Preface -- Please Read and Take Action

If you could only read one thing on our website, read this.

"You shall know the Truth, and the Truth shall set you free." Klaus Brauch has done more than any patient I have ever known to search for the Truth. He has interviewed the best and brightest doctors. He has found and read with amazing comprehension the published literature. He has spoken to other mesothelioma patients. He has zeroed in on perhaps the most critical question, that is, would an extra-pleural pneumonectomy (EPP) for a patient with early stage, epitheliod type and negative lymph nodes offer a better chance of long-term survival than a pleurectomy/decortication?

He has found the Truth, but it may not set him free. Klaus has discovered that despite the giant strides modern medicine has made in curing cancer, and despite the long-standing epidemic of asebstos disease in this country as well as worldwide, we have not even begun to truly find a cure. As you read Klaus’ story below, keep asking yourself how long must this cycle of diagnosis, despair and death continue before we as a nation fight back? Our nation has recently been reawakened to the importance of funding programs to target and eliminate terrorists in order to protect the health and safety of our people. And yet our government and the industry that is primarily responsible do little to nothing about eliminating the terror of millions of Americans, who continue to live with asbestos time bombs ticking in their chests.

The time is long overdue to launch a nationwide assault on mesothelioma. We must begin by addressing the fundamental need that doctors and patients have to evaluate the treatment options based on reliable clinical data. Over the past 40 to 50 years, patients have been treated at a variety of centers throughout this country with poorly documented results. It is imperative that a centralized databank be established in order to understand the natural history of the disease and the outcomes from treatments currently being used as well as those developed in the future, to better evaluate the benefits of the various current treatment approaches, and to best evaluate and prove effectiveness of future novel therapies.

Klaus and I both ask you to read this profile with the idea of taking action. Make a difference. We must learn from our mistakes, build on our knowledge, and constantly strive for excellence.

--RGW, Oct. 1, 2001

TESTS, TESTS AND MORE TESTS

On Monday June 11, 2001, Klaus Brauch was resting in his hospital bed when Dr. Colin Joyo, his surgeon, walked in with the test results. A few days earlier he had opened up Klaus’ chest to harvest tissue specimens. Now he had come to deliver the news. The pathologists at Hoag Memorial Hospital in Newport Beach, he said, had reached a diagnosis of "malignant mesothelioma."

Klaus, a 51 year old software company executive, had never heard the word before. He had been having trouble with hypertension and shortness of breath since September of the year before, and had even been told he had "congestive heart failure" (CHF). In October he came down with pneumonia. In treating this, his doctors detected a right sided pleural effusion of unknown origin. After conventional treatments, the effusion remained, so in February, his doctors performed a right-sided thoracentesis. The cytologic examination of the fluid was negative for any malignant cells, although the fluid was positive for the presence of "hyperplastic mesothelial cells," a finding that would later prove ominous. The doctors decided to wait and see if the fluid would return.

It did. Chest films in April revealed that the fluid was back. A recommendation was made to consult a thoracic surgeon for a biopsy to find the cause of what had become a partially collapsed lung. That’s when Klaus was referred to Dr. Joyo to reevaluate the working diagnosis of CHF and/or pneumonia. The working diagnosis was about to change.

NODULE FOUND DURING SURGERY

On Friday, after his surgery, Klaus had been warned that his problems were bigger than CHF or pneumonia. When he regained consciousness, his wife Susan explained what she had learned from Dr. Joyo. Dr. Joyo had found a large number of "nodules" spread about on Klaus’ diaphragm. Dr. Joyo dissected several specimens from the lung, diaphragm and pleura. In addition, he insufflated talc in the pleural cavity. According to Susan, Dr. Joyo didn’t like what he saw, but was going to defer his final opinion until after he received the pathologist’s report. 

