"Hello!" Jon McAlpin bellows when a new face walks into Methodist Hospital's Estabrook Cancer Center. Before Jon asks her name, he asks her another question: What doctor are you here to see?
Jon doesn't know her name yet, but he knows she hasn't slept the night before, because he has lived that sleepless night himself. He knows her stomach is knotted now, that she's struggling to breathe normally, because he has gasped for air, too.
And once he finds out this new face is a new patient of Dr. David Silverberg, Jon knows something else. Jon knows exactly what he's going to do next.
"Let me tell you a story," he says as they step into the elevator.
He has to be quick, because Dr. Silverberg's office is on the second floor, so he has boiled this story into three sentences.
Sentence one: "Three years ago, I was diagnosed with terminal cancer."
Sentence two: "As of last year, I'm cancer-free."
Sentence three: "My oncologist is Dr. Silverberg."
Then Jon takes off a pin he's wearing on his shirt, near his heart. He had a dozen of these pins made last summer after doctors gave him the news: Somehow, by some wondrous mixture of modern medicine and good old-fashioned miracle, the cancer was just ... gone.
The pin is white with black lettering. It says, "It ain't over 'til Silverberg says it's over!"
This is yours, Jon tells the woman as he hands her the pin. It's yours, as long as you promise to wear it.
"The hope in their faces at that moment ...," said Jon McAlpin, beloved Methodist cancer center greeter, longtime terminal cancer patient and suddenly healthy 62-year-old man. He shakes his head. "You just can't believe it."
He's right. I can't believe it.
I have written about Jon before, about his job at Methodist, about his years-long battle with intestinal cancer, about his optimism, his joy, in the face of the worst possible news. My first column about Jon got noticed by CBS, which led him to appear on "CBS Sunday Morning," which led him to become even more of a celebrity at Methodist.
But one thing didn't change, wouldn't change, couldn't. The CBS producers, his doctors, his wife and yours truly all knew how Jon was going to die. His cancer had been held at bay for years, but it was relentless, unstoppable. Jon himself compared his cancer prognosis to a slot machine. Sure, you can pull the lever for a while and keep winning, he told me last year. But eventually the casino will take your money. The house always wins.
Exactly. Except a funny thing happened on the way to inevitability.
Jon McAlpin hit the jackpot. A plan for beating the house took shape last year, when Silverberg called a meeting with Dr. George Dittrick, Methodist's oncology surgeon. Previously, Dittrick had ruled out surgery to remove Jon's tumor because it was lodged in a precarious and dangerous spot inside Jon's small intestine.
At Silverberg's urging, the surgeon reconsidered. Aggressive chemotherapy had shrunk Jon's tumor to a more manageable size. Plus, to be blunt, they had little to lose: Jon's body couldn't handle any more chemo. It was surgery or nothing.
The surgery came with risks — Jon's small intestine could be damaged, for example — and little chance of true success. And yet, after Jon went under the knife, tests showed that Dittrick had managed to remove the vast majority of the tumor.
But the last of the cancer cells remained, which meant another meeting with another skeptical doctor. Dr. Randy Duckert, a Methodist Hospital radiation oncologist, had earlier ruled out radiation for Jon because the small intestine can't handle the shotgun blast of gamma rays needed in order for radiation to succeed.
Now, however, the surgery had shrunk the tumor to a size that might allow radiation pinpointed like a sniper's rifle to erase it. Duckert made Jon no promises, but he did start him on 28 rounds of treatment.
Every day at 11:30 a.m., Jon left his normal work duties in the lobby of the cancer center, took the elevator down to the basement and lay on a table, where radiation was fired at a spot roughly the size of a flattened orange inside his intestine.
Jon completed the radiation therapy and went back to work as the greeter at the cancer center. He felt good, but he tried not to get his hopes up.
Last fall, he had a CT scan as part of a six-month checkup. Lo and behold: No sign of cancer. Maybe this will actually work, thought Jon, but he still tried not to get his hopes up — he knew that the cancer often returns before the one-year mark.
In April, he had his one-year CAT scan. He went into Dr. Dittrick's office to hear the news.
Dittrick looked at the scan. He looked up at Jon. There's nothing there, he said.
Just then, Jon's cellphone rang. An excited Dr. Silverberg was calling. Your CT scan is clean, he said.
Jon only half heard the doctors. He only half-believed them. He went out to dinner with his wife, celebrated with a giant Italian meal, and he wondered ... what now?
There is no reliable number to show just how rare it is for a cancer patient to go from "incurable" — Jon's previous prognosis — to his current prognosis, which is NED, or "no evidence of disease," said Dr. Duckert, the radiation oncologist.
Suffice it to say: It's extremely rare, though becoming less so as doctors learn how to target cancer at the genetic level.
There is also no script for how to act once you go from incurable to cured.
Here is what Jon has done since doctors delivered the news in April. He stopped eating so much ice cream. He went on a diet for the first time in years. He started thinking about that trip to Scotland, the one he thought he would never have the chance to take. He knows that no one can predict the months ahead — cancer is funny like that. But for the first time in a long time, he's thinking about the future.
"His goal now," said Dr. Duckert, "is to grow old and die."
Jon did one other thing when he found out his cancer was gone.
He went online and ordered those custom-made pins, the ones that are white with black lettering and say "It ain't over 'til Silverberg says it's over!"
He put one on his shirt, near his heart, and he went in to work at the cancer center, and he waited impatiently for the first new face who confirmed that, yes, Dr. Silverberg is my doctor.
Jon hands her the pin. Laughing, she agrees to wear it into her new oncologist's office. They are at the doctor's office door now, and Jon has time for only one more question.
Can I pray with you?
The woman puts a white pin over her heart on the second floor of Methodist Hospital's Estabrook Cancer Center. She joins hands with this complete stranger named Jon, bows her head and hopes someone is listening.