Attitude, support helps Reserve Airman beat cancer

  • Published
  • By Staff Sgt. Nick Przybyciel
  • 446th Airlift Wing
Finally drifting off to sleep after several restless nights, Deb Marshall was jolted into consciousness with a horrific epiphany. She turned to her half-awake husband, Lt. Col. William Marshall, and vocalized the thought responsible for robbing her of yet another night's sleep.

"What about his kids?"

Her husband mumbled something along the lines of, "Whose kids?"

"Robert's."

In the haze of sleep, Colonel Marshall tried to make sense of this. Their son, Staff Sgt. Robert Marshall, didn't have any kids. Expressing this, he finished the thought on a comical note: "At least any that I know about."

"I know he doesn't," his wife replied. "That's what's so unfair about this whole thing."

Lying awake in the middle of the night, the Marshalls were grappling with the painful possibility their young son may die before having the chance to give them grandchildren. They were living a parent's worse nightmare - their son had cancer.

With a tumor the size of a baby's head in his left lung, Sergeant Marshall, an Air Force Reservist from the 446th Airlift Wing, McChord Air Force Base, Wash., was suffering from non-Hodgkin's lymphoma. And it wasn't just a minor case: By the time he was diagnosed, the cancer had spread throughout his body and progressed to stage four, the most serious level of the disease.

However, Sergeant Marshall would incredibly defy the odds and become cancer-free within six months, owing to treatment described by his father as "seamless and amazing." When all was said and done, it wasn't just the treatment Sergeant Marshall received at Madigan Army Medical Center, Fort Lewis, Wash., that was amazing - so too was the inspirational attitude of the patient.

"He had about 30 minutes of woe-is-me and the rest of the time it was like, 'I'm gonna kick this thing in the ass and move on,'" Colonel Marshall said.

Sergeant Marshall's grave diagnosis came shortly after returning home from a deployment to Kyrgyzstan in February 2006. However, the 22-year-old aircraft maintainer began experiencing the subtle symptoms of lymphoma - a dry hack and slight fever - well before suspecting anything was seriously wrong with him.

"I was coughing a little bit, and I thought it was just due to dry air and all the dust (of Kyrgyzstan)," Sergeant Marshall said.
"It wasn't rare in that environment," said Senior Airman Bryan Martin, Sergeant Marshall's friend and roommate during the deployment. "People were all the time coming down with colds and whatever. It was pretty common."

Thinking it was little more than a case of the desert crud, Sergeant Marshall went through his deployment as if nothing was wrong. Despite the nagging cough, he refused to seek medical help in the deployed environment.

"We're sending guys into Afghanistan - you know - and they're getting shot at left and right. Here I was just working on aircraft, so there wasn't much to complain about," Sergeant Marshall said.

This hesitancy to go into the clinic during deployments is typical, according to Sergeant Marshall's father. The elder Marshall has served 31 years in the military, mostly as a nurse in the Air Force Reserve as an Individual Mobilization Augmentee at Nellis AFB, Nev.

"I think that's kind of common in a deployed situation," he said. "From my perspective, you see very few people who are sick, or hurt, seeking help. You look at the people you are treating every day and you think, 'What do I have to complain about?'"

When Sergeant Marshall returned home from the deployment, his cough continued, along with intense bouts of lethargy. It was at this point that his friends and family began to get worried.

To Airman Martin, something seemed different about his friend. The two were now sharing an apartment while taking classes at Western Washington University. "In spring quarter, the weather's getting nicer. I wanted to go out all the time. Robert would come out, but he just wasn't into it," said Airman Martin.

Sergeant Marshall began taking naps ... a lot of naps, according to his friend. However, he was still physically active.

"We were still going running all the time. I remember he was complaining about a burning sensation in his chest, but he was still beating me. That's incredible," Airman Martin said with a chuckle from embarrassment.

But as time passed and the cough persisted, other people became worried. Sergeant Marshall's mother tried relentlessly to get her son to seek help. "It finally got to the point where I said, 'If you don't go into student health at Western and get an X-ray, I'm going to drive down there and make you go.'"

Luckily, Sergeant Marshall heeded his mother's advice and went to the doctor's office. Since the symptoms of non-Hodgkin's lymphoma are nearly identical to bronchitis, he was initially misdiagnosed. But after several subsequent trips, an X-ray was administered and the Marshall's soon received the real diagnosis.

"There was absolutely nothing normal in his anatomy," said Sergeant Marshall's mother, Deb, who is a nurse at Madigan Army Medical Center. "The tumor was so big that there was no lung tissue there."

And it wasn't just his left lung being ravaged by cancer. His kidneys also had masses. Furthermore, Sergeant Marshall's heart rate was hovering in the mid 130s, whereas a healthy person of his age would have a pulse of 60-70 beats per minute.

However, it was the tumor in his lung that was the biggest concern. It was so large his aorta was moved over a full two inches and was compressed, slowing blood flow and making it difficult to breathe.

"He sat with his mouth open, like a fish trying to get air," Mrs. Marshall said.

Initially, Sergeant Marshall's friends and family were terrified. His parents got little rest in the following weeks, because they would take turns checking up on their son while he slept to ensure he was still breathing.

