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From 2014: Dr. Richard Deming and his nonprofit, Above + Beyond Cancer, will announce the destination of their next trip this week.

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Dr. Richard Deming and I were supposed to chat about the recent bike accident that left him with a punctured lung, a “big honking” chest tube, prescriptions for six kinds of pain medicines and a battered, bloodied helmet.

We ended up spending almost two hours talking about death.

For Deming, a renowned oncologist, death is ever-present. As the medical director of Mercy Cancer Center and the founder of Above and Beyond Cancer, a group for people touched by cancer, he sees death, helps some cheat death and speaks regularly about the impact of death on loved ones' survivors.

But what does a cancer doctor learn about mortality when he finds himself on the razor's edge between living and not?

It’s complicated.

A training ride turns into a nearly fatal crash

First, the accident.

What you need to know about Deming, 64, is that he pushes himself. A lot.

As a young doctor just out of medical school, he completed two years of intensive dive training to work with the Navy’s “bomb disposal men” in Hawaii.

He climbs mountains, regularly competes in triathlons and Ironmans, and once went helicopter skiing in Alaska. (To be clear, he does those things for fun.)

This fall, he planned to scratch his itch for adventure with Ironman Chattanooga. Ironically — considering the athleticism required for a 2.4-mile swim, 112-mile bike ride and a 26.2-mile run — the event is sponsored by Little Debbie snack cakes.

In preparation, Deming was on a “normal” high-impact training ride with some of his fellow adventurers. Organized into a tightly compacted “pace line,” with each bike inches apart, the group decided to speed up to work on their stamina and strength.

Suddenly, the rider in front of Deming tapped the back wheel of the cyclist in front of him.

“The morality of the laws of physics say that the person who taps goes down, not the tapped,” Deming said with a laugh from his hospital room.

The rider in front of Deming fell to the ground immediately and, at an inch behind, Deming had nowhere to go but over.

He launched like a “lawn dart” and landed on his head on the yellow center line in the middle of the road.

If not for his helmet — and the quick thinking of the guy behind him, who happens to be a neurosurgeon — Deming said he would be dead.

Deming’s final list of injuries reads like a commercial for the board game, "Operation." A concussion, six broken ribs, a broken shoulder blade, a broken collarbone, multiple abrasions and a punctured lung.

Sometime after I secured the Five Ws of the event, our conversation turned. I couldn’t shake the poetic nature of a doctor known for saving lives almost losing his.

“I mean,” I struggled to form the question, “what was it like to almost die? Because, you know, you’re a doctor who saves lives?”

“You mean what was it like to be on the other end of the stethoscope?” he asked.

“No,” I said, “what is it like to realize that all those nice platitudes we say to people about living and dying and fighting and finding purpose even in the toughest of circumstances might be true?”

“It reaffirmed what I have always known,” he said, “that we are all just dangling by a thread.”

'There are so many times that we almost die'

Deming was about 10 years into his career when came to accept his own death.

Working in healing, you start to understand in a deeper way than most that to live is to die, he said, and your card can get punched at any time.

“There are so many times that we almost die that we don’t know about,” he said. “That time we get on the highway and just miss getting caught in the pile-up. Or when the plane that leaves the gate before yours is the one that crashes.”

It’s not evil that makes people get cancer, Deming said, nor doing bad things that makes people die younger. It’s simply the way of the universe, so figure out how to get right with it.

“I’m totally prepared to die,” he said, surrounded by all the helmets he received as gifts. “If I died last Saturday I don’t know that I would have the opportunity to look back on it, but if I did, I think I would see mine as a life well lived.”

But for those who lose a loved one, it can be harder to accept, Deming said. There’s no right or sufficient amount of time to have had with the ones you love.

The same can be true for newer cancer doctors and their patients.

In the 10 years Deming learned to accept his own mortality, he also came to understand that when someone died, he had “not personally failed.”

“You learn to let go, to the appropriate extent, of the handwringing of, ‘Did I miss something? Did I do everything that I possibly could have?'” he said.

There’s a truth about his job that he'll never escape: Sometimes people die, and sometimes they die from cancer.

Narrative medicine creates connection

But then came an awakening. Sometime in the same decade that he accepted the inevitability of his death and the deaths of others, he figured out that he wasn’t just a tumor treater.

Machines treat tumors, he said.

He cares for patients. And he could be doing it better.  

Before, he compartmentalized life: Career over here and real life over there.

He was a doctor set on curing, and although he doesn’t remember interrupting patients after 11 seconds — the average time people talk before doctors jump in — he wasn’t seeking to make personal connections.

Then he heard about narrative medicine, a theory of care that highlights the huge effect a relationship between doctor and patient can have on the outcome. Not minor outcomes, he said by way of emphasis, huge.

He learned to create space for patients to share. He drew them out with questions about their philosophy on life and spirituality, their goals and what’s important to them.

"That style of medicine then became conducive to sharing bits about myself," he said, "and as I shared bits, I realized that had a positive impact on my patients' meaning of life — and the lives of those around them.”

Cancer has aftershocks, you see, and it doesn’t grow within one person.

Cancer spreads, metaphorically, throughout entire families. The tremors of loss are felt long after a loved one's passing by those who cancer touched.

But all that talking about mind, body and spirit that Deming gets his patients to do in the treatment process can act like breadcrumbs, guiding someone through the forest of grief.

Grief is a window into the human condition

Recently, I was sitting with a friend and the topic of newspaper reporters calling crime victims and their families came up.

"Why?" he asked incredulously.

Often families want to talk, I told him, because they want their loved one to be remembered. The death can seem too final, too shocking, and telling their stories helps makes them linger.

What victims and their families don’t realize is the effect telling their story has on those who read it.

Knowing the details of how something happened and how people responded helps the rest of us make sense of a messy world.

What I learned from the horrific murder of a transgender teen is that to live as your truest self is a radical act, but also a freedom and self-actualization few get to feel.

What I learned from a woman who lost everything in flash flooding is to reach out because the healing power of touch is universal. The hug I gave her as she cried on my shoulder was exactly what she needed, she told me later.

What I learned from the father of a 10-year-old boy who became an organ donor after he was killed in a freak accident is talking about death makes it easier to process.

When someone lets you into their grief, they open up a window into another side of humanity — a world we’ll hopefully never experience.

Basically, what I am trying to say is something Roger Ebert said much better in a 1987 review of the movie, “The Dead.”

“To cry for a stranger is to shed tears for the human condition, to weep because in giving us consciousness, God also gave us the ability to know loss and to mourn it,” Ebert wrote.

That July Saturday, it wasn’t time for Dr. Deming’s card to be punched. For that, he is thankful.

He’s also excited for the “post-traumatic growth” he’ll have from this experience, including, hopefully, still going to Tibet on a medical mission trip next month.

“It’s only when you reach above and beyond what you know you can do that you have any understanding of what you are capable of doing,” Deming said.

Recently, he’s been reminding himself of that and the other advice he gives his patients: It’s not cancer (or in his case, an injury) itself that gives you strength, it’s the journey with and through it that does, so learn to embrace life fully each and every day — no matter how hard.

And always wear a helmet.

Courtney Crowder travels the state's 99 counties as the Register's Iowa Columnist. Her grandmother, Thelma Crowder, is a breast cancer survivor. You can contact her at (515) 284-8360 or ccrowder@dmreg.com. Follow her on Twitter @courtneycare.

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