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Arnie’s Sentence

Friedman lives life to fullest after brain cancer diagnosis.

Potomac’s Arnie Friedman had it made. He reached the pinnacle of his profession as an oral and maxillofacial surgeon and had served as president of the Maryland State Society of Oral and Maxillofacial Surgeons. After a long, successful and gratifying career in dentistry, he retired from his practice in 2000. He was relatively young, healthy and enjoying life; little did he realize what was asymptomatically developing within his head.

The Bronx native, product of a working-class background, moved to the Washington area to attend Howard University’s Dental School, where he graduated first in his class. Upon graduation, he was selected for the oral and maxillofacial graduate program at Howard University Hospital.

Soon after completing his residency, he met his wife, Carol, a Silver Spring native, and the two decided to remain in the area. In 1976 he purchased an oral surgery practice in Riverdale, in Prince George’s County, and went on to convert a boarded-up, old gas station into his office. For 30 years, Carol worked at his side in his practice.

"I recognized there was tremendous need for potentially expensive and necessary dental care among lower and middle class patients, who didn’t have the means to seek it out." For 30 years he removed sick or infected teeth, cared for oral lesions, performed biopsies and provided cosmetic surgery.

TWO YEARS AGO, Friedman was at a juncture in his life where he could smell the roses. Up to that point all his time had been occupied with running the practice, attending meetings and patient care. Now he toured the Smithsonian museums, went to art galleries and took time to appreciate the beauty of Washington, D.C. "I didn’t have a schedule," he recalls. "I could stop and sit on a park bench and watch the world scurry by — just being the observer."

In March 2004, the Friedmans spent a weekend in Pittsburgh with their daughter, Melissa, who had just registered in a graduate program in audiology at the University of Pittsburgh. Throughout the weekend Arnie noticed he had a slight headache. He was rarely sick, and he dismissed the pain as nothing more than an annoyance.

A few days later, on April 1, Arnie awoke with a severe headache.

"During the course of the morning, I couldn’t get out of bed," recollects Friedman. "I was completely immobilized. The headache intensified along with nausea that was as debilitating as the pain."

Arnie contacted Carol at work and requested she return home immediately. She insisted he call his physician, but with his general practitioner out of town, the Friedmans went to Holy Cross Hospital. There they met emergency room doctor Jim Delvecchio; who impressed the Friedmans with his professional approach and empathetic demeanor. Arnie underwent a CATscan, which provided X-rays of a cross section of his head.

THE TABLE WAS turned. Normally Arnie was the one holding a clipboard, standing by a patient taking notes. Now he was resting on a gurney when Delvecchio returned with the grim results. The CATscan revealed a tumor, roughly 3-4 centimeters in size, in the right frontal lobe of Arnie’s brain.

"My wife — basically a strong, supportive woman I love dearly — looked at Jim’s face and recognized the gravity of the situation."

Upon hearing the diagnosis, "My world came crashing down," remembers Carol. "All the staff came to attention and rallied around us. ‘What was the ER doctor’s name?’ I asked him several times because I knew I needed to remember it. ‘Get organized,’ I told myself. ‘Get all of the facts. Forget nothing being said. But a glass wall had gone up and my mind and body couldn’t accept any sensory input.

"He told me his name was Dr. Delvecchio. I wrestled with trying to spell his name. As I asked him to write it down, I passed out." The doctor helped raise her off the floor, and she got up on the bed with Arnie.

ARNIE SUSPECTED the possibility of cancer but did not think it probable. There was a history of cancer on his father’s side of the family. Brain cancer never entered his radar. Symptoms of brain tumors include headaches, seizures, nausea and vomiting, and unsteadiness or imbalance associated with a headache. According to the National Cancer Institute, about 17,000 cases of brain cancer are diagnosed in the United States annually.

Upon hearing such news, "Panic sets in and fear becomes overwhelming. We were absolutely numb," Arnie said.

By 10:30 p.m., Dr. Greg Rubino, a young neurosurgeon who the Friedmans refer to as their "guardian angel," was at their bedside. He told them that what Arnie had was very serious.

Dr. Rubino suspected that the tumor was a "glioblastoma," very aggressive and difficult to remove completely, without leaving the patient with a variety of undesirable deficits including speech, visual, hearing and motor problems. These tumors typically appear in adults between the ages of 45 and 70. The prognosis was that Arnie could be dead within six months.

"This was the first time I had ever been confronted with my own mortality," Arnie said. "Carol and I had lost parents, and I knew that I was getting to that point where the fragility of life is more apparent, but somehow, when it is you, you don’t think in terms of your own mortality. It was as if someone smashed me with a mallet.

"I had financial security, a pretty wife, all the creature comforts that I cared to have at this point in my life, and all of a sudden, it didn’t matter. Nothing mattered. All the money in the world couldn’t turn this around. … Normally I fix others’ problems. But now I was not in the driver’s seat. My life was in other peoples’ hands."

According to Carol, "We went home that night, held each other close, and cried," she said. "We just had to get through the weekend and get all our family home together. We needed to be close, to hold each other and pray. We suddenly understood what it felt like to only have today — just this moment.

