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drug, vitamin supplements, dexamethasone (a steroid), and testosterone patches. OxyContin, the well-known pain reliever, at my discretion.
    It is all very expensive. One Revlimid pill alone ismore than $500 and they’re not easy to acquire. Only seven pharmacies in the country ship the powerful drug, and to become a customer requires a detailed background check and hospital authorization. Thanks to my General Electric healthcare plan for senior employees, my co-pay was just $15 per pill. What, I thought, does a farmer in Kansas do, or a small business owner in Kentucky, or any other multiple myeloma patient, to get on the list and pay for what appears to be, if not a breakthrough, at least a big step in the right direction?
    With the Mayo team, we had decided my case would be transferred to Memorial Sloan Kettering, the world-famous cancer treatment center in New York. Dr. Gertz was very high on a young Sloan specialist who was compiling an impressive record in treating myeloma. Her name is Heather Landau, and she is a stylish, intense New Yorker. MM is her specialty. For the initial meeting she brought in a Sloan physician who concentrates on pain management. Dr. Roma Tickoo wears a white smock with the phrase “Pain and Palliative Care” in bold letters.
    Given her unusual name I decided to just call her “Dr. Pain” but she laughingly rejected that, saying, “No, I want to be Dr. Palliative,” making it clear that relief from the pain in my deteriorating bones was a high priority.
    Dr. Landau agreed. “We think of pain pills as vitaminP,” she said. “We’ve had no cases of addiction and you’ll want to be comfortable.”
    Other Sloan physicians and executives dropped by during the initial consultation, just to say hello and offer their assurance I was in good hands and would be doing much better by spring. That was comforting but in fact I didn’t yet know all the steps to spring.
    One of the visitors was a Dartmouth medical school classmate and very close friend of our daughter Jennifer and her MD husband, radiologist Allen Fry. Pete Allen, a former U.S. Army surgeon in Iraq and former Harvard football player, is now a top cancer surgeon at Sloan. It gave me an emotional jolt just seeing Pete, an offensive lineman for the Crimson, fill out his operating room scrubs. What he faces every day, the skills he’s developed while retaining his droll sense of humor and his affection for Jen and Allen, add up to the qualities you want in every extended family member. These are people you’d like to keep around forever.
    In shifting from Mayo in Minnesota to Sloan in New York, it helped to know the cultural geography of both places. In Rochester many of the accents have a faint hint of the dialogue from the film
Fargo
, and the Mayo drivers are often big, beefy guys who grew up on nearby dairy farms until that business became too difficult. One of my Mayo overnight nurses was a high-energy, athleticyoung woman who commuted an hour each way from a small town in Iowa to work weekends. When I asked why, she explained that her husband was the girls’ basketball coach back home, the Iowa equivalent of being in the Main Street spotlight night and day. She wanted to be there for him during the week, when, in addition to all his other pressures, he taught fourth grade, and this year the class included their son and all his pals.
    We talked about the prospects for the Green Devils and life in Osage, their hometown. She was surprised that I knew it was a county seat—from my days of working in nearby rock quarries during the summer of 1957. It was hard work, I explained, but I made the same commute to Rochester on weekends to court a nurse who wisely was more interested in her career than in my attention.
    I think of my new Osage friend often—her nursing skills and, more important, the commitment she and her husband have to their marriage, their family, and their community. Those same core values are on display at Sloan,