“It is a wise child that knows his own father,” Telemachus says in Homer’s “The Odyssey,” the epic poem that is the foundation of Western literature. More than 2,500 years later, the experience of Robert Plick attests to this truth.
Plick, 64, spends his working days at UCHealth University of Colorado Hospital on the Anschutz Medical Campus on mini-odysseys, walking several miles to administer electrocardiograms (EKGs) to dozens of patients. He does so cheerfully, knowing that the work helped him to survive a much greater, long-running challenge that included bouts with three kinds of cancer, heart failure and most recently COVID-19.
He drew strength from a well also fed by deep religious faith and the worldly experiences of his father, Robert J. Plick. Born into the segregated South in New Orleans in 1932, Plick’s father joined the Army at 17, served a combat tour in Korea and earned the rank of command sergeant major by the age of 21. He completed three more combat tours in Vietnam before returning to the States for a final 30-year stint at Fort Carson in Colorado Springs.
Robert Plick shares a birthday with his father – February 26 – and at age 21 was also in the military, though he chose the Air Force over the Army. Father and son look startlingly similar in side-by-side uniformed photos taken 25 years apart. Plick says his father passed on more than physical characteristics.
“He taught me the importance of honor and duty, to be respectful, and to do the right thing,” Plick said. For him, doing the right thing meant serving patients at the hospital even as he battled through disease. He never missed a day of work through a grueling chemotherapy regimen and continued even as the COVID-19 pandemic worsened and increased his risk of exposure to the virus.
“If my dad could get through Vietnam and take care of his soldiers, I felt I could continue to take care of my patients,” Plick said.
Kidney cancer followed by lymphoma
The details of Plick’s medical odyssey demonstrate the strength of that commitment. In 2012, he was working in health care education at a Denver college when he discovered blood in his urine. His providers suspected a kidney stone, but imaging revealed cancer in the left kidney. He underwent robotic surgery that cleared the cancer while preserving two-thirds of the kidney.
With that behind him, Plick joined University of Colorado Hospital in 2015 as an ancillary health technician (AHT) performing patient blood draws and EKGs. All was well until 2018, when he noticed that he was more fatigued than usual. That’s ordinarily no cause for concern for AHTs, who routinely log several miles walking from unit to unit during a shift.
“I thought I was just tired from work,” Plick said.
Unfortunately, he needed far more than rest to recover. That spring, Dr. Manali Kamdar, clinical director of lymphoma services at the UCHealth Blood Disorders and Cell Therapies Center, performed a biopsy on tumors above and below Plick’s diaphragm. She diagnosed him with nodular lymphocyte-predominant Hodgkin disease – a cancer that originates in white blood cells called lymphocytes. It’s a relatively rare type of lymphoma.
Persevering through chemotherapy
Kamdar prescribed a chemotherapy regimen called R-CHOP: a combination of five cancer-killing drugs. Plick got his infusions on Fridays to give him the weekend to recover. He said the drugs took a physical toll. He was weak and jittery. When his hair began to fall out, his wife, Leatra, shaved his head.
His shaking hands prevented him from doing blood draws, but he continued to perform EKGs and maintained his 12-hour shifts without missing a single day of work. His spirit proved more than sufficient to bolster his physical weakness.
“Going to work helped me to stay focused and gave me a goal,” Plick said. As associate minister at the Northeast Church of Christ in Denver, he also drew strength from “a commitment to put others in front of yourself.”
His determination did not go unnoticed. After Plick completed his chemotherapy regimen, hospital management and his department recognized him for his unblemished attendance record. Kamdar praised his commitment while emphasizing that other patients should not be afraid to undergo the same regimen. Medications to treat nausea, diarrhea and other side effects help patients maintain their quality of life throughout treatment, Kamdar said, though many will require time off from work.
“Robert tolerated the chemotherapy well and pushed himself through,” Kamdar said. “Hats off to him.”
A hit to the heart
In September 2018, Plick’s cancer was in remission, but his ordeal was far from over. He continued to work, but physical weakness still nagged him.
“My legs felt like they weighed 50 pounds apiece,” he remembered.
Plick woke up one morning in December with a fever and a heart rate above 120. He went to UCH, where he was diagnosed with pneumonia, but that was only his most immediate problem. Tests showed the left ventricle of Plick’s heart had an ejection fraction of 13%, meaning that it was pumping at only about a quarter of its normal capacity.
His heart failure was a terrible turn, but in one vital way, Plick was lucky. He received care from Dr. Lavanya Kondapalli, the state’s only fellowship-trained cardio-oncologist. In that role, Kondapalli specializes in heart problems caused by toxic chemotherapy drugs. In Plick’s case, one drug in the R-CHOP regimen, doxorubicin, is linked to heart damage. Kondapalli recognized the issue and prescribed medications to help restore Plick’s heart health.