The gravity of the "new" diagnosis did not hit Klaus until later. Nowadays, it’s easy to be lulled into a false sense of security about cancer. We tend to believe that there’s no cancer that modern medicine can’t beat. So, at the time, that Monday morning when Dr. Joyo dropped his bombshell, Klaus’ only concern was how soon would he be able to schedule treatment and get on the road to recovery. Dr. Joyo handed him a set of color photographs taken during the surgery (see photograph on the right). The photographs showed sections of his diaphragm and chest wall. Klaus could see with his own eyes a smattering of white, stringy, barnacle-like bumps that were imbedded on top of his diaphragm. Surely there had to be a way of removing these trespassers.

"YOU'RE AN EDUCATED MAN - YOU'LL FIGURE IT OUT."

Dr. Joyo quickly rebutted that can-do presumption. His message was short but decidedly unsweet. "This kind of tumor is very difficult to treat. You need to go and see Dr. David Sugarbaker in Boston." Dr. Joyo admitted this tumor was beyond his expertise. Dr. Sugarbaker, on the other hand, was a thoracic surgeon who specialized in mesothelioma. Klaus’ mind began to pop with questions about treatment options, protocols, clinical trials, survival statistics, cures -- but before Klaus could pick his doctor’s brain, Dr. Joyo ended the brief meeting with this oddly flattering prediction: "You’re an educated man; you will figure it out."

Klaus was an "educated man." He had learned from his father at a young age to seize the day, to pursue knowledge like a hunter, and to avoid easy answers. These lessons became a way of life for Klaus. After graduating with a bachelor’s degree in anthropology, Klaus had worked his way up the corporate ladder in the computer software industry to the top. He was now a program manager for a software company, Intentia, a world leader in e-business strategic and logistical solutions. When not managing his company or providing for his three daughters, he had made time to write a science fiction novel. He played drums in a rhythm and blues band. He was an amateur astronomer and charter member of the Carl Sagan planetary society. On top of all that, he collected jokes like a little kid collects bugs or trading cards. He knew when to play, and when to work, and more importantly how to do both at the same time.

But there was nothing playful or funny about what he learned about mesothelioma when Klaus left the hospital and returned home. He and his wife Susan and their three daughters huddled in front of his computer, punched in the words "malignant pleural mesothelioma" -- and began to read, focus and assimilate. Within a few minutes, he had learned the devastating truth that mesothelioma was considered "incurable." Within 15 minutes, he had found the survival statistics and learned that an aggressive, multi-modality approach offered the best hope for long term survival. Within 30 minutes, he learned that there were only a few doctors who were brave enough to treat the cancer. Within 45 minutes, he had resolved to learn everything there was to know about this insidious cancer. Within an hour, he had already begun making contact with Dr. David Sugarbaker in Boston, and was printing out the contact data for Dr. Robert Cameron at UCLA and Dr. Dan Sterman at the University of Pennsylvania.

Klaus intended to be "one of the lucky ones." But to get there, Klaus realized it was going to take the courage of a pioneer, the perseverance of an athlete, the patience of a birdwatcher and the indomitable spirit of an alpine mountaineer.

MESO DIAGNOSIS CONFIRMED

This early in the game, the Brauch family was still holding out hope that perhaps the tumor was misdiagnosed. They had been advised that Hoag Hospital had sent the biopsy specimens to the Mayo Clinic in Scottsdale, Arizona for a second opinion. Unfortunately, a few days later Dr. Joyo’s office called with the bad news that the pathologists at Mayo had confirmed the diagnosis. The fight was on.

Klaus arranged to fly to Boston to meet with Dr. David Sugarbaker on July 10th. He only met with Dr. Sugarbaker for a few minutes, as the doctor had to leave for an emergency procedure. Klaus spent the next few hours with Dr. Michael Jaklitsch, who advised Klaus that he was a good candidate for the famed tri-modal therapy regimen. Dr. Jacklitsch recommended the extrapleural pneumonectomy (EPP), during which the procedure they would administer heated chemotherapy. Within 45 to 60 days of discharge, they would then radiate the incision marks to reduce the risk of tumor recurrence.

