The Kreitler Compact
By Peter Gwillim Kreitler
Wednesday, December 29, 2010
What is the Kreitler Compact
This is simply one person’s
story about being told he has lymphoma cancer. As a
priest of the Episcopal Church since 1970 I have
listened to and counseled with many people who have
faced the challenge of cancer. Perhaps my story
being told may be of value to others as were those
stories for me through the years.
The table of contents may be
scrolled through to access my experience. Each day
may be clicked on and the thoughts of that specific
day shared. I am hoping that as we progress other
stories may be shared so that we all gain a better
understanding of this all pervasive illness called
Peter's writings are in the navigation
column to your right.
This week's writing
is the last addition to the Kreitler Compact:
Items 1 - 7
below are an
Overview of a few hectic days in April of 2006.
The Beginning of the Story
About Lymphoma Cancer
Table of Contents
1. Over-view of a Few Hectic
2. Recent Personal History
3. Personal Story Continued
1. Over-view of A Few Hectic Days
In residency a young doctor begins to discern the
difference between and among people’s perceptions of
their own illnesses. Positive attitude, a sense of
humor, a great supportive team, and the expertise of
the doctor work synergistically to heal the patient.
Add to this mix a sense of the transcendent and the
power of prayer and a doctor quickly recognizes that
healing is more complex than the mere application of
a prescribed set of antidotes, medicines or
procedures. This collection of wisdom has now become
As a priest of the Episcopal Church I have often
relied on the medical community to build confidence
in individuals faced with life threatening medical
conditions. None is more debilitating
psychologically to whole families than hearing the
word cancer. I can remember back to 1966 when my dad
told his family that he had lung cancer. He had a
lung removed at Columbia Presbyterian Hospital in
NYC by Dr. Sam Wylie. We laid dad to rest just shy
of his 89th birthday last August. He was a
remarkable example of one who combined a trust in
the medical profession, a deep faith in God, while
allowing his family to be present for him during the
ups and downs of living with his illness. In 1995 we
said goodbye to my mother who died of lymphoma
cancer. As she was in the final stages of her life
her humor never left her, her love of life never
disappeared, and she taught us all how attitude is
crucial in confronting the challenges of life. When
asked what type of cancer she was dealing with she
would remark, Jackie O and I have the same type of
Cancer visited the Kreitler before and now is here
This week I have been diagnosed with mantle cell
lymphoma cancer. What I have learned from family,
the medical profession, and alternative
practitioners will stand me in good stead as I
address my own battles.
My compact with my family, friends, acquaintances,
and wider audience is that I will do my best to
focus on the positive aspects of my experience so
that all can benefit. If we can demystify the
process just a little, perhaps the collective wisdom
will be able to infuse hope in others.
Frankly, it is obvious that everyone has been
touched by this disease. Almost to a person a
success story has been shared with Katy and me about
a family member or friend. This collective story
telling emboldens families and can move entire
groups of people. Your story is important in
building a culture of hope.
2. Recent Personal History
On March 1, 2006 Ash Wednesday I had an umbilical
hernia repaired at St. John’s Hospital. This is a
routine outpatient procedure with few side effects.
Prior to insurance authorization a routine physical
is required and my all purpose terrific internist,
Dr. Ernie Prudente inquired as to how I was feeling.
I spoke of my occasional shortness of breath, a
sinus infection, or so I had self diagnosed, and a
bit of fatigue.
He noticed and examined the enlarged lymph in my
neck, requested that I get a heart stress test, and
demanded that I come in after the hernia operation
so he could evaluate all of the above.
I complied because he was direct and caring. When
the lymph activity had not abated he drew blood and
discovered a bit of anemia and a white cell count
abnormality. Being prudent by nature and by name he
initiated contact with a specialist; yes he began
mentioning the word cancer almost immediately, but
wanted an oncologist to re-affirm his suspicions. On
March 24 the Big C was now a real possibility
growing within me.
