Movement 1: Medical Missions as an Act of Selfishness

 [Note: I was "lovingly" told that some of my posts were too long and I need to include a summary at the top.  So here you go.  Tldr: I'm serving sick children in Africa! I'm also a prideful jerk! Who can save me from my pride? Jesus! What does my tendency to pride mean for medical missions?!?....O_o]

            I’m currently in Botswana, Africa.  I will be working in a children’s cancer ward that my hospital in the United States has an international partnership with.  I’m incredibly excited because international Pediatric Hematology/Oncology is the trajectory of my professional career and I feel that this is the first step.  I am struck by the fact that 80% of children in rich countries are cured of their cancers; however, 80% of the pediatric cancers occur in low- and middle-income countries, where survival rates are often less than 25%.  Children die every day of preventable reasons and I would like to be part of fixing that disparity. 

            As excited as I am, I have a thought that has been weighing heavily on me lately.  I’m bothered by the reason why I want to do this.  Saving a child’s life from cancer is clearly good work to do, but what is my motivation for doing it?  Now I think motivations can be mixed and there can be many contributing reasons for a given action, but as I navigate the answer to this particular question, one motive stands out above the rest: I am selfish.  If I’m being honest I have to say that it is really important to me that it makes me feel good and, more importantly, look good to go serve cancer kids in Africa.  “Look at what I’ve given up! See how altruistic I am!” are unfortunately common thoughts that energize my actions. 

            Before we proceed I should offer a disclaimer.  Self-glorification is not the only reason that I want to help people.  I am genuinely animated by a desire to serve the Lord with my life, by an altruistic impulse to help people, and by a deep longing for justice.  I would even venture to say that these motivations are much stronger than my selfishness.  However, I’m wondering if this selfish motivation is like the proverbial poop in the brownie mix, a little bit ruins the whole batch.  It is this tendency to corruption of something good that I will explore. 

            So now that I’ve established I am, among other things, kind of a self-interested tool, I need to answer a few more questions for myself:  Is this selfishness a problem? What does it say about me? What does it mean for my work in medical missions? 

Is my selfishness a problem?

As I’ve already pointed out, saving kids from cancer is inherently a good thing.  I think very few people would argue against that.  So if the outcome is good, does the motivation matter? Since I’m betting there are other selfish people like me in the world, maybe doing good deeds should be made as self-glorifying as possible so as to maximize good deed doing.  One can argue the point, to which I would reply that it is an undeniable fact that our society values right motives.  If Batman fights crime because he enjoys violence, we wouldn’t find him much of a superhero.  If a politician expands access to healthcare because he is invested in the insurance company, we would cry fraud.  If an activist raises funds by lying about the impact of his charity, even if much of the money returns to the charity, we call him a disgrace.  These examples show that society values motivations in judging the goodness of an action even when the outcomes are good.

Beyond a societal definition of what is good, I value motivations because I am a Christian.  As a Christian, what I find to be good and right is defined by the very nature of God himself and his subsequent description of how we should follow his example.  In one of the most famous verses in the Bible, we have a strong description of God’s motivation in acting in the world in John 3:16, “For God so loved the world that he gave his one and only son.” Love motivated God to give his son, Jesus.  If God’s reason for giving his son was for 10% of our income or to create an army of evangelical Republicans, we would feel very differently about this God.  In God’s love, however, I have an example of right motivation.  Philippians 2:5-6 goes on to say, “…have the mindset of Christ Jesus, who being in very nature God, did not consider equality with God something to be used to his own advantage; rather he made himself nothing by taking the very nature of a servant, being made in human likeness.” Christians are called to have the mindset of Christ, who was motivated to serve through love.  So motivations matter to God and, therefore, ought to matter to me.

What does my selfishness say about me?

           

            Now that we’ve established a reason to value right motives, let’s explore what my selfishness says about me. To do this, I’ll walk through what happens when I perform a “selfless” act of service.  To illustrate selfless service in the Bible, Jesus washed his disciples feet after his last Passover meal and right before his arrest and subsequent execution.  Christians find this imagery, that the God of the universe would bend a knee to wash the dirtiest part of his peoples’ bodies, to be a beautiful expression of what it means to follow Christ.  Some groups of Christians will do this ritual as an act of worship to God from time to time.  While it makes for a pretty description, let’s see what it actually looks like when its my turn to wash someone’s feet:

            Alright, its time to whack these guys upside the head with Love. We’ll see what God wants to do through me being a stud.  

