Talk I gave at Grace Church and Toastmasters storytelling in December 2015

"One's destination is never a place, but a new way of seeing things."  - Henry Miller -     The late American writer

Where is one’s destination? Where is mine? Where is yours? The answer to these questions is simple. It is not a discussion needed to be had by great minds, great philosophers, great theologians. It does not require a great amount of pontification. The answer is simply “here and now“.

My name is Rudy Yanuck. I am a 48 year old retired pathologist, the 2010 Gateway Area  Chapter of the National Multiple Sclerosis Society’s Father of the Year, and a 21 year survivor of multiple sclerosis. Though my life with MS is full of opportunities to live in the here and now, MS presents challenges each day.   My family shares these struggles with me.  I know it is not easy for them and I am truly grateful.

So many people, myself included, focus their time and energy searching for, agonizing over, what their destiny in the future may hold. Where they feel they should be in five, 10, 15 years.  They fret over what could be, should be, might be, hope to be.  They forget about what is, the NOW. They forget to appreciate, cherish, love what is right HERE in front of them. The NOW.  Or worse yet, they only focus on the bad, and forget about the good. I wish I could say I've always lived in the here and now, but it wouldn't be true.Today I’d like to share with you some of those moments.

In the spring of my surgery internship at the Naval Hospital San Diego, in 1994, I felt as though I was on top of the world. Life could not get any better.  About to finish the professionally most challenging, physically taxing year of which over twenty years later I am still most proud, followed by three years of flight surgery, then orthopedic surgery residency and career as an orthopod.  This was my destiny!  

Then one day, “Lieutenant, tomorrow at O-800 you WILL report to staff sick call.  You WILL obtain your medical record and you WILL report to the ophthalmology clinic.  You have an O-830 appointment with the neuro-ophthalmologist.  You WILL receive an MRI.” the Chief of the Department of Urology, sternly ordered me.  Immediately, I stiffened in fear.  

I wasn’t to concerned about the ophthalmology appointment.  I had been evaluated by The neuro-ophthalmologist two months previously as part of my flight surgery application.  I had been selected and would not have had the orders in hand to report for flight surgery training that summer had I had not passed the eye exam.  It was the MRI I feared.  That test had the potential to discover, uncover, reveal, ruin… and save me.  

During my internship I was generally referred to as doctor.  So when a captain referred to me as lieutenant, I knew the only reply was “Yes Sir”.

From July 1, 1993 to July 1, 1994 I did a basic surgery internship at the Naval Hospital in San Diego. Early in July 1993 on my trauma service rotation, I began having some difficulties with touch sensation.  Feeling pulses in order to get blood for an arterial blood gas measurement was difficult for me, sometimes impossible.  It became the running joke of one of the staff surgeons.  At times I felt the tears wanting to erupt but I refused to show my true emotions, laughing along with him.

As the year progressed, I started noticing other difficulties.  I had more trouble than most with fine, and even some gross motor tasks.  As the rest of my team would glide rapidly down the staircases, their feet seemingly not even making contact, I would be left slogging behind.  On call nights when I stayed overnight in the hospital and was awakened, summoned to assess a patient, I found it difficult to begin the long trek from my call room to the patient wards, spending the first 20 yards or so bouncing off the walls for balance.  One day I asked a fellow surgery intern if he was tired.  He emphatically replied “HECK YEAH I’M TIRED!  I’VE BEEN UP FOR THE LAST 36 HOURS!”  So I tried to convince myself that it was just a hazard of the job.  But deep down I knew there was something more.

I had been a surgical intern on the urology service for the month of April 1994.  The interns rotated Fridays,  performing minor surgeries with the department chairman.  The previous Friday was my turn.  Apparently he had noticed something in my surgical technique that caused him enough concern to lead to our Monday morning meeting in his office, and warrant a mandatory ophthalmologic evaluation and MRI.

At the appointment, The neuro-ophthalmologist performed essentially the same exam he had performed two months previously.  This time he asked more directed questions focusing on my peripheral vision.  He was looking for signs of bitemporal hemianopsia, the classic symptoms of a pituitary Adenoma. A brain tumor that affects peripheral vision.  Untreated it could cause blindness, endocrine disturbances, and potentially death.  

My responses to all of his questions where “No”.  “Your exam is unchanged from the last time I examined you.  I don’t see a justification for an MRI.”  “Whew.” I thought, finally releasing the breath I was holding.  “Well”, he said, “actually I do. If the captain wants an MRI, the captain gets an MRI.

