Rhett Butler
AUTHOR

Rhett Butler

Literature & Fiction
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It was the wrong answer on the test. I knew it was wrong but having lived the scenario, I simply could not bring myself to select, “do nothing”. My name is Rhett Butler and I started medical school when I was 44-years-old. As a younger man, it was never my intention to become a physician. Instead, I focused on my passion for performing on the guitar and was fortunate to build a career that allowed me to live that dream. On tour in 2004, I received the news that my younger brother, Ashley (24-years-old), had been diagnosed with a radiation-induced sarcoma. Ashley was previously treated with a very aggressive protocol for medulloblastoma in 1982 which left him mentally and physically handicapped. The payment for the deal that my family made with the Devil had come due. From 2004 to 2010, as my brother’s cancer progressed, I became increasingly involved with the decisions that were made concerning his treatment. In 2009, Dr. Robert Benjamin of MD Anderson Cancer Center, one of the world’s most experienced sarcoma doctors, told my family that there was nothing more to do for Ashley. I could not bring myself to accept this prognosis and I remember my justification clearly: We had struggled for so many years and had won. I was sure of what must be done and resolved to not give up on my brother. I convinced Ashley and my parents to try again. A few weeks later, a surgeon at University of California San Francisco, performed a right-sided pneumonectomy and removed a 20-cm sarcoma from my little brother’s thorax. That tumor recurred locally within 2-months and was mediating superior vena cava syndrome. Struggling for oxygen, Ashley collapsed in the hospital at an appointment with the radiation oncologist who was planning a short course of palliative treatment. He was resuscitated and intubated. I spent the next day convincing the radiation oncologist, the medical oncologist and the surgeon that it was worth treating Ashley with a 10-day course of Intensity-Modulated Radiation Therapy. The medical oncologist was certain that the tumor would be refractory to treatment and that further therapy was futile. I pleaded with the radiation oncologist who developed a plan to treat him while intubated. They wheeled Ashley to the basement daily for his radiation treatments and at day six, the signs of superior vena cava syndrome were gone. By the time he finished his treatment plan, Ashley had been extubated. He awoke to find his family who had not given up on him and within 2-weeks was able to walk out of the hospital one more time. Ashley passed away a few days later. The bill for my brother’s treatment at UCSF was 1.5-million-dollars. This is how I knew that the answer that I was picking on the test was wrong. I was supposed to do nothing. The patient in the vignette was hopeless. I am not, still.
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  • Beware of Cynicism cover art

    • Beware of Cynicism

    • The True Mythology of Medical Education and the Flumping of the Morality Police
    • By: Rhett Butler
    • Narrated by: Michael Dayson
    • Length: 5 hrs and 49 mins
    • Release date: 24-10-2023
    • Language: English
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