Klaus was sure that his tumor was "early stage." Although Dr. Joyo had not biopsied any lymph nodes, Dr. Jaklitsch was confident that the lymph nodes were negative, so confident that he saw no need to test the lymph nodes for disease. Dr. Jaklitsch advised that the biggest risk mesothelioma patients faced after surgery was recurrence of tumor, since you could fit a million malignant mesothelial cells on the head of a pin, and it was virtually impossible to record a 100% kill rate using the best techniques by the best surgeon. In an attempt to delay if not eliminate the recurrence risk, Dr. Sugabaker’s team was experimenting with heated chemotherapy which they inserted into the chest cavity after removing the lung, diaphragm and part of the mediastinum. The idea was to take a two-pronged attack on the tumors -- if the heat did not kill the cancer cells (human cells, both "good" and "bad" can only tolerate so much heat), the chemotherapy drugs would. Although an elegant idea, the therapy had neither been rigorously tested in any clinical trials nor reported on in the literature.

GENE THERAPY RULED OUT

Naturally, Klaus, who continued to feel relatively robust, was not excited about giving up his right lung and other body parts. He was also concerned about the risks of mortality and morbidity stemming from the radical nature of the operation itself. He decided to inquire about gene therapy. Klaus contacted Dr. Dan Sterman at the University of Pennsylvania. He learned that the gene therapy protocol was not recruiting mesothelioma patients at the time. Dr. Sterman also indicated that even if the protocol were open, he would still urge patients to pursue the surgery/chemotherapy/radiation route first.

The issue now was whether Klaus should choose the EPP or a pleurectomy/decortication (P/D), a procedure in which the surgeon would attempt to remove only the tumor and the surfaces adjacent to the tumors, without dissecting the entire lung and diaphragm. Klaus set up a meeting with Dr. Robert Cameron at the UCLA Medical School in Los Angeles on July 16, 2001.

DR. CAMERON ENDORSES PLEURECTOMY

Dr. Cameron advised that the P/D was less intrusive, safer, and would achieve results that were equal to or better than the EPP [the mortality rate for EPP patients was 6% or greater, whereas the mortality rate for P/D patients was about 1%]. He emphasized that neither he nor Dr. Sugarbaker could offer a cure. In that sense, since neither procedure offered a probability of a cure, both were considered "palliative" (i.e., "serving to relieve, ease or alleviate, without curing") -- a term which hardly inspires hope for a young man shooting for a cure.

After looking at the CT films, Dr. Cameron expressed concern about what appeared to be enlarged lymph nodes. Dr. Cameron generally does not operate if there is lymph node involvement; instead, he urges the patient to undergo chemotherapy first, as research shows that the order of therapies (i.e., chemo first, surgery second) is critical in reaching maximum survival. Dr. Cameron was prepared to operate, but first he wanted to schedule Klaus for a mediastinoscopy so he could biopsy his lymph nodes to rule out metastatic disease.

SEARCHING FOR SURVIVAL DATA

The more you learn the less you know? Not exactly. Klaus continued to scour the literature for articles that compared the survival data for patients who elected P/D vs. EPP vs. Simple Pleurodesis vs. Chemotherapy only vs. "Watchful waiting." The more he looked the clearer it became that there wasn’t any hard and fast data on this critical question. Despite mesothelioma’s long and ugly history in this country, there was no nationwide patient registry that doctors and patients could utilize to compare therapies and their respective outcomes. There had never been a large, randomized clinical trial for mesothelioma patients. Every hospital operated as an isolated fiefdom, with each offering it’s own protocol. It was very difficult to compare one therapy over another, as each doctor’s opinion was not anchored by a universal "standard of care."

Klaus read about a speech by Dr. Karen Antman who reported that the median 5 year survival for mesothelioma patients who chose P/D fared better that those who elected the EPP. He also read her disturbing conclusion that the EPP patients survived only a few months longer than those who simply opted for the palliative talc pleurodesis. Klaus was convinced that he was "one of the lucky ones." His youth, vigor, and epithelial cell type, plus his will to live contributed to his optimism. He did not, however, know for certain that his lymph nodes were negative.

