Family Secrets is a production of iHeartRadio. This semi conscious woman moaning loudly on the bench wasn't just anyone. This was Jane, my partner of thirty years. What was happening? Was she dying? She sure looked like she was dying. I desperately wanted to help her, but I couldn't suppress
my fear and confusion long enough to think straight. All the usual tricks we doctors used to create a self protected distance between an acubely suffering patient and our own psyches, the space that allows us to make an objective, rational plan to help. They weren't working. They couldn't work. This was Jane.
That's doctor Barrett Rowlins, oncologist, cancer researcher, professor at Harvard Medical School, an author of the recent memoir In Sickness, Barrett is a stunning story of love and subterfuge, secrecy and honor, loyalty and heartbreak, and the way that two brilliant people worked over time to keep themselves in the dark. I'm Danny Shapiro, and this is family Secrets. The secrets that are kept from us, secrets we keep from others,
and the secrets we keep from ourselves. Usually I start by asking my guests to tell me about the landscape of their childhoods. But in your case, I'm going to start in a different place, which is tell me how you and Jane met oh.
I would love to. I was a medical resident at the Boston Hospital, one of the Harvard Teaching hospitals, and Jane was a third year medical student at Harvard Medical School. So Jane was doing her internal medicine rotation, one of the core rotations that medical students are required to take, and she was doing it at the hospital where I
was working. The way that the hierarchy goes in the hospital is that a resident like myself at that time, as a senior resident, I was in charge of two teams, one of which I ran, another one was run by a junior resident, and then we had some interns working with us, and then the medical students would be right at the bottom of the totem pole. So there were two female medical students who are going to be on our joint team, one of my team, one or the
other team. So I hadn't met my students yet. But one of my jobs at the hospital as the senior resident, the nights that I was on call. I needed to figure out how many beds were available in the intensive care unit. In case anybody on the regular wards got really sick, I would know what the capacity was for
transferring them. So I was walking through the intensive care unit counting beds that I looked up and walking into the intensive care unit was this tall, willowy, gorgeous woman, you know, decked out in a short white coat, which is the humiliating sort of costume that the third year medical students have to wear. But she superseded the limitations of her uniform and she walked up to me and started asking me about some patient who was in the
intensive care unit. And you know, I didn't really know who was in the intensive care unit because I wasn't running the unit. I was only in their counting bits. And her intern or resident had sent her into the unit to find out how their patient was doing that they had transferred the night before. A perfect thing for a medical student to go do. But you know, again, she was talking to the wrong person. So I said
to her, do you understand my role here? Thinking that I would then sort of instruct her about what the various roles are with the people that she would meet whatever. Jane would tell this story, and she dined out in this story a lot. She would say that I asked her that question in the following way, do you understand my role here? In other words, supercilious, obnoxious, And it didn't matter how many times I tried to sort of fight against that story. When she would tell it, she
told it so well that nobody ever believed that. It wasn't a jerk when I talked to her about this. But eventually, you know, I explained to her what the roles were, and that was that. But our eyes had locked. I don't want to say love at first sight, but there was certainly a lot of interest at first sight. And from that moment on we tried to find ways
to flirt with each other. If she was writing a note in the chart, I would find some reason to write a note in another chart, and we'd stand next to each other and our hands would brush against each other, you know, stuff like that. The most striking sort of flirtation story, and this one we both agreed on, was that another one of my jobs as a senior resident was to work in the emergency room and see acutely
ill patients in the site who gets admitted. And one of the jobs of a third year medical student to sort of learn the ropes of medicine, was for every patient that they admitted it were taken care of, they were supposed to look at the urine from that patient
under a microscope. And in those sort of benighted times, there was exactly one microscope in the whole hospital that students could use, and it happened to be in the emergency room, and Jay knew that, and she knew that I was working there, so she kept trying to get urine from her patients. And what she didn't remember was that she was actually assigned to a ward of patients who had chronic renal failure. In fact, they weren't making any urine, and the word they were on didn't have
any bathrooms because nobody was making any urine. So after three or four days of frustration and coming to this realization, she went into a bathroom in another part of the hospital and peed into a cup herself and brought her own urine down to the emergency room so that she could look at pretending it was one of her patients. And she ran into me and we sort of bonded over this really romantic little cup of urine that she was looking at under the microscope. Things just sort of
snowballed from there. I didn't actually ask her out until she had rotated off the service, but that's where it began.
When Barrett meets Jane, they both come to the relationship carrying their histories. Barrett has an ex wife and a three year old daughter named Anna, who he adores, and Jane. Jane has her quirks. During their courtship, they're quick to fall into young love. They find one another extraordinary, but there are other forces at work. Barrett writes festooned with bright red warning flags plus sirens flashing lights, but I didn't see them. I was too far gone to let it keep us apart.
Jane lived in Cambridge, and when I went to her apartment, I was kind of flabbergasted to see that it was utterly infested with cockroaches. I mean it was like something out of a David Cronberg movie. It was really frightening, and I was, let's say, put off by the environment. Jane acted as if there was nothing wrong, and she had this odd habit of, yeah, we'd be in the middle of the conversation or watching TV or something, and cockroach would go across the wall and she'd just reach
out with her bare hand and crush it. And I thought, you know, okay, So I had a balance that ad against all the good stuff, and the good stuff went out there. Another example was in those days, Jane was still smoking cigarettes and the sheets on her bed were just riddled with these holes that cigarette ash had made. And then when I asked her what it was, she said, yeah, you know, they smoke it in bed, and you know, the ash falls and it burns a little hole. She
never changed, she never did anything about this. This was just sort of part of her thing and she just didn't think about it. And then there was the night before I began my fellow ship at Dana Farber in medical oncology. You know, I completed my residency and now I was going to do some specialty training, and it was pretty high stakes for me, this sort of shift to doing the fellowship, especially at a place like Dana Farber with its reputation, and so I was a little
on edge. But still the night before I started, there was a party that we were going to go to, and Jada's didn't show up. She just never came and I was getting more and more sort of worried about her. And finally, you know, it got to be like eleven or twelve o'clock at night and I needed to get to sleep before starting my fellowship and got home called
her a bunch of times, you know, no answer. Then finally she did answer the phone around one in the morning, and it turned out that that night she had gone to her ex boyfriend's house. One of these flashing red lights was that when she started going out with me, she was still involved in this relationship with an older guy. Guy was older than both Jane and myself, and she hadn't stopped that relationship when she started with me, and she was going to use that night to stop the relationship.
