Life in the Balance
A Physician's Memoir of Life, Love, and Loss with Parkinson's Disease and Dementia
By Thomas Graboys, MD
Reviewed by John O. Pastore, MD, PSR Board Member
Only fifteen years ago, in 1993, Dr. Tom Graboys was on top of the world. He was one of the most respected physicians in the rarified atmosphere of Boston cardiology and a member of the "dream team", convened to look into the controversial case of Reggie Lewis, the Boston Celtics star. Tom was a stalwart leader in the Lown Cardiovascular Group, named for Bernard Lown, a co-founder of the International Physicians for the Prevention of Nuclear War, which was the recipient of the Nobel Prize for Peace in 1985. Especially in the years leading up to the Nobel, Tom was active in IPPNW and in its US affiliate, Physicians for Social Responsibility.
But Tom was more and had much more than that.
He had a wonderful, accomplished and universally admired wife, Caroline. He had a brilliant mind and an athletic body. And he had a legion of patients who virtually worshiped him, as much for his humanity as for his skills as a Harvard cardiologist.
Tom was known to the rest of us in Boston cardiology as a premier practitioner of non-invasive cardiology in its truest sense. He spoke and published widely on the over-use of expensive and often unnecessary invasive technologies. Even more importantly, he argued tirelessly in favor of seeing, listening to, and treating as a fellow human being the whole patient. Countless times on ward rounds, I have told residents and fellows that my friend Tom Graboys across town would have encouraged us, with evidence to support his view, "not to rush to angioplasty or coronary bypass surgery on this patient".
But even I did not know everything that Peter Zheutlin and Tom himself have disclosed in this magnificent and beautifully written book. I did not know that Tom, after examining his patients, would sit with them on a couch, almost knee to knee, never with a desk interposed. I did not know that he gave each patient his home phone number. And I did not know that he always wrote out longhand some encouraging suggestions after his patient visits, never giving the patient a pre-printed sheet of instructions.
In essence, Tom was in many ways the best of us at holistic cardiology care.
Aided selflessly by the considerable writing skills of Peter Zheutlin, Tom recounts in this deeply personal book what he has lost in the last ten years: his cherished wife Caroline to colon cancer in 1998; his career to severe Parkinson's with Lewy body dementia in 2005; and perhaps forever, his graceful athleticism and the confidence it conveyed. Tom does not pull any punches. The Parkinson's and Lewy body dementia have ravaged his body, his mind, and sometimes his spirit.
What he has retained and gained is equally important, though. While he clearly still grieves over the loss of Caroline, he is re-married to an extraordinary woman, Vicki. One surmises from this book that Vicki is essential to his physical and psychological stability, and a woman who loves and supports him despite now being married to a very different Tom than she had expected. He also has the love and strength of his adult daughters, Penelope and Sarah, their spouses, Vicki's children, and his grandchildren. And he has great friends and former patients from of old.
In the last several pages of this book, Peter Zheutlin has Tom reflect on what advice Tom the skilled and compassionate physician would give to Tom the patient with a devastating illness, or to any patient facing what he has faced. The wisdom and poignancy of those pages, but also the entire book, convinced me to put this unique and unflinching story into the hands of every cardiology fellow at my own medical center. Despite having been a cardiologist for more than 35 years, I have learned from Tom's unforgettably honest story how to live and practice better.
Tom freely admits throughout the book that in retrospect he has not handled every aspect of his devastating illness as well as he might have wished. But in my view, he has been as graceful a patient as he ever was a physician. Both as patient and as physician, he has also not lost his capacity to heal.
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