HJAR May/Jun 2023

CTE 14 MAY / JUN 2023 I  HEALTHCARE JOURNAL OF ARKANSAS that, while your friends send you “get well wishes,” those in the healthcare field just say, “I am sorry.”With treatment, the aver- age person lives 1.5 years after diagnosis. When a biopsy came back a week or so later, we were told it was IDH-wild type, which meant it was the fastest growing tumor type. I asked the neuro-oncologist if they would please double-check. I figured based on the symptoms I had attributed to CTE two years earlier, it had to be slow-growing. If it was glioblastoma from the first time he was symptomatic, I told her, he probably would be dead by then. As puzzled as I was by that revelation, I really think I was trying to negotiate for more time with him on this earth. She told me they were certain. Smith faced death with more grace and dignity than I thought possible. He wasn’t fighting cancer, although he wished he had decades longer to live; he knew his prog- nosis. He would tell friends he was trying to make “peace” with the cancer. Smith couldn’t imagine fighting something that was in his own brain and was eventually going to win. Smith lived another 2.5 years after that first seizure. He turned living longer into a game and wanted to play it as long as he felt good. He played it well, as usual, and we turned what most consider a tragic time into a sweet one. Our game was to try to enjoy what would be his last days — to make them the best ones, however long we had. He, because of his condition, needed calm and peace. As a former cheerleader whose spirit naturally leans more toward “rah rah,” it became a practice to adjust to this calm state, but not doing so was actually dangerous for him. Seizures were always a concern. The peacefulness actually felt nice after a while and time was a gift. Sometimes knowing the time left on the clock is a beau- tiful blessing. Many of Smith’s college and high school teammates made the pilgrimage to visit us in Seattle. It was a testament of a life well lived. He had a way of collecting friends from each decade, and many of them came to visit, along with multiple visits from his mom, Aunty Carmen with her wonderful home-cooked meals and jams, the charm- ing uncles, a slew of sisters, nieces, nephews, and amazing cousins who exuded thought- fulness; we were enveloped in love. But his teammates had been in the trenches together, and there is a special bond formed that way. One players’ trip included his college coach Jackie Sherrill. Coach Sherrill had been one of the first calls Smith received when he posted on Face- book he had brain cancer. “I will walk you through the front doors of MDAnderson, if you decide to go there,” Coach told his for- mer player. Coach had pulled together game tape of Smith so we could enjoy it and had asked his teammates to write their favorite “Wally”memories. It was an especially poignant visit, because they knew it was probably going to be their last. Smith was going to be the first of that close group to run through the tunnel. They were watching his lead. At one point, while all the guys were telling war stories and laughing, Coach Sherrill was quietly looking at his phone in the corner. I walked up to him and asked him if I could get him something to drink. He looked up to me with tears in his big blue eyes. He was watching a livestream of the funeral of one of his graduate assistants, David Beal, who was A&M quarterback in the late 70s and went on to become a high school coach. “He died of glioblastoma,”Coach told me softly. My heart sank. “Well, that is two,”I thought. “I wonder how many there are?” Smith died at 54 in 2021. He donated his brain to science. He was excited to do so. His neuro-oncologist had asked him about it. A brain clinic is a hard place to walk into the first time when you have a tumor. You get over the initial shock of it soon, but the first time is difficult. At our first visit, there was a gentleman coming out of the bath- room, disheveled, confused, looking for his wife. Smith and I looked at each other with knowing eyes. He whispered, “Please do not let me get like that.” This was one of our last clinic visits. Smith had been through a lot: chemo, 60 days of radiation, a fewAvastin Hail Marys, his knees hurt and were bone on bone from knee surgeries as a player. He was now very close to being the man we saw that first day; Slices of Smith’s brain prepared for microscopic analysis to further Glioblastoma, TBI, and now CTE research.