But you know, one thing led to an other, she said to me, and she ended up going to bed with a guy, and I was floored. We had sort of planned all this stuff, we were going to move in together. I thought things are moving forward, and then she does this. And her explanation to me was, you know, she was having breakup sex. And I may be not the most sophisticated guy in the world. And one of the pieces of evidence for that is that I hadn't
heard of breakup sex. I mean, I now understand that it's a thing, but at the time, it didn't feel like a thing, and I was really fear as I felt betrayed. I thought that she was sort of playing with me and playing with this guy. I was pretty angry and ended up trying not to have any contact with her, and that lasted all of about forty eight hours, and then we got back together and I just decided, as I decided about so many things in the future, I decided, I'm just not going to think about this.
Everything's flying now.
And it's funny. It's something that I've heard over the years, which is that everything that you need to know about somebody's marriage can actually be discerned on the first date they're somewhere. Yeah, of course, with the twenty twenty hindsight, but still it seems like there was, you know, this intoxicating combination of great love and admiration. And also one of the taglines for this show is the secrets we
keep from ourselves. In a way, you were already, it seems to me, beginning with kind of a secret that you were keeping from yourself, which was there are these bright red warning lights, and I am going to ignore them.
Yeah, I think that's exactly accurate.
Barrett and Jane move in together. Both of their careers are in a state of ascendancy. Jane lets Barrett know right from the start that she does not want to have children. She's entirely focused on her work and wants to keep it that way. The idea of making a family together is a non starter.
When I think about that time, I think of sort of three threads that we were following. The most straightforward one is career. I was climbing the academic ladder as first a fellow and then a junior faculty member at Dana Farberton Harvard. And you know, that requires a fair amount of focus to stay on the track and a fair amount of accomplishment to be able to stay on the track. And I was lucky enough to be able to do that. And I do that's not false modesty.
I really do think that I was lucky. I'm not as smart or as naturally gifted around sciences so my colleagues were, but I was able to make career for myself. Jane, you know, was several years behind me, still trying to decide where she was going to do her internship and residency,
what sub specialty she was going to be on. But still, because she started late, she really had her eye on where she wanted to go, and so she was working very hard to make sure that she was sufficiently accomplished so that all options would be open to her at Harvard or wherever she decided she wanted to go. And Jane was incredibly smart, incredibly quick, and would be able to do that as long as she performed well. So we were both really focused on career and advancement, and
that was one threat. A second threat was I learned very very early on that the rules of our relationship were going to be that Jane would be dependent upon me for every practical matter. She didn't drive, I'd have to drive her wherever she'd wanted to go. I was responsible for doing the grocery shopping. I was responsible for the laundry. I was responsible for finances. You know, you could just go down the list of everything that's required to maintain a household, and that all ended up being
my responsibility. She really liked to just lie in bed when she wasn't busy working. You know, she was an Olympic level sleeper and napper, and that left all the practical stuff to me. Jane and I worked at the same place she was at. Dana Farber also is incredibly wonderful to be able to be working at the same place and we knew all the same people. We went
into work together and went home together. We worked very hard during the week, and again another domestic chore is making meals, and so I made all of our meals. But on Friday night we had eight night. On Friday nights, it was my job to make a reservation at a restaurant somewhere in Boston or Cambridge, and we would go out to yat and we would sort of review the week's events and gossip a little bit, and we wouldn't
linger over dinner because Jane wanted to get home. And the reason she wanted to get home was because as soon as she walked into the apartment, she would say, almost every week, she would say, guess what time it is? And I'd say, what time is it, deer, and she'd say, it's bedtime, and she would start shedding her clothes as she was walking to the bedroom, crawl into bed. And listeners may think that I'm exaggerating, but she would not pretty much get out of bed until Monday morning when
she had to go back to work. She watched TV. She played Solitaire later you know, computer of games. I would bring her her meals in bed and she would just sleep, wake up, watch little TV or have a meal, sleep again, you watch movies, sleep again. That was really essential for her. I think had nothing to do with
the physiology of sleep. I'm still not quite sure what it had to do with, but it was an essential part of her personality that she be disconnected as much as she could from the real world when the opportunity presented itself.
And the third thread in this complex braid was Jane's attitude toward Barrett's very young daughter Anna. Early in their relationship, when Jane had learned about Barrett's previous marriage and daughter, she had said, I waited for you. Why couldn't you have waited for me? A nonsensical question, But as their relationship continues, this is a feeling Jane maintains, and it manifests in her not wanting to have anything to do with Anna. Not only does she not want children, she
doesn't want a stepchild either. She has no interest in Anna and is actively dismissive, always finding a way to get out of seeing her when Barrett tries to get the family together.
There was a real effort on Jane's part to deny that I had had any other life, and this is one of the parts of the story that I am most deeply ashamed of. You know, there is a lot of complicity in the kinds of secrets that couples keep, but in this particular case, a lot of Jane's secrets could not have been kept had I not been complicit. And to my undying shame, I suppressed my underlying desire to spend time with my daughter so that I wouldn't make Jane angry or any more jealous than she had
to be. And I can't begin to tell you how terrible I feel about that, but it's what I did.
What I'm thinking about right now, Barrett, is it's almost like the emotional arc of how you held all this and how it made you feel. Because what you're describing, and this is earlish in your relationship was the initial red flags, and then the degree of being taken care of that Jane required, and then her inability and complete lack of desire to have anything to do with with your child during those years. How did you hold that?
Where did you put that? And how did it make you feel about Jane during that time?
