Life, on the Line (49 page)

“Makes sense. There is going to be a storm of inquiries. What do you want me to do?” she asked.

“Nothing. That's the statement in full for now. Except, well, if you get a call from someone prominent, just give them my cell number. I don't want them bothering Grant.”

Five minutes later my phone rang. I recognized the number as coming from the
Chicago Tribune,
since they all start with 312-222. I figured it was Mark Caro, who penned the article about Trio's last night and whom I now hired to work on the Alinea cookbook based on that piece.

“Hello, this is Nick.”

“Nick, hello. This is Phil Vittel from the
Chicago Tribune.”

“Wow. That was fast,” I thought.

“I'm sorry to bother you on what is obviously a difficult day, but I was hoping to ask you a few questions. And of course I wanted to convey to Grant just how concerned we all are for his well-being and recovery.”

“Thanks. Sure. Whatever you need.”

Phil Vittel was the head dining critic of the
Tribune,
and I wasn't surprised he was calling.

“Well, can you tell me more about the cancer? I've done a little research, and if he has an advanced stage of squamous cell cancer that's a difficult prognosis, right?”

I chose my words very carefully, something I would do over and over that day with a number of people in the media. I focused on the positive: Grant was getting the best possible consultation from the best doctors around the country; Alinea was busy and he was fully engaged; we expect that he will beat this.

All of the reporters sounded upset. All of them offered personal wellwishes. But they all pressed me: “What if?”

“What if he loses his tongue?”

About the third time a similar hypothetical entered the conversation I slipped. “Well, if that does happen, then it would be a Shakespearean tragedy. The irony is not lost on Chef. Still, we're not concentrating on that, and I'm sure that if anyone could overcome such a thing it would be him.”

“What irony is that, Nick?”

“Well, it would be no different than a painter losing his sight, right?”

I woke up the next morning to the sound of the
Chicago Tribune
hitting my nightstand. Dagmara had it folded in half and dropped it on the table. I saw, on the front page, the article announcing Grant's cancer. And I immediately saw my name. “‘It's Shakespearean,' said Nick Kokonas, Achatz's friend and co-owner of Alinea. ‘This is like a painter whose eyes are taken from him.' ”

I recoiled in horror. That was not what Grant needed to hear. “Brilliant,” was all I got from Dagmara, with a roll of her eyes.

My phone rang a minute later. It was Grant.

“Shakespearean? I guess you're the one who needs some media training!” he said, laughing. “That's just great. Why don't you come by and poke out my eyeballs while you're at it.”

I felt terrible, but was glad that he knew how the media worked.

“Front page, though. Front page,” I said. “I think we finally have our angle for Oprah.”

Grant laughed. I still felt terrible.

 

“Grant. Wake up. I just got a call from the University of Chicago, the guy I've been trying to reach. They can see you immediately. Call me.”

I rolled over and saw the text message from Nick on my phone. I had no desire to go to another doctor. I felt like shit. The painkillers made me tired as hell, I could barely open my mouth, I'd barely eaten in days, and I had run out of options. I had been given a clear directive: Cut out your tongue as soon as possible.

I thought long and hard about what the doctors had all said. They weren't saying, “We'll cut out your tongue and then you'll be fine.” Instead, removing my tongue was only the beginning. Chemo would follow, then years of therapy—if I lived that long. The quality of life seemed low at best, while the odds of dying anyway were very high.

And despite everyone's encouragement it was unlikely that I could be a great chef. Or perhaps I could, but would I want to be? Would I want to be surrounded by food that I could never eat?

I didn't want to live without my identity. And I didn't have the energy or desire to create a new Grant Achatz.

“Hey,” I said when I called Nick. “Thanks, but I'm not going. What are they going to say that's any different? We went to Sloan-Kettering and we saw Ebert's guy. I'm sure Ebert and the whole staff of the paper were searching the world for the best doctor. They both said the same thing. I'm going back to sleep.”