'Hey everyone, God says we are supposed to love and serve one another as Jesus loved and served us. To illustrate that point I’m going to wash all of your…’ (sick-nasty) ‘…feet.’ 

 Good speech, that really set a pensive tone.   I wish there was some epic music playing in the background, like I’m the main character of a movie – mental note for next time. Who first? Jeff just said something dumb and Nate is still snickering at him.  I’ll wash Jeff first to both give him a little love fist-bump and to heap some proverbial burning coals Nate’s way. Bwaha. Ok, somberly grab the water and then take off his sho- Oh shi….rrrroudofTURIN! That smell! Don’t react, don’t react, don’t react.  Hey I kind of hope the others smell that.  Ok slowly wash. Bleghh, is that a bunion? Hmm maybe nonchalantly angle the foot out so the others can see it better.  Perfect.  Look how much I am suffering! I wish I could capture this moment in Sepia tone. Embed a photographer - another mental note for next time.  What a good illustration of God’s love – high five, me! 

Although there is a heavy dose of facetiousness in the story, note the obsession with image and appearance.  Even while doing something selfless, there is a meta-narrative unfolding in my mind that is reframing the experience to be about me.  This reframing will direct my subsequent actions.  It is this corrupting feedback loop that turns an action into an exercise in pride.  The action may start well-intentioned and emanate from a genuine desire to benefit others, but as the corrupting thoughts occur, it slowly pulls the direction of my focus from others to myself.

The corrupting thought doesn’t necessarily have to be appearance.  It could be a motivation for a good feeling.   A common response to the question, “Why do you do the work you do?” is the answer, “It’s just so rewarding.”  A variety of interpretations are possible in that statement, but if I said it, I would probably mean that it makes me feel good to help people.   A degree of nuance is needed here to admit that the good feeling from helping others is itself not a bad thing (the same can be said for looking awesome while serving).  But it becomes a bad thing (i.e. a selfish thing) if that is my main motive for serving.  These corrupting thoughts can take many forms, from desire for material gain, to sex, to power, but they all have the final common pathway of self-serving motives.  In other words, pride.  

So here is what I’ve noticed about myself.  When I try to do something good, no matter how genuine, how well intentioned, there is a significant temptation to make it about myself instead of the object of my service.  I have a continual tendency to pride and self-exaltation, which are both grave sins in the Christian vernacular. Am I alone in this struggle? Thankfully no.  The Apostle Paul had something to say about the continual struggle with sin in Romans 7:21-25:

So I find this law at work: Although I want to do good, evil is right there with me.  For in my inner being I delight in God’s law; but I see another law at work in me, waging war against the law of my mind and making me a prisoner of the law of sin at with work in me.  What a wretched man I am! Who will rescue me from this body that is subject to death? Thanks be to God, who delivers me through Jesus Christ our Lord!

That’s me, a wretched man. I want to do good but I know that sinful pride is right beside me, or more accurately inside me.  It’s comforting to know that Paul struggled with similar feelings.    And truly, I think he’s describing a more universal struggle.  It is a basic fact of the human condition that no matter what we do, no matter how impressive our accomplishments, no matter how dirty we get serving the poor, no matter how much personal sacrifice, the corrupting influence of sin remains. For me, as I’ve already confessed, that corrupting influence is pride.  I am the most important thing in my life.  How do I escape a situation where the very problem is that I exist?

            Thankfully, God has provided an answer through Jesus.  I’ve found I cannot change how important I find myself to be.  But Christ provides a definitive, external answer to my internal cycle of corrupting self-love.  As the omnipotent, transcendental Creator, he posses an existence much greater than my own and, therefore, is a much greater object of worship than I am.  Through his sacrificial death on the cross, he provides a way to change my basic motivations by connecting me to God and teaching me what selfless love truly is.  Christ can redeem both the object of my desire and my motivations for obtaining it, from self-focused to Christ-centered.

            Though Christ offers such a beautiful redemption, I still struggle with sin.  I’m not perfect, nor will I ever be while I’m here on earth.  The Christian life is a process of learning to reflect Christ’s love more clearly.  Like a mirror, I cannot project my own light but rather I’m learning to more clearly project Christ’s.  So I will continue to serve.  Sometimes I will make it about myself.  Other times, and hopefully more and more frequently, I will genuinely say that I am serving with the mindset of Christ. 

What does this mean for International Medical Missions?