KLAUS ASKS THE TOUGH QUESTIONS

Medical science had helped him define his diagnostic status, but now he needed guidance in choosing the best treatment plan for him -- a 51 year old male, epithelial cell type, (probable but not confirmed) negative lymph nodes, post-talc pleurodesis, minimal symptoms. Klaus fired off questions to both Dr. Jaklitsch and Dr. Cameron, asking them to send him data on the percentage of their respective patients who were alive at two, five and seven years from the surgery. He posed the pivotal questions. What percentage had recurrence, and at what interval from the surgery, and where did the recurrence occur? How many patients with recurrence had adjuvant chemotherapy and/or radiation? What exactly was "a negative margin?"

Klaus needed assurance that whatever treatment regimen he chose, it would offer his best chance for long-term survival. He was, in his words, "prepared to choose a more aggressive strategy in exchange for a realistic shot at a curative outcome." He instinctively shunned any option that fell under the "palliation" rubric. He was prepared to go the distance.

There was, in Klaus’ mind, one major complicating factor. At the Hoag Hospital, his surgeon had performed two wedge biopsies of his right lung. Klaus was concerned that the procedure may have inadvertently opened a pathway for the tumors to invade the interior of the lung itself. It seemed logical, therefore, that the best way to eliminate this risk was simply to remove the lung. This argued in favor of the EPP. Dr. Cameron, however, assured that he would be able to extricate a thick portion of the lung adjacent to the biopsy incisions. In the vernacular, he would be able to leave a "clean margin."

WHAT EXACTLY IS A "CLEAN MARGIN?"

The conceivable wedge biopsy risks led to a discussion on what exactly Dr. Sugarbaker meant when he wrote about leaving "negative margins" in his post-EPP patients. The "margin" for an EPP is basically the heart sac, soft tissues and the chest wall, which consists of muscle and bone -- not exactly the kind of surface that can be scraped clean. There is no diaphragm, which is replaced by a Gortex patch in an EPP, and much of the walls of the mediastinum are removed. Every surgeon is of course proud of his technique, but the architecture of the chest cavity and the diffuse and microscopic nature of the cancer do not lend themselves to "clean" margins, as the same surgeon would have to agree that mesothelioma cannot be whipped by surgery alone. The margins may be "clean" to the naked eye, but teeming with tumor cells through the lens of a microscope.

The premise for Dr. Cameron’s P/D approach was that in those patients without lymph node involvement in the lung itself is uncompromised by the tumor and should be preserved. Granted, P/D patients do experience loss of lung function, but if they develop pneumonia or tumor recurrence in the other lung (which happens in up to 50% of all surgical patients), the extra capacity afforded by the preserved lung would prove vital in preventing suffocation.

DR. CAMERON ADVISES LYMPH NODE BIOPSY

Regarding Klaus’ candidacy for surgery, Dr. Cameron agreed with Dr. Jaklitsch that he was an excellent candidate, but only if the lymph nodes, which appeared irregular to Dr. Cameron on the CT scan, were negative for tumor. It was standard procedure for Dr. Cameron to rule out lymph node involvement before operating. Dr. Jaklitsch called to reassure Klaus that their data indicated that positive lymph nodes did not necessarily mean there would be no benefit from surgery and that life extension was still better with surgery than doing nothing. Brigham and Women’s Hospital would continue to offer EPP and to offer the trial, even if Klaus’ nodes were positive.

THE GRIM STATISTICS

Regarding survival data, neither Dr. Cameron nor Dr. Sugarbaker’s team could point to timely, reliable, published statistics. Both reported having patients who have survived 7 years from the date of surgery. Dr. Cameron offered his summary of the survival numbers, as follows:

• Talc Pleurodesis only -- nine to 12 months (this means the average person has the disease progress to death by this time);

• Pleurectomy/Decortication -- 17 to 18 months; and

• Extra-Pleural Pneumonectomy -- 18 to 20 months.

