My dad has Parkinson's disease. Taking a trip with him one weekend taught me a lot.

"Watch him like a hawk. Take no excuses."

Those were some of my mom's last words to me as I set off with my dad for D.C. He hadn't been up north to see his own father, who is pushing 100, in over a year, and my dad's advanced Parkinson's disease made traveling alone impossible. So I was enlisted to go with him. For the first time, I'd be in charge of his medication, along with shepherding him through the airport, getting him in and out of bed — pretty much everything.

"You can't take him at his word," she'd tell me.


"Don't hand him his pills and walk away. He'll never take them. Don't leave him while he's brushing his teeth at night. He'll never make it to bed before the medicine knocks him out. Don't assume he's going to do what he says he's going to do."

"You have to watch him like a hawk," she said. "Take no excuses."

Maybe that's why it felt so good when I was finally able to text her, on our return trip, that we had made it through security and were almost at our gate.

My dad was in the bathroom while I leaned against the wall outside waiting for him. We were flying out of Reagan International, and in four days of travel, there were no emergencies. No crises. No disasters or catastrophes. There had been no medicine mix-ups, no missed doses, no falls, no accidents. Everything had been fine.

That's not to say it had gone easy, but at least it had gone. Though we weren't home yet.

Not quite anyway.

When my dad came out of the bathroom, we headed to the seating area in front of our gate. As we passed a small concession stand, awkwardly pitted in the middle of the room like a prize counter at an arcade, he mumbled something about being thirsty.

"A pink lemonade sounds good," he said. And he reached out and grabbed one from the cooler.

We had all of our bags on us. Him carrying one, me rolling the other with a duffel slung over its handle. I looked at the narrow, winding queue leading to the cashier and back down at our bulky bags as my dad slowly started to drift away from the concession stand, lemonade still in his grasp.

"Why don't we get settled over by the gate, put our bags down?" I said. "Then I'll come back over and get you something to drink."

With him, I had learned to think several steps ahead. I learned to scout obstacles and anticipate problems.

I learned enough to know that, with only one hand free, he'd have trouble getting his wallet out of his sweatpants, or he'd trip over his feet and tumble into the people in front of us, or he'd inadvertently shoplift this lemonade if I didn't take it and put it back.

But still, it felt awful to say something so patronizing to my own father.

He agreed that we should get settled and we made our way over to the gate, finally coming to a stop in front of a row of roomy handicapped seating.

"Dad, you want to sit here with the bags while I go get us a drink?"

"OK, sure."

He just stood there.

"Dad?"

He does this thing where he's always standing. He'll wander into a living room conversation where everyone's sitting, and he'll just stand in front of a seat and talk from there. You'll ask him if he wants to sit, and he'll bend his knees slightly but then pause, almost as if he's forgotten he was going to sit in the middle of doing it.

There's something unsettling about someone standing when you feel like they should be sitting.

"Dad, you want to just sit here for a minute while I get us a drink?"

On that, he plopped down and I positioned our bags so they'd be in his sight and reach.

"A muffin would be good, too," he added.

"OK. I'll see if they have muffins."

I turned and headed back to the concession stand. I couldn't have walked more than five or six steps before I glanced back over my shoulder at him. He was still sitting there. I don't know what I expected to see — like he was going to erupt in flames the moment he was out of my sight or something.

I got in line, and as I waited my turn, I kept looking back.

“Watch him like a hawk."

We hadn't come this far to have him fall down and break his wrist or have our bags stolen from under his nose.

We hadn't come this far without a disaster to have one now.

I paid for the lemonade and a blueberry muffin I spotted in the display case. And I looked back over at my dad again.

He was standing.

What is he doing? I wondered. Is he sifting through our bags? Is he going to wander off?

I hurried back over and found him contemplating our belongings. He was hoping to find a bag of sliced oranges we'd packed for the trip, trying to solve our luggage like it was some impossible puzzle.

I unzipped the outermost pocket of my suitcase and handed him the oranges, the lemonade, and the muffin.

We both sat down and he began to eat.