This framework is my foundation for a Christ-exalting, thoughtful and (hopefully) intelligent approach to international medical missions.  I must start with understanding my own state in the world, both wretched and hopeful, before I can focus outwardly on serving others.  In future posts, I hope to more explicitly connect these dots.  Stay tuned. 

Eulogy: Land that Drinks the Rain

[Author's Note: The subject of this meditation is a family friend and not a patient of mine.  I have received permission from his legal guardians to publish this post.]

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He saw too much hardship.  He died too young.  He was 7 years old, far too young for a funeral.  How can those he left behind process such a tragedy?  

It is customary at funerals to give a eulogy, a recounting of the life of the dearly departed.  The design of such a speech is to celebrate the deceased by memorializing the events if his time on earth. Through this narrative, we hope to illuminate the meaning of the loved one’s life.  But what if the deceased has felt so much pain and experienced so much evil, that it is hard to see the meaning through the suffering?  How do we see the good when it is wrapped in darkness? Perhaps this is the true purpose of a eulogy. By recounting the good despite the bad, perhaps we will find meaning of the young boy’s life:

“You were born into poverty and grew up in a broken home. You spent your early years lonely and afraid.  While you could not care for yourself, you had no one else to care for you. You were separated from your family and sent to a children’s home to find a better life.  As stability was within your grasp, cancer ripped it away.  You fought hard, enduring years of treatment, and you won many battles.  You even thought you had it beat, you thought it was gone, the doctors told you so, and yet the cancer returned, more vicious and deadly than before.  As the hopelessness grew, you soon found an army of friends, family, doctors, and nurses beside you. The struggle was fierce; you fought to the point of breaking.  You endured many things that kids your age should never have to endure.  Good news and the promise of victory again gave way to defeat.  The cancer again returned, and this time there was nothing we could do.  The cancer slowly took you from us, and now you are gone. 

                        Despite these trials, the good that we can recount about your life is plentiful.  I knew you briefly, but I quickly learned your smile could light up a room and your joy, when it shined through the pain, was as infectious as it was evident.  You were resilient, able to endure treatments designed to push your body to the brink of collapse.  You were obedient to your foster parents, always trusting in their guidance and ever respectful of their wishes.  You loved well and loved much, always thinking of the wellbeing of your friends and family.  You were imaginative, playful, and free spirited; it was very clear the cage your body had become could not adequately contain your lively soul. Moreover, you had a community around you that loved you dearly. You meant the world to your brothers and sisters, caretakers, and foster parents at the Home.  You were also always faithful to your God, believing in him to the very end for hope, strength, and salvation.  All of these examples illustrate the undeniable fact that while your body slowly deteriorated, your soul and your spirit were beautifully alive.   Those of us you left behind will forever cherish these memories of how you have impacted our lives…”

            …Is this where the eulogy ends? I have recounted the good of his life and assured him I will forever hold fond memories.  Is the meaning of his life the memories we shared? Yet I cannot keep the immense pain he have experienced from seeping into the spaces between the memories, dampening their color and obscuring their light.  I find myself, despite these good things, pressing my questions: Why so much suffering? What is the meaning of it all?

            There are those who see only the material world and declare there is no ultimate meaning.  Richard Dawkins expresses this sentiment when he says, “the universe that we observe has precisely the properties we should expect if there is, at bottom, no design, no purpose, no evil, no good, nothing but pitiless indifference” (River Out of Eden, 1996). He believed that the material world is all there is to existence, so there was no more meaning than that which we can create within ourselves.  Such a view can offer someone nothing more than a recounting of a life’s events yielding a subjective assessment of its significance.  The value of a life is in the eye of the observer as he decides what the historical data of a life means.  As the French existentialist philosopher Jean-Paul Sartre declares, “One always dies too soon — or too late. And yet, life is there, finished: the line is drawn, and it must all be added up. You are nothing other than your life” (No Exit, 1944). 

So is my dear friend truly nothing other than the sum of the events of his life? What if it’s characterized by so much suffering as his was? Was it still worth living? There exist no scales on which I could begin to weigh such values, yet confined to the pitiless, indifferent world, this is exactly what we must do. So bounded by naturalism, significance cannot extend beyond an observer’s ability to evaluate a life.  As the remembrance of his existence passes, then so does his significance. We can exalt our finite importance as high as humanly possible, and yet in the end it cannot escape the gravitational pull of meaningless oblivion. Surely there is more to life than this. 

