The world does not stop for COVID, though it might seem that way. The cancer wards don’t.
Trevor Bayliss, 44, a hematologist oncologist at Berkshire Medical Center in Pittsfield, was in the room where cancer and COVID-19 violently collided in March. Rick Bua, a patient from Clarksburg he had been treating for Hodgkin lymphoma, was back in the hospital, two weeks after his chemotherapy regimen had come to what seemed a satisfying outcome.
But, he was sick again, with a serious lung infection, and Bayliss was concerned that one of the drugs he had been giving Bua — it was a tumor-attacking antibiotic called bleomycin — might have been responsible for the white haze that was showing up on Bua’s lung scans.
Instead, in a development that would serve as the first foreshadowing of a life-altering pandemic suddenly come to roost in the Berkshires’ backyard, Bua tested positive for the coronavirus, the first known case of community transmission in Massachusetts.
“I immediately had to go into quarantine,’’ Bayliss said. “And that was really in the early going, before we had guidelines on what to do about this stuff. And we had to change everything about how we practiced. Suddenly, we were in a world of PPE and masking up and keeping visitors out of the facility.’’
One thing that didn’t change: “We had to keep rolling along,’’ Bayliss said, “with the patients that really needed us. Because they were, you know, acutely dealing with their cancer.’’
But, because of all the COVID-induced restrictions, Bayliss found himself having life-and-death conversations with patients who no longer had the comfort and support of family members by their side.
“That was a really dramatic shift,’’ Bayliss said, “and difficult in a lot of ways.’’
Those conversations are not incidental to Bayliss’ practice. They are central to what he does, and who he is.
To understand that, you have to know a little of his backstory.
Something was seriously wrong
In prep school, Bayliss, who grew up in Williamstown, was New England’s 800-meter champion, and as a star runner and ice hockey player he entered Williams College intending to continue the legacy left by his grandfather and great-grandfather, both standout athletes for the Ephs, great-grandad Oswald Tower enshrined in the basketball Hall of Fame.
But, from the start of his freshman year, something was not right.
Cross-country practice left Bayliss drained, puzzled why his times were slower than what he had run in high school. Hockey proved even more exhausting, so, he quit, electing to hold his energy in reserve for track that spring. But, that’s when he and others noticed a bulge in his abdomen.
That summer, he discovered that he had an enlarged spleen, five times bigger than normal, and during the course of surgery to remove the spleen it was discovered that he had large T-cell leukemia, a rare cancer, especially in someone so young.
Doctors held off on treating the disease at the time, preferring to gauge how it progressed.
Bayliss stayed in school for his sophomore year, treating his condition through a variety of holistic modalities, and as he went into his junior year, he decided he was ready to try competing again. He was wrong. He had no energy, and when he discovered that his lips and fingers were turning blue, he realized something was seriously wrong.
He was right. The cancer had spread to his lungs and liver.
Eventually, he went to the Fred Hutchinson Cancer Research Center in Seattle, where the plan was for him to undergo a bone marrow transplant. But, because he had responded so poorly to chemotherapy treatments, he was told that undergoing the bone marrow procedure was out of the question. He remembers sitting in a conference room with his mother, Ellen, and asking what came next.
The message came back blunt, and unsparing. You are not responding to treatment. You have months, maybe weeks, to live. There was nothing they could do.
Let’s go home, Bayliss told his mother. What happened next, he can’t really explain.
“I think it was that next night,’’ he said. “I’m sort of lying in bed, just really processing all of that and, you know, shedding tears, and suddenly it all just kind of went away. And I just had this unbelievable sense of peace.
“I’ve always had a really hard time explaining what happened that night. But, going forward from there, the fear just kind of dissipated.’’
In its place was conviction that it wasn’t about giving up, but letting go.
“Just accepting,’’ he said, “and being fully in the moment.’’
And just when death never had seemed closer, deliverance. When Bayliss returned home, the oncologist overseeing his care at the Southwestern Vermont Medical Center, Dr. Eric Pillemer, told him about a promising trial in which methotrexate, a drug ordinarily used to treat rheumatoid arthritis and certain skin conditions, had proved effective for a small number of cancer patients.
“I said, ‘Well, I’ll go with the methotrexate,’ ’’ Bayliss said. “So, I was on the cusp of this being realized as a treatment, literally in the nick of time.’’
Within weeks, the cancer had gone into full remission. Methotrexate now is considered a first line of treatment for T-cell leukemia. Bayliss not only went back to school and finished his degree, he felt the return of his old competitive urges. He went out for the hockey team and was the last player cut.
‘Really, I’m back’
He turned to indoor track, and in his first meet, with his mom and grandfather Oswald in attendance, he won the 600 meters, a distance he never had run before.
“Only a couple of years before,’’ he said, “I couldn’t walk up a flight of stairs. I know it’s a cliché, but the victory was putting my toe on the starting line.
“But, then I’m out there, pushing my body to the absolute brink, and that pain was like, I’m fully alive. And then coming down the homestretch, and winning the race, and giving my grandpa and my mom a hug, that was the moment like, ‘Really, I’m back.’ ’’
And somewhere in the midst of that exhilarating journey, Bayliss remembered the bleak, soulless message he had been given in a conference room devoid of hope. That’s when he told himself: I want to become a doctor, the kind that will not let a patient twist on the vine of despair but instead deliver a message that you do not abandon hope, even in the darkest of hours.
This was something, Bayliss realized, that was bigger than himself.
“Whether you want to call it God or spirit,’’ he said, “but faith, faith that there is something that ties us together and helps guide us through this.
“It was sort of this experience of just feeling a connection. That was something that nothing can really get between. No, not cancer. Not even death.’’
That is true for his cancer patients, the ones for whom, before he steps into their rooms, he takes a deep breath, clears his mind and makes sure he is fully present for them. It is why he is so proud of the pilot integrative oncology or supportive care program that is made available to Berkshire cancer patients, the offerings of yoga and intuitive painting and acupuncture and nutrition and mindfulness and the other modalities that remind us that not all healing comes as a result of a doctor’s scalpel, a vial of medicine or a tube full of chemo.
And what is a fundamental truth for his cancer patients resonates for those afflicted with COVID, too, Bayliss said. For him, coming home to be a doctor has meant so much: taking care of the neighbors, friends, strangers who know the places he knew as a child.
“There are certain things that are out of our control,’’ he said. “Nothing teaches you that better than a cancer diagnosis. We can’t control that COVID is here. What we can do is take all the preventative measures, we can take all the care, we can socially distance, we can wear masks, we can do what the experts are telling us to do. And that’s what we can do.
“So, we do that, and we do that to the best of our ability and we let go. And we let go what we can’t control. I think that’s a lesson there.”