He attacked the muffin the way you might eat an apple — gripping it with the entire width of his hand and lifting it to his face for enormous bites. It crumbled as he mauled it, massive pieces tumbling over the wrapper and landing on him. All over his lap and his shirt and his seat and the seat between us.

He was not mortified, like I would have been if it were me.

He wasn't even affected.

Halfway through, he had clumps of muffin pinched precariously between his fingers. He was picking up stray blueberries off the seat and eating them.

People were staring. I wanted to help, to do something, but I didn't know what.

I had my phone to my ear now, working out the last minute details of our shuttle pickup. I had my other hand death-gripped around his pill case, which I was under strict orders to never let out of my sight.

As my dad gnawed his way further into the muffin's core, I noticed this older bald guy in a fleece jacket across from us stealing glances at the scene. I thought about telling him to mind his own business, but reconsidered given the absurdity of what was happening. I understood why he'd be compelled to look.

But I started to hate this random guy anyway.

There was nothing spectacular about him. He was bald with some prickly silver stubble covering his chin and an orange fleece pullover. He was just a guy, really.

But what stood out about this man, to me, was that he didn't have any food stains on his clothes.

He didn't have elastic shoelaces or drawstring pants. He didn't have hearing aids. He didn't have anyone with him to help him get on the plane without getting lost.

I started to hate him because I thought, this is who my dad was supposed to be.

My call finally ended and I hung up. At this point, I had seen enough of the muffin massacre and was ready to go get us a plate, some napkins, something. But I remembered I hadn't gotten us a preboarding pass yet and we'd be boarding any minute. My dad — not surprisingly — doesn't do well with people nipping at his heels, squeezing around him, crowding him, hurrying him. We needed to board before the rest of the passengers. It was one of the last obstacles between us and home.

At the ticketing desk, I kept glancing back as I talked to the agent.

“I'm traveling with my father who is, uh, he has… He's handicapped."

I never know how to describe it.

When it comes to Parkinson's, "handicapped" always seems to be both wildly conservative and entirely overly dramatic at the same time.

It doesn't come close to telling the whole story.

As we wrapped up the transaction at the counter, I caught my dad standing again from the corner of my eye.

Is he sifting through our bags? Is he going to wander off?"

As soon as I got our preboarding pass, I hurried back over to him.

He had, to my complete surprise, cleaned himself off pretty well with a stray napkin. He'd brushed the crumbs away from his shirt and pants. He'd wiped the seat clean, save for a few hangers-on in the crevice. And he had stuffed all the trash into the small white bag that the muffin came in.

In that moment, I got a glimpse of my dad. The real one.

The one who raised three kids and taught us how to throw a football, how to use a hammer, how to treat people. The one who, in another world, would have been leading me through the airport, reciting Civil War trivia as we walked. The one who, to an outsider, would have been just a guy.

The one who, to those who knew him, was far from just a guy.

He looked at me as I approached and said, "Are we ready to go home?"

For a second, it felt like we were already there.

We stood and waited to board, watching travelers deplane from the previous flight. We were mostly silent because no one ever wrote a handbook on how to ask your father if he's sure he doesn't need to use the restroom and then jump into shooting the shit about sports.

So it was easier to just say nothing.

But it was a comfortable silence. Maybe even a happy one. Because the catastrophe I had dreaded and been warned about and tried so hard to avoid, well, it ended up just being a particularly unwieldy muffin.

And all it took was a single napkin to wipe away any trace that anything had ever gone wrong.

If only for a second.

This article originally appeared on August 27, 2015

Oh, society! We have such a complicated relationship with relationships.

It starts early, with the movies we are plopped in front of as toddlers.

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This article originally appeared on August 27, 2015

Oh, society! We have such a complicated relationship with relationships.

It starts early, with the movies we are plopped in front of as toddlers.

Keep Reading Show less
True

Each year, an estimated 1.8 million people in the United States are affected by cancer — most commonly cancers of the breast, lung, prostate, and blood cancers such as leukemia. While not everyone overcomes the disease, thanks to science, more people are surviving — and for longer — than ever before in history.