            For those of us who claim a relationship with a transcendental God, there is more. For if God exists beyond the natural world, and if he is a personal being with values and preferences, then anything that God values is imbued with a transcendental significance. Because of the nature of God, this significance is eternal, immutable, and infinite.  It is incomparable to any that we know in the natural world. While there is certainly some significance in human accomplishments and relationships, it is a finite, fluctuant, and temporally limited sort. If you look for this type of human significance juxtaposed against God’s infinity, it will be hard to see.

From this it follows that if God values us, then we have such a transcendental significance. But how are we to know if God values us? Earlier, I said that a eulogy is a speech of praise meant to articulate a person’s value.  The word “eulogy” comes from the Greek “eulogia”, which can mean either “praise; good or fine language” or “blessing”.  Note that our modern word for eulogy comes from the Greek word for blessing.  So a euology can be thought of as a final blessing for the dead. In the New Testament we find that God’s blessing, his eulogia, is directed towards us. 

Land that drinks in the rain often falling on it and that produces a crop useful to those for whom it is farmed receives the blessing of God.  Hebrews 6:7

           Much can be said of this verse about the nature of suffering and its relationship to a benevolent, omnipotent God, but I haven’t the space for adequate treatment in this meditation.  For our purposes, let us note that our lives are described as “land that drinks the rain”.   Now rain can either be good or evil, nourishing or destructive, depending on the context.  These rains are the events of our life.  As land cannot control the location or amount of rain that falls on it, so we too cannot control most of what comes to pass for us.  Thus exposed to the tumult of nature, we must endure the experience of reality as it comes, with the hope that something redemptive exists beyond the horizon of this land with its erosive forces.

            Beyond the horizon, we find God.  He promises to bless us, to articulate our significance through his own eulogia of us. What he asks of us is to produce a crop, in this context meaning knowledge, faith, and joy in Christ Jesus. Here we see our lives can have a transcendental significance to him.  The rain that falls may be an overwhelming flood.  Someone may experience only suffering in his life, and yet through God, he has eternal significance. Regardless of our subjective evaluation of our lives, we are significant because God has declared it to be so through his eternal, unchanging, and ultimate evaluation of us. 

            There is one final component of how God values us that must be mentioned.  He does not see us as though he were watching a comedic movie or a tragic play.  God is not a mere spectator of our lives.  He intimately understands us through Jesus Christ, who has experienced the full breadth of evil, pain, and suffering.  Christ himself drank the rain through his life, death and resurrection. So we can be confident that whatever our suffering, be it from pain, loneliness, cancer, rape, or torture, He who declares us eternally significant understands its cost because he paid it himself. 

            So for my young friend who suffered so much, who died, and who was faithful to his God to the end, let us see the significance of his life through God’s eulogia for him:

“He knows the overwhelming pain of your life because He was there.  Through the sleepless nights, the loneliness, the abandonment, He was there.  Through the diagnosis, the breaking of your body, the poisonous treatments, He was there.  Through the love of your family, the support of your friends, the joys of your life, He was there.  Through all of it, He was there because you are infinitely valuable to Him.  You are so much more than the sum of the events of your life. Your significance to Him extends beyond life, death or time and into eternity.  You have drunk the rain and now you may forever rest in His eternal delight.”

           

           

             

On a Christian Solution to the Syrian Refugee Crisis: Who is my neighbor?

“But the religious expert, seeking to justify himself, said to Jesus, “And who is my neighbor?”

This question, uttered 2000 years ago by a man wishing to know the limits of personal compassion, echoes throughout history as mankind tries to define who is worth loving and resounds loudly today in the public debate of the refugee crisis.  To this question, Christ has a ready reply in the parable of the Good Samaritan. 

As the story goes, a man was assaulted on a lonely road from Jerusalem to Jericho.  Two Jewish religious leaders give a wide berth of the man as they pass him by.  A Samaritan then sees the man bruised and bloodied and stops his journey.  Surely the questions of his own safety occur to the Samaritan, as there is no guarantee the person or people that assaulted the man are not still lurking in the shadows.  To help a stranger is to leave himself all the more vulnerable to attack.  And yet he picks the man up, takes him to an inn, and pays for the man's needs himself.  In the parable, Christ illustrates the neighbor as the man who crosses cultural boundaries, who sees his fellow man in need and, despite personal risk and financial loss, comes to his aid.  To his questioner Christ poses the question, “who was a neighbor to the man who was assaulted?” to which the religious expert rightfully answers, “the man who showed mercy to him.”