Dr. Cameron cautioned, however, that the statistics don’t tell the whole story. The EPP + chemotherapy + radiation regimen was not for everyone. Only a certain patient profile was eligible , i.e, relatively young, early stage, negative nodes, epithelial subtype. Just to be able to actually complete all stages required incredible strength. The published data from Brigham and Women’s only included patients whose surgery went to completion and therefore completed all three prongs of the protocol. Patients who entered the trial but whose tumors proved to be un-resectable were not included in the statistics. And there’s always the quality of life issue for the survivors -- it’s not exactly easy to put Humpty Dumpty back together again after such a radically traumatic surgery, which often gives rise to secondary infections and chronic pain.

Dr. Jaklitsch sought to put Dr. Antman's unfavorable comments regarding the EPP in perspective. He credited her with encouraging Dr. Sugarbaker to begin the EPP at Brigham and Women’s, but felt that the first two years of experience with the EPP had colored her perception of the procedure; the mortality and morbidity statistics were higher during the first two years, but had fallen afterwards. At the time of her experience with EPP, the multi-modality approach was in its infancy stage -- the surgeons and nurses were still "learning the ropes."

The surgical technique had improved and, unlike the earlier tri-modal approach whose results BWH had published, the timing and quality of the chemotherapy therapy had changed. The protocol offered to Klaus (i.e., EPP + heated intracavitary chemotherapy wash + radiation) was experimental. The regimen was interesting, perhaps even promising, but the lack of published data certainly was not reassuring. Dr. Jaklitsch advised that they were in the process of assimilating the data using the heated chemo and it should be ready by Christmas, 2001. He indicated that the results certainly were at least as good as their previous results and did not represent an increased mortality risk or a poorer result.

SO MANY QUESTIONS, SO FEW ANSWERS

Klaus was now confused. Here were two first class hospitals offering widely competing viewpoints. Dr. Cameron wanted to preserve the lung, Dr. Sugarbaker’s protocol necessitated its removal. Dr. Cameron did not recommend post-operative chemotherapy unless and until a) there was a promising agent available and/or b) the tumor had recurred, as evidenced by CT scans taken every three months from the date of the operation. Dr. Sugarbaker absolutely mandated chemotherapy, not post-surgically but during surgery, using a technique that had not yet been certified by the FDA as safe for all surgeons to use.

But Klaus was willing to "push the envelope." If both procedures were guaranteed to leave stray malignant cells behind in the chest cavity, wouldn’t it be prudent to try to swish around an agent that by virtue of its cytotoxic and/or thermal properties had a chance to kill those bad cells? Sounded good, but after the lung, diaphragm, pleurae and part of the heart sac/mediastinum had been removed and/or replaced with synthetic patches, would "swishing" around a hot soup that included malignant cells result in leakages that would inevitably spread the tumor to the abdomen or elsewhere?

EXPERIMENTING WITH HEATED INTRACAVITARY CHEMO

And how do we protect the good cells from the toxic heat? The normal body temperature is 37 degrees Celsius. It’s not clear what the temperature of the heated chemo should be -- 42.5 C? How do we maintain that temperature consistently throughout the chest cavity? The heart is like a sink that will grab and distribute the heat to the rest of the body through the circulatory system. So it can absorb the heat shock, but what about the rest of the chest cavity? Have models been set up in which thermometers have been placed throughout the chest to measure the actual temperature at key spots to make sure the heated fluids were not too hot or too cold? A stream of endless questions, each provoking a new stream of ponderables. No easy answers.

As Klaus put it, "it’s not the surgical procedure that scares me, it’s what’s left behind after the surgery" -- the millions of tiny microscopic malignant cells that thirst for eternal life. Radiation has not proven effective, nor has systemic chemotherapy. Despite the experimental nature of the heated intracavitary infusion, Klaus was willing to run with it. He was ready to run, but again he ran into another brick wall. The trial at Brigham and Women’s had FDA approval, but Brigham and Women’s had changed the drugs, and was forced to go back to a phase I trial, which meant more delays.