We asked three people whose lives have been impacted by cancer to share their stories – how their lives were changed by the disease, and how they're using that experience to change the future of cancer treatments with the hope that ultimately, in the fight against cancer, science will win. Here's what they had to say.

Celine Ryan, 55, engineer database programmer and mother of five from Detroit, MI

Photo courtesy of Celine Ryan

In September 2013, Celine Ryan woke up from a colonoscopy to some traumatic news. Her gastroenterologist showed her a picture of the cancerous mass they found during the procedure.

Ryan and her husband, Patrick, had scheduled a colonoscopy after discovering some unusual bleeding, so the suspicion she could have cancer was already there. Neither of them, however, were quite prepared for the results to be positive -- or for the treatment to begin so soon. Just two days after learning the news, Ryan had surgery to remove the tumor, part of her bladder, and 17 cancerous lymph nodes. Chemotherapy and radiation soon followed.

Ryan's treatment was rigorous – but in December 2014, she got the devastating news that the cancer, once confined to her colon, had spread to her lungs. Her prognosis, they said, was likely terminal.

But rather than give up hope, Ryan sought support from online research, fellow cancer patients and survivors, and her medical team. When she brought up immunotherapy to her oncologist, he quickly agreed it was the best course of action. Ryan's cancer, like a majority of colon and pancreatic cancers, had been caused by a defect on the gene KRAS, which can result in a very aggressive cancer that is virtually "undruggable." According to the medical literature, the relatively smooth protein structure of the KRAS gene meant that designing inhibitors to bind to surface grooves and treat the cancer has been historically difficult. Through her support systems, Ryan discovered an experimental immunotherapy trial at the National Institutes of Health (NIH) in Bethesda, MD., and called them immediately to see if she was eligible. After months of trying to determine whether she was a suitable candidate for the experimental treatment, Ryan was finally accepted.

The treatment, known as tumor-infiltrating lymphocyte therapy, or TIL, is a testament to how far modern science has evolved. With this therapy, doctors remove a tumor and harvest special immune cells that are found naturally in the tumor. Doctors then grow the cells in a lab over the next several weeks with a protein that promotes rapid TIL growth – and once the cells number into the billions, they are infused back into the patient's body to fight the cancer. On April 1, 2015, Ryan had her tumor removed at the NIH. Two months later, she went inpatient for four weeks to have the team "wash out" her immune system with chemotherapy and infuse the cells – all 148 billion of them – back into her body.

Six weeks after the infusion, Ryan and Patrick went back for a follow-up appointment – and the news they got was stunning: Not only had no new tumors developed, but the six existing tumors in her lungs had shrunk significantly. Less than a year after her cell infusion, in April 2016, the doctors told Ryan news that would have been impossible just a decade earlier: Thanks to the cell infusion, Ryan was now considered NED – no evaluable disease. Her body was cancer-free.

Ryan is still NED today and continuing annual follow-up appointments at the NIH, experiencing things she never dreamed she'd be able to live to see, such as her children's high school and college graduations. She's also donating her blood and cells to the NIH to help them research other potential cancer treatments. "It was an honor to do so," Ryan said of her experience. "I'm just thrilled, and I hope my experience can help a lot more people."

Patrice Lee, PhD, VP of Pharmacology, Toxicology and Exploratory Development at Pfizer

Photo courtesy of Patrice Lee

Patrice Lee got into scientific research in an unconventional way – through the late ocean explorer Jacques Cousteau.

Lee never met Cousteau but her dreams of working with him one day led her to pursue a career in science. Initially, Lee completed an undergraduate degree in marine biology; eventually, her interests changed and she decided to get a dual doctoral degree in physiology and toxicology at Duke University. She now works at Pfizer's R&D site in Boulder, CO (formerly Array BioPharma), leading a group of scientists who determine the safety and efficacy of new oncology drugs.

"Scientists focused on drug discovery and development in the pharmaceutical industry are deeply committed to inventing new therapies to meet unmet needs," Lee says, describing her field of work. "We're driven to achieve new medicines and vaccines as quickly as possible without sacrificing safety."