Like any form of business today one’s rolodex often
defines who we are and Dr. Ernie requested I call
Dr. Larry Piro of the Angeles Clinic in Santa
Monica, an oncologist high on Dr. Prudente's list of
referrals. He said he was the best for lymphoma
cancer and this is what was emerging as the type
with which I was dealing. At 10:00 am the following
Monday March 27 Dr. Piro confirmed he suspected
lymphoma but wanted a couple of biopsies to be sure.
He said he wanted Dr. Orloff at St. Johns to do a
bone marrow biopsy and whomever for a lymph biopsy.
I said that Dr. Prudente had suggested Dr. Robert
Andrews. I have learned through the years that water
seeks its own level and indeed many of us are known
by the company we keep. I deeply respect the
judgment and expertise of Dr. Ernie so it was a
logical step to trust his recommendation.
I call this the triangle theory of relationships. If
I like Ernie and Ernie likes me it is logical that I
will like the 3rd person he brings into the
triangle; i.e. Dr’s Piro and Andrews. He was right
on both counts. How we build a strong team is the
triangle theory going into motion and as Buckminster
Fuller taught us, the strongest unit is the circle
made out of triangles; i.e. His geodesic dome.
Wholeness derives from putting strong and good teams
together. I was developing confidence in others
simultaneous to feeling sadness about what might lie
At this point it began to be clear that cancer was
now to be a real part of my life for the foreseeable
future ant that The Kreitler Team was going to be
built and would be the only way I was going to deal
with the challenge effectively. A team working
cooperatively will be required to solve our
increasingly difficult personal and global
challenges, and perhaps what I was now to experience
could become a metaphor for life in the macrocosm.
Here I was moving into my 64 year with relative
confidence that I could manage the type II diabetes
and continue to contribute to making a better world
for my children and grandchildren. Teamwork has been
essential in building Earth Talk Today and having a
strong positive co-host like Alexandra Paul has been
invaluable. Our environmental television talk show
requires about 15 people to produce, but I had also
come to rely primarily on my own initiative and
strength to move forward in life. Now a team was
going to be required and the doctors, family and
friends form the triangle of support that will allow
me to address cancer with confidence. I can’t do it
alone, I won’t do it alone, and I will allow the
positive messages to inform my being on a daily
Frankly, this is the theme of these writings and the
beginnings of my building a framework for success.
Facing cancer with confidence is the backbone of The
3. The Personal Story Continued
At 10:00 am on March 27th, Dr. Piro believed it was
necessary for a bone marrow biopsy and yet Dr.
Orloff had no openings until three days later. Dr.
Piro contacted the Dr. directly and at 11:15 on the
same day Katy and I walked into outpatient surgery
at St. John’s Hospital. The first person we saw was
long time friend Toni Gundershaug RN. That was
comforting to say the least. Blood was quickly taken
and I was positioned left side down on an operating
table with Dr. Orloff administering a local
anesthesia. Toni held the cold compresses to my head
as 3 inches of my bone marrow was extracted. Not a
walk in the park and frankly many folks are knocked
out for this simple, but painful procedure. I was
praised for my stoic demeanor and ability to
withstand pain. Heck this was easy compared to
another little procedure a few years ago.
On the wall of the operating room is the pain chart
illustrating smiling faces from pain level 1-2,
grimacing faces at 3-5, really sad at levels 6-8 and
crying at 9-10. I assured the three person operating
team that I knew what 9-10 were like from a prostate
biopsy, so anything below that was acceptable.
Frankly, I passed level ten on that day and simply
passed out so I may have hit 15. After the biopsy
and a bit of recovery we ambled on over to the head
of head and neck surgery for a consultation with Dr.
Robert Andrews. A lymph removal was scheduled which
was accomplished without incident on March 30th.
Once again this procedure can be accomplished with a
local anesthesia. I have learned it is less
expensive and easier on one’s system to accept the
doctor recommendations; and both times a simple few
shots in the hip and neck did the trick.
