Eric Winer Professor: I decided this year when I was giving the McGuire Lecture at SABCS 2016 to not only talk about breast cancer but to talk about my own personal story. I did that with the hope that talking about my story would help other people; that it would help some of the patients in the audience; and that it may be of some interest and some use to some of my physician and scientist colleagues.

 

I have had a few more medical problems than the average person my age. I have had medical problems since I was born because my grandfather had hemophilia and I was born with hemophilia. When I was a young child up to the age of 13， I had a lot of bleeding problems in my joints and I was in and out of hospital all the time. When I was 13， factor VIII concentrates were developed and that changed my life to being a pretty normal teenager. I went on to college and when at college， I thought that having hemophilia had been a gift because it had allowed me to see the world in a different way to most people. I recognized it was a gift that I certainly didn’t ask for， but it was something that I could still see a positive in. I initially thought I wanted to be a doctor. I ended up studying Russian history， but at the end of my university training， I still wanted to be a doctor and I went to medical school. When I finished medical school， I did a residency in internal medicine and then oncology.

 

But there were complications along the way. When I was a medical student， the AIDS epidemic started. As it turned out， virtually everybody with hemophilia who received factor VIII concentrates was infected with HIV and hepatitis C. Initially， they said very few people with HIV would get sick， and then that changed to everyone would get sick and die. By the time people were making these dismal predictions about HIV， I was married and had three children.

 

HIV was not a disease that anybody wanted to have and indeed many looked down on people with HIV. They thought it was a disease contracted through intravenous drug use and in a time when people were much more narrow-minded about the gay movement， there was a lot of discrimination against gay people because of the incidence of HIV in the gay population. There wasn’t a lot of generosity shown to people with HIV. It was also worried that HIV would spread through casual contact and therefore that doctors could give their patients HIV. During all of those years， I worried a great deal about that stigma， about being ostracized， about my children being ostracized. To a very large extent， my wife and I kept my medical problems to ourselves， which was a pretty isolating experience.

 

Thankfully， attitudes in society changed. New therapies came out. And in truth， HIV became a non-problem for me. My health from an HIV standpoint， which initially wasn’t good， became much better. But there were other problems. I had hepatitis C， which required treatment with interferon and ribavirin， and on top of that I developed portal hypertension and had very significant gastrointestinal bleeding that ultimately led to the need for a shunt procedure. So over the course of my late 20s， 30s， 40s and early 50s， I was dealing with major health problems on a regular basis. In truth， I never thought I would live to see my children grow up and never would have believed the type of career I have had. Thankfully， for the last 8 years， I have been entirely well. I still take treatment for my HIV， my hepatitis C is cured.

 

There have been some lessons that I have learned， and some lessons I haven’t learned from all of this. It is widely believed that people with medical illnesses become different people，they see the light and reprioritize their lives and never get mad and never yell at their children and are somehow more saintly. I can tell you that is not the case. I yelled at my kids plenty， in spite of knowing that I might not be alive to apologize for it ten years later.

 

I feel I was someone who was able to cope very well with my medical problems for two reasons. Firstly， I had been coping with medical problems since I was a child， so I had a lot of experience. The other is that， as a doctor， I had access to great care and I could manage it so I didn’t have to wait for procedures and I could live my life and not have my medical problems take over my life.

 

It is important when we take care of patients that we try to help them cope as best as we can and we should remember that patients are not illnesses. People may have an illness， but there is a lot of life that goes on in addition to that illness， so we have to be careful not to take over that life. We have to help people see the positive aspects or the silver lining in every bad situation when we can. Some people can’t see that themselves， but we can help them see that. Sometimes that helps them deal with their situation.

 

Finally， we have to help people be hopeful. In my case， science moves forward，there are new treatments all the time. Something that may be very dismal one year may be much better the next. For my hemophilia， treatment come out that made my hemophilia better. And the same for HIV and hepatitis C (although I was not able to take advantage of the newer advances for hepatitis C and got some of the “bad old” treatment， which still worked anyway). Now， the treatment for hepatitis C is so much easier.

 

The other big lesson is that everybody is dealing with something. There are very few people in this world who lead unblemished lives and who aren’t confronting some challenge in their life. For people like me it is going to be health problems. For others it is health problems of a family member. For someone else， it may be another kind of trauma. We all have to remember that this is part of living and what is critical is to just move on if you can. I am very thankful for the fact that I have been able to do all of the things I have been able to do， and I feel like a very lucky person. Not that I wish I had had to deal with any of these problems， but I know that I am different because of those problems. As hard as it has been at times， getting through them has made me a stronger person.

 

So that is my story. I was telling it to perhaps help other people. I was very gratified to see that when I told this story at this San Antonio Breast Cancer Meeting to 8000 of my closest friends that people seemed to appreciate it. That has meant a lot to me.