Happy Meal
AUTHOR: Jerry Evans
My wife was officially diagnosed with cancer 12/13/2023.
The impact of such a diagnosis cannot be contained within the boundaries of one life. There were two of us, so this is OUR story.
The Wilderness
Our cancer journey started on April Fools’ Day in 2023. We didn’t know at the time Joie, my wife, had cancer, but that is the date, in retrospect, the dominoes started to fall and the first physical symptoms took hold. We had helped Joie’s cousin cut down five large trees in Joie’s mother’s backyard on their farm in Bald Knob. Joie’s cousin and I ran the chainsaws. Joie and her 93-year-old mother stacked brush. Following this effort, Joie had some minor back pain and discomfort, which we assumed was muscle soreness or perhaps a pulled or strained muscle. We came back the following weekend and added insult to injury with the final cleanup.
The back injury did not improve. She still had no problems walking or doing most things, but she backed off anything that put stress on her back. We went to her doctor after things did not improve. There was an additional visit to her PCP and to my PCP over the next several months. Remedies offered, including muscle relaxers, pain relief and physical therapy, did not help much. At one of the visits, the doctor took an X-ray and saw no problems in her back, commenting that he wished his spine looked as healthy as Joie’s. Time passed and she did not improve. One day, she was using a squeegee on our glass shower when she heard a pop in her back, followed by more pain and additional limitations. Back to the doctor we went, and an MRI was ordered, which revealed a fractured vertebra at L5. At that point, her doctor referred her to Ortho, as the condition seemed beyond his “pay grade.”
During the spring and summer, Joie gradually lost mobility. She could no longer drive. We could not keep our grandkids’ dog because of the danger a rambunctious dog posed to her. She was getting a bit unsteady on her feet. When I took her to doctor visits, we had to take my truck. Her car, a small Toyota, was not gentle enough to permit her to ride without suffering. She felt she was unable to make the trip to visit her mother in Bald Knob. I got her a basic walker at Don’s Pharmacy, which improved her mobility in the house. I also found a shower chair at Walmart.
Things were rapidly changing in our lives. Joie could not go out and garden, tend beds or maintain the landscape around our house. We had to move from the primary bedroom to the guest bedroom because of the two steps down into that part of the house. It essentially cut her off from the sitting room and the bedroom where she stored her Christmas decorations, which played a major part in her preparations for our favorite time of the year. She slowly lost the ability, but not the desire, to do the things she loved.
The first time she needed a wheelchair was during our first visit to Ortho. I distinctly remember parking at the door, going in to get the wheelchair as I fought back tears. Joie had always seemed to be in perfect health, and now she needed a wheelchair. Why? I parked Joie inside, went out and parked the car, and as I walked back in, I hid my emotions from her. As I grabbed the wheelchair handles and pushed her to the elevator, tears started to stream down my face. It was OK. She was facing away from me. On the way up to the second floor, I wiped the tears and regained my composure before we checked in and parked in the waiting room. It overtook me again for several minutes after they called her name and I rolled her into the exam room.
I remember pleading with the doctor to help us solve this labyrinthine medical mystery in which we were lost. She had been spiraling slowly downward for months without a diagnosis that would plot a course of recovery. Plotting the data points and mentally graphing her condition told me that it was headed to a bad place.
Ortho tried to respond, ordered a bone density scan and subsequently diagnosed severe osteoporosis. An effort was made to gain approval to treat with Evenity, an advanced bone-strengthening medication, but insurance did not approve it. Joie was prescribed a heavy dose of prescription vitamin D2 and calcium. It was during this time that Joie started getting very sick. She was nauseous and had no appetite. I had to start dressing her and followed her to the bathroom every time she got up at night because I was afraid she would fall or have a serious nausea episode. Sleep was elusive for both of us.
We decided the vitamin D2 might be too much for her, so we asked for an alternative and ended up with D3. We changed to a different type of calcium. This helped with the nausea. A sacroplasty was performed at Ortho but did not help much. Over the course of several months, Ortho did multiple MRIs and CT scans. Each scan seemed to add another problem to the list.
Independent of Ortho, we sought a second opinion from a doctor from a spine specialist. They did X-rays, which revealed multiple vertebral fractures. Kyphoplasty was discussed but seemed ill-advised because of the number of fractures. The X-ray of her spine prompted an order for an MRI. For a reason that was never clear to us, we could not get in to talk to the doctor as a follow-up regarding the MRI results.
Since the beginning, medicine had not or could not provide a clear, concise diagnosis that would lead us to some remedy or improvement, something that would plot new data points that, in my mind, would bend the trajectory of the curve upward in a more positive direction. At this point, she couldn’t take a shower by herself, prepare meals, drive, lift pans, get plates down from the cabinet, open the refrigerator door, use the microwave or pour her own milk.
