Reading My Friend Peter’s SNAFU Letter at Christmas Time

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Training Rats to Save Lives Apopo.org

I’m not terribly fond of Christmas letters, which sometimes resemble those Facebook entries in which people tell you all the details of their day, including every morsel they ingested.

But there was one letter I always looked forward to receiving. It was from my friend Peter, my colleague at the continuing medical education company that was my last job before retirement.

Technically, I was Peter’s “boss,” a word I loathed, as I really believed in a collaborative work environment. But with Peter, it was irrelevant: he needed no bossing. 

Though his position was medical editor, he possessed two masters degrees and a PhD. It was our/my great good fortune that he wound up in that office. He was brilliant.

In terms of his work, that meant not simply meticulousness about spelling, grammar, punctuation, organization—even style. He would find errors in physicians’ manuscripts and illogical conclusions in published journal articles.

And he would rewrite passages of the manuscripts we were preparing that wouldn’t otherwise pass muster. Oh, how he could write!

He also had a very offbeat, sardonic, often hilarious wit with an eye for life’s absurdities that others might miss.

And his restless intellect encompassed such varied interests—many different types of music, especially opera (the more obscure, the better), good films, politics, travel, and on and on—that his Christmas letters were a joy to read.

The absurdities parts were often featured prominently. I loved them.

At some point a number of years ago, Peter developed a dry cough. His doctors treated his symptoms, but they lingered.

After several weeks, he told me he was having night sweats. That set up a warning light for me, and I asked him if I could check with a physician friend. She led him to the oncologist who diagnosed a rare T-cell lymphoma. The prognosis wasn’t great.

But Peter had a strong will to live, and he beat those odds. We celebrated his five-year survival.

In his Christmas letters, he wrote about all the medical indignities and horrors he’d been subjected to with an astonishing degree of humor and objectivity—and not an ounce of self-pity.

A few years later, the company we worked for was failing, and I was required to lay off Peter and several other terrific people. I wept; Peter was visibly upset, and I worried that he’d never forgive me.

But he did, and my husband and I attended several of his delightful home musicales/dessert parties, where he and some friends, accompanied on the piano by his very charming and talented music teacher wife, regaled us with songs. He had a fine tenor voice.

Then came a SNAFU Christmas letter, explaining in a matter-of-fact tone that the lymphoma had returned, and treatment had once again commenced.

This was 11 years after his first occurrence. We had all been so sure it was a horror that he’d never again have to face.

After that, Peter’s SNAFU letters weren’t just at Christmas. He began regularly describing his strange new journey—always with humor, always with a sense of the absurd, and—once again—always without self-pity.

He went through hell, but he never dwelled on all that.

His last missive was dated October 20. It was longer than usual because the process to prepare him for stem cell transplantation had begun.

He knew the odds were not in his favor, and he knew what he was facing, but his incredibly strong desire for life overrode all else. 

He titled the email “SNAFU Sequel: A Million.” The million referred to the first count of his harvested cells. But “a million cells is not like a million dollars,” he wrote.

“Ideally, a transplant for T-cell lymphoma requires 6 to 10 million stem cells.”

The last amount he documented was a harvest of 2.8 million cells, and it was increasing.

Despite his situation, he found silliness everywhere. Told in the hospital to go to room 318 for an MRI, he walked through a long dark corridor where there were no rooms.  Suddenly the hall ended and became room 318,

“and there we entered a new dimension…The room and atmosphere reminded me of the creepy opening hotel lobby scene from Stanley Kubrick’s The Shining. The MRI was uneventful.”

He continued:

“As with Stalin’s 5-Year Plans, the pace of my medical procedures accelerated as I got closer to a transplant date.

“On Monday (the 14th), we had to be in at 6:30 AM for a procedure to insert a central venous catheter with 3 lumens (the proprietary name is Trifusion, but I call it King Ghidorah, after the ludicrous 3-headed Japanese movie monster that appears to shoot arcs from Tesla coils) to facilitate the harvesting of stem cells…

“At 10:30, I was instructed to have blood work, and then we had to wait until 6 PM to get an injection of Mozobil, which is designed to promote the creation of stem cells (it is very expensive, so the pharmacy only makes it at 6, and only if the patient is present).

