R.N. just died.

She was my first breast cancer patient out of fellowship and training. My first breast cancer patient where I was the "doctor". No backup. Nobody to turn to for advice. I write the orders, I explain the side effects. I hold the hands.

She was only 33 years old when she was diagnosed 4 years ago.

She and her husband had just moved from Denmark only months before for his company. Something with maritime equipment that brought him to the mid-Atlantic.

Then she found the lump. A small, 1 cm mass in her breast.

So young.

Triple-negative. A bad prognosis.

But, still stage I.

She got chemo, lots of chemo. bilateral mastectomies. We took her ovaries out when we saw that she had a genetic predisposition to breast and ovarian cancer.

All the while, I learned a little bit about Scandinavian stoicism.

She and her husband and their three children were amazing. Gentle, intelligent, kind. So loving and so close.

Well, you know the deal.

She relapsed only 7 months after therapy.

We tossed the book at her. More chemo. Even salvage radiation to the arm and neck.

Another remission.

Maintenance chemo.

And then, home.

She went back 18 months ago.

She died two weeks ago.

During her course, she became very philosophical, as we all do during illness. She started to read about diet and about this woman, Jane Plant, a British scientist who advocated dietary changes to combat cancer. Who felt that much of breast and prostate cancer is related to meat and dairy products and that we need a radical way of overhauling our diet to better suit what we were evolved to eat.

She gave me a book, "Your Life In Your Hands", by Dr. Plant.

I was rummaging around, rearranging my bookshelf today, and I came across it. My patients know I love to read, so I have a little section with gifts from them and here was R.N.'s book.

In it, she inscribed that she hoped that I could learn something from this. That she wished she had learned something about diet and lifestyle growing up, if only to give her a slightly better chance of surviving.

That she knew she might die. But, that she hoped that I would learn from this book. That maybe I would incorporate some of the insights into my own health.

But, mostly, that maybe I would spread this gospel to others. That we CAN do something about our health. That our toxic lifestyle and food supply is at the root of many of our medical problems, both physiologic and psychologic.

I have striven to live up to this for the past couple years. I preach health to patients and friends. I have tried to change my own behavior, to live with less. To eat and live consciously, for health, but also for animal rights and for ecological reasons.

I have tried.

Rikke, I hope you are at peace. You were one of my most memorable patients.

You have changed my life forever.