Every Second Counts (26 page)

Slowly, Bart told us the story. His kid brother, David, had stubbed his toe in a game of pickup basketball over the weekend. It had gotten terribly bruised and swollen, but David just thought it was broken. The next day, he got a nosebleed that wouldn’t stop. Blood gushed down his face, and finally he had to go to the emergency room, where a staff doctor diagnosed leukemia and admitted him to the hospital in order to start transfusions. Now, virtually overnight, he was in a precarious state and could die.

David Knaggs was 31 years old. His wife, Rhiannon, was pregnant with their first child.

It was the middle of the night back in the States, but I didn’t care. I started calling and e-mailing all of the cancer doctors I knew. I called Dr. Jeff Murray, the child-cancer specialist from
Fort Worth
who had treated Kelly Davidson. I also called Steve Wolff, the chairman of the LAF Scientific Advisory Committee who had consulted on my own case and steered me to the right specialists. I woke Dr. Wolff up, and he immediately offered to consult. He promised to check on David’s status, and in the meantime recommended that we quickly get David transferred to a cancer center.

“We’ve got to get your brother moved,” I told Bart.

Bart just nodded, still too devastated to talk much. “Listen, I’m here with you,” I said. “You can’t fall apart. We’ve got to get a move on.”

Next, we set up a human chain to help get Bart home to
Austin
. I reached Jim Ochowicz, who was still in
Paris
, asked him to meet Bart at the
Paris
airport and take care of him. Och met him at curbside, got his bags checked in and upgraded him, and held his hand, literally.

Just before Bart boarded the flight, Steve Wolff called back with worrisome news. David’s white blood-cell count was 177,000—and the normal white blood-cell count for a young man is between 4,000 and 7,000. “He’s got about thirty times too many white blood cells, and that indicates a lot of disease,” Dr. Wolff said. “It’s very aggressive.”

The immediate danger, he said, was leukostasis, a life-threatening thickening of the blood. “He’s at a critical juncture,” Wolff said. He recommended that David be moved, and quickly, to a specialized facility equipped to deal with aggressive leukemias; otherwise he could deteriorate quickly. “He needs to make some immediate progress against the disease,” he told us.

Bart got on his plane, worried sick. He and Och flew to the States with Bart sitting bolt upright. Finally they touched down in
Chicago
, and as he changed planes for
Austin
, Bart talked again to Steve Wolff. David was going to be moved by ambulance to the M. D. Anderson cancer facility in
Houston
, where a specialist was waiting to admit him.

Bart landed in
Austin
, got in a car, picked up his mother, and began driving to
Houston
. He was so tired that his mom had to sing songs to keep him awake as he drove. They reached M. D. Anderson at about
four
A.M
.
, and David’s new cancer doctors, Archie Bleyer and William Wierda, met them there. What happened next was a testament to the power of science.

By
seven
A.M
.
they had performed a bone biopsy on David and typed the cancer. Next, they performed a procedure to lower his dangerously high white blood-cell count. They gradually removed the blood from his body, pulling it from his inner thigh, in order to remove some of the white cells. They centrifuged the blood and put it back into his body. By
noon
, the procedure was complete and his white blood-cell count had fallen below 100,000.

The last time Bart had laid eyes on David, his younger brother was a robustly healthy man with an easy way about him, one of the many smart, athletic young Austinites who’d found a good life in the city, who tapped at a computer by day and played pickup basketball by night, and who was so sure and secure in his future that he was starting a family.

Now Bart stood by David’s
bedside
. In 24 hours, David had acquired small blue bruises all over his body. They were the marks from the capillaries that were bursting and bleeding inside him because he had no platelets. His breathing was labored and shallow, because there was a mass in his chest.

Once David was stabilized, he embarked on a course of clinical-trial chemotherapy, a regimen only available at specialized cancer centers. By August 1, he was undergoing the rigors and toxins of chemo, and he had a fighting chance to survive.

I talked to Bart every day, and I sent David handwritten notes regularly. “I believe in you,” I wrote. “I know that what you’re doing is even harder than what I did. I see how hard it is on your brother. But I know you’re strong, and he’s strong. I’m just another guy who’s had cancer, and who knows that you can do this.”

David did well until November, when his health went sideways. He lost the use of his hands and feet, the result of nerve damage. He could move one finger. That was it. The doctors began talking about a bone-marrow transplant and looking for a donor, testing the members of his family for a match.

David’s wife, Rhiannon, spent most of her pregnancy sleeping on a Murphy bed in his room at M. D. Anderson. One evening, as David slept, she went into labor. Rather than wake him, she rushed with her mother to the Texas Women’s Hospital. Later, as she fought through her contractions, she reached David by phone. She lay there in the delivery room, while David talked to her soothingly. David listened on the other end of the receiver as his first child came into the world. Isabella Knaggs was born on
November 24, 2002
.

At Christmas, they found a perfect sibling match for David’s bone-marrow transplant: Bart.

On the day after Christmas, my 36-year-old best friend went to
Houston
to begin the process for harvesting his bone marrow, so it could be transplanted into his brother. After a series of EKGs and MRIs, to make sure he was perfectly healthy, the doctors put Bart on Neupogen, the blood-boosting drug that I’d been given during my own chemo. They also gave him a series of shots in order to build up his stem cells. Twice a day for five straight days, Bart had to get shots in his stomach from a long hypodermic needle.

The shots and the drugs gave him terrible bone aches. He complained of horrible, dull, incessant pains. I knew exactly what he was talking about: they’re called bone flares, and chemo patients get them all the time. One minute you’re lying in bed, feeling okay, and the next minute a deep pain flares through the center of your bones, deep down below your muscles, where it seems no painkiller could ever reach.