The answer to this question of who is our neighbor is important for us today.  Prior to asking it, the religious expert had correctly answered Jesus that the second most important commanded is to “Love your neighbor as yourself”. So for those of us who follow Christ, contained in this interchange is both the command to love, the definition of who to love, and a demonstration of what it is to love. 

UNHCR 2015.  International refugees and internally displaced 

people by year.

To what degree can we apply these principals to the Syrian refugee crisis? The United Nations High Commissioner for Refugees estimates there are over 60 million refugees in the world today, either seeking refuge internationally or as internally displaced people.  Not since WWII, and arguably in the history of the world, has the number been higher.  Half of these people are children.  Taken together, these people would be the 24^th largest country on the planet.  Their original countries are broken, so they are wanderers on the road, existing in a space between national borders and legal status.  Their needs are the fundamental needs for all humans: shelter, nourishment, medical care and a place to call home.  They are an entire nation of the man found assaulted on the road.

Yet there is potential peril to ourselves if we help.  If we take in Syrian refugees, the argument goes, then who knows if we are letting in ISIS.  Are we leaving ourselves vulnerable to attack? Will we be the next Paris? Is there the potential for something worse than Paris? There are many questions and few answer to such objections.  Yes the potential for harm exists, no we cannot guarantee against unintended consequences if we allow these people in.  History and human psychology would suggest xenophobia far outpaces actual risks of xenophilia, but nonetheless risk remains. Like the Samaritan, as we stop and gaze at the assaulted millions, the risk of personal involvement weighs heavily on us.

Furthermore there are financial considerations.  What does an influx of thousands or millions of displaced people do to an economy? What about jobs? I find it hard to believe that our economy is at the point of a zero sum game, where one more person in means one other person out, and yet it seems incredible that there is room for everyone.  As more people come in, the economic stretch will be gradual, and those first affected will be the poor on the fringe. If 10,000 refugees mean 1,000 American families are displaced from jobs, what is our moral responsibility to those families? What about the already burgeoning costs of medical care, education, and social welfare? I can conceive there is a balance where at some critical number of new people, the scales will tip toward economic disaster, where more people will end up hurting than if we had never allowed anyone entrance in the first place.  Like the Samaritan, we will certainly feel our wallets lighten and our resources stretched by the moral obligation to provide for those we have taken responsibility for.

What conclusions can we draw from the above discussion? Is this a Good Samaritan moment where we help every person we encounter on the road? Or are the complexities such that we are justified denying refuge to those seeking it? The answer, as almost all answers in the real world, lies in a balance somewhere between the extremes.  For Christians, the command to love is overwhelming.  “Loving our neighbor as ourselves” is the second greatest commandment, subordinate to and proceeding from the greatest command to “love the Lord your God with all your heart, soul, mind and strength.” Christ’s answer to who is our neighbor is the man on the road in need of help.  Personal and financial perils are inherent in this command and acceptable risks to take, as Christ himself demonstrated on the cross. We are no greater than our master.  Yet we are also not called to be destructive with our love.  After this experience, I doubt the Samaritan did then give up everything and committed his life to roaming the roads, looking for hurting people to help.  There was also a limit to Christ’s healing ministry, he did not heal every person in every place he went.  He also spent time alone, praying and resting, valuable time than could have been spent helping the poor.  As Christians, we are called to selfless love, but we are not called to self-destruction. 

How do we strike such a balance with Syrian refugees? This balance does not give us an exact answer, but it certainly gives us the criteria by which we should approach an answer.  The correct answer is a selfless but not self-destructive one.  The answer that shows we love our neighbor as ourselves, and that accepts a certain amount of risk.  An answer that shows we are not first preoccupied with our own wellbeing, but rather the wellbeing of our fellow man.  However, It is also is an answer that accepts the complexities of the potential for harm in well-intentioned actions. 

With this discussion in mind, I will attempt a concrete solution to the problem.  I think the Christian response is to let Syrians in.  We need to be thoughtful about the amount we take and perhaps take some steps to verify the identity of the individuals, but we should open our doors to a decent number of them. We should encourage both our European partners and American continental neighbors to do the same, so no one is burdened with too many.  Then we should stay vigilant, having a good way of accounting for these individuals through appropriate identification mechanisms, perhaps tracking bank accounts and financial transactions, living situations, etc.  We should be strict in the law, with felony offenses resulting in removal from the country. We should also commit to social services commiserate with their humanity, such as basic housing, food assistance, education and job training and medical care all delivered with the goal of self-sufficiency within a few years time. 