“That left 7 hours to sit in the hospital to get a single injection. I decided to play a literature game, inspired by Woody Allen’s film Love and Death, in which 2 characters converse using Dostoevsky novel titles (e.g., ‘They say he was Possessed.’ ‘No, he was an Idiot.’).

“As a patient and medical editor, I have dealt with absurd drug titles that lend themselves to bad literature. With apologies to Sophocles, here is my one and only Greek tragedy (those not in medical education may want to skip this section).”

[Note from Annie: All the names below refer to medications or medical procedures; I’m assuming Peter had endured each one.]

“In the city-state of Amlodipine, known for its high level of education and culture, King Azacitidine and Queen Romidepsin rejoiced at the birth of their son, Granix. According to custom, they brought the child to the Temple of Invokana. 

“They were alarmed when the high priestess Apheresis prophesied that Granix was destined by the gods to be the worst playwright in history. 

“They tried to avoid the prophecy (not recommended in these plays) by sheltering their son and home-schooling him. 

“When they died, he was unaware of the prophecy until the soothsayer Carmustine revealed the curse. Terrified, Granix changed his name to Zarxio and fled into exile.

“He decided to avoid his fate by settling in the city of Thiazolidinedione, whose ruler, King Actos, forbade all education and culture. 

“Soon, however, the city was besieged by the dreaded monster Mozobil, who tormented the population with riddles such as ‘How do you spell your city’s name?’ ‘Is the word ‘data’ singular or plural?’ ‘Is ‘health care’ one word or two?’ In desperation, King Actos issued a proclamation for anyone to rid the city of the monster. 

“Displaying his hubris, Zarxio stepped forward and answered all the riddles, and then drove Mozobil away by challenging him to explain why ‘nonadherent’ did not have a hyphen. Instead of gratitude, King Actos wondered why Zarxio knew so much, in a city where being educated was a crime. 

“Eventually, Etoposide of Amlodipine, who had been searching for Granix, heard about Zarxio’s exploits. Etoposide explained that Zarxio is an alternate form of Granix, unmasking the criminal. 

“For defying the will of the gods, Granix was banished to the realm of Polypharmacy, where, in a drug-induced stupor, he churned out the worst plays of all time.

“The moral: It is better to play with your cell phone than to try to write a Greek drama.“ 

Peter provided considerably more detail about what he was experiencing, and then wrote:

“Now for the reason this is such a long SNAFU. The current plan is for me to enter the hospital next Tuesday or Wednesday… In order to ensure the complete response, for 6 days I will receive a very strong chemotherapy called BEAM…, which is associated with serious adverse effects.

“ If nothing else, my multiple regimens (Hyper-CVAD, CHOP, ICE, clinical trial, and soon BEAM) will make me a connoisseur of chemotherapy.

“After 1 day off, I will have the transplant and continue to stay in the hospital for about a month. The SNAFU Sequel will be on hiatus.

“I am sure that when I return there will be numerous hilarious episodes to recount. With a recovery period that may last a year, the SNAFU Sequel will inevitably become a tome.”

He then observed:

“The hospital neighborhood, which I have noted is a nightmare of construction vehicles, iron plates, and gridlock, has a few surprising areas of calm as well.

“Across the street is an armory where I ran track while in high school, providing me with an unintentional foundation for surviving lymphoma. 

“One block west, the traffic noise cannot be heard.

“Instead, you see a veritable United Nations of medical students with their youthful exuberance, quizzing each other and giving one some confidence in the future, as opposed to our political situation. 

[Here he expressed his profound gratitude and love for his wife and appreciation for his friends—and then became philosophical]

“The Tao Te Ching, perhaps by Lao Tzu (Laozi), contains an often misquoted statement, with the true meaning close to ‘The journey of a thousand begins beneath one’s feet’ (obviously, they did not measure distance in miles 2,500 years ago). 

