Imperfect: A Cancer Surgeon's Journey

By Ronald B. Irwin

In this engrossing and heart-tugging memoir, Dr. Irwin tells the story of his life: from gardening with his grandmother as a young child, though a tormented and dysfunctional upbringing to the trials and tribulations of self-funded educational pursuit, resulting in national prominence as a cancer surgeon.

• Language: English
• Publisher: Lulu.com
• Release date: Jan 18, 2016
• ISBN: 9781329839328

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Imperfect: A Cancer Surgeon's Journey

Imperfect: A Cancer Surgeon’s Journey

Ronald B. Irwin

Copyright © 2015 Ronald B. Irwin

All rights reserved. No part of this book may be reproduced, stored, or transmitted by any means – whether auditory, graphic, mechanical, or electronic – without written permission of both publisher and author, except in the case of brief excerpts used in critical articles and reviews. Unauthorized reproduction of any part of this work is illegal and is punishable by law.

Disclaimer:

The events and people described in this memoir represent my memory and my perception of defining moments in my life. I have in some instances combined personalities or utilized artistic license in the use of names, although dialogue as quoted is as exact as my recollection would allow. It is not my intention to disparage any individual or institution, only to describe my understanding of interactions as they occurred from my frame of reference.

Cover designed by Rob Dick

Hardcover Printing: January 2016

eBook ISBN: 978-1-329-83932-8

Hardcover ISBN: 978-1-329-82328-0

Paperback ISBN: 978-1-329-70695-8

Published by;

Cunning &Associates, LTD

501 Andover Rd

Wilmington DE 19803

Distributed by:

Lulu Publishing Services

www.lulu.com

Willingness to accept responsibility for one’s life is the source from which self-respect springs.

Joan Didion

TABLE OF CONTENTS

Foreword

Chapter 1: The

Chapter 2: High School

Chapter 3: Go Blue

Chapter 4: Medical School

Chapter 5: Internship

Chapter 6: US Navy

Chapter 7: Residency

Chapter 8: Mayo Clinic

Chapter 9: Private Practice

Chapter 10: Harvard

Chapter 11: Musculoskeletal Tumor Surgery

Chapter 12: Medical Administration

Chapter 13: Rebirth

Chapter 14: Retirement

Chapter 15: Marriage(s)

Chapter 16: Fatherhood

Chapter 17: Alcohol

Epilogue

Acknowledgments

Foreword

Step into this story of a blue-collar kid who grew up in a dysfunctional family, worked his way through Michigan undergrad and Medical schools, did fellowships at Harvard and Mayo, and became a world renowned orthopedic oncologist. It was not a perfect or pretty path. As the title implies, Dr. Irwin’s journey was littered with broken marriages, broken promises, broken hearts, and broken addictions. It is an inspiring story of transformation and grit.

This story contains insightful commentary on private struggles, public policy, personal relationships, organizational change, and a hard won victory over alcoholism. It also contains heart-breaking glimpses into the tragedy that cancer wreaks on young and old lives alike. It is poignant, honest, insightful, and funny. You will find it fascinating from start to finish.

I have known Ron for more than 4 decades. We first became acquainted when my wife served as Maid of Honor at his first wedding. We have remained steadfast friends ever since.

So let me tell you a little about a guy who, in spite of all his imperfections, worked diligently every day in the pursuit of perfecting his craft and saving lives. Ron is a guy I have called on many occasions with my minor and major complaints and he has always responded fully and thoughtfully. I have called him when he was on vacation to stitch up a friend’s finger, and he was at my door 15 minutes later. I have called him to let him know that my daughter lost her first baby at 9 months into the pregnancy, and he called every week for a year to see how we were coping. I have called him to take a look at a suspicious growth on my wife’s hip, and it was off the next day in his operating room. I have called him for advice on 3 hip surgeries and 2 back surgeries, and he graciously reviewed the x-rays and rendered his opinion. In short, Ron is the person you want in your corner if you are a friend with a life changing disruption or a patient with a life threatening disease. I will never forget being admitted to Beaumont hospital with a stomach issue and having him stop by to see me while I was stranded in the hallway waiting for care. To the jaw dropping shock of all the nurses standing around, I said: Hi Ronnie Donnie. No one could imagine anyone calling this highly esteemed surgeon and Chief Medical Officer Ronnie Donnie!! The ever-dignified Dr. Irwin responded, Hi Tricky Ricky! And then he asked, Why is Rick not in a room and being seen, and I don’t want him referred to as a case but as a person with a name! Needless to say, I quickly received more attention than I had received in months and had never experienced in a hospital.