Early in the relationship, I would be angry. I would try to suppress it, but it would bubble up, and when it did bubble up, I would be frustrated. One of these things happened. I just made Jane her lunch and give it to her in bed, and then she asked me to do something, or maybe she had refused to see Anna the next day. And then as I walked back to my little home office, I kicked a
huge hole in the drywall. And I surprised myself because I'm not a demonstrative kind of guy, and when I get angry, I really don't yell on screen and pound the table. But clearly there was a lot of feeling in there that came out in my right foot. I think I remember sort of thinking to myself, Oh, holy shit, this stuff is really bothering me. But I didn't do
anything about it. What I worked at, instead of dealing with the anger like a healthy person, what I want work that was suppressing it even more so that I wouldn't have.
Said, Jane, We'll be right back. Years pass as Barrett tamps down his feelings of anger, and the couple stays deeply immersed in their very intense work. What could be more intense than the work of saving lives. Eventually they moved to a beautiful apartment in Boston's Back Bay, overlooking the spot where fireworks are set off each fourth of July at Dana Farber. Barrett and Jane have lunch together
every day. They're attached to the hip, and though they have a world of colleagues and friends, and though a kind of hero worship surrounds Jane, it's really just the two of them. Even when they seem sociable.
We were very much in a bubble, which is kind of ironic because this business, the lunch table, sort of looms large in James legend. In fact, some of the senior faculty members used to derisively call it Jane's high table. There were lots of our contemporaries, and especially a younger junior faculty, who would love to sit with us and have lunch. And Jane, she was clever, and she was witty, and she actually cared quite a lot about junior faculty. You know, one of the reasons she was revered is
that she was just an outstanding mentor. She took incredible care of the junior faculty that some of whom she was responsible for, some of whom she wasn't. It's just so obvious that these were surrogates for the children she didn't have. So the lunch table, which involved a lot of laughing and a lot of stories, and there was a rule that you couldn't talk about your works, which meant that anybody could then be there. Nobody was trying to jockey for position based on the kind of stuff
they were working on. That was very, very social, and people felt like they were our friends because we were sitting around the lunch table having these raucous times. But Jane would adamantly refuse, for the most part, to have contact with people like that, colleagues, friends outside of that environment. When she was home, she was home.
And also her family of origin, her mother, her brother, her sister, you describe as Jane really not feeling close to them.
She really pushed them away. There was sort of no objective rationale. Her family was lovely. She would tolerate calls from her mother she would tolerate calls from her brother. She actually would not tolerate calls from her sister. From my point of view, these were all lovely people, but I was team James, so I really couldn't do much about them.
Barrett and Jane have their occasional friction, as every couple does, but for the most part, they've built a fulfilling life together professionally and personally. In many ways, their relationship from the outside is enviable. It's twenty twelve. They are about three decades into their marriage, both at the pinnacle of their careers. Jane is sixty. One week they head to
their usual lunch in the hospital cafeteria. That evening, they'll go on their usual Friday date, business as usual, but in an instant, the ordinary instant, as Joan Didion has called it, catastrophe strikes.
It was just a typical day. In fact, it was a Friday, and I had made reservations at our favorite Mexican restaurant for date night. And what we would do on you every day is I would come by Jane's office and pick her up, and then we'd walk to lunch together. So we're walking down the hallway to lunch,
and Jane Jay was very tall. She's feet even sometimes sixty one when she was really standing up straight, but she had this sort of loping gait like tall people have, and it was always a little slower than I was. But that day she was even slower than usual. You know, I had the sort of what I called a Jane adjusted gate that I would adopt, but she was even slower. And I remember turning to her and saying, you know, Hun, are you okay? And she said, yeah, yeah, it's fine.
And we turned the corner to the cafeteria and she just plopped herself down on a little bench and her lips were blue. She was breathing very hard, her eyes were closed, and you know, I said, what's going on? Are you all right? She said she just looked at me and said, you know, really couldn't tell me what was going on. So I was scared to death, and I thought, you know, I've got to get her to
an emergency room. She obviously can't walk anywhere anymore. And I look around for a wheelchair, and you would think, of course, in a hospital he'd find a wheelchair at every corner, but none. So I told her, you just stay right here and do not try to get up. We were in the building that has the cafeteria also has in the upper floor. So I jump into an elevator and go up to an upper floor to try to find a wheelchair. Still can't find one. So by
that I'm still worried about Jane. So I run back downstairs and sort of retrace the path we had been walking on to get to the cafeteria, and I turned that corner and now Jane is lying down on this little bench which is way too short for her, heads hanging off one end, theater hanging off the other, and now she's unconscious. With every exhale she moans, and she's
having an hard time inhaling. One of my colleagues, one of our colleagues, happened to walk by and saw this and realized that Jane was, you know, having some sort of cardiac or pulmonary arrest, and called you know, a code a code red or a good It's actually called blue. You know. I can't sort of overstate how surreal this
was that, you know. I then hear over the loudspeaker code blue cafeteria, and I'm thinking, you know, part of my brain is thinking Oh, that's an odd place to have a code, And the other part of my brain is thinking, you dumb assd this is what's happening right in front of you. So, you know, the code team arrives on the site, crash cart there with all the equipment they need to resuscitate somebody. A colleague of ours who was, you know, running the code team that week,
starts barking orders. They start intravenous lines, putting EKG on her. Her heart hadn't stopped, so nobody had to do CPR, but she was unconscious and the friend or colleague who was running the code sort of turned to me and said, what's going on? And I said, I have no idea. At that point, we've looked down at there's this little trickle of blood that's started, you know, coming from under
Jan's shirt and it's tracking up towards her neck. And this woman looks at me again and said, basically, what the fuck is going on here? And I just said, I don't know. I have no idea. So Jim gets transferred to the emergency room, and it's complicated because Dana Farber didn't have its own emergency room. She had to be taken to a hospital next door, and believe it or not, they actually had to call an ambulance to take her across the two hundred yards to the other hospital,
which meant that I couldn't ride with her. Craziest situation. I just sort of felt buffeted. But I found my way to the emergency room in the other hospital through a series of bridges and got there. And by then she had already been intubated, so she's on a ventilator.
They've removed her clothes, and she's in a hospital gown and Johnny and I'm standing at the entrance to the room, you know, maybe ten or twelve feet away from her, and I notice that there's this huge lump underneath the right side of her Johnny, on her chest, and part of it is down a little bit, and I see that there's this enormous mass, it's like the size of a football, sitting on her chest. And all I can think of it to myself is what the fuck is this?