“However, my own path has comprised many paths. A better way to sum up my treatment journey is a quote from the Pirkei Avot, compiled about 2,000 years ago:

“‘You are not obligated to complete the work, but neither are you free to desist from it.’

“So off I go to the big city, with Kander and Ebb’s ‘New York, New York’ ringing in my ears.”

……………………….

At his wife’s suggestion, I had planned a phone call with Peter shortly and a visit once he was out of isolation. Peter died on November 19 at age 65. He left his body to science.

His wife referred to him as her “brave warrior.” Though he was a peace and social justice advocate, her words seem apt in terms of how valiantly he fought to remain on this earth.

I learned many things from Peter, and one of them was the extraordinary intelligence of rats. Yes, rats.

Peter requested that anyone who wanted to make a contribution in his memory send it to Apopo, a non-profit organization that trains African giant pouched rats to save the lives and limbs of children and others by detecting landmines that are buried in more than 60 countries that had been at war. The rats can also detect tuberculosis, which is often otherwise undiagnosed and therefore deadly. Thus, they are called HeroRATS.

I’ll end this post by borrowing Peter’s typically Peter closing. I find its generosity of spirit, in view of his own circumstances when he uttered these words, nothing short of remarkable.

“I hope you all have wonderful times and holidays ahead. Remember to laugh!”

Annie

34 thoughts on “Reading My Friend Peter’s SNAFU Letter at Christmas Time

  1. Thank you, Annie, for sharing that with us! As Peter exemplified his bravery and humor in his posts, he also shared some of those qualities with you. For you to share this information is to share a piece of you. This had to have been a huge loss for you, as the two of you had obviously developed a deep and abiding friendship. I admire your willingness to share this, because in-so-doing, you may also have saved some lives. Thank You!

    Liked by 1 person

  2. Well, that one brought a tear. I can imagine how the two of you got on. One of life’s great friendships. I’m so happy for you.Thank you for sharing him with us.

    Annie — if you haven’t yet read art critic Peter Schjedahl”s piece in The New Yorker, Dec 23rd issue, I think you would like it. Coming to terms with a life-threatening illness, it’s a memoir / apology / and call to wake up to one’s life– and death. I’ve followed his work for years and will be sad when he’s no longer writing. Perhaps it was the timing of the two pieces — I finished that and then read here about Peter.– that has twisted up my insides. Both last lines linger.

    Happy holidays my dear blogging pal and to those with the good sense to read you.

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  3. Thank you, Denise. Unfortunately, there were years when Peter and I had essentially lost touch. Though my mindfulness tells me not to regret, I do regret that loss—as well as the opportunity to talk with him one last time.
    I’ll look for the Peter Schjeldahl piece. I am surrounded by half/read New Yorkers.
    And happy holidays to you and family. The message clearly is carpe diem/laughter!

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  4. Hi Anne,

    In a sad coincidence a co-worker of mine, the educational consultant at my nursery school, died pretty much the same way last month also. We all had high hopes that she would make it and it appeared that she was doing well but, like Peter, she ultimately lost the fight. We saw her a few days before she died and she was suffering greatly.

    As my Aunt Marcia says, remember to rejoice that you had Peter in your life even as you mourn his passing. Thank you for sharing his life with us. He obviously was a very special and inspirational man.

    S >

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    1. That is certainly a sad coincidence. I do feel grateful to have known him, and am trying not to regret the years in which we had little contact.
      I’m sorry for the loss of your co-worker.
      Thanks for sharing your inimitable Aunt Marcia’s wisdom. You should really record her—or write everything down.

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  5. WOW..That was such a wonderful and emotional piece.. Peter brought out the beauty of the mind and how we should live our lives. I love the way you write and think and obviously you and Peter were able to communicate on a very special plane. That loss creates sadness but thank you so much for being able to communicate his specialness. It reminds me of “Every man’s death diminishes because I am involved in Mankind….Peace and Love

    Liked by 1 person

    1. Hi, Noah—How lovely to hear from you, and thanks so much for your generous comment. I love the phrase “Peter brought out the beauty of the mind and how we should live our lives.” He did, indeed! Peace and love to you too!