KLAUS CALLS EPP PATIENTS, COMPARES NOTES

With a dearth of published or even pre-published data, Klaus found himself in the cockpit, at the controls, flying at night without any formal aviation training. He was forced to rely heavily on instinct. He began calling other meso patients from Brigham and Women’s. What he learned both encouraged and discouraged him. The younger patients who survived the radical EPP told Klaus about a slow, painful and miserable road to recovery. Some, however, were still cancer free. Other patients, including a 38 year-old patient, told him about qualifying for the surgery -- which raised their hopes and dreams -- only to have the operation aborted mid-stream.

The more patients he spoke to, the more he read, the more he worried about whether he really was a good candidate or whether he was being over-sold the availability of tri-modal therapy at Brigham and Women’s. Klaus assessed the situation as follows:

What we have going on in Boston reflects a willingness to operate on even some marginal cases, not always as part of the clinical trial but as a form of treatment. The ethics of that are something we can debate till the cows come home, but the bottom line is that Dr. Sugarbaker, by accepting marginal candidates and predicting a favorable outcome, may be giving all of these patients unwarranted cause for optimism. It's a tough situation. I don't know which is harder, being told you have a chance when you don't or being told no one can help you when there is a slight chance that they might.

LEANING TOWARDS EPP, BUT CONSENTS TO ANOTHER BIOPSY

Klaus was leaning toward Brigham and Women’s, but agreed with Dr. Cameron that he ought to have his lymph nodes evaluated. On July 16, Klaus underwent another surgical procedure (the mediastinoscopy), which required an incision at the base of the neck and the insertion of a hose, equipped with a camera and pinchers, into the trachea.. A few days later Klaus heard the good news that all five of his lymph node biopsies were negative for tumor. Klaus was indeed early stage -- another plus for his prognosis. He also learned that the pathologists at Brigham and Women’s had confirmed (for the third time) that he did indeed have mesothelioma of the epithelial cell type.

Although mindful of the negatives, Klaus was not distracted. He focused on the facts of his case -- compared to most, he was not in dire straights. His pain and shortness of breath were not acute. His lungs continued to function, after his pneumothorax had healed. He was still able to swim in his backyard pool and ride his bike around the neighborhood. And his optimism remained strong.

KLAUS CHOOSES THE EPP -- "best shot for curative outcome"

After weighing all the pros and cons, Klaus chose the EPP. He reasoned that Dr. Cameron’s approach seemed purely palliative.

I felt that Dr. Cameron's aim appeared to be prolonging life in the expectation of finding some other curative procedure in the future. Dr. Cameron is careful not to promise something he cannot deliver. Sugarbaker is more vocal about shooting for a cancer free result from his tri-modal treatment. As few of them as there are, those long term survivors of Sugarbaker's surgery offer hope for those of us who have favorable indicators.

To use a sports analogy, I am not the kind of person who will choose a nine yard play when I need a first down and given the options open to me, I simply don't have sufficient evidence to convince me that there is any benefit to P&D over EPP. Both are extremely severe surgeries and both offer only slim chances for survival. Given what I know today, I believe I have at list twice to three times the chance to survive this cancer with EPP as I do with P&D.

It was settled. Klaus and Susan would fly to Boston. He had arranged to go under the knife in the week of September 17th. He was anxious to go forward. He understood that he could not "diddle" about while his tumors grew stronger. It had already been nearly three (3) months since his diagnosis and he would not remain "early stage" forever. He was ready to go, but then something inexplicably horrifying intervened. On September 11, terrorists had skyjacked four jet planes, including two jets that had been launched from Logan Airport in Boston. In the aftermath, commerical flights were cancelled and Logan Airport had been shut down for at least a week. Klaus would have to wait.

AFTER DELAYS, SURGERY SET FOR MID-OCTOBER

As of this writing, Klaus is scheduled for surgery in mid-October -- fully four months after his diagnosis. Throughout the ordeal, Klaus has shown a remarkable detachment from the horror of his predicament. He does not dwell on the negatives. He has been staying busy. Disappointed that the medical community, after 50 years, has never attempted to build a patient registry or database in order to compare the merits of particular treatment options, Klaus, who has experience as a computer programmer, started his own database.