Ron is a man of abundant achievements, but what he is rightly most proud of is his family. Having had the privilege of watching his three kids grow and develop since birth, it is easy for me to say that, whatever his imperfections, Ron’s kids always command the largest share of his heart. I had the distinct pleasure of attending the marriages of all three of his children. He was visibly touched by these significant milestones and the changes they represented for him and for them; I was moved by the deep grace and beauty of each of their lives.

As he writes in this memorable memoir, Ron is a bit perfectionistic and obsessive. Whatever he does, it needs to be just so. I have seen him in a tormented state because his boat wasn’t perfectly square on his lift. I have seen him suffer great angst over a couple of scratches on his hardwood floor. But thankfully for those of us who have been under his care, he has applied that same diligence to the smallest detail of his patients’, families,’ and friends’ minor and major issues.

This memoir is about a loving guy who pours out his thoughts and feelings in an honest and self-deprecating way. If you want a peek into the heart of a devoted father, you will find this book captivating. If you want to enter the world of a Chief Medical Officer trying to change the way health care is delivered, you will find this book fascinating. If you want to crawl into the mind of a world-class surgeon, you will be touched by the personal stories of triumph and tragedy. If you want to gain a deeper appreciation of the struggle with alcoholism, you will want to pick up this compelling confession. If you want to touch the soul of a really good man and be, in turn, touched by it, read this book.

Richard Bellingham

Co-founder and CEO, Possibilities, Inc

Chapter 1: The Early Years

You see the one that I am, not the one that I was. But the one that I was is also still part of myself.

Jean Amery

Ronnie, will you fix my bad heart when you grow up?

Sure grandma! But first we have to finish planting these carrots!

One of my fondest memories of childhood is of helping my paternal grandparents plant and care for their garden in the backyard of their Detroit home. My grandma Irwin liked to take credit for my wanting to become a doctor to fix her bad heart. In reality, her heart attacks were gall bladder attacks as she had a rare condition in which her organs were on the opposite side of normal -- (situs inversus in medical terms) -- thus the normally placed right sided gall bladder actually caused left sided lower chest pain mimicking that of a heart attack. Once she had her gall bladder removed (I can still see her gall stones sitting on her mantle!), her symptoms ceased. I of course didn’t know any of this when I was a child helping her tend her garden and first heard her declaration of my future career.

I am told that I was a relatively miserable and cranky infant born under the astrological sign of Virgo, for which I blame my predilection toward exactness and perfectionism. Indeed, I have always sought to be perfect in all endeavors: early on as a student and athlete, certainly as a son and grandson, in my professional life as an Orthopaedic Oncologist (bone cancer surgeon), and as a husband, lover, father and now grandfather. In my attention to detail I have driven many folks nuts, alienated more than a few (including 3 wives), and endeared myself to my patients and office staff. My inability to achieve such exactitude has been a life-long disappointment with resultant acting out in various forms. After years of therapy and a life-saving membership in Alcoholics Anonymous, I now realize that living one day at a time and believing in a power greater than me is the only way to peace and serenity.

As I recall it, I thought Ben Casey, chief resident of Neurosurgery on a TV show of the time (played by Vince Edwards) was a really cool guy and somebody I could become one day. He was tall (taller than I ever achieved), good looking and a real hard-ass. There was another TV doctor on at the time, Dr. Kildare, played by Richard Chamberlin, but he was way too much of a wuss for my style; good looking dude though.