And I gradually realized that what is growing on her chest is an enormous, neglected, untreated breast cancer. It was black, you know, the technical term is necrotic. That the tissue was dying. It was oozing blood, it was oozing pus. I just don't have the words to describe how shocking and awful this was. And just at that moment, the doc who was running the er who I know and Jane Duke, came up to me and said, so, what's the story. And I said, well, you know, we were
walking down the hallway and Jane suddenly collapsed head. Oh, I know that she's had a huge pulmonary embulance. She had a clot that traveled from her veins and her legs and got lodged in her lungs and that's what was She actually said, I know she had a palmarenesis what's her cancer story? And I had to stand there like the idiot I was and say to him, I
have no idea. You know, I'm her husband. She has this thing growing on her chest that had to have been there for years and years, and I had to stand there and tell this guy, I don't know what's going on. It was just awful. And then you know, she gets taken to see t scan to take a look at the plot. And then when she comes back, the guy for the emergency and takes me back into the office with a radiologist me. Now he's dealing with me like I'm radioactive because he knows the story is
just too weird for him to handle. And he says, well, the radiologist will tell you about the findings and the clots there he got. But what he really points out is, you know, whether there's this fifteen centimeter mass replacing her right breast and it looks like there are a tasta see, so the spread of the cancer to her ribs, her spinal bones, there are metastatic deposits in her lungs and in her liver. I'm just standing there. So in the space of an hour, I discover she's got this thing
growing in her chest. But now I also discover that the cancer has spread throughout her body, which means that she's good to die at this and went from making reservations at our Mexican restaurant I'm going to lunch together a few hours later, I'm dealing with the fact that my wife has had this secret breast cancer that is now going to kill her and probably less than a year.
Many times on this podcast we've talked about the secrets we keep from ourselves, or another way of putting it is the unthought known, what we know but don't allow ourselves to consciously hold in our minds. When asked by the doctor about Jane's cancer story, Barrett believed himself to be in the dark. But later Barrett realizes he did
have a story. He did have information, information about something that had happened four years earlier, something he'd agreed to bury deep and never speak of again.
I think this is a perfect example of the unthought known, because it didn't occur to me to talk about this with the doctor who ask me the question. Even later, when the unthought numb became a little sought, I didn't want to talk about it because it would have been involved betraying Jane's secret, and so I had two reasons not to sort of face that. One was that I just didn't want to face it. The other was I
didn't want to betray Jane. And it really wasn't until hours later, when Jane was in the intensive carry unit and I'd finally gone home that I had to try to get sleep that I began to face the fact that I really didn't know what was going on, but didn't want to think about it. In our twentieth year of marriage, Jane suddenly became very withdrawn. All sexual intimacy stopped. Suddenly,
with no explanation. She began wearing to bed a kaftain that went from her chin to her toes and you know, just zipped up right below her chin, and you know, it was a pretty potent symbol of, you know, don't touch me, don't get anywhere near. And when I would try to talk to her about any of this, she would clamb up and not talk about it. And you know, among her many quirks was the fact that she couldn't
fall asleep unless the TV was on. And up to that point, you know, I would kind of lie there and tolerated, and if I could hear her breathing that suggested that she was asleep, I could turn the TV off and roll over and I could sleep. Now, she was also having trouble falling asleep, and I just every time I try to turn off the TV, shees sort of growl to me, not yet, And so you know, it was this loss of intimacy, that's sort of refusal to talk about things that not yet with keeping the
TV off. I have to tell you, I think I have watched every episode of Law and Order at least five times. That was her favorite show. But I finally got to the point where, you know, I wasn't getting any sleep, and so I started maybe once or twice a week sleeping in our guest room, and then it got to be three and four times a week, and then finally I just threw in the towel and we began to sleep in different rooms. And again, this was
something we just didn't talk about, just not discussed. So there was this bizarre behavior that just came out of nowhere in year twenty, you know, and I just adapted to it, like I adapted to everything else with Jane. And I think listeners have to understand how important her approval and love was to me, and it continued to be, and I continued to make these compromises. I thought that these were rational decisions I was making for myself.
And you also didn't talk to anybody about it, because to talk to anybody about it would be a betrayal
of Jane. And one of the things that was really striking to me was there was so much that was so much about control, so much about her need for order in all the different ways, whether it's the weekend long naps, or the way that she would travel with headphones on from a minute that the cab pulled up to the minute that she got to the hotel wherever she was going to do whatever, Like she would have music in her ears the entire time going through security
getting on the plane. There was this way in which, for whatever reasons, she desperately needed to control her environment and to upset That Apple card just came with such risks like your anger was no match for her anger.
That's exactly right, and I really needed help. And I wasn't averse to therapy. I had gone through six years of analysis when I was in medical school and graduate school. I knew how helpful it could be. But the fear of betraying Jane and having her be angry at me was really sufficient to keep me from seeking any outside help.
In his fear of inciting Jane's anger, Barrett had buried a certain incident which had become part of the landscape of his unthought known. This incident occurred on a Saturday morning, about six years into Jane's withdrawing from intimacy and about four years before her collapse.
So Jane was ensconced in bed and I was sort of puttering around the apartment and I heard her call my name, which she never did, and she was in the bathroom and the door of the bathrooms closed, and she called my name again, and I said through the bathroom, what's going on? And she said you need to come in, which you know I never did when she was in
the bathroom, so I knew something was serious. So I walked in and the site I was met with was was Jane lying on the floor and she had her klftin on but it was partially unzipped and over her right shoulder. She had a towel under the klftan and I could see there was a little bit of blood on the towel and I said, my god, well, you know what's going on and she said, I'm bleeding to death. Said you know, tell me what's going on. She said, listen, I have breast cancer. It's invaded my skin and it's
invaded a blood vessel and I'm bleeding to death. I said, okay, well, I'm going to call by to one one and she said, don't you dare? And I said I was going to do it again. And one of the only times she's raised her voice at me. She screamed, don't you dare do that. I will never forgive you do that. And I said, what do you want? I just don't want to die alone. And I again I capitulated to my shame, but I did, and I said, well, what do you want? And she said, well, read to me. And she had
been doing the New York Times crossword puzzle. So the Times was in the bathrooms. I picked up the Times and I started reading the first section to her. You know, a bunch of stuff that neither of us was interested in, but it was enough to distract. It was kind of like, I guess I was fulfilling the role of law and order on TV. It was something that kept her from thinking about herself. And after about an hour she still wasn't dead. And she said, okay, well looks like a
stop leading. You can go now. And I said, no, I can't go now. You know what is going on. She said, I'm not going to talk about it, just go And I tried a couple more times and just impossible. So I ended up walking out of the bathroom and about a half an hour later, she had cleaned herself up, or she had put on some kind of a dressing onto the wound, and she came back out of the bathroom and went back into bed and turned on TV and told me what she wanted for lunch.
