(Pagano is the head coach of the NFL’s Indianapolis Colts)
I don’t get how having cancer is inspirational. In most cases, it strikes indiscriminately. Except for some few cancers that can be traced to environmental (e.g., benzene induced leukemia) or behavioral (smoking for lung cancer; cycling for testicular cancer) factors, and some identifiable genetic anomalies, so far as medical science is yet capable of ascertaining, cancer occurs randomly. It is a matter of bad luck. Even behavioral or environmental or genetic factors can’t be resolutely pegged as cancer agents—a great many people smoke without getting lung cancer, and a great many (in fact, most) who get lung cancer have never smoked. Not all professional cyclists get testicular cancer, but the incidence of testicular cancer amongst cyclists is far higher than in the non-cycling population, just as lung cancer among smokers occurs far more frequently than it does amongst non-smokers. Not all women with the so-called breast cancer gene get it. About all that can be said about cancer and causation is that some behavioral and environmental and genetic conditions are present at a greater than average rate when cancer appears. There is a loose correlation between some specific conditions and the appearance of cancer, implying, but not proving, causation. Outside of those few correlations, we haven’t a clue.
Even more random is whether or not any particular cancer might be treatable. While the five-year survival rate of, for example, pancreatic cancer is near zero, it’s not zero. Some few get lucky, or perhaps have enough resources at their disposal that standard protocols can be tailored for their specific treatment, such as can be imagined happened with Steve Jobs. Money matters in health care, no matter what sort of government initiatives are taken to level the playing field, and it especially matters in cancer treatment. Cancer treatment is evolving, mainly in the field of therapeutic agents like chemotherapies, fast enough that standard protocols available to patients in medical backwaters are not likely to always be the best available therapy. It helps to be able to hire the very best, and mainly, best informed, among cancer therapists. But still, all the money in world won’t necessarily yield a cure. Steve Jobs didn’t live much past the five-year anniversary of his diagnosis of what was a rare and uniquely treatable form of pancreatic cancer. First diagnosed with an islet cell neuroendocrine tumor in October 2003, he died almost exactly eight years later, in October of 2011.
I find Jobs deeply admirable for the manner in which he dealt with cancer. He never made cancer his identity. He never pretended he could “beat” cancer. Nobody beats cancer. An indifferent Fate either allows treatments to work such that life can continue, or she doesn’t. There is very little to a battle with cancer except crossing the fingers and carrying on as best can be. Jobs ignored his cancer as much as he was able, which tells me that he was a man quite comfortable in his own skin; that he had contemplated and accepted the temporal nature of his own life long before the diagnosis. People who set up a cancer diagnosis as a life or death morality play seem, by contrast, rather childish. Cancer is not beaten because of a cheery, hopeful disposition. It is really never beaten at all, but to put it more aptly, cancer doesn’t concern itself with the moral rectitude of its sufferer’s efforts. It kills or not as it will.
Which is why I don’t find Chuck Pagano’s story at all inspirational or compelling. Chuck Pagano, in the first year of his tenure as head coach of the Indianapolis Colts of the National Football League (the oblong, US style of “football”), was diagnosed with acute promyelocytic leukemia (a form of acute myelogenous leukemia) early this season. He took time off for treatments, but returned in time to coach the team for the last game, a victory over the Houston Texans, a team that could have won home-field advantage throughout the playoffs with a win (i.e., a team sporting one of the league’s best records). APL is highly treatable, usually entering remission with the administration of a derivative of vitamin A. The reports are that Pagano’s cancer is in remission. Good for him. But the cancer is also highly susceptible to relapse. The end of the line treatment in the event of a relapse is a bone marrow transplant, which is a harrowing, life-threatening ordeal that requires months and sometimes years from which to recover, if at all.
It was the first of September that Pagano was diagnosed. He was back at work by the end of December. Aside from a thinned out head of hair, he looks rather hale and hearty. What exactly did he do that was inspirational? He took the relatively benign treatments, they worked (for now), and he’s back at work.
Football is often, in the minds of its fans, considered a morality tale—a battle of good versus evil. So too is a cancer diagnosis often cast as a morality tale—a battle of mankind’s innate goodness against the evil that would harm him. Anytime cancer (or other life-threatening illnesses) and football intertwine, the amplitudes of each of the morality tales are conflated and magnified. Battling cancer in order to be able to battle the foe across the field makes for an especially worthy hero. But neither football nor cancer is a morality tale. Football is a fun-to-play and enjoyable-to-watch game. Watching or playing football is entertainment, nothing more and nothing less. And there is no such thing as battling cancer. It either kills you or not. So Pagano doesn’t inspire me in the least. I would in fact admire him more if he would do like Jobs, and refuse to let cancer define him, and tell everybody who believes otherwise, that football is just a game, and point out how wonderful it is that we’re so rich and well-fed and otherwise healthy that we can coach and play and watch it.
The National Football League and the media hounds covering it promote the game as a morality play, so it loves nothing more than having a battling cancer story line to add to what it already sells as game that tests and reveals the moral fortitude of its players and coaches. The Colts improbably made the playoffs with a rookie quarterback at the helm. The team was supposedly inspired to such heights (after an utterly dismal losing season a year before) by its absent head coach’s battle with cancer. But these are professional athletes, each making well in excess of six figures, some in several multiples of seven figures per year, to play a game. This is their job. What more inspiration should they need than a paycheck? And two other teams improbably made the playoffs with rookie quarterbacks this year. The inspiration of Pagano’s battle with cancer will undoubtedly be pegged as the motivation for the Colts’ success if they go far in the playoffs. Pagano’s successful “battle” (so far) is a story of the type loved by the media, and by the league, so it will be ceaselessly repeated in the hype leading up to each game the Colts manage to play.
The league would like nothing more than to see an AFC championship game between the Colts and the Denver Broncos, a team led by Peyton Manning, the former quarterback for the Colts. There would be young Andrew Luck (the Colts’ rookie quarterback), battling against his veteran predecessor in what has to be his last good season, on a team coached by a cancer survivor–so many juicy angles burnished with moral tincture that the media would have too much on its plate to say grace over. I rather just enjoy a good football game, and by the time the conference championship games roll around, the teams are always pretty good, and so usually is the game (the winners of the conference championships play in the Super Bowl).
I have a son who has suffered through two bouts of leukemia, somehow managing to survive two bone marrow transplants. If Pagano relapses and requires a bone marrow transplant, he might discover how utterly indifferent is cancer to the battles he might wish to engage. I found nothing inspirational about my son’s two bouts with leukemia. As he well knows, there is no battling cancer. Cancer will do what cancer will do. Sometimes the luck holds and a cure, or at least a successful treatment, is effected without killing the patient. But anyone who thinks they “beat” cancer is a fool. If they won, it was only because cancer let them. Where is the inspiration in that?