It seemed that we just could not find a medical home for Joie’s malady. We continued, it seemed, to wander around in a wilderness without a clear idea where this was all headed. I was concerned that if we didn’t bend the curve up soon, I would not be able to handle her at home. The thought of that was frightening. I was not willing yet to let my thoughts dwell on such.
Back at Ortho, during subsequent scans, a radiologist noticed a small lesion on her hip. There was a possibility it was a cancerous lesion. That is when a full-body bone scan was ordered. The follow-up with the doctor at Ortho indicated they were referring us to CARTI for a biopsy, assuming CARTI would clear the possibility of cancer. The risk of cancer seemed minimal.
The Road Home
We were in the middle of a cancer journey but didn’t know it. But that was soon to change.
We met with Dr. Briggler at CARTI in November. He took labs and ordered a biopsy for November 28, 2023. This visit left a favorable impression in that CARTI was a very patient-centered, caring place, and Dr. Briggler seemed competent and confident. At this point, we believed we were there to “clear” the possibility of cancer so Ortho could continue to work with us.
On the morning of the 28th, we walked into the impressive waiting “living room” at CARTI Surgery Center. We checked in, sat down and Larry Charles, CARTI chaplain, came through the room talking to those who were there for treatments, remedies, procedures or, like us, a biopsy. He introduced himself and talked with us for a while. We explained we were there just to clear away the possibility that we had cancer.
He hoped that was the case, but now I know he knew the probabilities were favorable that he would probably see us again. He prayed and incorporated Isaiah 40:31 into his prayer:
But those who wait on the Lord
shall renew their strength;
they shall mount up with wings like eagles,
they shall run and not be weary,
they shall walk and not faint.
I had heard this verse cited by the starter at the Little Rock Marathon several years before. It was fitting at the start of a marathon, and it would soon prove especially fitting to me once again. I had run 21 Little Rock Marathons in a row but finished what was to be my final one, at age 74, in March 2023. I quit running in late summer 2023.
Even though I quit running and have not run since, the endurance and fitness poured into me over the years helped me weather the demands made on me during 2023 and for the next several years. I was glad I ran those 21, but also glad I have not run one since.
After the biopsy, they wheeled Joie out in a wheelchair and put her in the truck. The final comment made by the nurse as I got in the truck was, “They will call you in three days with the results.” I told Joie that our experience so far at CARTI was that the place ran like a finely made watch, so we would know for sure in three days.
We were scheduled for an appointment on December 13, 2023, but I decided to drive to CARTI and get the results immediately. After driving to the facility, I went out to my truck and read the report that fateful afternoon.
Even though the report was very technical, I understood that Joie had multiple myeloma. Surprisingly, I was not stunned because, I had suspected such. Even so, I had not taken an opportunity to consider exactly what a diagnosis would mean.
We have cancer.
I could not get past this phrase turning over in my mind. I sat there for 10 minutes trying to figure out how to approach this with Joie. I guess this is why you wait and let the doctor explain things to you. I went home, we talked, she read the report, we cried, then started to learn all we could about multiple myeloma.
During the time before we were to have our follow-up with Dr. Briggler, we studied the disease from our couch using our phones and notebook computer. We learned the disease was highly treatable and we had excellent options for treatment. We developed hope about the treatment possibilities that eased our minds about the future.
Our confidence slowly increased, reaching a crescendo just before we left in the truck for our planned visit with Dr. Briggler. When we drove down our driveway, we talked about how we felt. It seemed that we were finally headed out of the wilderness. We were about to get an official diagnosis of cancer, which meant one thing to us: answers, treatment, a direction upward rather than downward and an opportunity to bend that curve up toward the parting clouds, the sun coming out and the blue skies.
We were both elated that we were finally going to nail down a diagnosis, even if it was cancer. It was an easy and expectant ride to CARTI.
While with Dr. Briggler, we heard everything he said, positives and negatives. We weren’t shocked or stunned. We had been through all that the week prior. We were prepared for the discussion and quickly assimilated all that he said. He may have been surprised that we seemed almost happy to get to this point and were now ready to move forward with the treatment he had to offer.
We briefly discussed options and decided CARTI was the place for us. One memorable thing he said was that Joie was “lucky” that she had multiple myeloma rather than some other “less treatable” version of the disease. I had never expected to hear the word “lucky” in connection with Joie’s diagnosis, but the more we learned about the treatment options, and seeing the course other forms of cancer had taken through the lives of friends and family members, “lucky” was a good way to put it.
As I rolled Joie down to the first floor and parked her by the fire in the large waiting room, I started thinking about dinner. I got the truck and picked her up as staff brought her out.
Over the ensuing months, we would get to know the CARTI staff stationed at the front door well. They were caring, wonderful people. Before long, they began to recognize my truck as we approached and brought out the “small” wheelchair that we preferred. It was more Joie’s size and style.