The month of May, I spent assigned to the pediatric surgery service at a private hospital in San Diego.  As an unlicensed physician, as most interns are, I had a very limited role in actual patient care at this hospital for liability reasons.   I primarily observed, not being allowed to write notes and orders in patient charts, cover inpatient call, not even allowed to “scrub in” on surgeries.  The relaxed pace was sometimes boring but a welcome reprieve from the frenetic pace of the rest of the year.   

Preoccupation over my upcoming MRI towards the end of the month blurred my memory of that rotation.   One event does, however, stand out.  I had been informed of a little boy who had received a gastric tube for feeding because of a congenital abnormality.  He was having difficulty breathing due to indigestion and bloating.  Later that evening, the father called me with the same complaints.  As instructed, I told him to “burp” the tube and go to the emergency room if his difficulties continued.  I went to bed.  

Early the next morning, around three am, the father called me back to inform me his son was dead.  I froze in panic.  “My God, what do I say?  What do I do?” I thought.  I had never been in a situation like this.  Medical school only prepared me to take care of the living, never teaching how to deal with this inevitable scenario.  

Previously, I had been a part of a team in these kind of situations.  The more experienced attending physicians handled this stuff and I stayed in the background with the rest of the surgical entourage.  This time I was alone having to talk with an acutely grieving parent. I expressed my condolences for his loss.  I hung up the phone with the unsettling feeling that I handled it all terribly wrong.  Eight months later, when my daughter died at 4 dAys old, I would learn that there was nothing I could have said to ease his pain, but to have said nothing would have been inexcusable.

The morning of Thursday, May 26 I went to the radiology clinic for my MRI.  The machine looked like all the other CT scanners and MRI scanners I had seen previously.    But this time, I was the patient lying on the table whose head the unseen magnets would rotate.

I lay supine on the table.  A cage was placed over my head.  I imagined I looked like a hockey goalie or baseball catcher.  The table slid into the scanner,  automatically positioning my head in the narrow opening.  “!-!-!” went the scanner, then silence.  Suddenly a loud “gnweuew”, followed by “dupt-dupt-dupt-dupt-dupt-dupt-dupt-dupt, blop-blop-blop-blop-blop-blop-blop-blop, doof-doof-doof-doof-doof-doof-doof-doof, rat-tat-tat-tat tat-tat-tat-tat.  The sound would have been deafening had it not been for the headphones placed over my ears.  Then silence.  A few seconds later  it started again.  This pattern continued for the next two hours.

The following afternoon I called the radiology department to get the results.  I spoke to the neuroradiology resident who was reluctant to discuss the preliminary results.  Radiologists generally don’t discuss results with patients, only doctors.  Dilemma, I was both.  He nervously stressed the results were only preliminary, not yet reviewed by his attending radiologist, not yet finalized.   he then delivered his preliminary findings, which were word for word of the eventual finalized report,with a shaky voice,not out of nervousness and insecurity in his interpretation, but out of concern for what his interpretation meant to the person on the other end of the phone line, me.  

I listened, hung up the phone, and steadily, with heart pounding, throat closing, and eyes welling, walked to the men’s room.  Once the latch clicked behind me, I collapsed to the floor against the corner, in a heap of wails and sobs.  I wept like I never wept before, and only thrice since.

My pituitary gland was fine.  The test uncovered severe bilateral demyelination of my periventricular white matter, ultimately resulting in a diagnosis of multiple sclerosis.  Just like that, my professional hopes and dreams, my destiny, vanished.  The Navy forced me into a field of medicine I had  never  enjoyed, never considered, and in fact, had felt not really a true clinical specialty, pathology.

I did my pathology residency at the University of California, Irvine, a prestigious program, with some prestigious names in the field of pathology.  I could not see that then.  I was too busy mourning the loss of what could’ve been, should’ve been. I was too busy being angry at multiple sclerosis for what it had taken from me professionally. I was too busy fighting accepting what was there in front of me, the here and now.  I did not see nor  appreciate the opportunities being given me.I wanted my destiny back!  

Anger prevented me from accepting the what is and fully engaging myself in my training. Had I done so, it would not have taken me the many attempts to pass the pathology specialty boards as it did. Life would’ve been so much easier for me and my family had I embraced the opportunities.

