Pokin Around: Dr. Bob Saylor looks at death through eyes of a patient

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By Steve Pokin

Dr. Bob Saylor sits slumped in a wheelchair waiting for me outside Mercy’s Cancer Center.

His wife of 46 years, Marcie, stands behind the chair. She seems to be slumping, too, as if punched in the gut.

Dr. Bob Saylor

Retired doctor Robert Saylor poses for a portrait at the Mercy Cancer Center. He headed the hospital’s ethics program. He now has brain cancer and faces questions of his own life and death.

Bob, 64, has brain cancer. He is dying.

The plan was to interview him for about 90 minutes as he received chemotherapy. But he and Marcie have just been told his white-blood-cell count is too low. His fragile body can not handle the rigors of chemotherapy.

I ask if we can still do the interview. His voice is a whisper — sure. I wheel him into the small chapel in the cancer center.

I want to establish a starting point for our conversation. I don’t want to presume. So I ask him: Do you believe you are at the end of your life?

“Yes, I do. Do I see myself dying tonight? No. Would I be surprised if I did? No, I would not be.”

Bob is a nephrologist — a kidney specialist. But about10 years ago he went back to school for a master’s degree in bioethics. For the past several years he has been the director of ethics for Mercy in Springfield.

During this time he has worked with doctors, nurses, patients and their families. He has explored the big questions of life and death and tried to determine — case by case — when medical intervention should cease, when you simply let things be.

“Just because we can intervene as doctors does not always mean we should,” he says.

Now, as cancer takes hold of him, he is the patient. He is the one who must choose how to live his remaining days.

The deadliest cancer

In November, he was betrayed by his left hand. It stopped working. He thought it was carpal tunnel syndrome.

It wasn’t. It was a glioblastoma multiforme brain tumor the size of a small fist. Sadly, the fist has opened and spread its malignant fingers.

Weeks later, he was in Houston being prepped for brain surgery at the University of Texas M.D. Anderson Cancer Center.

The nurse practitioner looked at him and said: “If I were you, I would go home and get my affairs in order.”

In the chapel, he tells me, “That’s not how we do things at Mercy.”

The surgeon removed 92 to 95 percent of the tumor, which is good, Saylor says. He would undergo chemo and radiation to try to get the rest.

Once back in Springfield, Saylor added a new, different treatment — a supplement to the chemo and radiation.

It was a non-invasive procedure called Optune. Electrodes were placed on his scalp. They sent wave-like electrical fields into his brain to prevent the cancer cells from multiplying.

The initial results offered hope. Mercy issued a press release. The News-Leader ran a story — “Mercy doc tries new tumor-zapping treatment for brain cancer.”

Then the tumor came back.

“We can’t say it failed,” Bob says. “It is not doing what we thought it was going to do.”

“Well, I guess you’d say …

What can make me feel this way? My girl. Talkin’ ’bout my girl.”

Bob Saylor and Marcelene McMartin were 14 when they met at East High School in Sioux City, Iowa. They married at 18.

The song of their life together is “My Girl,” by the Temptations. Their boat, docked at Table Rock Lake, is “My Girl II.”

He plays that song every time they leave the dock.

“She has been my pillar of faith,” Bob says of his wife. “She has been my caregiver. She is my wife. She has kind of been my everything.”

Although he is ready to die, he clings to this good life of rewarding work, three brothers, four children and seven grandchildren.

“I still feel I have so much to teach people,” he says. “I have physicians coming down the hallway to discuss cases, to talk about things.”

He blames no one and no thing for his cancer.

“I never said to myself, ‘Why me? Why is this happening to me?’ I guess I have never been that way. What is going to happen is going to happen.”

He has a medical directive that gives Marcie oversight of his care. He will not tell me what it says. He does not want to unduly influence anyone else’s decision of what they should do. That decision is personal. It is based on the narrative of one’s own life.

But he does offer this: “I am far more concerned about quality of life than quantity of life.”

SOGI task force

I first met Bob at Brentwood Christian Church, where we attend. He sought me out to discuss our coverage of the community debate on the Sexual Orientation and Gender Identity ordinance.

This was before the ordinance was repealed in April. Bob was on the SOGI task force. He supported the law.

“Our job as a community and as a government is not to legislate morals,” he tells me. “It is to protect people from harm.”

The issue of protecting people based on their sexual orientation was important to him in large part because years ago he treated AIDS patients while in the Army at Fort Sam Houston.

Later, he was one of the few physicians who treated AIDS patients in the 1980s in Sioux City. And he treated them in Springfield, at Mercy, as well.

Bob served on the task force with others, including Dick Hardy, a former president of the Assemblies of God Central Bible College, which has since ceased operation. Their views on social issues — including SOGI — are as different as the music of Black Sabbath and, let’s say, the Temptations.

The two men discovered they both attended East High School in Sioux City. They did not know each other in high school. Hardy is 61.

They met for lunch. Hardy showed up in his high school letter sweater.

“We talked about life and friendships,” Hardy says.

They understood each other better; they respected each other; but continued to disagree.

“A friendship and a relationship are far more important than any task force that comes and goes,” Hardy says. “A friendship is from start to finish.”

Hardy calls Bob regularly.

“He will just start out in prayer,” Bob says. “They are beautiful prayers. He is a wonderful man. Yes, we have completely different social ideas. But he cares not about that. He cares about me as a person.”

The hopes of others

If anything, Bob is a pragmatist. As such, when he was first diagnosed he was unsure how to respond to those who said they prayed for him.

“I’m not sure if their prayers are going to matter in terms of whether I live or die — but it helps them,” he says. “My oldest son, Rob, has told me that when people pray for me it means they care about me. And if I ask people not to pray for me I take away their hope. I leave them only with despair. And I don’t want to do that.”

I ask Bob if he believes in an after-life.

“Do I want to? Yeah, I want to. Everybody wants to. I guess I do. I suppose I do. … I am not sure what life is before we are born or after we die. I guess that is as existential as you can get.”

I ask if he is in pain. He is not.

What is your greatest concern?

“Losing my cognitive ability is my greatest fear of all,” he says.

“Your business is your mind. If I can’t do what I want to do or am trained to do, it would be very difficult for me. Very, very difficult.”

He has, thus far, kept his sharp mind and occasionally sharp tongue.

“Some people think that during my brain surgery they should have taken out a little more of my sarcasm,” he says.

Bob can no longer walk on his own. His left hand still does not function. Yet he writes extensively on the website Caring Bridge about the loves of his life: his wife, his brothers, his parents, his co-workers, his in-laws, his pastors.

He will not pen good-bye letters to his four children. He doesn’t want to tip the scale of memory to his final days.

He and his father, who is deceased, shared a love of poet Robert Frost, and in particular the poem “Stopping by Woods on a Snowy Evening.” It is a poem about the inevitability of death.

A few months ago, Bob dreamt of his father reciting this poem to him in his baritone voice. Bob believes the dream has meaning — that his life will continue to have value until it ends. The closing stanza is:

“The woods are lovely, dark, and deep.

“But I have promises to keep.

“And miles to go before I sleep.

“And miles to go before I sleep.”

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