"I took a nurse’s advice and started making phone calls. But how do you share this kind of news? ‘Hi, Arnie is seriously ill. He might even die.’ You learn a lot about people and yourself when there’s a crisis."

Some people reacted with fear or panic in their voices, and Carol found herself saying, "I’m going to hang up now. Call back when you can have a smile in your voice. We need you to be strong."

Others, even people they barely knew, were more supportive, stopping by to share a hug, a story, advice or prayers. The collective outpouring of love and support overwhelmed them.

Monday was Passover. Arnie led a Seder, supported by family members and by close friends. The following morning he went to Holy Cross for surgery at 8 a.m., for pre-op. Surgery was scheduled for 10 a.m. but it didn’t commence until 11:30. Sitting in the surgical waiting area was Arnie’s immediate family.

BEFORE SURGERY, Arnie implored Dr. Rubino, "Greg, you’ve got to save my life, but keep me intact. I have to know who I am when I wake up." Entering surgery, Arnie was aware of the possibility of emerging with physical or mental disabilities.

The moment of truth occurred the next day when an MRI determined the outcome of the surgery. Arnie was fortunate in several respects. He came out of the surgery intact cognitively, with his motor skills unaffected. He never had seizures prior to or subsequent to the surgery. When he was in the intensive care unit (ICU), someone took out a cell phone and asked him to identify the object. "I said, ‘Don’t be silly; that’s a phaser or a tricorder used by Captain Kirk.’" Arnie knew his personality was whole and that his sense of humor was still present.

WITHIN 48 HOURS he was walking, eating well and feeling well enough to be discharged from the hospital. The day after being discharged, Arnie and Carol went to temple with their daughter Melissa and son Dennis at Har Shalom in Potomac. They did not know what time evening services commenced, but arrived just as a small service concluded, and approached Cantor Civezar. "We all held hands and prayed. It was short, personal and very intense," Carol recollected.

On Wednesday of the following week, the Friedmans met with a radiation oncologist. This person was the first to provide definitive postoperative results. The Friedmans went home and held one another and cried all night. Based on the statistics they were looking at 12-month survival prognosis.

SEVERAL DAYS LATER, he was referred to an oncologist — Dr. Jim Brown, who was thorough and compassionate. Dr. Brown wrote a letter and sent the X-rays and oncology report to Dr. Henry Friedman at Duke University. Soon thereafter, Dr. Friedman called and told Arnie that he had not a good resection, but a great one. The resection removed the tumor, and it had done so without causing residual damage.

It was as if a weight had been lifted off his chest. He once again had hope. Friedman says, "From Henry I heard, ‘You have a good chance for survival."

The following week, they met with the radiation oncologist, Dr. Laurie Hersher. Five days a week for six weeks the tumor area was bombarded with radiation. Arnie equated Dr. Hersher and her team with hunters. "They were aiming this big gun at ‘the beast’ — the invasive cancer that had come into my life." The beam of radiation was not painful, although it tended to dry and burn his skin slightly. In addition, it left him somewhat fatigued and caused significant hair loss. A year of rotational chemotherapy was to follow.

His results were encouraging. His oncologist, Dr. Brown, told him, "All the stars lined up in the right order for you." Arnie found himself rediscovering his religion. "I became very spiritual," he said.

WITH FEW EXCEPTIONS, for most of the past year, he has been able to keep up with his daily routines. At the gym, Arnie developed a support network and felt in control. That he was in excellent physical shape prior to and following surgery enabled him to better withstand the debilitating side effects of the chemotherapy and radiation therapy.

"Going to the gym was and is very important to me. Within the first couple weeks out of the hospital, I ran in a 5K fundraiser for brain tumor research. Almost every day for 15 months, without exception, I’ve been going to the gym — the Sport and Health Club in Bethesda," he said.

Arnie had the locker straight across from mine. I had known him peripherally for years, but had never had a substantial conversation. One day, I noticed all his hair was gone. At first, I thought he was just sporting a new haircut; then I saw the scar on the right side of his head and knew that was not the case.

I did not want to intrude into his personal life, but he is about the same age as I am, and we seemed to have good rapport; I asked what had happened. He told me in very blunt terms that you can have it all one day, and then in a moment, it can be taken away. His brush with death has enabled me to confront my own mortality. I only hope I can do so with same courage, tenacity and hope.

He has inspired others at the gym as well, among them Katie Rubio, fitness director at Bethesda Sport and Health, who said, "Arnie is truly one of those individuals who amazes and touches everyone he comes into contact with. When he got sick, his positive attitude amazed us all. … His dedication to his health and his never-give-up attitude makes me proud to work in the fitness industry."

Arnie believes he is not done yet. He feels that he has a job to do, although he wonders what that might entail. He hopes that by telling his story, it will help others learn never to throw the towel in too soon when confronted with the words, "You have cancer."

"A diagnosis like mine does not have to be a death sentence. I’m in a pretty good place. I believe that I will be around for a long while," he said. "Carol and I were in New Zealand several years ago, where we tied bungee cords to our ankles and jumped off a 100-foot bridge. I intend to jump off more bridges."