"This deep dive has been going on for almost ten years," Dr. Tom Braithwaite said while sitting in a doctor's office at the Mayo Clinic in Rochester, MN.
As he got his blood pressure taken and went through a few consultations, the day was all about him. When a nurse asked him how his weekend was, however, Braithwaite was thinking about others.
"We got the house kind of taken care of and ready," Tom said.
And that means leaving the lights on.
"He felt good enough. He was able to go out there, the two of us, or with help of friends, we got everything done," Braithwaite's wife Tacey said. "We even have the Christmas lights up. We don't want to be the only dark house on the cul-de-sac."
"Our cul-de-sac decorates, so we didn't want to let down all of our friends and neighbors," Tom said.
The internal medicine physician has had his own darkness to deal with for the last decade. In 2003, he was diagnosed with non-Hodgkins lymphoma. He went in remission, but the cancer came back. He went into remission again, but relapsed just a few years ago.
Though he was in remission recently, high dosages of chemotherapy essentially destroyed his bone marrow, giving him a disease called Myelodisplastic Syndrome. After not one, but two attempts to find him a match at bone marrow donor drives in his honor in the Sioux Falls area, none of his friends and family were suitable donors.
However, in August, Tom got the call that a match was found somewhere else in the United States.
"I won't deny when we left home yesterday we had a good cleansing cry. It's very emotional leaving your home base. It's not a sadness in a sense that I'm not going to be back, but you do feel your life is in a sense of suspended animation for a while," Tom said.
After a few more tests and consultations with doctors and pharmacists, Tom will be ready for his bone marrow transplant.
Stem cells are collected from Tom's donor, and will be flown into the Mayo Clinic in Rochester the day of his procedure. The donor, a woman only described as being from the continental United States, will remain anonymous for a year, but Tom knows he may never meet her.
"It's hard to spin, to you know, play forward and see a year out what situation we would be in. But, you can't put the gratitude into words. You just can't put the gratitude into words," Tom said.
Technology has helped increase the survival rate of this procedure. The Mayo Clinic has done bone marrow transplants for about 50 years, and will usually do about 450 per year. The transplant is not like a kidney or a liver transplant, because there is no surgery. This will be more like a blood transfusion. The donor cells will be transfused via a catheter that is put under Tom's collar bone.
Even though he's not going under the knife, there are still plenty of risks.
His blood counts will be low and his risk for infection will be high. He will have to wear a mask to protect his immune system. He could also get graft versus host disease, a deadly condition which means the stem cells could reject his body.
"The risk really starts a few days or weeks after the process. That's why he has to be here for three to four months in Rochester and our care team sees him on a daily basis," Dr. Mrinal Patnaik, a hematologist at the Mayo Clinic said.
Tom and Tacey will stay at a nearby transplant house while Tom has outpatient treatment. Through the chemo, blood transfusions, good days and bad, Tom's background as a doctor has helped him understand this whole process.
However, it also means he is all too aware of how a bone marrow transplant does not always mean a cure.
"I remember the first time I met him, I could see the pain in his eyes, hearing a younger physician go over some of these things, talking about death, the process of dying. How it can be averted, some of the things that can be done. What was beautiful is he processed that," Patnaik said. "I talked to him a few days later and he said, 'I'm ready, let's do this.'"
There really is no way to know, donor or not, what the outcome will be from this day on.
We asked Tom if he was prepared for anything; if it was even possible to be prepared for anything.
"Oh, you have to be prepared for it," Tom said without hesitation. "You know the phrase we have used time and time again, or what I've used is I have one foot in reality. I'm a physician and I know to a great extent what is possible and what could occur here, but we have one foot firmly in hope and that's what drives us forward."
Tom had his bone marrow transplant at 10:30 p.m. on November 14. The transplant happens whenever the donor cells arrive at Mayo Clinic.
Tom has found a donor, but there are millions who will not. The National Marrow Registry has millions of people on its donor list, however matches can be very rare.
Patnaik said, if anything, he hopes Tom's disease will inspire others to become bone marrow donors. Saving a life is as easy as a cotton swab test at the doctor's office, or you can even have one mailed to your home.
Tom hopes this will be the cure he has been waiting for and hopes others are inspired to become bone marrow donors as well.
Just like he did with his Christmas lights, as he moves forward to the beginning of a new journey, for himself and for the people who will go through this same process, Tom is leaving the light on.
"I think we can take even the darkest moments of our lives, the times that are most challenging, the times that really cause us to face our deepest fears of death, fears of loss of connection and what you might miss out and you can use that as a way of achieving good. At least that's our hope and prayer," Braithwaite said.