How a beloved doctor, self-advocacy and a full-time job helped one man get through treatment for lymphoma

Andy Firpo poses for a portrait
Andy Firpo was diagnosed with Burkitt lymphoma in 2014 and was treated by Dr. Oliver Press of Fred Hutch. Robert Hood / Fred Hutch News Service

Andy Firpo is a Fred Hutch employee who works on the center’s strategic initiatives team.

One Saturday morning in April 2014, I was shaving and I found a lump on my neck. I looked at my throat and saw my tonsils swollen, and I thought, “I’ve got a swollen gland.  No big deal.”

Later that week, I noticed the lump was larger, and my swollen tonsils had gone away.

After a trip to the ER, a course of antibiotics, and a visit to a specialist, Andy’s lump was biopsied. A couple weeks later, the specialist called him back.

“I’ve got the results,” she said. “Come and talk to me.”

At her clinic, the doctor walked in and said, “Okay, it’s cancer. We’re not quite sure what cancer it is yet. We know it’s a lymphoma. So we need to find you an oncologist and get you set up with some follow-up care. Here’s the cards for some oncologists that you can pick from.”

I said, “Well, I work at Fred Hutch and get all my regular medical treatment at UW ― I think I’m going to go for treatment there. No offense, thank you for all your help.”

I called my boss, who was the chief information officer at that time, and I said, “Hey, I just got this diagnosis, and I’m going to tell the rest of the leadership team. I just wanted you to know.”

He said, “Send me your scans.”

I said, “Okay, you’re the CIO … are you really going to give me a second opinion?”

He said, “No, you idiot. I’m going to go to Fred Appelbaum [Fred Hutch’s deputy director] and ask him who you should see.”

He called me back that day and said, “Ollie Press will be your oncologist.”

I met with Ollie the following day, and I was getting bone marrow and spinal tests the day after that. Later on the day of the tests, Ollie came back and said: “The bad news is you have this hugely aggressive cancer and you’re at stage IV, but the good news is that this is Burkitt lymphoma, and its aggression makes it relatively easy to treat. If you can stand up to a fairly aggressive chemo treatment, I can offer you up to an 80 percent chance of a full cure.”

Hearing him say that was hugely transformational. I said, “Sign me up, where do I start, what do I do?”

I had eight rounds of chemo, a week inpatient, two weeks outpatient. It was hell on earth. I’ve never been through anything like it before, and if I’m blessed I never will again. It was a huge loss of dignity. It was a huge loss of my control over my own personal being. It was a violation of my body, in ways that I never would have considered.

Yet, in truth, I had it ridiculously easy. I spent every third week in the eighth floor transplant ward at UW for my chemo, and every day I would go out and walk the floor. I was surrounded by people who had it far, far worse than I did. While what I was going through was very challenging for me personally, it was nothing compared to other people. I think that helped me. It was easier to focus on getting through what I was going through, knowing that it was just a tiny piece of what  others were dealing with.

I kept working during the entire chemo. I worked full-time for the first four rounds, and I worked half-time for the last four rounds. That was a significant contributor to my comfort. It was amazing how accommodating the entire universe around me was. Part of the value, I think, of sharing what was going on with my leadership team and the teams that were reporting to me was that it got pretty quickly past any sort of awkwardness. And the nurses that were over in the university transplant ward were accommodating. They would walk in, and if they saw I was on the conference phone, they would come in and take my vitals without bothering me. But the part of it that was transformative for me was when I was on those conference calls, I wasn’t stuck in a cancer ward having my hair blasted off with chemicals. I was here at work at Fred Hutch. I was mentally with the team that I was engaging with.

Ollie delivered what he suggested. He had said, “If you can handle going through this aggressive treatment, I can give you an 80 percent chance of being cured.” And I’m now two years into remission. Every sign is indicating ― and Ollie is telling me ― “You’re cured, the numbers say this isn’t going to come back.” I even got my hair back.

I think Ollie read me pretty well when we first met. He was able to assess whether I had the commitment to doing this kind of treatment and energy levels to be able to live it. I think he was spot-on. It feels like there was some unspoken assessment done, where Ollie was matching his bedside manner to me as a person. It was very practical. It was very matter-of-fact. I have no idea how he is with any other patient, but with me that was the exact perfect way to go about it.

When I was diagnosed, I asked Ollie, “What I can do?” And he said, “Be your own advocate.” Having my oncologist, who was the head of the Fred Hutch Clinical Research Division, telling me to be my own advocate — it empowered me to be specific, and if I didn’t understand something, to ask. I think that really did help with the outcomes. It enabled me to participate in my care in ways that I otherwise wouldn’t have known to do.

Ollie cares, and that really comes through. He worked very hard, and if there was something he could change, he would do it. I have no idea about the other 50 bazillion things on his mind, but none of that came through. He was focused on me. I really appreciated that.

One of the other ways Ollie expressed caring for me was being willing to engage personally ― showing me pictures of the cool ocean life he’d photographed when he went scuba diving with his son the weekend before I happened to see him. That was very much a part of my image of him as my physician. I think many doctors learn to avoid that engagement, or perhaps the reality of having so many patients die causes them to back away from it. I didn’t get that from Ollie at all.

Working with Ollie, having him as my oncologist, and watching what he’s done here at Fred Hutch, has caused me to try and raise my game. I’ve struggled with the question of how do I give back? I have found myself paying attention to things that I never would’ve had on my radar before. I’ve been able to do fairly well in fundraising in Base2Space [a stair-climb up Seattle’s Space Needle to raise money for research at Fred Hutch]. I would never have dreamt of climbing the Space Needle two years ago. And now it’s something I’ll do as long as my health allows.

Editor's note: Story based on an interview conducted Jan. 17, 2017.

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