1. Pemmaraju, Naveen MD

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"It's okay, Doctor"

I knew something was not right


Well before you ever did


But I was too busy


Far too busy with life's all too familiar, ever-present-never-stop-to-do-list


That I had happily incorporated


Into my new life


Too busy to come to see you


For, if I stopped my new life's new routine,


That you had given back to me five years ago yesterday,


If I have to stop the dance I am dancing now,


In order to come to your clinic,


Then it would affirm, give space, and allow


The dawn of a new unwanted reality


Lurking within me


On that day, our hi/hello visits of recent years past


Incredibly came to a halt.


Because on that day, a tiny but menacing purple bump,


A violaceous invader violating my epidermis,


Whispered to us that it had returned


Because on that day,


One single drop,


Just a solitary, matter-of-fact drop of blood


Sitting on the pathologist's slide-


And staring back up at you, whispering,


Told you what I already knew


Because, on that day,


My bone marrow betrayed my new story,


It whispered to you, in taboo-hushed languages


It announced to you, in an ages-old secret code


In which my DNA undressed itself to expose my inner truths to you


Unravelling; unfaithful to the bonds that were supposed


Supposed to last me for a lifetime


Now you are going to sit down with me


Glasses off, grimace in step


Your off-kilter rhythm when things are not just, not right, not so;


I remember this pang, this deep-down feeling,


From my original diagnosis day,


Unmistakable for what is to come next.


You are about to tell me-


That I may not be around for my first-born daughter's wedding,


Or for my husband's surprise-but-he-already-knows-retirement party


Because you have to tell me


That I have to dance with you again


That I have it again


Blastic plasmacytoid dendritic cell neoplasm




From my vulnerable skin to my stained bone marrow


To my lymph nodes which are now crying out in pain, yearning for relief,


That it was in hibernation, a skin deep remission,


Past the mark of when it should come back


And now it is back, relapsed with a mission-


But, It's okay, doctor,


Yes, It is okay for you to shed a tear for me,


To think about my family back home and what they will say,


But now it is time for you to take six deep, slow, purposeful breaths of life,


Now you have to remember to tell me


That it's time that you have a plan for me,


Just like you had done before for me all of those years back,


That you are once again ready,


And that it is time to do that dance together again


Naveen Pemmaraju, MD, is Assistant Professor in the Department of Leukemia at the University of Texas MD Anderson Cancer Center. "I dedicate this poem to all patients and families out there, with a family member with blastic plasmacytoid dendritic cell neoplasm (BPDCN), a rare, life-threatening hematologic malignancy that affects the skin, lymph nodes, bone marrow, and blood. I have developed a clinical and research focus in this difficult-to-treat disease, and am working with many collaborators and teams to develop novel clinical trial therapies for patients with BPDCN."

Naveen Pemmaraju, MD... - Click to enlarge in new windowNaveen Pemmaraju, MD. Naveen Pemmaraju, MD