"I don't know if I could find a time in my life when I had a more pronounced emotional hit," said Colonel Marshall.

Meanwhile, Airman Martin got the earth shattering news after phoning Sergeant Marshall, who he thought was in Oklahoma visiting family. "I literally felt sick. I think I asked him, 'How's Oklahoma going?' Then we joked around a bit, but I could sense something was up by the sound of his voice."

That's when Sergeant Marshall hit his friend with a bombshell. "I just told him - hey man, they found a spot on my lung and they think it's cancer."

"I kind of wished I had come down with it too, so we could go through it together," Airman Martin said, regarding one of his first reactions to the news.

Things wouldn't stay gloomy for long.

Since Sergeant Marshall was within 120 days of getting off active-duty orders, he still qualified for full medical coverage - a Reserve benefit that may have saved his life. Immediately after his diagnosis, the medical professionals at Madigan began radical treatment to kill the cancer throughout the young Airman's body.

"It's just amazing what people did for him and how receptive they were to his questions and concerns," said Colonel Marshall, who works alongside his wife as a nurse at Madigan in his civilian career. Now on the other side of the patient-doctor relationship, the Marshall's had to trust the expertise of their coworkers at Madigan to save their son's life.

"Everyone laid all the options out on the table, and they were like, 'What do you think?' It wasn't like, 'This is what we're going to do and you have no choice,'" he said.

"There's absolutely nothing they won't do for the patient," Mrs. Marshall said. "If something has to get done, it gets done."

Immediately, Sergeant Marshall began an intense chemotherapy regiment. He went through almost five months of chemotherapy, followed by 20 days of radiation therapy.

But the doctors at Madigan didn't stick to just traditional treatment. By combining lymphoma with renal treatment, Sergeant Marshall didn't have to lose a kidney. "Years ago, if you got kidney or renal cancer, it was coming out," his father said.

The treatment was so successful that Sergeant Marshall's treatment was the subject of an article in the "Journal of Urology."

Between his chemotherapy treatments, Sergeant Marshall completed his 5-level maintenance career development course and Airman Leadership School by correspondence.

On the path to remission, Sergeant Marshall's family and friends provided a compassionate blanket of support for him. However, they refused to coddle him and it seems likely Sergeant Marshall wouldn't have taken well to that course of action.

"Actually, Robert was the one who made it okay to talk about it," his father said.

"Chemo took me down for most of the evening, and then a day or two later I was back on my feet again. It was probably after the third or fourth session that I started school again," Sergeant Marshall said.

Although unable to continue classes at Western Washington University, Sergeant Marshall enrolled at a community college close to Madigan. In addition, because he was on light duty and could not perform his maintenance job, Sergeant Marshall spent time volunteering at the Washington State Veteran's Home in Orting, Wash.

"When I asked him what he got out of this volunteer effort," said Colonel Marshall, "he told me that those folks are the true heroes and that in this way, he could show his appreciation for them and the sacrifices they have made."

Refusing to be a victim, he confronted the disease on his terms. "I actually got a big head about the whole thing," Sergeant Marshall said. "Whenever you see a TV show or something about cancer, you see all these people suffering through chemotherapy and being just so miserable. It wasn't like that at all (for me)."

Two days after a chemotherapy session, Sergeant Marshall was running around, playing sports with his two sisters on the Fourth of July. There was one sport in particular he took up last summer in order to stay active. "We really picked up golfing that summer, because I didn't have to put a lot of energy into it," he said.

Colonel Marshall recounted a story that symbolized his son's tenacious - and humorous -attitude during chemotherapy treatments. After the first treatment, Sergeant Marshall went through almost a complete 180 degree transformation, with his heart rate dropping from 130 beats per minute to 70, according to his father. On top of that, his appetite was back with a vengeance.

"The six of us are sitting around the table (at a restaurant). Robert mentioned he would probably be promoted when he got back to work and Chris (another friend and fellow Airman) said that Robert would probably be his supervisor."

Reminding his possible supervisor of favors performed for him in the past, Senior Airman Chris Kaplan asked Sergeant Marshall, "Remember that time I helped you move?"

Sergeant Marshall immediately quipped, "Yeah that was the time I had, ummm ... cancer."

"I wish I could bottle that and show it to some of our patients," Colonel Marshall said. "Life threatening diseases or not, there are a lot of people who play the sick game very well. And Robert's not a fair competitor in the sick game - he doesn't stay with the game very long."

In March, he returned to normal duty with the 446th Maintenance Squadron at McChord, and plans on transferring back to Western Washington University.

"Through all of this," said Colonel Marshall, "he has had tremendous support from his chief (Chief Master Sgt. Danny Bass) and two of his best friends (Airmen Martin and Kaplan). I mention these names because they just reaffirm to me that you just can't find better family than in the military."

As for his parents, they credit their son with reassessing how they perform their jobs each day at Madigan.

"On our badge at Madigan there's a little thing that says, 'Care with compassion,' and I know we do that every day," Colonel Marshall said. "But now being on the other side of it - being the recipient - I see that we do that."