Klaus was also writing a book for cancer patients, which he artfully sprinkled with humor and silly cartoons. Klaus is a firm believer in the salubrious effect of laughter. As he wrote in the book’s prologue

I have always laughed. Laughter is the window to my soul and I laughed at myself more often than I did at those amusing things that happened around me. You can imagine my delight when medical science confirmed that a hearty laugh is excellent medicine for what ails us. I strongly believe that this should apply to cancer too . . . ."

AUTHOR DEDICATES PROFITS TO MARF

Writing has also been therapeutic for Klaus. Just recently Klaus published his first novel, a provocative science fiction thriller about an elite corps of soliders who teleport into the future to combate alien invaders, only to be captured and used as gladiators (see synopsis below).* Klaus wrote the book in about one year. He dedicated the book "to all those afflicted with Malignant Mesothelioma, past, present and future. It would be wonderful if the miraculous medical technology of the Crystal Refuge were already available today."

Seizing the opportunity to make a difference for future mesothelioma patients, Klaus has also pledged to donate a percentage of the book’s profits to the Mesothelioma Applied Research Foundation (MARF), a non-profit charity whose mission is to eradicate mesothelioma as a life-ending disease. Like many of us, Klaus is deeply disappointed at the lack of funding this disease has attracted, relative to other forms of cancer (Please read Klaus' essays by clicking HERE). He has vowed to help MARF raise both awareness and dollars so that the amount of money the government allocates to mesothelioma research at least comes close to approximating what it spends on a couple of cruise missiles.

HUMOR AND DIGNITY

Recently, as we prepared for his deposition, Klaus asked me what the appropriate attire was. Since we were taking his videotaped deposition in his home, I suggested he dress casually -- certainly no necktie. Well, on the morning of his deposition, Klaus greeted me at the door wearing a big smile and a presentable tie with an interesting pattern of little snowballs against a dark backdrop. I looked closely and grinned: the snowballs were none other than Luke and Leia, the Brauch’s loveable Bichon Frise pets. Klaus was also wearing what looked like an apron. "What’s that?" I asked, pointing to the garment. "It’s an apron," he said without apologizing. "I’ve been baking chocolate chip cookies and pound cake all morning." I just shook my head, amazed. "Hey, just because I have mesothelioma doesn’t mean I have to lose my sense of humor, or my good manners. Defense lawyers got to eat, too!"

Yes, Klaus has chosen to try to stay positive. But he’s human. Humor, hope and optimism help him cope with his mesothelioma, but at the end of the day, he still has a monster festering in his chest. What he wants -- what all mesothelioma patients want -- is a reasonable shot at ridding his body of the monster, or at least keeping it at bay. The anguish comes from knowing that despite his best efforts, his good attitude, his intelligence, the malignant beast has "a mind of it’s own." The truth about the deadly course of this tumor may not set Klaus free, but it has certainly made him determined to do everything within his power to get more life, and help others along the way.

* The ADAR Chronicles by Klaus Brauch is an exploration of the meaning and purpose of humanity's existence. It chronicles the rediscovery of humanity's nobler purpose after a devastating, but stalemated, conflict with an alien species in 2011. A group of contemporary soldiers are fed into a new invention, the Atomic Disintegrator And Reintegrator (ADAR) in order to be teleported into combat against the alien invaders. They awake 300 years later only to find themselves being used as gladiators in a cycle of death and resurrection. Even though they are seemingly pitted against weaker versions of the alien invaders of 2011, it is modern humans who control the bloody games. Who are the occupants of Earth's only remaining city, the Crystal Refuge? Where did they come from, and what purpose is there to the organized carnage? Why did they abandon all pretense of humanity and justice? What master do they really serve and are they truly free to choose their own fate?

*** POSTED OCTOBER 2, 2001 ***

An Update 9/16/02