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A patient came to our CSH today by helicopter MEDEVAC for evaluation.  He was a 26 year old SGT who complained of a several week history of fevers, weight loss, and generally feeling tired and run-down.  He also complained of a fullness in his neck.  Well, this fullness in his neck turned out to be a whole bunch of enlarged swollen lymph nodes.  I am sure even some of you non-medical types know that swollen lymph nodes with fevers, weight loss, and fatigue are not a good sign. 

We drew some blood.  His CBC (complete blood count) showed a very low white blood cell level of 800 (normal is usually over 4,500).  His hematocrit was 28 (normal in a male is over 40).  His platelets were 122 (over 150 is normal).  When all three cell types are low, this is called a pancytopenia.  This is usually a very bad finding.  His liver functions were normal, but his albumin and protein levels were a bit depressed.

We took him for a CT scan which confirmed our suspicions.  He had enlarged lymphnodes all over his neck, his chest, and his abdomen.  Additionally, his spleen was quite enlarged.  As we suspected, he surely had lymphoma.  Holy shit.  I couldn't believe it.

This is the second case of cancer we have diagnosed in a US soldier since we have been here (our radiologist diagnosed a civilian sub-contractor with lung cancer as well).  That is pretty impressive given the young healthy population we serve.  Plus, we care for only a small fraction of the US forces in Iraq.  I don't like discussing numbers, but our population up here is not as big as other places in Iraq.  We have been here for 10 months, and it is hard not to think how sucky life is at times.  This soldier made me feel really bad for feeling that way.  Certainly a year deployment is MUCH better than a diagnosis of lymphoma.  Over the last 10-plus months I have certainly realized that staying here for a year and going home healthy and in one-piece is MUCH better than the alternative.  No matter how bad YOU think you have it, I guarantee you someone has it worse. 

Every morning when I wake up the first thing that occurs to me is that I am happy to be alive.  The next thing I think of is that I am one day closer to going home.  Then I tell myself I am going to have a great day.  Here, you have two options - you either make the best of this situation and get as much out of the day as possible, or you walk around miserable feeling sorry for yourself.  The latter option is way too depressing, so I choose the former option.

Our patient will soon be evacuated to Landstuhl and probably moved on to his home duty station where he is in for long courses of chemotherapy.  The soldiers we see here have the most amazing attitudes and are STRONG fighters, so I know this guy will do well.  All of us from the 67 CSH wish him the best wishes and Godspeed.