cells to another organ in the mayor’s body – likely as the result of a primary lung tumor. And given the generally poor prognosis for lung cancer, Ford would have been in a much more dire situation. Under no circumstance would Dr. Cohen have used the word “optimistic” to describe the potential result of Ford’s cancer treatment, as he did after revealing the diagnosis of an extremely rare tumor: Plemorphic liposarcoma – evolving from fat cells in deep soft tissue.

Chemotherapy offers the mayor a fighting chance for remission.

Wikipedia explains that liposarcoma is “a typically large, bulky tumor which tends to have multiple smaller satellites extending beyond the main confines [of the mass].” This accounts for Dr. Cohen’s finding of a secondary tumor near Ford’s buttock. Prognosis “varies depending on the site of origin; the type of cancer cell; tumor size, depth and proximity to lymph nodes. Well-differentiated liposarcomas treated with surgery and radiation have a low recurrence rate (about 10%) and rarely metastasize.” Ford will not be treated initially with radiation or surgery – such potential follow-up to be determined by how the abdominal mass responds to chemotherapeutic agents. It is far trickier than liposarcoma elsewhere, such as in the limbs. But, Ford’s cancer is treatable.

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DR. ZANE COHEN EXPLAINS MAYOR ROB FORD’S CANCER DIAGNOSIS TO THE MEDIA AT MOUNT SINAI HOSPITAL HERE IN TORONTO.

I know Zane Cohen very well and I swear by him, as do hundreds of others. He is regarded among the top colorectal surgeons and clinicians in the world. He has twice operated on me for Crohn’s Disease (1993 and 2002) – the first time having to repair a serious complication from an ileosecal (small bowel) resection I’d undergone six months earlier. When re-joining two segments of bowel (or intestine), doctors today utilize surgical staples rather than sutures (sewing the ends together). Stapling is a much quicker process than suturing and has proven to be accurate and reliable. In my situation, 21 years ago, it proved otherwise.

Shortly after my resection in May 1993 at Sunnybrook Health Sciences Centre, one or two staples broke free, creating what is known as an anastomotic leak. Anastomosis is simply the connection point between two structures – in my case, sections of healthy bowel unaffected by Crohn’s. When the staples came loose, well prior to healing, it enabled bowel contents to spill into my abdominal cavity. This led to a large abscess (collection of pus) in my abdomen and a week-long stay at the Tarzana Medical Center northwest of Los Angeles shortly after Wayne Gretzky and the Kings knocked off the Maple Leafs in Game 7 of the 1993 Stanley Cup semifinals (I’d attended Games 3 and 4 of the Canadiens-Kings Cup final at the Los Angeles Forum). The abscess was “drained” with a large surgical needle that drew the infection into a plastic pouch outside my stomach (thankfully, I was all but out cold during the procedure). A host of antibiotics were then pored into me.

To make a long story short, I felt awful all summer and into the fall with mild abdominal discomfort and low-grade fever. My gastroenterologist claimed I had not sustained an anastomotic leak but rather a quick recurrence of Crohn’s that thinned my bowel wall to the extent of perforation (a hole that enabled the passage of contents). I found that difficult to believe, given that post-surgical remission from Crohn’s typically lasts years, not months. In late-October, my uncle suggested I meet with Zane Cohen at Mount Sinai Hospital. I sat with Dr. Cohen at 7:30 a.m. one day and explained my plight – so incredibly frustrated with being sickly for five months. Almost immediately, Zane said I did not have a recurrence of Crohn’s but that a staple or two had broken loose after my surgery, causing the leak. He was traveling to France that night for ten days and suggested I update him when he returned.

By that time, I could not lift my right leg to put on a shoe. Every time I tried, the pain was excruciating. And, I was just lethargic, with fever and mild nausea. I called Dr. Cohen’s secretary, Rina, who advised me to be examined at Toronto General Hospital for another abscess. I said to her, “Rina, please, I need Zane to operate on me. I can’t go on like this any longer.” She put me on hold then came back and said to meet Dr. Cohen at Mount Sinai Emergency. Which is exactly what I wanted to hear.

Six days later (Nov. 17, 1993), Dr. Cohen performed a lengthy operation to clean out a massive amount of abdominal infection. When he came to see me the following day, he suggested I didn’t get there a minute too soon. “You were in bad shape,” he insisted. His assessment – as usual – was accurate… I had suffered an anastomotic leak. When I questioned him about the surgery, he told me it was a “a challenge” and then, with a smile and a little fist-pump, said, “but it was great. I like a challenge.”

And that’s why Rob Ford is in the best hands – figuratively and literally. Not only does Dr. Cohen make quick, accurate medical decisions, he has a remarkable bed-side manner. He’s also a serial fan of the Toronto Blue Jays. I went to a game with him last year and saw the kind of intensity he takes into the operating room. Zane is a very close friend of Larry Tanenbaum – who owns 25% of the Maple Leafs – and you can be sure he and Ford have talked some sports in the past week.

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MAYBE THIS SCENE I PHOTOGRAPHED IN THE SKY OVER WEST TORONTO WAS AN OMEN FOR ROB FORD. IT OCCURRED MINUTES AFTER ZANE COHEN’S MEDICAL UPDATE. THE DARK CLOUDS REPRESENT CANCER BUT THE RAYS OF LIGHT OFFER HOPE.

So, here’s a prayer for the mayor: May he recover from this ominous set-back and spend many more years with his family… mom, wife, brothers and children. As for politics, who really cares? Right now, Rob Ford is on a life-and-death journey. Let’s hope he prevails.

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