And we never spoke of it again in those years, those four years between that night and then the day that she collapsed, you never spoke of it again. Where did it reside in you? Was it something that broke through your thoughts, Was it something that you thought about in the middle of the night, or did you successfully put it away for yourself?
It would come up at really odd times. For example, in those days, I used to run the Boston Marathon every year, and I would raise money for Dana Farber, and I think in retrospect, this was my attempt to control my life. The training schedule for training for a marathon is wrote. You know, your schedule is set for eighteen weeks, And it was really a way for me to put some order into what felt like a very disordered life. I didn't start doing that until James withdrawal,
So I think the connection is pretty clear. And in the early years when I would run the marathon, she and a couple of people from her office would walk down to a place along the marathon route that was near where Data farmers, and she would sort of cheer me on and I would stop and I would you give her a big, sweaty kiss on the cheek and then keep running. And I would always tease her about the fact that she ruined my marathon times because I always stopped to give her a kiss. And after a
while she stopped doing that. In retrospect, it was because she was getting weaker and weaker, but I didn't really know at the time why she had stopped doing that. But after that episode on the bathroom floor, whenever I would think about Jane coming down to see me running in the marathon, I would have this thought, you know, she's got breast cancer. She's going to die of this, and there's going to be a time when I'm running
by there and she's not going to be there. The rare times that she was tender were so meaningful that her absence and the loss of those few really tender moments was something that would allow me to think about, you know, sort of the dire consequences of what she had confessed.
To We'll be back in a moment with more family secrets. About two weeks after Jane's clapse. In twenty twelve, Barrett makes yet another discovery. While Jane is still in the ICU, Barrett goes home to prepare for her discharge. He's cleaning the bedroom and getting everything ready for her homecoming and recovery when a new secret presents itself.
I go to the top tower and addresser, which is her underwear drawer, and I start to clean it out, and then in the back behind her underwear, my hand hits these something that I didn't recognize. So it turned out to be a pile of maybe twenty five or so pill bottles. Some are empty, some are full, some are half full. And I looked at the labels and they were all versions of either hormonal therapy for breast cancer or she was giving herself. But far worse were
oral versions of toxic chemotherapy. You know, chemotherapy that would lower your blood counts, that you ill, would make you susceptible to infections and bleeding and so on. There are several times in this story where I stood and looked at something for twenty seconds, thirty seconds, a long time before I could really figure out what I was looking at.
And this is one of those examples. Jane had been treating herself, and she'd been doing that without monitoring things like blood counts, things that we all do as in colleges that she did as not colleges. She was flying blind. It in retrospect explained some things that there were times when Jane would just be a lot sicker than usual, a lot paler than usual, and she'd probably given herself a little bit too much of this chemotherapy. But you
know another profound secret that was life threat. That one I was not complicit in. That one she had completely kept from me successfully.
One of the things among Jane's quirky behaviors is that when it came to her own physical health, she never ever went to the doctor. She didn't have an internist, she didn't have a primary care physician, she didn't go to the dentist, she didn't get pap smears. She had what seems like was a phobia of being a patient herself, which is so profound and ironic given that she was an oncologist.
Yes, I think the best explanation is a phobic response, maybe partly a phobic response to the pain or discomfort of interventions like going to the dentist. Is uncomfortable, you know, or it's uncomfortable to get a mammogram. But it's also I think a phobia about loss of control. If you're a patient, there's almost definition a loss of control or at least some control that you're seeding to a physician,
and I think she was phobic about that too. And you're right the irony of her going into oncology, which is sort of nothing but serious medical problems. I mean, one of the reasons that I went into oncology, I'll confess, is that I'd love taking care of patients, but I did not like taking care of the worried well. I think there's an important role for doing that. But what I liked about oncology was the first question in the decision tree, is the patient sick or not? It's always yes,
the patient's sick until proven otherwise. A headache is not always a headache, you know, A cough is not always a cough. And I just liked being able to know that whatever was going on was serious. And for Jane it would have been exactly the opposite that It's one of the reasons that she decided right away when she was a faculty member that she just wasn't going to
see patients anymore. And when she was honest about that, she would say one of the things that scared her the most was how in our field at that time, where every treatment was toxic and potentially life threatening, as life threatening as the disease was, she was deathly afraid of harming her patients. So, yeah, the whole thing is just gripping with ironies.
Well and with paradoxes too, because you're not describing a person who, on the surface of things, is tremendously empathic. I mean, certainly she wasn't to you, you know, with some exceptions, and yet what you're describing is as a physician, the degree of empathy that she felt for her patience made it unbearable for her to treat them.
It's also what made her a great doctor. Her patience loved her. I mean, her office when she was still seeing patients for that brief period was just filled with Chachke's and little gifts that her patients with her, and they would, you know, desperately try to contact her all the time. And I think it's because there were settings in which she allowed herself to be empathic. Couldn't do with my daughter, but she could do it with these patients, and they really responded to her.
Barrett spends a great deal of time trying to understand why why did Jane treat herself? Why did she make such a herculean effort to keep her illness a secret. Near the end of her life, she tells Barrett a heartbreaking story about the lengths she went to to hide her cancer. She had made a day trip to New York for a conference, and at the time Barrett had wondered why she'd taken the train rather than a quick flight.