Following my residency, I did hematopathology fellowship training at the Armed Forces Institute of Pathology  in Washington DC, a very prestigious program, with many prestigious names in the field of pathology. It was during this training when I began to accept my destiny, embracing the here and now.  I started seeing it in a new way. Interestingly I began to enjoy my job, finding it less difficult than it had been. I began having fun.

After a 20 year career in pathology, my multiple sclerosis had progressed to the point even the low physical demands were becoming physically taxing.  After a three year battle to save my job, I took a forced federal disability retirement. Again, I failed to see the opportunities presented. I did not embrace my new destiny. Once I finally did, I began to enjoy my new life. I began having fun.

Today - my here and now - I am a full time at home dad to five kids, ages 4- 21, spending my days with my children and working on taking care of  my health. These are the moments I cherish. Life could not get any better.  THANK YOU

Almost Famous

“Guitar player wanted,” read the ad in The Harrisburg Patriot News classified section in early spring of 1985.  I had recently been kicked out of the band I was in after the one and only concert we played, an assembly at my high school in Mechanicsburg, PA, which I booked.  Suffering from mono at the time, no warning, discussion nor common courtesy was extended.  They just dropped off my guitar equipment after the show and that was it.  Determined to continue with my passion for the guitar, I searched for another outlet.  

Rick Ream answered when I called the number in the ad.  Rick, six years my senior, lived in the neighborhood adjoining mine.  He told me he and Bret Sychak had left their previous “cover” band, The Spectors, and were putting together a band that would only perform original material.  They intended to use the next six months to “get tight” then move to Los Angeles.  He asked my plans.

“College,” I replied.  I obviously was on a different trajectory.  After all, an education was in my near future and they had aspirations of becoming “starving artists”… or so I thought.

A few months later, Rick and Bret were at the high school passing out pink paper flyers containing four individuals photos, each occupying a quarter of the page, of Rikki Rockett, Bret Michaels, Bobby Dall, and Matt Smith.  The flyers announced that their band “Paris” would be the performers for that evening’s high school dance, although heavy metal is not really danceable music.

After school, the cafeteria was abuzz with students waiting for their buses to take them home, while “Paris roadies” fought the outbound current of kids, like salmon heading to their spawning grounds, bringing platforms, drums, amplifiers, and guitars into the cafeteria.  Rikki and Bobby entered confidently.  Rikki looked much the same as I had always known him to look.  Bobby strolled in looking nothing like I remembered.  

When we had met years earlier, he looked much like an MBA grad student with a preppy button down shirt, slacks, and a short cropped haircut.This day he wore a leather jacket, t-shirt, and torn jeans with long flowing locks of dark hair extending to his low back, the prototypical “bad boy of rock” look.

A few minutes later Bret sauntered in with the same look as Bobby, his usual style, with an air of what I interpreted at the time to be arrogance, but what I now see as calm self assuredness. Matt Smith, the guitar player whom I had never met before, frantically entered, almost on the brink of a nervous breakdown.  While loading his equipment for transport, he had dropped his Marshall 50 watt amplifier head, shattering its tubes that provide the patented Marshall sound.  Without them, the amp would not work.  He had neither the time nor the money to replace them on such short notice.

I had a Marshall 100 amplifier head that I  offered him for the show.  Back at my house, I strapped on my Kramer Voyager Imperial with Floyd Rose Locking Tremolo, my favorite “ax”, slang for guitar, to give him a quick tour of the amp head.  I started playing a riff that I had made up some weeks earlier.  Matt excitedly slung on the strap of my Les Paul Standard, another of my axes, and excitedly exclaimed, “Cool lick.”  “Teach it to me,” he requested.  So I did.

The fall of my sophomore year at Dickinson College in 1986 as I strolled through the bookstore, an album cover on an end cap caught my eye, stopping me in my tracks.  “No fucking way.” I murmured to myself in disbelief.  The album cover was almost exactly the same as the flyers being passed out years earlier, only the name of the band had changed and C. C. Deville’s picture sat in the quarter of the cover that used to be occupied by Matt’s in the flyer.

I purchased the album and went straight to my dorm room, placed the record on the turntable and the title track began.  “NO FUCKING WAY!” I screamed within the first four beats.  There it was.  My riff.  The title song.  I was floored and in shock.

No one believed me.  At least not until, while at home for break,  I went down to the basement where I had my “studio”, a portion of the basement my dad and I had “finished” years before.  I intended to learn the other songs on the album.  After all, I already knew the title track.  The first song began.  Within four measures, the basement door flew open.  My mom stood at the top of the stairs shouting, “Rudy, They’re playing your song!”