It is raining this grey afternoon is Asheville. We have been having warm and sunny weather but a front moved in today that is predicted to be with us through sometime on Sunday. It somehow seems appropriate. My dear friend Jean Ann Rogers died last night.

As some of you know, Jean Ann, her husband Jim, and I were supposed to go to Puerto Vallarta together in March for a week, but had to cancel a week or two before the trip because of Jean Ann having symptoms of an undetermined illness. She had suddenly begun retaining enormous amounts of water, predominantly in her trunk but to a lesser degree in her legs and feet. She was pretty uncomfortable starting in early or mid-February but her primary care doc didn’t feel that there was any reason to be particularly concerned. He prescribed a diuretic and said she should see how things went. By the time we were scheduled to go to PV, they had determined that the meds were of little benefit and decided to get her into a gastroenterologist. Her primary suggested that we postpone the trip until the water retention was dealt with.

She saw the gastroenterologist in early March and he scheduled her for a March 19th MRI to see if anything showed up. The radiologist read the MRI and wrote a report the next day but neither the GI doc nor her primary bothered to share the results with Jean Ann or Jim for another 8 days. On the 28th of March, after having to insist on being seen again by the GI doc, she was told that the MRI indicated what appeared to be lesions too numerous to count that appeared to be metastases on her liver. With that sentence, Jean Ann was told that she probably had cancer that was, at a minimum, second stage.

About another week and a half passed before she could get in to get a biopsy and still another 5 or 6 days before she was given the results. It showed that she had adenocarcinoma of an undetermined origin. Another delay of several days followed but by now, several of her friends, myself the most demanding, got involved. We got her in, through the back door, to see a doc generally considered to be the best oncologist in town. He reviewed all her tests and history and began to speculate on the origin of her illness. He also ordered some specialized blood work to try to determine the primary site of her cancer. When nothing conclusive emerged, he told her he wanted to start her on two chemotherapy drugs on April 30th and she was scheduled to see his PA for guidance and to work out the details a few days before she would have her first dose. That appointment was a week ago today, but Jean Ann had gone home from work on Wednesday afternoon and had an uncomfortable night, so she called on Thursday morning and asked to switch the appointment to Friday. By Friday, she was feeling so bad that Jim decided that she needed to be hospitalized and she was admitted to St. Joseph hospital a short distance from my house.

Her condition worsened dramatically after she was admitted and Saturday morning she was put on a morphine drip to control her pain which was, by then, severe. Once on the morphine, Jean Ann pretty much left us. She remained largely unconscious the rest of the time she lived. I visited Monday afternoon after taking my friends Shaghig Kodbashian and Jonathan Boynton to the airport at the end of their 4-day visit here. By the time I saw her, I don’t believe she knew anything that was going on. I spent some time in the room with her by myself and said the things to her that I wanted to say, hoping that at some level, she was aware of my being there. She fluttered her eyelids a few times, but her eyes were rolled partially back and she couldn’t look at me. I will never know whether or not she knew I was there or heard what I had said. Sometime on Monday, her kidneys stopped working and at 8:30 on Wednesday night, she finally stopped her fight and ceased breathing.

In less than a week Jean Ann went from going to the office to death. All of her friends and loved ones are stunned at the speed with which this disease took her. No one knows where this cancer started or when. What we do know is that until she saw her oncologist less than 3 weeks before she died, no one who treated her seemed to be in any hurry to find out what was wrong, communicate with her, or help ease her growing discomfort. What we did learn from the oncologist is that an MRI done in mid-November when she had a kidney stone showed clearly visible metastases and either the radiologist who read the image didn’t notice it or didn’t bother to report it. There is no way of knowing now if it would have made a difference if she had been alerted back then to her illness. If nothing else, she might not have spent so much time feeling bloated and miserable.

There will be a memorial this weekend for Jean Ann. I am thinking of wearing something cheerful. I don’t think she would have wanted a bunch of people standing around mourning for her. Jean Ann was a smart, clever, happy, funny, and very loving woman. I will miss her enormously.

Soon I will compose a happier post about many of the good things that are going on here. . .and there is much of that.