Over the last 10 weeks, I have spent four or five weeks in the hematology/​on­col­o­gy ward of Mt. Sinai hospital here in Manhattan.

I had reached a crisis point in my four-year battle with multiple myeloma.

The original hospitalization was for the installation of a port and admin­is­tra­tion of a treatment consisting of dexamethasone ^[1] (Decadron), cyclo­phos­pha­mide ^[2] (Cy­tox­an), etoposide (VP-16), and cisplatin, commonly ab­bre­vi­ated as DCEP, in a last ditch effort to get my myeloma under con­trol.

If the myeloma gets sufficiently under control with DCEP, I will have an­oth­er autologous trans­plant and then an allogeneic (donor) trans­plant. My sister is a “perfect match,” and her stem cells have already been har­vested and are waiting for me.

Unfortunately, during my first DCEP administration, I developed an infection – DCEP is a powerful destroyer of one’s immune system. The wonderful port that had been installed in my chest to obviate the need for an IV and twice daily blood draws through my very sad veins had to be removed and an abscess lanced on my arm.

Other complications ensued, which have kept me hospital bound for much of the past two months.

We were hoping to get me home in time for a Passover Seder, but my white cells refused to budge, so some­what reluctantly, the staff allowed me and my family to have a Seder in one of the day rooms (with masks and gloves).

My youngest son could not attend as he had a cold. However, through the wonders of computers, he joined us through “Facetime” from a friend’s Seder just a mile away on the other side of Central Park. He even played the fiddle for us in the final songs. Last Tuesday, I joined the family Seder through the same means – a camera built in to our computers.

This extended time at the hospital gave me plenty of opportunity to contemplate about cancer care.

The hematology/oncology ward at Mt. Sinai is large and getting larger as the hospital tries to accommodate its aging patient population. The 1,100 bed hospital, which is one of a half dozen comparably sized in­sti­tu­tions in New York City, now devotes about 70 in-patient beds to cancer patients, and the ward is often full. Fewer people are dying of heart and respiratory diseases; the aging population needs more and more can­cer care on an in-patient basis.

We cancer patients are perched on the 11th floor, the top floor of one of the many Mt. Sinai hospital build­ings. If you are ambulatory, you can pace the corridors and see phenomenally exciting views of upper Man­hat­tan.

Even though I was neutropenic, I have been lucky enough to be ambulatory during most of my stay. My doc­tors decided it was more important that I keep up my strength by walking around with a mask rather than sit­ting in my hyper-clean room.

At all times of the day, you could find me walking the corridors, which extend a full block from Madison Ave­nue to Fifth Avenue. On the Fifth Ave­nue side, you can catch a glimpse of Central Park, the running paths and roads, and the billion gallon reservoir that sits between Central Park West and Fifth Avenue. The incred­i­ble skyline of Man­hat­tan lies beyond. I was even allowed a few walks in Central Park itself, which at this time of year is just coming out of its winter slumber.

Two weeks ago, as I paced the halls with my IV bags dangling on their aluminum frame above me, I became intrigued at the size of the vast army of people who were taking care of us 70 patients in the ward.

By far the bulk of us are “geriatric,” meaning over 65 years old. I need to point out, though, that before I lost my immune system and went into isolation for a day, I did have a roommate who was in his twenties, and a few others were in their thirties and fourties. At 66, however, I am pretty near the median in age.

I was born at the beginning of the baby boom, the 15 or 16 years after 1947 when more than four million Americans were born each year. The life expectancy for each year of the baby boom can be plotted on a graph, and that the graph takes the shape of a bell-shaped curve.

The hematology/oncology ward in which I was ensconced last month is part of a vast effort of American health care providers to enlarge the shape of the bell-shaped curve ever so slightly so that more of us could die on the right hand of the curve. It’s an extraordinary and wonderful effort to keep us alive slightly longer than the shape of the curve would have predicted even 10 years ago.

The size of the army of caregivers working on our behalf is truly staggering. Registered nurses are posted outside of every room, either organizing chemotherapy regimens or entering data into the computers on their rolling carts. Nursing assistants are coming into the rooms every 30 to 60 minutes to check vital signs. Clerks are sitting at desks in the central island around which the patient rooms are arranged. In the morn­ings, a whole array of doctors comes by; for me, I saw the hematologist, the endocrinologist, hospital­ist/​internal medicine specialist, an infectious disease specialist, and a surgeon (and his assistants), who came to treat my wounds where the infections had occurred and been lanced and drained.

The non-physician and non-nursing staff is even more numerous. X-ray technicians come by to give x-rays to non-ambulatory patients. CAT and MRI technicians are located in the basement. The pharmacy staff pre­pares the medicines and chemotherapy concoctions and gets the blood ready for the transfusions. Tech­ni­cians are analyzing lab results and recording results into the hospital computer systems.

Physical therapists give in-room treatments. The cafeteria staff comes by twice daily with the menu and checks off your choices on their iPads. The cleaning staff comes through and sweeps or polishes the floor and the bathrooms and empties the trash containers. And, of course, behind the scenes there are plumb­ers, electricians, elevator repair technicians, HVAC specialists, carpenters, cooks, dishwashers, patient transporters, security guards, clerks, computer programmers, data entry clerks ... ad infinitum. The list is endless. And staff has to be on duty 24 hours a day, 7 days a week.

My crude estimate is that, on the floor of the hematology/​oncology ward, there are well over 200 people em­ployed daily to take care of the 70 patients on a 24/7 basis.

According to the Bureau of Labor Statistics, health care is the most quickly growing field in the United States. In New York City, almost 10 percent of the working population is devoted to health care, driven both by its research institutions and by the aging baby boomers and their predecessors.

One hundred years ago, this army of workers – most of whom were first-generation immigrants –would have been spending its time working in sweat shops, shoe factories, boat yards, the waterfront, bakeries, and food distribution industries. Now this army of immigrants is devoted to the care of the city’s elderly.

I feel quite grateful to be the beneficiary of these heroic measures to extend my life beyond any reasonable measure of what I could have expected when I received the myeloma diagnosis.

As I read news articles that bemoan the increasing health care segment in government spending, I have to chuckle. The demographics of America is its destiny. Four million births a year in the late 1940s through the early 1960s means a rapidly aging population. There simply is no way around providing for the health care needs of that generation. My caregivers have been great to me. We have been providing them jobs; they have been providing us love and medical care.

Here’s to the graying of the American population! And here’s to the nurses and doctors and huge attending staff of the hospital behind them trying to keep us alive to experience the joys of spring one more season!