Laugh, Sing, and Eat Like a Pig [Paperback]

As the wife of the publisher (full disclosure), I was privileged to read "Laugh, Sing, and Eat Like a Pig" in draft form a number of months ago. I haven't met Dave in person yet, but without a doubt his book changed my life.

I received a diagnosis of bladder cancer last summer, and have been in treatment ever since. I think any cancer patient will find Dave's story extraordinarily compelling, not just because Dave is an extraordinary patient, but because he teaches us how we can all be extraordinary patients.

Dave's attitude is contagious, and every time I turned a page I found myself growing in my own sense of courage to face my cancer, and in personal power to take more responsibility for medical decisions.

He's honest about his feelings, determined to fight his disease with every resource he can muster, yet always knows that "reality is what it is" and that acceptance of whatever happens is a powerful approach.

I wasn't familiar with the concept of e-patients before I read this book, but reading it transformed me into one. This book will teach you (as it did me) what a huge difference being "empowered, engaged, equipped, and enabled" can make when facing a serious illness.

Why should a doctor read this book?

You're a busy physician, and these patient self help books are all over the place. Why should you read this one?

1) It's a spectacular medical save.
Any doctor reading this book will find renewed pride in our profession. We really ARE saving lives, even those on the very brink of death from formerly incurable disease. I felt good about that, and I guarantee you will, too.

2) You'll find out how your severely ill patients REALLY feel while you're treating them.
Unlike most authors telling a story, Dave didn't know if he would live or die while writing the journal entries comprising most of this book. That brings with it a power and an immediacy absent in similar books. Consider: "Most of all, I cried out of knowing that when I go under anesthesia, there's nothing more I can do, and that's scary. Dr. Wagner's team is going to remove that cancerous kidney, and I'll have nothing to say or do until I wake up" (p. 28). It may be routine for us, but definitely not so for the patient.

3) You'll find out what you can do to help.
First, read Paul Levy's introduction, "Yes, Patients CAN help their Doctors." Mr. Levy, CEO of the hospital where Dave was treated, explains how a simple attitude change on our part can improve our patient interactions to the benefit of both of us:
"[Dave's] story is how doctors and a patient working in partnership can learn from one another." And Mr. Levy is not just pontificating from his C-suite - he served Dave his dinner one night, complete with hand-washing, apron and hairnet.

Second; learn from the book and Dr. Danny Sands' introduction how you can discover and 'vet' the best websites for your patients, and enable them to both help themselves and help you. Dr. Sands' (Dave's primary care physician) prescription for Dave when they discovered he had stage 4 renal cancer? A slip of paper with "[...]" written on it.

4) You'll find out an 'e-patient' is not just going to bug you to death.
A few quotes from the book should suffice here:
"Yet a year ago I vowed to do everything I could to take responsibility for my own outcome."

"....for every on-in-a-thousand disease, each physician has one or two patients! Who could keep up with the latest on every one-in-a-thousand disease?"

"Reality is what it is, whether we know it or not; and regardless of what we think."

Finally, I'll leave you with this: I saw on Dave's Facebook page that a patient was going to buy a copy of this book for his primary care doctor, who wasn't sure about this e-patient business.

Don't you be that doctor. Beat 'em to it. You won't regret it.

That was, to be perfectly frank, my initial response when I learned that Dave de Bronkart--widely known on the Internet as e-Patient Dave--was publishing a book about his battle with stage IV kidney cancer. I mean, sure, I've read my share of cancer-survival stories, but in this case I figured I already knew the story. Dave de Bronkart is all over YouTube, and he tells the story quite frequently: how his doctors discovered his cancer, what his initial research told him about the cancer, Danny Sands giving him the prescription for ACOR. It's all out there. Go ahead and look it up. Dave's a charming speaker, and hearing him tell his tale won't affect your reading of the book. You should listen to Dave's talks, and then you should buy this book.

First, you should buy this book because it's not just a cancer survival story or even just a cancer survival how-to book. Laugh, Sing, and Eat Like a Pig is a book on patient empowerment, on why and how to take control of your life, even in the face of personal tragedy. You don't have to have cancer or know someone with cancer to get a lot out of this book.

Second, I loved the book. I'm still loving the book on the second read, and I usually don't re-read anything. I think grad school did that to me. I had so much to read, so much to translate, and so much to analyze that I never wanted to read anything again unless it was absolutely necessary. Every book I re-read is time stolen from one more new book I could be reading. Still, I've really enjoyed Dave's book. I love the way it bounces in and out of chronological sequence. I love the asides and insertions. The format, with its four-dimensional look at Dave's experience and the experience of cancer in general, reminds me of John Brunner's experimental science fiction novels Stand on Zanzibar and The Sheep Look Up. Sorry, that's the English major in me taking over the conversation and dragging it off on another tangent.

Now, not everyone who reads this book loves it. Some, recently, have argued that Dave, like many other cancer survivors, puts the onus of survival on the cancer sufferer. They think he's blaming the dying, accusing them of weakness of will, or faith, or chutzpaph. Yes, I admit that I, too, had that impression. At the beginning. Occasionally, Dave does interject that he had decided to live, does say he decided that he wouldn't accept sub-par care. It's easy to read that kind of didactic mode as "anyone who dies must have either accepted the death or accepted sub-par care."

Easy, but false.

Yes, Dave gives advice based on his own experiences, and doing the opposite of what he suggests just might have lost many lives. Talk to Regina Holliday. Her husband received sub-par care, and I don't think he realized as much until it was too late to matter. Dave also discusses his own fears and sorrows in facing impending death. He knows his attitude alone wasn't going to save his life. He admits that while he hoped for full recovery, he knew the dark other possibility was still looming. My grandfather succumbed to cancer, and while he was still lucid, even he said you can never give in to something like that. When the HDIL-2 begins to work, Dave rejoices in being one of the lucky 20%. I don't think it's fair to condemn his rejoicing in his own survival. Yes, 80% do not have Dave's luck, but that tragedy is not Dave's fault. I would add to that bit of luck with the HDIL-2 a reminder that Dave's cancer was found early, almost by accident. The x-ray that discovered a metastasis in his lung was for a shoulder injury. If not for that shoulder x-ray, it's hard to say exactly when Dave would have found out about his cancer. Would the weeks it took for the pains to start also have been enough to slash his survival chances? Surely. How much? I doubt anyone could say with any certainty.

So, read the book. Whether you have cancer and need a little advice or don't have cancer and need a little help dealing with the modern medical instrumentality or just want a good book to read, read the book. You won't regret it.