We also need to address the supply of refugees from Syria, which means increase the military response to ISIS in an intelligent manner as well as a work with our multinational coalition to end the war in Syria.  Of course, this recommendation makes the situation sound simple when it is actually ludicrously complex and such an answer may be year away or may end in the dissolution of the state or worse, who knows.  But it needs to be higher on our priority list as a nation or else the humanitarian catastrophe will continue to degenerate and the Middle East itself will be at risk of explosion.  

Moreover, we need to pray.  Pray for the refugees, for a just solution to this madness. Pray for the disaster that is Syria, for peace and an end to the war. But also we need to pray for ISIS, for both the individuals’ salvation and the organization’s destruction.  An enemy is still an image-bearer of God, made in his likeness even if the eternal light in him seems long snuffed out. 

Lastly, this needs to elevate other matters of compassion in our minds.  Syria is all the rage right now, but what about the Latin American refugee children or refugees from other nations? What about the homeless American veterans? What about our actual neighbors next door with cancer, with broken homes, with selfish pride, with mental illness? Ultimately, this is a question of a Christian’s response to the evil and suffering of this world.  Christ’s answer to the problem of evil is a call to selfless, risky, sacrificial, but-not-self-destructive Love. 

“And we, seeking to justify ourselves, say to Jesus, ‘And who is my neighbor?’”

To which Christ responds, “Everyone.”

On Combination Chemotherapy: Hope through Death

The following is an essay limited to 500 words and answering the prompt, "What new medical intervention in the last 50 years had the greatest impact on pediatric medicine?": 

Leukemia is form of liquid death.  First described in 1845 after a patient died from a “suppuration of blood”, any such ghostly white appearance of the humors portended certain death. Slowly, doctors learned the true depravity of the disease: it was the blood, the ‘life of the flesh’, which attacked the body.

In the early 1960s, leukemia remained uniformly fatal.  Surgery had made progress against solid tumors and radiation oncologists had treated lymphomas, but both were impotent against the amorphous liquid cancer.  In humanity’s great battle against cancer, leukemia was the victor.  However, the first glimmer of hope arose from the ashes of one of humanity’s greatest battles, World War I.   As nitrogen mustard gas crept across the killing fields of Europe, researchers noticed it depleted the leukocytes of its victims. Thus began intensive research into chemotherapeutic agents, poisons that could kill cancer faster than they could kill the body.  Researchers discovered many types of chemotherapy, but none with enough killing power to completely eradicate leukemic cells.  After decades of research and war, doctors won several fights, but leukemia consistently won the battle and claimed its victim. 

Doctors Emil Frei and Emil Freireich of  the National Cancer Institute realized no single chemotherapeutic agent possessed enough power to eradicate the leukemic cells from the body.   So the duo proposed a clinical trial of a four drug combined regimen: vincristine, amethopterin, mercaptopurine, and prednisone.  VAMP, as it would come to be called, was a wildly controversial idea.  No one had administered so many poisons to a person before.  Even worse, the trial was for children, leukemia’s favorite target. Despite the opposition, Drs. Frei and Freireich maintained that the body had to be pushed to its limit, to the door of death itself, to push leukemia into the abyss.

In 1962 the trial commenced and the infusions started.  As the drugs dripped slowly into the children’s veins, their little bodies began to shrivel.  Leukocyte counts plummeted, as did the body’s ability to fight infections.  Some children experienced days of fever-induced delirium, others spent nights retching in the bathroom.  Drs. Frei and Freireich could only sit at the bedside, hold a hand, and wait.  Slowly, the miraculous began to happen.  The shriveled bodies plumped up, their energy returned, their infections subsided.  Laughter soon bounced off the walls of the oncology unit as the trial participants became children again.  Even more awe-inspiring, the cancer cells were gone from the blood and the first true remissions had been achieved!

The VAMP trials proved that cure was possible, and the work of Drs. Frei and Freireich inspired generations of doctors to continue research on combination chemotherapy.  The results of this effort are stunning: from 100% mortality 50 years ago, a child’s chance of surviving leukemia in certain circumstances is now greater than 95%.  From its dark beginnings as a weapon of war to its ascendant triumph as a lifesaving cure, the story of combination chemotherapy is a beautiful reminder that even in the darkest times, hope lives.