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July 22, 2012

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Diagnosing the price paid for keeping hope alive

THIRTEEN years into her marriage, during her son's 12th-birthday party, Amanda Bennett found her husband, Terence Foley, doubled over in pain on their bed. Alarmed, she rushed him to the hospital, where he was found to have a severe bowel disease. A doctor casually mentioned that a scan also showed a "shadow" on his kidney. "You are going to want to get that looked at," he said.

As Bennett writes in her memoir, "The Cost of Hope," the shadow was looked at. It was rescanned, removed and sent to a lab. It was diagnosed twice - first as "collecting duct" cancer, then as "papillary" cancer (doctors still disagree over what it was) - and treated with drugs bearing price tags of US$200 per daily pill and US$109,440 for four one-hour intravenous drips. It also spread to Foley's lungs, and in December 2007, it took his life. He was 67. The bill for his seven years of treatment totaled US$618,616.

Bennett is a Pulitzer Prize-winning journalist and an executive editor at Bloomberg News. Her memoir is equal parts marriage confessional and skilled investigative report. It's a story of the sometimes amusing, sometimes baffling relationship and hectic but rewarding life she shared with Foley for more than two decades. It's also the fascinating account of an illness - its origins, composition and progression - and of the cost (mental, physical and financial) of trying to treat it via the complicated, frustrating, outrageously expensive American health care system.

Bennett recounts how she met Foley at a party in Beijing in 1983, while working as a correspondent for The Wall Street Journal. She was 32; he was 44. A stout man in a bow tie and "owlish" glasses, he told her he was a Fulbright scholar studying China and the Soviet Union, and she eagerly interviewed him - only to find out later that he had lied and was in fact the director of the American Soybean Association. "You're cute. You're a journalist. I wanted to talk to you," Foley explained. "How long would you have talked to me if I told you I was in soybeans?"

She stomped away. But they rendezvoused again, later married, had a son and adopted a Chinese daughter. They worked, traveled, loved, fought. Then came cancer.

Back then, with insurance provided by her employer, she paid a small share of the often impenetrable bills. "Since none of us - Terence and me included - had to account for the cost of these procedures," she writes, "all of us, doctors and patients alike, could casually afford to pop them like cherry Twizzlers."

Yet "The Cost of Hope" is not a polemic against the medical industry, even if Bennett underscores its numerous flaws. She acknowledges that doctors and expensive drugs often extend lives.

In an era of furious debate over health insurance she vividly presents the startling price and the occasional payoffs of hope, which buys us, at best, the simple "dailiness of our lives."




 

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