Now she tells him the truth. She had stopped flying because on a previous work trip, she had been flagged by a TSA agent because the dressing she'd rigged up around her tumor had looked suspicious. She just so desperately did not want to be seen as sick. She couldn't bear the idea that people would respond to her with, as Barrett puts it, a condescending mixture of indulgence and pity. She wanted nothing to do with being a brave fighter or engaged in a battle, or being a warrior or
fighting the good fight. All the awkward and sometimes damaging language around cancer.
Even now, when I think about episodes like, you know, being flagged by TSA and her being forced to reveal her deepest, darkest secret to a bunch of strangers in taddy uniforms, it just makes me want to cry. And when she did go to New York and it was to give a talk, it was part of the thing
that made her think that her life was worthwhile. And when she forced herself and go to New York in the train, you know, she'd also fallen on the street and scraped her palms and she just about collapsed in penestation. It just tears my heart out that she ended up being subjected or subjected herself to those kinds of horrible episodes because she couldn't control how she felt about her disease.
Is just the saddest thing in the world. You know, her thing about the fighter, I think is really important, and she convinced me of this really early on, long before she ever got sick. But you know, the trump of the fighter the reason that bothered her, especially for something like breast cancer. Survival in breast cancer have gotten much much better for most of our training. You know, you could treat early stage breast cancer, but metastatic breast
cancer was simply not curable. You could make people feel better, if you're very lucky, you could make them a little bit longer, but you can't cure it. And the problem that, as Jane saw it, with somebody with metastatic breast cancer putting on a pink ribbon and saying that to fight this thing is it gives the illusion that a patient with metastatic breast cancer has agency when she actually doesn't.
It gives her the illusion that if she just fights hard enough, she'll be able to overcome the breast cancer. And when the inevitable occurs, because she doesn't have agency, she and her family are at risk of feeling like failure. What's worse than simply suffering from breast cancer dying of it, it's thinking that you're doing this because you have somehow failed. And this is I think an example of Jane's empathy
that she had empathy for patients with intractable diseases. In fact, all of her research was about, I think, based on empathy for patients with intractable diseases and how there are social constructs that are in one form another kind of like victim blaming. So I think these were actually important concepts that she brought to the practice of oncology.
Yes, it's heartbreaking, and that was like so lucid what you just said. And at the same time, she couldn't extend that empathy for herself.
Now she was if you think about her career, she made it to the pinnacle of academic medicine at the time when there weren't very many women who were able to do that, and her career was probably the most important thing in her life. But I think she was worried that if she were ever perceived as being sick, especially if she had cancer, that she would be perceived this week and not taken seriously by the powerful men in academic medicine, and she just couldn't let that happen.
These stories about collapsing in New York are about the horror of having to be taken aside at TSA and reveal to total strangers what was going on with her. These are stories that she didn't tell you until she was quite near the end of her life. It sounds like once she was out of options and you know, came to understand that she wasn't going to be going back to work and life was not going to be
getting back to quote unquote normal. It sounds like she was more able to share with you some of what her process had been.
More able, but not totally able. One of the most tragic comic episodes in her last year was about eight or nine months after her collapse, and so only about four months before she died. Jane was sick enough and you know, requiring intravenous antibiotics and sometimes requiring intravenous narcotics for her difficulty breathing because her lung metastases had grown. The oncologist who has taken care of her said, you know, what you really need is an indwelling venus access line.
That's something called a portocaf that gets put in one of the large veins in the chest, and then a little port a little area that has a rubber stopper in it that you can put a needle through to inject things. Is put underneath the skin, almost like a pacemaker, so it sort of you know, goes underneath somebody's just lateral to somebody's shoulder. And she didn't want to do this because you know, in our experience, especially in the years that she was training, when somebody needed a portocaf
an indwelling line. That was sort of a sign that things had gotten bad enoughs that you know they were on their way out. And she never wanted to surrender, and it took a lot of convincing to say, no, this is really about improving your quality of life. And she finally agreed to do it. And it required going back into the hospital, which was a big deal because she didn't want anyone to know that she'd come into
the hospital. So we were actually on a maternity board way down at the end so that nobody could visit see her. And she goes down for her surgery to have the thing put in, and I wait for her and she comes back and she's a little broggy. We get back out to her room and she sits up as the anesthesia wears off, and she feels for where the portocath is and she screamed at me, no, how could you let this happen? I said, well, you knew
you were going to get a portocath. No, no, no, how could you let them put this where it was? What she was complaining about was that it was too close to the center of her chest, so that she were to what she finally explained to me was that to go back to work and wear a shirt that was open or addressed, that even the slightest bit low cut people could actually see this. And I thought to myself, this is maybe the single most delusional thing that she's done.
You know, she was so clearly never ever going back to work, but it gave me a window into her soul and what was propelling her day to day even at that late date was the idea that she'd be able to go back to work and do the things that made her life meaningful. And again, that was one of the saddest things that I've ever experienced, the revelation that she thought she could go back to work.
After this sad and seminal moment, Jane finally seems to accept the reality of her fate. This acceptance extends to a willingness to see her elderly mother and siblings. She hadn't had a relationship with them in years, but she agrees to see them now to say goodbye. But still she refuses contact with Barrett's daughter Anna.
So, my daughter is an incredible person. She is saint like she really is. I couldn't really hide from her that Jane was not interested in her. That began when she was three or four years old and continued until she was in her thirties. And I just kept waiting for her to be angry at me for letting this happen and feeling alienated and not wanting anything to do with me, and God damn it, she never behave that way.
We are closer now than we ever have been. Just as every year goes by, we just get closer and closer. And part of her saintliness was that when the whole thing came out, she knew Jane was my wife, and because of Anna's love for me, she said, I would really love to come by the house and say goodbye to Jane, which is just the most touching thing if you think think about what she was doing. And I wanted to say about is somebody who wanted nothing to do with her, And so I thought, this is, you know,
the most amazing thing. This will even melt Jane's heart. And so I went to Jane and said, listen, most amazing thing, Anna would like to come and see you, and Jane said absolutely not, no way, again breaking my heart and breaking Anna's heart.