“Get dressed. I'm picking you up in thirty minutes. I'll drag your ass out of bed if I have to.”

 

We drove south toward the University of Chicago hospital along the lake. The sun was bright and the lake looked beautiful. I had never been to U of C before, and was surprised that a gothic-style university existed on Chicago's South Side.

“You know, Grant, there is something magical about this place. If I could go back to school, this is where I would go. It's filled with intellectually curious people. I read Dr. Vokes's studies, and his statistics and conclusions were consistent and logical. I know nothing about the hospital, but I'm hoping it's like the rest of the place.”

“Whatever it is, this is the last one. Then I have to decide. I already have, actually.”

“Fair enough.”

We parked and found our way to the reception area of the oncology center. Nick walked up to the desk to check me in, but before he could do so another woman approached from the hall and walked directly to me. “Chef Achatz, I'm glad you could make it this morning. Dr. Vokes saw the article in the
Tribune
and then we realized that your friend had called here already. So we reached out to get you in as soon as possible. Dr. Vokes is confident he can help and is anxious to meet you.”

We followed her to an exam room where she asked me a few questions about my insurance and I filled out a few forms. Dr. Vokes came in with two younger doctors.

Tall, angular, with cropped thinning hair and an unidentifiable European accent, Dr. Vokes introduced himself. “Hi, Grant, I'm Everett Vokes. I'm glad that we were able to find you so quickly. It is important that we sort this out as quickly as possible. I understand from what I could gather that you have an advanced case. But we will look that over right away. I have also taken the liberty of calling Sloan-Kettering and Northwestern to get copies of your scans, with your permission, of course.” Vokes spoke slowly but confidently, and began to put on some rubber gloves. He realized that he hadn't introduced himself to Nick and said hello and waved since he already had the gloves on.

“Grant, or should I call you Chef? If you could come over here and sit down, I'll give you a brief exam. I assume it's okay for Nick to stay?”

“Just call me Grant. Nick is the guy who dragged me here today against my will. He can stay,” I said, laughing.

“Okay, then. Why did he have to drag you? Are you not feeling well?” Dr. Vokes asked this with childlike simplicity.

“You know, Doctor, he does have cancer,” Nick said. Everyone smiled.

“I meant, are you feeling different or unusually unwell compared to how you were feeling, say, a week ago?”

“No. I just didn't really see the point of coming.”

“Well, let us be the judge of that. I think you might be surprised. So, then. Open your mouth as wide as possible. This will not feel great but I will take care.”

Dr. Vokes gently pulled the tip of my tongue out and over to get a good look. The pain was excruciating, but he acted slowly and methodically. In a minute he was done.

“Well, it is as they said. You have a late-stage cancer in your tongue and probably in the lymph nodes on the side of your neck. I will have to see the scans to know more, but I can tell you a little bit about what we do here.”

Dr. Vokes went on to explain that while the standard of treatment over the last twenty years put surgery first, the clinical trial under their guidance had reversed the process, putting chemotherapy first.

“We intend to shrink the tumor with a series of chemotherapies, including the use of cetuximab followed by aggressive targeted radiation. Our goal is not just the eradication of the tumor, but limiting the occurrence of metastasizing after eradication of the localized area and overall preservation of the organ whenever possible.”

“That sounds like you're saying that you don't want to cut off my tongue,” I said.

“Indeed. I most definitely do not wish to cut out your tongue. We try to balance quality of life with preservation of life. The two should go hand in hand. But if the treatment is not working then certainly we will look to surgery as an option to save your life. We do not sacrifice one for the other. But I also believe that we do not have to. Our method works better and saves more lives while saving organs.”

This was unbelievable to hear. No other doctor had even considered this, and yet it made so much sense to me. I looked over at Nick.

“My father-in-law is a patent lawyer who does a lot of pharma work and he steered me towards Erbitux,” Nick said. “In his words, ‘when it works, it really works' and . . .ʺ

Dr. Vokes interrupted Nick, “Yes, that's right. When it is effective in an individual, for whatever reason, it significantly reduces the size and scope of the tumors.”