Among the drugs Lee has helped develop during her career, including cancer therapies, she says around a dozen are currently in development, while nine have received FDA approval — an incredible accomplishment as many scientists spend their careers without seeing their drug make it to market. Lee's team is particularly interested in therapies for brain metastases — something that Lee says is a largely unmet need in cancer research, and something her team is working on from a variety of angles. "Now that we've had rapid success with mRNA vaccine technology, we hope to explore what the future holds when applying this technology to cancers," Lee says.

But while evaluating potential cancer therapies is a professional passion of Lee's, it's also a mission that's deeply personal. "I'm also a breast cancer survivor," she says. "So I've been on the other side of things and have participated in a clinical trial."

However, seeing how melanoma therapies that she helped develop have affected other real-life cancer patients, she says, has been a highlight of her career. "We had one therapy that was approved for patients with BRAF-mutant metastatic melanoma," Lee recalls. "Our team in Boulder was graced by a visit from a patient that had benefited from these drugs that we developed. It was a very special moment for the entire team."

None of these therapies would be available, Lee says without rigorous science behind it: "Facts come from good science. Facts will drive the development of new drugs, and that's what will help patients."

Chiuying "Cynthia" Kuk (they/them) MS, 34, third-year medical student at Michigan State University College of Human Medicine

Photo courtesy of Cynthia Kuk

Cynthia Kuk was just 10 years old when they had a conversation that would change their life forever.

"My mother, who worked as a translator for the government at the time, had been diagnosed with breast cancer, and after her chemotherapy treatments she would get really sick," Kuk, who uses they/them pronouns, recalls. "When I asked my dad why mom was puking so much, he said it was because of the medicine she was taking that would help her get better."

Kuk's response was immediate: "That's so stupid! Why would a medicine make you feel worse instead of better? When I'm older, I want to create medicine that won't make people sick like that."

Nine years later, Kuk traveled from their native Hong Kong to the United States to do exactly that. Kuk enrolled in a small, liberal arts college for their Bachelor's degree, and then four years later started a PhD program in cancer research. Although Kuk's mother was in remission from her cancer at the time, Kuk's goal was the same as it had been as a 10-year-old watching her suffer through chemotherapy: to design a better cancer treatment, and change the landscape of cancer research forever.

Since then, Kuk's mission has changed slightly.

"My mom's cancer relapsed in 2008, and she ended up passing away about five years after that," Kuk says. "After my mom died, I started having this sense of urgency. Cancer research is such that you work for twenty years, and at the end of it you might have a fancy medication that could help people, but I wanted to help people now." With their mother still at the forefront of their mind, Kuk decided to quit their PhD program and enter medical school.

Now, Kuk plans to pursue a career in emergency medicine – not only because they are drawn to the excitement of the emergency room, but because the ER is a place where the most marginalized people tend to seek care.

"I have a special interest in the LGBTQ+ population, as I identify as queer and nonbinary," says Kuk. "A lot of people in this community and other marginalized communities access care through the ER and also tend to avoid medical care since there is a history of mistreatment and judgement from healthcare workers. How you carry yourself as a doctor, your compassion, that can make a huge difference in someone's care."

In addition to making a difference in the lives of LGBTQ+ patients, Kuk wants to make a difference in the lives of patients with cancer as well, like their mother had.

"We've diagnosed patients in the Emergency Department with cancer before," Kuk says. "I can't make cancer good news but how you deliver bad news and the compassion you show could make a world of difference to that patient and their family."

During their training, Kuk advocates for patients by delivering compassionate and inclusive care, whether they happen to have cancer or not. In addition to emphasizing their patient's pronouns and chosen names, they ask for inclusive social and sexual histories as well as using gender neutral language. In doing this, they hope to make medicine as a whole more accessible for people who have been historically pushed aside.

"I'm just one person, and I can't force everyone to respect you, if you're marginalized," Kuk says. "But I do want to push for a culture where people appreciate others who are different from them."