The crucial catch was the product of collegial collaboration. Kondapalli and Kamdar have worked together for several years building the Collaborative Cardiac Care for Lymphoma Patients program to guard against heart problems caused by the drugs used to treat that specific cancer. Each lymphoma patient gets a baseline echocardiogram before beginning chemo. After they are in remission, Kondapalli schedules a checkup, which includes another echocardiogram to detect any signs of heart damage.
Kondapalli said the checkup normally occurs within one year after patients finish chemo. But a tiny fraction of patients, including Robert Plick, suffer “acute toxicity” that results in a catastrophic decline in the heart’s pumping power, she said.
The medications Kondapalli prescribed have gotten Plick’s ejection fraction back into the mid-40s. There is no guarantee that it will stay there, but he has reason to be hopeful if he takes his pills every day, Kondapalli noted.
“He is managing a chronic medical problem,” she said. “Many highly functional people are in the [ejection fraction] range he is in.”
Yet another cancer challenge
Plick did continue to function after Kondapalli’s treatment, but another threat emerged in the late summer of 2019. It started with a stubborn sore throat that made swallowing difficult. He was working a shift at the hospital one day when he encountered Kamdar making her inpatient rounds. When she asked him how he was, he told her about the pain that was bothering him.
“I was worried and wanted to make sure there was nothing there,” said Kamdar, noting that the chronic lymphoma that Plick had can recur in survivors. She pulled out her cellphone, asked Plick to open his mouth, and shined a light on his throat. When she saw swelling, Kamdar told him she wanted to check out the problem right away.
In September 2019, a PET scan showed a mass on his right tonsil that turned out to be a third type of cancer invader. This time it was squamous cell carcinoma, which affects the outer and middle levels of the skin. Surgery would mean cutting out part of his tongue. Instead, Plick met with medical oncologist Dr. Antonio Jimeno, a specialist in head and neck cancers, who recommended radiation and another regimen of chemo, this time with a single drug.
The 35 radiation treatments turned out to be Plick’s toughest challenge yet. The cancer-killing beams made his throat feel like it was badly sunburned. Swallowing was painful, so he rarely ate solid food. Ninety pounds melted from his 240-pound frame. His daughter, Shonta, had to buy him a new set of clothes in medium, the size he had worn in high school.
“I wouldn’t recommend that diet to anybody,” Plick said.
The radiation finally forced him to the sidelines at work. He took short-term disability to cover a 40-day recovery. He returned to work in December 2019. Kamdar said that exams in August and November 2020 showed no evidence of residual cancer, although he will continue to see her, Kondapalli and Jimeno in follow-up visits to guard against recurrence.
Cancer and COVID-19
The challenges to Plick’s battered body didn’t end with the last cancer treatments. He was doing EKGs in the Emergency Department at UCH one night in August 2020 when his supervisor pulled him aside and told him he “didn’t look right.” A charge nurse took his temperature, which was 103, and his heart rate, which was 124.
Her order was succinct: go home now. A drive-thru test the next day confirmed he was positive for COVID-19, and he immediately quarantined for two weeks.
“I was devastated,” Plick said. “I was afraid I’d wind up on a ventilator.” To make matters worse, Leatra also tested positive for the virus.
Plick battled through another round of pneumonia after the COVID-19 diagnosis, but both he and Leatra recovered and have gotten both doses of their COVID-19 vaccinations. For now, at least, his medical struggles have ceased. Both Kamdar and Kondapalli are quick to note that Plick can take justifiable pride in his own journey back to health.
Individual strength – and plenty of help
“A lot has to be credited to Robert and his optimism and insightfulness in bringing his symptoms to us sooner,” Kamdar said. “And everything we have asked him to do, he has done without fail.”
Kondapalli added that Plick is “an active member of his care team. He does a great deal to make sure he advocates for himself. He has never felt sorry for himself. He is going to do what he has to do to keep moving forward. He is going to live the best life he can live and help people. His mental strength is remarkable.”
Thanks to his own determination, the support of his providers and unwavering commitment from Leatra, Plick can look forward to a more hopeful 2021. Yet 2020 left him with a permanent loss that he cannot undo.
In November, Robert J. Plick passed away in Fort Collins at age 88. Plick says he saw his father in the flesh a week before he died. He hopes to join him again in spirit this summer at Arlington National Cemetery, where his ashes are to be interred with full military honors.
The life lessons of his father, tested by the long struggles with disease, have indeed left him wiser.
“Life is fragile,” Plick said. “From one day to the next, having the honor, duty and ability to help patients, that’s my greatest reward, besides my faith.”