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    1. Yes—you were probably better able to appreciate that part than most of us. I had to look them up. It’s tough to imagine, though, despite his humor, that they’d become part of his treatment regimen.

      He certainly was a creative soul!

      Liked by 1 person

  6. You provide a moving and thought provoking tribute to a special and unique individual. Thanks for sharing Peter and his story with us. I read Peter S’s piece a couple days ago. Quite a coincidence that these two moving, unsettling, somewhat related stories appeared simultaneously in print. They prompted me to wonder how I would react and respond in a similar situation …..something about which I have really never thought.

    Liked by 1 person

    1. It is quite the coincidence. I am reading Peter Schjeldahl’s story now; I’m so far behind in my New Yorker stack that I might have missed it if Denise hadn’t drawn my attention to it.

      I don’t think it’s possible for any of us to know how we’d react to such circumstances, but I think few would have the blend of inner resources that Peter drew upon. Gentle though he was, that’s what made him the warrior his wife described. And his humor, I think, was foremost. His exhortation “Remember to laugh!” is, I believe, the gift he left us in how to maneuver through the most challenging times—both internal and external.

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  7. Your friend was such a gem, a glowing light and inspiration for us all. He left the world too soon. Posts like this will keep his charming wit alive for people like me who didn’t have the pleasure to meet him in person. Thank you Annie for telling us about him.

    Liked by 1 person

    1. Thank YOU, Janine. I’m so glad I read this comment after I’d read your newest post. I’ve responded to you there, but I’ll simply say that humor and eloquence in the face of adversity are traits that you also have demonstrated in abundance.
      All good wishes,
      Annie

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  8. That was very fun, so glad your friend could face his treatment with humor, and sad that he did not make it. My wife is an NP in haematology and I know those people can suffer terribly.
    Thanks for sharing his story.

    Liked by 1 person

  9. Thankyou, Annie, for this beautiful contribution. It sounds like Peter was a wonderful person. I can’t relate much to Christmas letters, as we don’t celebrate that Holiday, but I do connect with Peter’s T-cell lymphoma, since our daughter has just finished chemotherapy for that diagnosis, and we’re very much hoping it’s cured her (she’d need a bone marrow transplant if not). Wishing you Happy New Year!
    George

    Liked by 1 person

    1. Oh, my, George—I am so sorry that your daughter and you all have gone through this. I share your fervent hope that she’s now free of disease and can move on with her life, as can you. That will, indeed, bring happiness to the New Year.

      May this dawning new decade bring all sorts of good things to our country and world!
      Best wishes,
      Annie

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    1. Thank you for reading through it. I’m so sorry to hear about your friend. I find that people like Peter and him serve as inspirations with regard to how we can live our lives.

      When you say “online friend,” do you mean a blogging friend? I ask because that’s yet another of the surprising ways that blogging has enriched my life. The depth of caring about someone you’ll probably never meet–the concern you feel when you know they’re ill or troubled–is world-stretching. I’d never thought about it when I started blogging, but now it’s one of the aspects I value most highly.

      Nice to connect with you.

      Annie

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  10. Very inspirational post and something I can identify with. My son donated part of his liver to my husband, Michael. The operation was successful but, sadly, the patient died. Michael wasn’t as poetic as Peter, but he was special in his own way, as are so many people.

    Liked by 1 person

    1. Oh, Gail–

      Your comment gave me chills, and I am grateful to you for sharing it here. I met Michael only a few times, very briefly, but knowing you, I am sure he was special. And your son clearly is as well.

      I hope the New Decade brings you all good things.

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  11. Thank you for introducing us to your friend and for this loving tribute. We come into contact with so many people during our lives, but isn’t it true that a few stand out in the way they navigate life. I am sorry for the loss that his family and friends have experienced.

    Liked by 1 person

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