I wonder, I mean this is just occurring to me. But I wonder whether somewhere in Jane's own psyche the idea that there was this other person that you love in the picture, your daughter, that was so sort of impossible for her to tolerate that, the idea that she's dying and that you're going to continue to have You're going to live and have an ongoing relationship with this other person, this other woman in the picture, that's just my armchair.
Oh, I think that's absolutely right. I think you know, prior to Jane's mortal illness, you just sort of disc but pretty accurately, as jealousy. Here's this female that I'm clearly in love with and James jealous of her. But then once clear that Jane is dying, then you add on to that this notion that, in a way, if you're really a jealous and angry person, you might think, of shit, she won. She's going to be alive and have him, and I'm going to be gone. So I
think there was some anger there. Seven or eight years into the marriage, I had tricked myself into thinking that I had come to terms with james demands and any affect that might have been associated with my frustration really never rose again. No anger, I had no interest in other women. I was all in in the marriage and just figured this is it, and I've made this deal, and it's great because she's really wonderful and I feel
really good when she directs her attention to me. And you know, I do not doubt for a minute that Jane loved me in her way. That was just never a question. When things started to get tough twenty years in, my challenge was not feeling anger. My challenge was how to deal with the resignation. And I've had suicidal thoughts.
They were very concrete for a while. Work was difficult at the time for a variety of reasons, and Jane's alienation was also very difficult, and I just remember very concrete notions of which window I was going to in our tel floor apartment I was going to jump out of and where I'd end up. When sometimes I would as I was falling asleep, I would close my eyes and imagine lifting up the sash and then lifting up the storm window and lifting up the screen and perching
on the ledge and launching myself. Well, I know that those are pretty scary signs, and I just didn't realize that. In retrospect, I think about how dangerous that all was. Once Jane collapsed, the energy flowed in a very different way. I became, to a really striking degree just sort of all in in taking care of her. And a huge part of what necessity the complicated multi step procedures that were required to take care of her tumor. And initially
they were once a day. After a while, it was twice a day, and it was very complex, and that had to be taken care of every day without fail, whether the visiting nurses showed up or not. So it invented all sorts of ways that I could do with myself. She needed to be on blood thinners, and the most effective ones were ones that you know, were injected under the skin, and so every morning I had to give
her her injections in the skin of her abdomen. All of my waking moments were spent thinking about taking care of Jane. I think I see in retrospect that it was a very convenient way not to think about anything bigger than that, like, you know, what is this relationship? What does this all mean? How am I going to feel when she dies? I just had to spend all of my mental energies were focused on taking care of that was, as horrible as it was, was a luxury.
Oh and then when she was really having trouble breathing, I was giving her intravenous narcotics through her port through that porticath that we talked about. All these things were just really convenient ways to keep from having to think about her dying.
Three hundred and sixty days after Jane's collapse, she dies.
When she did die, it wasn't a matter of all of the feelings suddenly rushing back. It was a slow, slow progression of stuff that sort of put me back in touch with my feelings. And they were triggered by things like going through her closets and getting all of her old clothes ready for goodwill. You know, among her many other attributes, she was an incredible pack rat. I hadn't been in her closets for decades, and I found shoes and outfits I remembered from thirty years earlier that
he just hadn't thrown out. I mean, I ended up piling big piles of boxes full clothes for good will that were taller than I was in our front hall. I would come across things that she had left behind, And you know, a big part of getting in touch with how I was really feeling about things was that finally, you know, maybe two weeks after Jane died, I asked somebody for a referral to a therapist who I've now been seeing for almost eleven years. So what a relief to finally do that as well.
So it's so interesting you had such fidelity to her secrets and not betraying them at any point, even to the point where keeping that information as much as you possibly could private and within the hospital system where you both worked. And now you've written a book about it and we're talking about it, and many people will listen
to the story. And once she was no longer living, you were able to seek the conversation and the help and the the dialogue that you needed to be able to have where you no longer had to keep her secrets because she was gone. Was there any hesitation about that once she was gone or did it really feel like no. Now I've been living with this for so long, it's my right to tell this story and to lighten my burden in some way.
Oh my god, Dan, there was so much reluctance so much took me almost ten years after James's death before this book was published. Initially, I would tell myself, I should really write this down. But then I thought, why would you do this? Because no one's ever going to read this, because you can't possibly publish this or can't
even show it to anybody. What I thought about was that if I were to write this, all of these people who worshiped Jane, the people that she mentored, the people whose lives she touched, they would be furious at me. She wanted her secrets cap she was a private person. This would be a betrayal of betrayals, and so that was part of what sort of stayed my hand. Eventually, though,
there were two things I realized. One was that by writing this down it would allow me to gain a little bit of control over a thirty year period of my life which I had very little control. That this was a way of sort of helping me understand what I had done, helping me understand the secrets and why I had kept secrets. You know, what the motivation was for being complicit in those secrets I didn't tell anybody else was my secret too, and that was part of it.
But I think also I came to this realization maybe seven or eight years after she died, that well, you know, it's my story too. It's not just Jane's story, and I get to tell my story if I want to tell my story, and I can tell it in a way that I hope will make it clear that I loved Jane and that she loved me, and that this isn't at core a betrayal of secrets. It's a description
I tell people. The under line story here is somebody keeping a big, huge, neglected breast mass a secret for years and years until you know it was too late to do anything about it. And she's oncologist by the way, you know, and brilliant by the way. You know. It's
very lurid. But the core story is a story of a marriage, and it's a story about the deals that we make with each other in couples, the deals that couples make with each other, and the sort of arrangements that they make, most of which are not explicit, in order to stay together for thirty years. And if you
strip out the lurid aspects, that's what it's about. And it really has to do with you know, what secrets are acceptable, which ones aren't, which ones can you talk about with you know, the person that you're in a folly ado with, and which ones can't you talk about? And pretty personally, that's where I think I justify saying these things. And you know, before I published it, I showed typeescripts to some of the people that Jane had trained, and I was, really, you can't imagine how nervous I
was about this and writing about things that have been secrets. Everybody, I think feels the same way. But the shocker was that almost all of them said, oh, you needed to do this, and they would start telling me things about Jane that they know, things that they didn't understand and couldn't explain, and said, you need to talk about this. I do have one person who kind of trolls my social media accounts and says that I'm being a terrible person, but everybody else is sort of on board.
