Hope

Teddy Ryder was born in 1916, when type 1 diabetes was 100% fatal. I often think about him when I think about having stage 4 pancreatic cancer, which has only slightly better odds today.

When Teddy was diagnosed with diabetes, patients were treated with a starvation diet which did not cure them, but which sometimes extended their lives by one or two brutal years. These patients were often limited to less than 500 calories a day and had to be kept away from home, with limited visitation, because families would almost universally find a way to feed their starving children more than the strict limits.

Teddy Ryder was one such boy, diagnosed at 4 years old and wasting away to 12.5 kilos — just over 27 pounds — by the age of 6. Teddy was at death’s door, facing the inevitable outcome of a deadly disease, when everything changed.

Teddy’s uncle was a physician who had been following the work of Frederick Banting and Charles Best at the University of Toronto, to extract insulin from pancreatic tissue. He met personally with Dr. Banting, pleading for him to accept Teddy in his earliest trial. Dr. Banting was persuaded and Teddy became one of the first eleven patients to be treated with insulin. Teddy recovered rapidly and soon was well enough to return home. Many years later he became the first person to live seventy years with type 1 diabetes.

Since I first read it years ago, young Teddy’s letter to Dr. Banting has had a special place in my heart, and I read and re-read it after my own pancreas went wrong in a different deadly way.

You could say that there was no reason to hope when Teddy was wasting away to nothing along the predictable course of a deadly disease. But Teddy’s uncle had hope, and Teddy had hope, as did Dr. Best and Dr. Banting and the many people working with them to solve a fatal disease.

Diseases are incurable until they aren’t, and one of these days there will be breakthrough treatments that allow more people with pancreatic cancer, and metastatic cancer in general, to recover.

I thought about this a lot when I was diagnosed. At first I wondered what the point was, really, in treating an incurable cancer. More time with my loved ones, of course, but what kind of time would that be? I’d heard horror stories about chemo and the accounts I read online made it seem like it would hasten my death and fill my remaining days with misery. Fortunately, my oncologist had a different take. It was worth treating for extra quality time, and because there are reasons to be hopeful.

Dr. Banting would later write to Teddy Ryder: “I shall always remember the difficult times we had in the early days of insulin. The outstanding thing I remember was your strength and fortitude in observing your diet and the manly way in which you stood up to the punishment of hypodermic injections.” Why did Teddy endure two years of starvation followed by an experimental treatment except for hope, however improbable, that a cure may come in his lifetime?

For the moment my disease is controlled by chemotherapy. It is not easy, but I try to follow Teddy’s example in enduring it with consistency and a dedication to surviving. The longer I can endure chemo, the better chance I have of making it to see the next big breakthrough. I am keeping my body as strong as possible with the hope that I can one day be eligible for a trial that helps, in even a small way, to increase the chances of surviving for others, if not myself.

What Teddy got was not a cure, exactly, but a manageable treatment that brought him a gloriously normal long life. Breakthroughs in medicine are often imperfect and slow to come, but incremental progress still saves lives. We are at the cusp of great progress with pancreatic cancer which I hope will let many of us live on with a chronic condition, however inconvenient, rather than a certain death sentence.