Keeping busy sometimes is best medicine for serious illnesses

May 21--The winter that cancer ate its way through his body, Dr. Raymond Schaerf should have had it made.

An accomplished thoracic surgeon, he was at the pinnacle of his career, just named chief of staff at Providence St. Joseph Medical Center in Burbank in 2002. After 26 years in the business, he thought nothing of working 75 hours a week or of visiting patients at home.

He was pretty young, in his mid-50s, and busting with work ethic. That energy was tempered, however, by mesenteric lymphoma, cancer of the lymph nodes accompanied by a fat tumor tucked near his bowel. He went under the knife on Dec. 21 to take out his tumor, then headed back to his office New Year's Eve. He never missed another day in the office.

"The tonic for me was going to work," he said. "I love what I do. If I hadn't have kept going, I would have started psychologically deteriorating. I needed to have a reason to get up in the morning, not just lay in bed and stare at the ceiling."

Schaerf's tale mirrors many high-profile struggles to balance work and wellness. Lance Armstrong beat cancer to win the Tour De France six times, while Earvin "Magic" Johnson rebounded from the AIDS virus that ended his basketball career to become a fabulously successful entrepreneur. ABC News anchor Peter Jennings is laboring behind the scenes, undergoing lung cancer treatment as he attempts to return to nightly broadcasts.

Their high profiles, wealth and professional status set them apart from average workers, but their diseases are no different. This year, the Centers for Disease Control reports 1.4 million people will be diagnosed with cancer, while an estimated 850,000 to 950,000 Americans are living with HIV.

With improvements in treatment techniques, the American Cancer Society estimates roughly two-thirds of cancer patients will return to their jobs. While staying on the job can provide good economic and physical stimulus, it can also be incredibly taxing.

"Can you imagine having to fight with an HR department when you feel like crap?" said Gail Sperling, patient services manager for the Leukemia & Lymphoma chapter that covers San Bernardino County. "Can you imagine what it's like if you have to go in and hide it? Or even worse, you have a disease, you're here working, English isn't your first language, you don't drive, you don't have insurance, anything? You can't imagine the pressure, it's so scary."

Things weren't so bad for Virginia Garner when she fought off chronic myeloid leukemia eight years ago. At age 52, she was preparing to start the school year at Diamond Bar High School, pulling a full-load of classes with one Advanced Placement and two honors courses. She made it her goal to stick with her students and get them ready for their exams at the end of the year.

"It was saving my life, having that responsibility and a reason to overcome the challenges," she said. "It helped me survive, but it was hard. I'd come home every day and hit the bed."

When she came down with pneumonia, she had to take time off. When her mouth sores, a byproduct of her treatment, got so bad she couldn't talk, she reluctantly had to stay out of class. Many nights, she found herself waking up over a pile of half-graded papers, worn out after a day of chemo and teaching.

She credits the co-workers who brought her soup and made her eat it and thanks the students who left her notes of encouragement. Her memories aren't so fond of a dean who gave away her AP class, saying it was too challenging for someone in her condition.

"The subscript was, you might die and the parents would be upset," Garner recalled. "That hurt -- it's also illegal. It's like kicking you while you're down."

Provided that the illness doesn't seriously impair a worker's ability to do his or her job, employers are barred from discriminating against them by the Americans with Disabilities Act and California Fair Employment and Housing Act. That's not to say that problems don't arise, however. Around one-fourth of the Los Angeles-based Cancer Legal Resource Center's inquiries stem from workplace disputes.

Even highly physical jobs should offer some accommodation for sick workers, according to Barbara Schwerin, the center's director.

"If someone's a policeman and they can't be on their feet, they could be reassigned to desk duty for a reasonable amount of time," she said. "What we'd like to see is a dialogue between employer and employee. Most work to try to come up with a solution."

Monica Adams' solution came in the form of occasional days off as a nurse case manager for Chubb Insurance, days off to prepare and recover from the ravages of the chemotherapy treatment. While coping with breast cancer in 2003, sometimes she'd work from home, sharing the load with co-workers. Stopping work was not an option.

"You think its a death sentence," the 38-year-old Long Beach resident remembered. "It's a lot of pressure. I'm thinking, who's going to take care of my daughter? Her father's not in the picture; my mom had just died. I started looking at my life insurance, to see what I had."

After a mastectomy, half a year of chemo and reconstructive surgery, Adams didn't need that life insurance. She's still on medication, which she'll take for five years, and she now works from a home office, but she no longer worries who'll look out for 8-year-old Jasmine.

That workplace support can make the difference between a speedy recovery and a treacherous ordeal. With colleagues leaving notes of support on their desk or sending flowers, patients look forward to going to work, making them healthier and more productive.

Grace Lara, a secretary in Queen of the Valley Hospital's cardiac unit, has had cancer four times and successfully went back to work after each surgery. Now 68 years old, she got her first breast cancer diagnosis at the age of 44, her second at 56 and a pair of skin cancers in 2003.

"When I got the news at work, it was like the people I work with got cancer, they were all so sad," she said. "Two years ago, I went back for two more surgeries, and two of my doctor friends went in with me to support me."

That same kind of support proved essential for Sharon Smead, a Long Beach accounts payable specialist. When she got breast cancer in 1990, she'd have her radiation treatment on the way to work and miss a day every other week. Her colleagues rallied around her, as they did again last year when she relapsed and the cancer spread to her ovaries.

Radiation took the harshest toll on Smead, knocking out her immune system as it killed off her cancer. Only on her sickest days did she fail to show up at her desk, determined not to alter her routine even when she felt awful.

"I had to miss some time because my white cell count was so low," she remembered. "I called my employer, and they said, don't even think about it, go home and get better. They were with me each step of the way.

"It's not a good experience, but it puts you in a position where you still feel like you're normal, going to work every day, doing what you have to do."

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