It was getting close to our dinner time as I pulled away from the CARTI front door. I was hopeful she was hungry and, if so, I was 100% certain I knew what was on her mind. As the truck rolled slowly out of the parking area toward CARTI Way, I asked, “What’s for dinner?”
She gave a simple but certain reply: “A Happy Meal!”
Just like a five-year-old knows with certainty that Santa Claus exists, I knew that would be her answer. So, on the way home, we went by McDonald’s and picked up a Happy Meal for her and a fish sandwich for me. We don’t normally celebrate major events via McDonald’s, but this one was indeed special. We were both in a celebratory mood, and a Happy Meal was a perfect fit for the occasion.
As Christmas approached, we had not even thought about trying to put up a tree and decorate the house. I asked her if she wanted to put up a tree, and her immediate answer was no. She knew she could not be involved, and she thought it would put more on me. We had more important things to worry about.
I insisted we get the tree out of the attic, throw a few lights on it and pick out a few ornaments from her extensive collection. She relented, so my brother came over to help. Once we set the tree up, we took ornaments out one by one and asked her if she wanted each one on the tree and, if so, where.
In the past, she did the entire thing. Her amazing assortment of ornaments and her eye for detail and arrangement produced a work of art every year. She sat on her walker and supervised the event. It was not perfect, as it was constructed by “untrained” hands, but it was still a beautiful thing to behold, given the past year and the blessings we had been given.
We were thankful for the tree, for family, for the immense help family provided and continued to provide and for the fortune we had to end up at CARTI. For Christmas that year, we got something we desperately needed: a medical home.
The Blessing of CARTI
Dr. Briggler and CARTI subdued the cancer quickly. By February or March 2024, the myeloma proteins were dropping dramatically. Soon, the word remission was used.
The approach used to subdue the myeloma Joie had was effective. Every myeloma case, as I understand it, can be a bit different, and the approach has to be tailored to the genetic makeup of the cancer and the genetic abnormalities in the bone marrow of the patient. The course of treatment was matched to Joie and her specific cancer. The treatment was evaluated weekly for a time, then every two weeks, then once a month. CARTI was “on it” all the way.
The physical changes that resulted from the degradation of Joie’s spine have been significant. She lost five inches in height, has had considerable pain and discomfort and still has serious limitations. But she no longer needs her walker. She is relearning to drive, with a booster seat, after a three-year absence. She has limited strength and endurance but is improving.
She has continued problems with nausea because her stomach and intestines have all been compressed into a smaller place. She can manage going up and down steps now and can help with meal preparation. She no longer has concern that she will fracture something if she picks up a pan or carton of milk. She is getting back into walking for exercise and, if she “hoofs it,” as she says, she can do a mile in about 35 to 40 minutes.
Dr. Briggler and his staff have been amazing in every respect. They have gone far beyond what would be expected and have tried to respond to our every need. Cancer brought us to CARTI, and we thank God for that.
The culture that exists at CARTI, which was evident to me from our first visit, is unlike anything we have seen anywhere, in any other medical facility or office, since our cancer journey began. Dr. Briggler, Laura and their staff are prime walking, breathing examples of that extraordinary culture.
We have been around competent physicians and staff in the past but have never encountered the type of patient-focused culture that exists at CARTI. It creeps into every nook and cranny of the place, from the facility, grounds and gardens to Chaplain Charles and his prayers and hope; the piano artists who inspire during the midday hours; everything about CARTI Surgery Center; The Bridge, where Montana has done an amazing job of helping Joie; Hope Bistro; the culinary lessons with Chef Coby; the greeters and helpers at the door and on the deck; and the janitorial staff who also manage the coffee alcoves.
It is extraordinary, and every medical facility and every patient- or customer-based organization or entity could benefit from emulating what CARTI has created. My only suggestion to CARTI is: Don’t change it.
Joie’s improvement continues slowly but unmistakably. I can’t look at this by week or month, but over the sweep of time.
As Christmas approached in 2024, Joie helped with the tree some and helped box up some of the decorations for storage. But in 2025, I put up the tree, and she put on some of the lights and all of the ornaments. It was done just the way she liked and, admittedly, looked better than any tree since 2022. Progress.
To paraphrase Eleanor Roosevelt, true happiness is not a goal but a byproduct of a life well lived. Joie has always looked at life this way. Even as we were lost in the wilderness and in the grips of something we couldn’t see or define, she never lost hope or her basic connection to her own happiness. It’s one of the many things about her that kept me going.
She got this from her amazing mother, who is now 96, losing some ground but still going strong. We are able to go up and stay with her now every other weekend, when we both function as caregivers for her mother.
Occasionally, we will be running late, headed home and both getting hungry, and I will turn to her and ask, “What’s for dinner?”
She turns to me with that same bit of a smile on her face and utters those now-famous words that take us both back to that day when our lives changed for the better:
“A Happy Meal.”
