I don’t know about anyone else, but when I was diag­nosed with mye­loma back in 2004, my work hours, which were already slim, were immedi­ately cut back. When it be­came clear I could no longer perform my usual and customary job du­ties, my employ­ment ceased entirely. I didn’t receive any unem­ploy­ment bene­fits after my termination.

Before anyone rushes to comment on my rights as a worker, let me add one ad­di­tional note: I was self-employed. At the time of my initial diag­no­sis, I was a law­yer in a small office in my hometown. I didn’t have disa­bil­i­ty insurance; I didn’t have medical insurance.

I don’t know what others out there in Cancerland do when they are too sick to work. I don’t know how accom­modating employers are, whether or when unemployment benefits or disability payments kick in, or whether others have to change jobs or take early retirement.

I only know my own story, and it is this: as a self-employed individual, myeloma had a devastating impact on my livelihood and capacity to earn an income. In fact, eight and a half years after my initial diagnosis and eight years after my initial treatment (high-dose thalidomide ^[1] (Thalomid) and tandem stem cell transplants in the summer of 2005), I am still recovering economically.

Or, more realistically, I am probably as recovered as I am ever likely to be.

In looking back, it is clear that the myeloma started to work on my eventual unemployment months before the disease was unmasked. My hours in the office started dropping. I still got the work done, but the pace was agonizingly slow. As my billable time declined, my earnings started to slide.

There were ripple effects, of course. My initial treatment, which started within weeks of my diagnosis, wore me down. My hours continued to drop and my income continued to sink. My increasing weakness made me unable to keep regular office hours, commit to long-term projects, or take cases that would require a lot of evening work (such as zoning, my specialty). My reduced earnings made me unable to pay my bills. Being unable to pay my bills jeopardized keeping the lights on and the table set.

In short, I was going down the financial tubes.

A lot of things changed in the first half year of my diagnosis and treatment. I shut down my practice, turning my open files over to my colleagues. I applied and qualified for Medicaid, so at least my medical bills were met. I moved to a smaller, cheaper rental. Other than my utilities, I defaulted on all my obligations, including income taxes (which I filed but did not pay). I knew this would have long-term repercussions, but I also knew I had few options.

I still had a small stream of income coming in, primarily from clients paying for work I had completed before I stopped practicing, and that kept food on the table. My parents, despite being retired, paid my rent and helped with utilities.

I got by. Coming out of the summer of transplants, I was physically unable to work for many weeks. Looking ahead to the future, I knew I was not yet up to practicing law. More fundamentally, I knew I never would be again.

I retired my license. I continued to heal. My parents continued to pay my rent. I filed for bankruptcy.

Six months after my second transplant, I went back to work as an independent contractor for a local court. I could finally pay my own rent. When I became ineligible for Medicaid, I had enough to pay, slowly and in installments, my own medical bills, which were relatively small as I was in remission.

I continued to string together a living until I was hired at our juvenile court as a part-time mediator. The job change meant less income, but more stability; it gave me regular paychecks and great medical insurance. After years of monthly payments, I finally paid off the last of the taxes, although I still have two tax lien re­leases to file.

My credit record is in pretty bad shape. Filing those releases will address the most egregious marks on it, but the report will still be ugly. It will never be truly good again. My checking account remains slim. I have no savings. It is unlikely I will work long enough at my present job to receive much in the way of retirement, so I am looking at social security in a decade, assuming I am still around to collect it.

Of all the impacts multiple myeloma made in my life, the financial one was in many ways the most severe. It is the one that over the years has caused me to lose sleep and feel utterly defeated at times. On the other hand, it is what it is. I cannot change what happened.

In looking back over what I experienced, there is nothing I can say to help anyone prepare for the financial devastation of a catastrophic illness. It is the tornado leveling the house, it is the tsunami sweeping bare the landscape.

When Mount St. Helens erupted in Washington in 1980, tens of thousands of acres of forest were destroyed. In the 33 years since then, the barren, scoured landscape has gradually grown back. It is not the dense forest that existed prior to the eruption, but it is a living landscape arisen out of the ashes.

I am reminded of that transformation as I write these words. Myeloma buried my finances fiercely and sud­den­ly, changing my economic landscape permanently. But in the aftermath of the devastation, new growth began.

My economic health is not the same as before and never will be, but it is stable, and I am grateful.