BPDCN: Your Cancer May Be Rare and Deadly, But Face It Down Anyway

Written by Paul Pavao

The power of a cancer patient’s good attitude cannot be over-emphasized. Within the first week of chemo a nurse was willing to tell me, “We can all tell who is going to make it and who isn’t. The ones with the good attitude make it; the others don’t.” (This cannot be 100% true, of course.)

I had a little advantage over most people. I was not only a Christian, but I had been teaching Christians for 35 years. I wanted to prove I was not a hypocrite. I was hungry to live out what I taught to others. Suffering is not a curse, but one of the routes God uses to bring us to perfection. Christians should meet suffering with joy.

By the time I was diagnosed with blastic plasmacytoid dendritic cell neoplasm (BPDCN) my red blood cell count was dropping rapidly. It took only three weeks before I needed my first transfusion. I had never felt so weak, and I was doing everything slowly. I really wanted that blood, so I wrote a post about being a vampire. A couple days later, I found out my room at Vanderbilt was going to be on the eleventh floor, so when I checked in, I said, “I believe I have a reservation in the penthouse.” I got a smile, but not as much of a reaction as I wanted. It probably qualified as a “dad joke.” That’s a joke that dads tell that makes their kids roll their eyes.

I was trusting God, staying positive, and encouraging others not to worry. I called my upcoming round of chemotherapy a “hospital ministry.” I really thought my attitude would be unique.

Then I was admitted.

I quickly found out that a lot of cancer patients did not need my hospital ministry. The blood cancer ward at the Vanderbilt Cancer Center was one of the most positive places I have ever been! Yeah, it was wonderful to be able to encourage and pray with the old man whose wife had just relapsed for the second time, but mostly I was the one being encouraged. In fact, I talked to one man in the family room who had relapsed, and he told me, “But I’m 60, and the sun is still shining on my head!”

The atmosphere in that ward was incredible. Twenty-six laps around the squared hallways made a mile, and there was a huge bulletin board showing us what destinations we could reach by walking one mile, two miles, or even ten or twenty miles.

I made it my goal to walk two miles a day. During the height of the chemo, though, I had a terrible case of hemorrhoids, and walking was extremely painful. The doctors pushed me to walk at least a few laps. Once the chemo started wearing off, my body started healing, and I was able to return to walking. I was in the hospital for 35 days before my blood counts recovered enough to leave the hospital. (Because of BPDCN, my chemo was very strong.) I made it to 50 miles the day before they released me.

Dr. Watson, I Presume

Another fun moment during that first chemo was meeting Dr. Watson.  My wife greeted him with, “Elementary, my dear Watson.” Then she laughed and said, “I suppose lots of people say that to you.”

He smiled and said, “No. Most people say, ‘Dr. Watson, I presume.'” We roared with laughter. (If you don’t get the joke, it is Dr. Livingstone, the African missionary and activist, who was greeted with, “Dr. Livingstone, I presume” when he was found. Dr. Watson was Sherlock Holmes companion.)


A lot of unusual things happened to me during my treatment for BPDCN. In some other post, I will tell you about the infectious disease doctor who asked me if I did anything that was not unusual. In this post, though, we’ll stick to the first unusual thing. All my gray hair fell out before the dark hair did!

I had just turned 50. My hair was salt and pepper, but for three days it was as black as it has ever been. My main doctor came in on his rounds one day and said, “Good morning, young man. It is nice to meet you. I am Dr. Strickland.”

My wife immediately threw in, “Hi Dr. Strickland, I am Paul’s mom.”

Later, I asked the nurse why my gray hair fell out first. She said, “I have no idea. I have never seen that happen before.”

Cabin Fever

Just before I got out, as my blood counts were starting to kick back in, I asked if I could walk outside. The nurse told me that they only let patients do that when they can’t stand being inside anymore. I asked her if she would tell Dr. Watson, who was on duty at the time, that I was depressed and needed a walk. She said she would sell it the best she could.

She came back a few minutes later. “He said no. I don’t think he believed me. You’re the best patient we ever had.”

Dr. Watson came to my room later. He asked, “That was just a ruse, right? You’re not really depressed? I do have to check, but I certainly did not believe the nurse.” I confessed, and he took the time to explain to me the dangers of picking up bacteria outside before my white blood cells had recovered.

Doc Halliday

A blog post on my first round chemo cannot be complete without mentioning Doc Halliday. He was a delight, and like Dr. Watson, we got a kick out of his name. He wore cowboy boots every day, so he must have enjoyed his name as much as we did.

I had four rounds of chemo including the chemo that prepared my for the marrow transplant. There’s a lot more to tell about the third round, but I will get to that in another post.


Check out Paul’s blog here.




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