“So, in reading everything,” Nick skipped ahead, “the argument against doing this type of protocol is that it turns the tissue to mush, not the technical term, and if the tumor remains the necessary surgery becomes difficult or, well, really difficult.”

“Yes, that is true. But we have a great team here and we do a very targeted radiation to try to preserve as much of the surrounding tissue as possible. It could very well be that Grant is not responsive to the treatment, in which case we revert to a standard treatment. But a majority of people are responsive and the resulting surgery, if any, is less than it would have been, which preserves the organ.”

“And your survival rates?” Nick asked.

“Unpublished at this point, but we are nearly inverting the previous rates.”

Nick was beaming.

“So why is it that everyone everywhere else we've been has told us the opposite? Why is it that you're the only ones embracing this?”

Clearly this made Dr. Vokes a bit uncomfortable, like he knew the answer but didn't want to be so blunt. Thankfully, two other members of his team—the surgeon, Dr. Elizabeth Blair, and the radiation oncologist, Dr. Daniel Haraf—had entered the room.

“Someone needs to be the smartest guy in the room, I guess,” said Dr. Haraf.

We all laughed at that.

Dr. Blair explained that unlike many surgeons, she believed that the ideal situation was one where she never had to operate on a patient. Sure, she wouldn't publish new techniques, but her patients would be alive. Dr. Haraf had a morbid sense of humor as he described the radiation protocol. “Basically, we target it exactly to the spot of the tumor using a computer model of your head in 3D. That said, I'm the guy that makes you so sick that you'll want to die. But ideally you won't.”

I instantly liked the team. It's hard to describe. It's not just that they were saying what I wanted to hear—that I had a chance of living and that if I lived I would keep my tongue—but that they embraced the idea of doing something new, something different, something better.

“You know, I've been waiting to hear this, and now I'm a bit wary. We named our restaurant ‘Alinea,' which means a ‘new train of thought.' We strive for new and better and different. And still, I'm thinking that you guys are either really smart or really crazy.”

“Let's hope smart,” Haraf said. “But there is nothing wrong with a little crazy, too.”

The doctors left for a few minutes so we could talk it over and see if we had any questions. The most amazing part was that because it was a clinical trial, the university paid for any nonstandard treatment. The only toss-up was the double-blind study regarding the amount of radiation and whether or not it was inpatient with a three-week stay in the hospital, or outpatient and five days per week.

“What do you think?” I asked Nick. “I can't see a reason not to do this. What choice do I have?”

“I think we're home, Grant. These are good people.”

Chef Keller reached out to me and asked if it was a good idea to throw a party for Grant and a few close friends. “A blowout dinner somewhere.”

Of course, his heart was in the right place. He had called Grant several times, and I knew that Grant was downplaying the gravity of the situation. I wrestled with what to do. Should I e-mail chef Keller and tell him the whole story? Or would that be betraying a trust I had with Grant? Ultimately I decided to write Thomas a detailed e-mail, running through our entire experience yet trying to remain as objective as possible. I let him know about the daunting prognosis, the disappointing doctor visits, and yet the hope we had for Dr. Vokes's course of treatment. After all, he cared so much that he deserved to know the full extent of what Grant was going through. I also knew how proud he'd be to know what a strong leader he still was at the restaurant, and how much his support of Grant meant to him. I welcomed any questions he had and offered him a place to stay if he wanted to visit, as I suspected he no doubt would.

I couldn't help but feel that I was writing a letter not to a mentor of Grant's, but to another member of our family, even as I felt that I was betraying a bit of trust that Grant had placed in me.

 

Nick called to say he was arriving in a few minutes to pick me up for my first chemo treatment. I got dressed, and oddly I felt better than I had in months. I was wearing two morphine patches on my arm, so I was definitely feeling no pain. Because of that I ate well, slept great, and, despite the fact that I was pumped full of narcotics, I wasn't in the least bit tired. I was amazingly clearheaded.