Immune System and Spirit Kept Cancer at Bay for a Year


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Jason Greenstein in July at Presbyterian/St. Luke’s Medical Center in Denver. He was given a new treatment that vanquished his Hodgkin’s lymphoma, but prolonged exposure to chemotherapy and radiation weakened his body and he died on Aug. 10.

Credit
Nick Cote for The New York Times

I recently chronicled the story of Jason Greenstein and his battle against cancer. He was at the vanguard of a new kind of treatment that unleashes the immune system to fight the disease as it does infections caused by viruses and bacteria.

But his reprieve lasted just over a year. Jason died last week, leaving as he spent much of his colorful life — on his own terms.

Jason, a personal friend since childhood, spent more than four years going toe-to-toe with Hodgkin’s lymphoma before all seemed lost in March 2015. He had 15 pounds of tumor on his left side, doubling every few weeks, and his oncologist tearfully told him it was time for hospice.

Then came the miracle. Jason was infused with an experimental drug. His immune system, in turn, destroyed his tumors within weeks and gave him new life. Over the next year, Jason relapsed, went into remission again, relapsed and, all the while, suffered an accumulation of medical trials caused by his prolonged exposure to chemotherapy and radiation. At one point, his back had to be rebuilt after steroids used in his treatment so weakened his vertebrae that they were disintegrating.

Days before the story ran, Jason was feeling strong, but his liver was giving him trouble. He had a surgical biopsy and experienced heavy arterial bleeding; doctors were forced to put him on a ventilator.

On July 31, the day the story ran, Jason had come off the ventilator but its effects left him temporarily unable to talk. Over the phone, I read him some of the comments from people who had read the story.

“Jason is an inspiration because of his indomitable spirit,” one wrote, “You helped humanity in your darkest hours, although it may not feel like it.” Another reader, who grew up in Boulder, Colo., with Jason and me, wrote: “Your dad was our hero growing up, now you are as adults.”

As I read, the nurse holding the phone up for Jason told me that my old friend smiled and nodded. In the following days, he climbed out of yet another pit. His voice came back. The biopsy was negative for cancer, but it did show serious infection that led to liver failure.

On Aug. 9, a psychologist and one of Jason’s doctors sat at bedside and told him he appeared to be facing systemic organ failure, could die before he left the hospital, and in the best case would have to spend the rest of his life on kidney dialysis.

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Mr. Greenstein with the reporter, Matt Richtel, a lifelong friend.

Credit
Nick Cote for The New York Times

“I’m done,” the psychologist, Andrea Maikovich-Fong, said Jason told her. He added, “I gave it about as good a try as anyone could.”

With the same firm resolve he lived his life, Jason decided it was time to say goodbye.

After five years of taking everything that disease threw at him, why was he choosing to let go?

Perhaps he was undone by the accumulation of medical setbacks. Perhaps Jason, the ultimate adventurer, couldn’t see past the tether of an illness that had become his life. If he couldn’t roam America’s roadways, radio blaring, going from one entrepreneurial thrill to the next, what was the point?

The night of Aug. 10, my wife and I drove to the hospital to say goodbye. There, at the foot of Jason’s bed, his mother, Catherine, sat as she had for so many days and nights, a stalwart, the stalwart, the fountainhead of his fighting spirit. Next to the bed sat his girlfriend, Beth Schwartz, a source of profound love and connection for a gregarious optimist stranded in a hospital bed. Cathy kissed him on the forehead. His breathing was labored. The nurse gave him morphine. He calmed. There was talk that he could last a few days.

The thing is, Jason never liked waiting around. My wife, a doctor herself, noticed a change in his breathing. She quietly told us: This is it.

Beth wiped the hair from his forehead and kissed him there.

“Goodbye, my sweet love,” she said.

Jason took a final gulp of life.

A few minutes later, I stood alone with Jason, for the first time in his fast-paced life, inert. I thanked him for friendship, promised he would be missed and remembered. I told him that I hoped my son would carry himself with Jason’s same dignity and class.

Jason, 49, was buried Tuesday in the presence of the same friends and fans who had been drawn to his free spirit and his prodigious athletic talent.

Born May 15, 1967, to Catherine and Joel Greenstein, Jason earned a degree in political science from Occidental College, where he played baseball and basketball, and subsequently graduate degrees in law from the University of Denver and business from Thunderbird School of Global Management. In addition to his mother and his girlfriend, he is survived by three sisters, a brother and 15 nieces and nephews.

The day after he died, Jason’s psychologist, Dr. Maikovich-Fong, emailed me. When she showed him his pictures in The New York Times, she wrote, tears of pride rolled down his cheeks.

“Usually I got a huge monologue from him regarding whatever he was talking about,” she said. “After seeing those photos he simply looked at me and said: ‘What a ride. I think I did pretty good.’ ”

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