We Danced With The Devil: One Firefighter’s Cancer Chronicles

An exceprt from this article appears in the December 2009 issue of Firehouse Magazine.Editor's Note: Chief Trevino's share a brief story about his good friend Dave Jacobs in this article. Mr. Jacobs lost his battle to cancer before the article could be...

I wondered over almost three agonizingly slow weeks, waiting to begin the process. During this time I had many more tests and scans, and also had a rigid plastic-mesh mask made for my head and neck to hold me immobile so that the radiation treatments could be properly focused on the affected portions of my body without unnecessary collateral damage. I had seen no less than eight other doctors, ranging from radiation oncologists to chemotherapy specialists to swallowing specialists. I had also seen a specialty dentist who told me to expect that most of my salivary glands would be permanently destroyed by the treatment. This dentist, unlike any other I had ever been to see, was ready to pull any teeth on-the-spot that needed dental work; it seems that you can't begin radiation therapy anywhere near your mouth with any dental issues at all. Luckily, my mouth was in good shape and I went away with only cast-trays to give myself fluoride treatments for life since, due to a lack of saliva which provided it, my body would no longer be able to fluoridate my teeth to protect them.

This is also about the time I met Dr. Jay Liao, my radiation oncologist. I would get to know him a lot better over the coming months.

I also had minor surgery on Day 40 to install a stomach tube so I could eat. My "food" was to be three to six bags of liquid nutrition that would go directly from plastic IV-style bags into my abdomen via a PEG-tube, which hung from my stomach like a 10-inch, surgical-plastic umbilicus.

When the day for my first radiation treatment finally came, on Day 41, I was really nervous. My lung infection had gotten so bad that I was coughing up huge amounts of thick, green phlegm all day and all night. As soon as I lay down, the fluid in my lungs would rise to my throat and I would begin to cough and choke. The night I spent in the hospital when I had the stomach tube installed I was up all night because I simply couldn't breathe. Even when propped-up into a sitting position, my breathing was so labored it was like breathing through a small straw for each inhalation and exhalation, an exhausting process. Appropriately, I was placed on strong antibiotics for the infection before my first radiation treatment.

This was when my real nightmare began. I had been anxious to get going with treatment, but when it finally started, I found it was like entering a friendly torture chamber.

I've never been claustrophobic. I've never been afraid of confinement. I've been able to use an self-contained breathing apparatus, or be strapped down, or enter tight, dark spaces without even giving it a second thought. But getting radiation changed all of that for me. The rigid plastic mask they had made for me was designed to fit very tightly and hold my head and neck completely immobile. To administer radiation to the throat, a patient is placed on a hard table with restraints immobilizing the ankles, knees, arms, and torso. The rigid plastic mask is placed over the head and face and secured with clamps to the table. It is so restrictive, the patient can barely part his/her lips, much less open the mouth.

Once the team of technicians anchors the patient down, they all leave the room closing a huge metal, vault-like door behind them to protect from undue exposure. The room is then darkened and a large machine rotates around your upper body making strange noises in the shadows. My major fear was that I would have a coughing attack and would choke on the large amounts of phlegm in my upper respiratory system. I made this clear to the techs. They told me if I got into trouble that I should signal them by wiggling my fingers and making whatever noise I could during the procedure. They would be watching and listening from outside the room on closed-circuit television cameras, and they would come to my aid if needed. But I knew if I started choking it would take them at least a minute or two to get my signal, de-energize the radiation equipment, re-enter the room, un-strap my restraints, un-bolt my face mask, and allow me to sit up to cough and spit out the phlegm so I could breathe again. I was terrified. To try to keep from coughing as the goo rose up again in my throat, all I could do was pray to God for help. I alternated between Hail Mary's and Our Father's for 45 minutes until it was finally over, trying desperately to arrest the urge to cough which would bring on certain choking because I couldn't swallow.

As I prayed, my mind again wandered back in time to June 14, 1974: my first greater-alarm fire. The Polson Building on the downtown Seattle waterfront, home of the Ace Novelty Company, was on fire. All eight stories of it. And it was packed to the gills with plastics and other combustibles.