Quarter-size lymph was removed from my neck. The
biopsy was to be the determining procedure that
would ‘seal the deal.’ Yes, the bone marrow biopsy
and the lymph biopsy both indicated that mantle cell
lymphoma was in my marrow and throughout my lymph
4. Technology Time
In between and concurrent with these invasive
procedures I had a chance to lie down and be sent
back a forth in a big fancy camera that took
pictures of my inner landscape from my neck to my
groin. These C T and PET scans provide a benchmark
for involvement. Establishing a baseline of lymph
activity enables Dr. Piro to assess whether my chemo
therapy is working or not. Comfortable and
definitive this high tech equipment is recognized as
an ingredient in the process of getting me well.
Katy watched the procedure and sure enough it is
clear that my lymph node system is being compromised
by cancer from my neck, throat, chest, abdomen and
down into the groin.
I now have a baseline to work from. In two months
the same scans will determine if all is working, if
all is well, or if we need to go to plan B.
Primary question everyone wants to know: What were
the signs Peter? I have tried to ask myself; what
indicator lights came on when and where in my body?
Shortness of breath was noticed a year ago and of
all places at an ecological reserve in Mexico where
Katy and I were celebrating our 20th anniversary. I
had been trying to windsurf and became so exhausted
that I had to be rescued. I attributed this to
elevated blood sugar and thought nothing more of the
incident until 10 months later when I began to feel
shortness of breath going up stairs which I
attributed to being out of shape. Another indicator
was the swelling of the lymph’s in the neck which I
attributed, wrongly of course, to a sinus infection
drain. Granted these self diagnostic attempts were
not that far removed from reality, but most likely
the cancer had begun a foothold and I was not being
debilitated to the point of dysfunction.
However, there was a warning light that was flashing
and yet I made no connection to cancer at all. I was
not sleeping and for the past 2 months I was
sleeping in blocks of 1, 1 ½ or 2 hours. Anything
longer was a rarity. Therefore, bedtime at 10 was
followed by a visit to the bathroom at 12, 2, 4 and
6, at a minimum.
Not only is this a sure indication that the days
were long, especially when attempting to accomplish
what I have learned to expect of myself, but what
ever I did to remedy the situation proved futile.
Once again I based my dilemma on the logical
explanation readily available; that is, I had an
enlarged prostate and frequent trips to the john in
the middle of the night was to be expected. My guess
now is that there were and are other factors
contributing to this; such as lymph activity near
the bladder and prostrate.
My hope is that the treatments will reduce the
activity and that once again I will be treated to
the blessings of sound sleep.
In retrospect, my own sensitivity to my body,
brought on 15 years ago with the onset of type II
diabetes, may have masked the real story of what was
happening. Hindsight is never of great value, so
let’s move on with the process ahead, and a bit of
reflection on what others experience when a friend
or family member is suffering.
Initially, chemo-therapy is the preferred treatment
for mantle cell lymphoma. I begin April 5th, 2006
with a 5 hour intravenous interlude. This is
followed by two days of treatments less intense and
less timely. I guess a few hours of forced reading
and relaxation never hurt anyone.
I have found that the needle works better for me
through the veins in my hands rather than in the
fold of my arm, and this quiet time can be used to
good advantage. The downside at this point is the
unknown. The specifics will be shared as
My body is different than yours or anyone else’s so
generalizations about effect is a pointless
exercise. The range of projected reaction is
complex, but the doctor is optimistic that I will
not lose all of my hair. Actually, I have more to
lose on my face than my head.
I will repeat the process 28 days later. This 3 day
interlude followed by 4 weeks of recuperation is
scheduled to last 8 months. As I mentioned, at the
end of two rounds another set of scans will be taken
to determine efficacy of the particular drug
cocktail I am taking. If it works it continues. If
it is not shrinking the cancer then plan B is put
into action and I am not telling what Plan B is at
I will write about what transpires over the next 8