Over Labor Day weekend, registered nurse and current medical student Derek Neal unexpectedly went from the role of health-care provider to gravely ill patient.
Neal, 41, a second-year medical student at the University of Arizona College of Medicine in Tucson, spent six years as a nurse caring for sick children before going back to school to become a physician.
Now the married father of two young children is looking at the medical system from a new vantage point - as a patient facing advanced-stage cancer.
"On August 31st I was a medical student. But on September 1st, not anymore," Neal said in an interview last week. "It's been really weird for me. I was waiting for my CT scan and thinking how lonely this place can be for patients."
Neal's life changed when he went to the emergency room with a stomachache. He'd diagnosed himself with pancreatitis. Doctors at the UA Medical Center spotted something far more serious - a mass in his right lung, lesions on both adrenal glands, and lesions in his bones.
Further scans revealed lesions on his brain. Neal knew he would be fighting for his life.
But he was also incredulous about the diagnosis - Stage 4 lung cancer. Once he got over the shock, all he could think was, "Are you kidding me?" As a medical student he was familiar with thinking he was at risk of one disease or another. But not this.
"Ironically, I remember sitting in our pulmonary block (in medical school) last spring when we talked about lung cancer," Neal said. "I thought, 'I've made efforts to be extra careful with my lungs. I don't smoke. I've never smoked. At least that is one cancer I don't have to worry about'."
Indeed, the vast majority of lung cancer cases are in former smokers and smokers. But it also happens to people who have never smoked. Doctors often refer to this as "never smoker" lung cancer. About 12 percent of lung cancer deaths per year are in "never smokers," according to a 2008 study published in the PLoS (Public Library of Science) Medicine journal. Non-smoker lung cancer became more well-known in 2006 after Dana Reeve, the wife of the late actor Christopher Reeve, died of the disease.
After his diagnosis, Neal made changes in a simple way - by listening to his body.
He no longer has a desire to eat processed food or meat. He's been vegan since Labor Day, which means he eats no animal products, including dairy.
The last time he drank a Diet Coke, a longtime favorite, was Aug. 31. He tried to drink it a week later, but had an aversion. An avid coffee drinker, he finds it difficult to drink coffee now.
Instead, he's been drinking fresh squeezed juice, and eating flax seed and vegetables like kale and bok choy. He's also been eating a lot of turmeric.
"Being cleaner with everything appeals to me," Neal said. "If you'd asked me a month ago if I had a healthy diet I would have said 'yes, we have salads most nights'. But I wasn't as healthy as I thought I was."
In addition to Western medicine, he's incorporating integrative medicine in his healing and is exploring acupuncture, aromatherapy and Chinese herbs. He's not always successful at staying in the moment, but that is the goal. Each day with his wife and children is a gift, he says.
Now experiencing first-hand the financial toll that chronic illness takes on families, even those with medical insurance, Neal gets emotional when he talks about all the support he's getting.
"It's hard to come to terms with. I think, 'what makes me more deserving than someone else?' I also don't know how anyone could go through this alone."
A graduate of the UA College of Nursing, a former UA Medical Center nurse and a current UA medical student, Neal is well-known in the local medical community.
"For our unit he will always be family, and we take care of family here," said Pam Spencer, a nurse in the UA Medical Center's pediatric intensive care unit, where Neal worked for six years. "We are hoping to raise enough money so his wife can take time off to be at home."
As a student of science, Neal says he's never given much thought to miracles. But that perspective is changing, too.
"I'm thinking, 'is there some other lesson I am learning, to make me a better person or a doctor?' I hope so. ... I'll let my patients know, 'I am here to support you, because it's not easy'."
How to help
Updates on Derek Neal's condition and information about how to help his family are at: http://teamderekneal.com/
Contact reporter Stephanie Innes at firstname.lastname@example.org or 573-4134.