All of this took place during junior high days as we called it then, at which time I also had to write a career paper. I researched and wrote on Pharmacy (I think I was enamored of those little white tunics they wore-similar to intern garb) and discovered that 6-7 years of college and post-graduate work was required, so I thought, what the hell, I might as well become a doctor! Truthfully though, I felt some great urge to help others, a trait that persists to this day and one attributed to Virgos as well. My desire to become a doctor was quite surprising to my father as I had spent my earlier years being sick to my stomach whenever blood was mentioned, or seen, or even thought about. He used to drive a black van with tinted windows for the Detroit City Morgue and would come home for lunch with bodies stuffed in the back for us neighborhood kids to wonder about. He reveled in telling us and showing us pictures of sectioned bodies found in garbage cans, or of auto accidents with blood all over the street. I of course was mortified by all of these taunts as even a plate of spaghetti with red sauce would bother me if good old dad mentioned how that looked like something he’d picked up recently.

Look at that! Looks just like the guts spilling out of a guy I picked up this morning! Eat your food goddamn it!

That was good old Ed Irwin: hard-ass on the surface, but really a softy when pushed. If not yelling at my mom, pretty much a daily occurrence, he was making some off-color joke, or bigoted comment, though in the 50’s that was more the norm than the exception.

I contracted rheumatic fever in third grade as I had a heart murmur and some abnormal blood tests (though that diagnosis was a bit overdone in those days, and I’m still not sure I really had it). Back then that required staying in bed for a whole year! I spent that year on the living room couch and was able to watch my classmates through the front window as the school was right across the street. My teacher Miss Schemansky came over twice a week to keep me up to date in my school work, and my dad always took her home. I’m fairly sure he was screwing her as he was always gone a long time though she lived close by; she was rather pretty, and my mom was always yelling at my dad about that possibility when she thought I wasn’t in earshot.

Where have you been? She only lives a few blocks away! I’m tired of you constantly screwing around!

Oh shut the fuck up Barb, you’re just paranoid cuz she’s prettier than you!

I would disappear, usually to my or my sister’s room, but earlier in my life I would cry and plead with them to stop to no avail. I finally learned to just go away to a place where I couldn’t hear them.

In fourth grade and going forward it seems that I was a bit of a problem as my mom once shared with me a letter from one of my teachers mentioning my lack of respect for authority, class clown behavior and what today would be called ADHD (attention deficit hyperactivity disorder). I was a satisfactory but poor citizenship type student till my junior year of high school when I started to get all As on my report card. To my dismay the principal wouldn’t let me run for class president senior year as I’d been in his office too many times the preceding years.

I have few memories of family life while living in Detroit but I do remember my older sister (by 18 months) Carol beating the hell out of me with boxing gloves in the front yard. About that same time my dad cautioned me:

Ronnie, if you ever get into a fight, you may win or you may lose, but rest assured that you will get beat again when you get home!

He was against my fighting except with boxing gloves with my big sister! He didn’t mind taking the belt to both of us though; I remember more than once trying to pull my dad away from Carol, usually when she got caught smoking in the attic. Carol and I drifted apart over the years, but now we are good; she was always the first person I called when I had marital problems, and I’ve had a lot of those-more on that later.

We moved from Detroit to Grosse Pointe in my 5th grade of elementary school. I was crushed. I had just fallen in love with somebody whose name I can’t remember now and asked my best friend to watch over her till I returned someday. You know how that turned out: they exchanged ID bracelets (in those days that meant you were going steady, but not much else compared to today’s hooking up). I didn’t see him again until he became one of my patients 30 years later. A few years later he died from a different cancer than the one I treated him for, as did his son from a similar cancer a few years later, again after undergoing surgery by me for a malignant thigh tumor. Though I was not fond of him at the time of his betrayal, I grew to love him again; he and his family certainly didn’t deserve the pain and suffering they endured during those sad times.

I couldn’t