I teased Bart, trying to keep things light, but it hurt me to know that my best friend finally, fully understood the cancer experience. “Oh-ho,” I said. “Now you’ve joined the bone-pain fraternity.”

On New Year’s Eve, they siphoned Bart’s blood out of him, and centrifuged it, taking it from his left arm and putting it back into his right arm. They separated out the plasma. It was difficult to grasp that what was left, a small yellow drip bag with some fluid in it, contained stem cells from Bart’s bones and was his brother’s best chance to live. The transplant was done: some of Bart’s life passed into David.

It took 100 days before we knew whether the transplant was successful. Each day went by, and Bart hoped, and I watched from afar, sending messages from my various travels. “The strength is in
you
,” I wrote to David. “You’ve just got to believe it.”

One day in early May, Bart called me. His voice trembled as he said, “David is well, and he’s coming home.”

On
May 6, 2003
, David came home to
Austin
. He was temporarily leukemia-free, and his platelet count was normal. He was still on medications for nerve pain, and he was 50 pounds lighter—cancer takes the mass out of you. He’d lost his job, and the body he knew, and he had a lot of rehab ahead, with an uncertain outcome. But he was home.

I wasn’t there when he came home, because I was in
Europe
, but I sent him a present. It was a bike, a black Trek mountain bike, and a fine-looking thing. Bart mounted it on rollers and plugged it into a windtrainer in David’s living room. David rode it every day, as part of his rehab. He sat and watched Cubs games and rode his bike. We hoped his strength would return, but it didn’t. A month later he relapsed and as of this writing he was back with his team of doctors at M. D. Anderson, starting the fight all over again.

We don’t do anything alone, none of us. I certainly didn’t fight cancer alone, or regain my health through some extraordinary solo effort. I survived with the help of six different doctors, four chemo cycles, three surgeons, a devoted mother, dozens of tirelessly caring friends, and several much-cussed-at nurses, including my oncology nurse LaTrice Haney. An important fact was that they didn’t disagree or fight amongst themselves. My friends took turns caring for me, and none of my physicians objected to a second opinion or declined a consultation. Instead, they worked together to heal me. We could only try to do the same for David.

When I first won the Tour in 1999, I knew my old cancer ward was following my progress. Each day I thought about my old hallway at the
Indiana
University
Medical
Center
in
Indianapolis
, where I suspected that LaTrice turned on the TV and watched, nervously, to see if my lung capacity would hold up in the mountains. I knew that each morning, LaTrice came to work and pointed to the TV and proudly said to whoever she was treating, “He was a patient here.” I still know it.

Each time I cross that finish line, she jumps around the room, hugging nurses and doctors and patients. Once she said, “You felt us. I know you felt us.” And I did.

Who would want to be a singleton, when you could have all that? Anyone who imagines they can work alone winds up surrounded by nothing but rivals, without companions. The fact is
,
no one ascends alone.

CHAPTER 7

My Park Bench

I
’ll be honest with you: I don’t wake up every morning thinking
I want to be an inspiration to somebody today.
Some days I don’t even want to put shoes on. I just want to wander around barefoot, dragging the cuffs of my jeans in the
Texas
grass, and think about nothing more complicated than whether to drink a beer or play golf, or both. Usually, I decide to drink a beer for every hole of golf I
would
have played.

For a while, after I won the Tour for the fourth time, I quit shaving. I’d get up in the morning and look in the mirror, and think,
Well, why should I? Who cares?
The stubble on my chin grew until it was patchy and uneven, and my friends called me “Chewbacca,” or “Grizzly Adams.”

College said, “What are you doing that for?”

I was doing it because beer and a beard were my puny versions of excess.

“It’s all I have,” I said.

But eventually, I got tired of it. Hard as I try, slacking doesn’t agree with me. Everybody needs something to do with their days, to occupy their mind and energies, and in my case that’s especially so. I don’t just need to take my edge off; I need to wear it off, saw it off, and sand it off. When I’ve let myself go for too long, gotten way down in the slackage, I look at myself in the mirror, unhappily, and say, “You sorry sack of slack.” And I get back on my bike.

But I can’t ride in the Tour de France forever, and eventually, I’ll have to find something else to do. I guess my next career won’t be in diplomacy. Here’s something else to consider about retirement too: if the Joux-Plane was my hardest day on a bike, it was still easier than giving a speech.

One day, like it or not, I’ll be faced with the inevitable cooling of my career—and then what? What will I do when my muscles and tendons don’t respond to the bidding from my brain, and I’m vulnerable to upset, and the stage victories don’t come in the thick clusters they used to? Or when I suffer a bad-luck crash I can’t recover from? These are all things that could determine when I quit.

My plan is to keep racing through 2004 and beyond, and to try to win a record-tying fifth title. Whether I can actually do it is another matter: people constantly ask me about the record, but I’m superstitious, and I know too much about the race, the accidents that can happen and the way a body can give out, to say that I’ll do it.

The greats will tell you that a fifth Tour was hard, and a sixth was impossible. In 100 years, no one has ever won six, and the very best have tried. It’s as if there’s an invisible barrier. Indurain won five straight from 1991 to ’95 and made a valiant attempt at a sixth in ’96, but on a big climb to Les Arcs in the seventh stage, his body failed him. Instead,
Denmark
’s Bjarne Riis won the tour. Jacques Anquetil won his fifth in 1964 but then vanished from the podium entirely. The great Eddy Merckx was going for a sixth in 1975 when he was dealt a vicious blow by an irate fanatic: a man leaped from the crowd and punched him in the stomach as hard as he could. Two days later he was still sore and laboring, and he was finally beaten on a mountainside by Bernard Thevenet.