Well there's always one. And I'm so glad you just said that about marriage, because that's how I see this story as well. Barrett's story is not only about his marriage to Jane, however, it's a story of another marriage too, Believe it or not. It's a happy story.
I described Jane as being a medical student who came on to the hospital where I was. There were actually two medical students that arrived the same day. There were classmates, and as I said, I oversaw two teams, one that I ran myself and then one that was run by a junior residence who kind of technically reported to me, but not really. Jane was on the other team, the junior residence team. The student came onto my team. His name was Lynn. Was like the best medical student I'd
ever had. She was really smart, incredibly hard worker, really fun to work with. It turned out that, you know, the students need to be on call every third night as well, and her schedule was such that she was on call the same nights I was. So we would work together and I would teach her stuff, and I'd help her with the patients that she was being assigned, and you know, stay at all hours and taking care of things. And she was great. She was funny, and
she was very confident. And those rotations last a couple of months, and on the last night we were on call together, we'd had a particularly busy night, a lot of patients, a lot of sick patients being admitted. It was about four o'clock in the morning and we were sitting in the nursing station on one of our awards, writing up our admission notes and she stuck turned to me and Lynn said, listen, I need to talk to
you about something. And I said, fine, what do you want to talk about She said, no, I can't talk to you about it here. Well, what do you want to do? It said, follow me. So that ward was a long, long halway with a window at the end. So we walked down to the window and it's completely black. You know, it's four o'clock in the morning, so patients were sleeping the lights off. So we sat in the window sill and Lynn turns to me and says, listen,
I have to tell you something. Said fine. And she told me something that no woman had ever told me before, and no one has ever told me since. She said, I'm really attracted to you, and I wonder if we should do something about that. I was unbelievably flattered, and I said to her, oh, Limb, you know, I think you're amazing, But didn't you tell me that you're engaged to be married and your wedding has taken place in
like two months, and she said yeah. I said, well, you know, I'm not going to get into the middle of that. You really to think about this, Plus, I've already asked out your classmate Jane. And to Lind's credit, she just kind of rolled with it and said, yeah, yeah, I suppose you're right, and things didn't get awkward. We spent the next three or four days as she finished up her rotation, it was absolutely fine. And then she went off and she got married, and I, you know,
took out Jane. But that was an unusual event, and I would think about it over the next several decades. I have a friend who has sort of the quantitative turn of mind that I told this story too. Why He said, oh, so how often did you take about it? Was it once a year? Was it four times a year? Was it ten times a year? And I told him, you know what he could do with his questions. But I did think about this every so often. So after
Jane died, I was not interested in seeing anybody. I figured, you know, before I examined things really closely, I thought, you know, I'd had a long, wonderful marriage. Many people don't even get that. I don't want to try this again. The castro Ole ladies would come by, and I just was not interested. But then, almost a year after Jane died, I get this email and it's from Lynn, and my pulse races a little bit, and she says something like I must be living under a rock us heard that
Jane died. I wanted to let you know sorry I am, and that I have lovely memories of thirty years ago when I was a medical student. And so I wrote back and said, this is a lovely thing that you've said. I also have lovely memories of that time, and thank you so much for writing. And Lynn wrote back once more and said, listen, I'm working in New Jersey, right across the George Washington Bridge forever in New York. You know, just let me know we can have coffee or a
meal sometime. And I wrote back and said, yeah, I would love to do that. I can tell you about the most amazing woman who ever lived.
Barrett doesn't really have any intention of meeting Lynn for coffee or a meal. First of all, he's not interested in rekindling some long ago spark. Second, he's pretty sure she's still married. But then a close friend from their early days in medicine. Visits Dana Farber to give a talk, and it turns out that she's Lynn's best friend. She proceeds to tell Barrett that Lynn's marriage is on the rocks. Barrett responds that he doesn't care. He's not going to
get into the middle of this. But then when he gets home that night, he writes to Lynn. He tells her he's going to be visiting New York the following week. Maybe they could have lunch. He picks a restaurant on the Upper West Side and in walks Lynn, looking just as he remembered her, in his words, gorgeous.
So we go inside and we talk. She tells me about her husband soon to be ex husband, as it turns out, and I tell her stuff about Jane that I hadn't told anybody else. I really hadn't talked to anybody about Jane's secrets and what it was like to take care of her. But I told Lynn, and things just moved very quickly, and within a year she had moved up to Boston to live with me. A couple months after that or about a year after that, we got married. And so now I am happily married to Lynn.
She has three sons who I love dearly. She has two dogs who are part of the menagerie, and my daughter adores her and my grandkids adore her. So I think you know. The way I've described this sometimes is I've learned a lot about secrets. I've learned a lot about misery. I've learned a lot about marriage and secrets and marriage. But as it turns out, I've also learned about redemption. My life has sort of been redeemed by this relationship with Lynn. We've now been married for almost
ten years. It's really something.
Here's Barrett reading a final passage from his wrenching, searingly self searching memoir.
It was no better feeling in the world than being in James's good graces. Her formidable intelligence and finally, hone taste combined to make her approval something special. A nod made you feel like a million bucks, and for exactly the same reasons where disfavor was crushing. This was true for anyone who interacted with Jing, but of course I felt it much more intensely because love was added to
the mix. I crossed Jing west Or twice in our marriage, and her response had been to withdraw not just her affection, but everything. Being frozen out felt like the worst punishment imaginable. I would respond with a desperate scramble to find anything that might restore me to her favor, including in this case, I promise not to do anything about her breast cancer. Now, I felt deeply ashamed of my inaction. Fear of Jane's
displeasure was an absurd excuse. I asked myself, what kind of husband could stand by idly for four years while his wife's breast cancer grew. I'm still asking that question.
Family Secret is a production of iHeartRadio. Molly's Acur is the story editor and Dylan Fagan is the executive producer. If you have a family secret you'd like to share, please leave us a voicemail and your story could appear on an upcoming episode. Our number is one eight eight eight Secret zero. That's the number zero. You can also find me on Instagram at Danny Ryder and if you'd like to know more about the story that inspired this podcast, check out my memoir Inheritance.
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