Brian & Gerri Monaghan - The Power of Two

Brian Monaghan, a supporter of The American Ireland Fund for more than 20 years, sits on the National Board of Directors.

He received the AIF's Heritage Award at the San Diego Gala in 1999. When Brian took the stage to accept the Award, many of those in attendance were startled to see his usually thick thatch of hair missing.

Just a few weeks before, Brian had undergone surgery to remove a brain tumor. He had been diagnosed with Stage IV melanoma and been given six months to live. That was ten years ago. Now Brian and his wife Gerri have written a book about their battle and victory over cancer-a story that celebrates not only Brian's courage but Gerri's fierce determination to stand up as his advocate.

The Power of Two (Workman Publishing), to be published in April of 2009, is a book Gerri and Brian felt they needed to write, both as a "pay it forward" gesture of thanks to all who helped them, and as a message of hope to anyone going through a serious illness. We interviewed the Monaghans about their love of Ireland and their amazing journey together over the last ten years.

Q. The book begins in 1998. Tell us about what happened in April and May of that year.

A. BRIAN: In April, 1998 I completed a four-month-long, very difficult, very significant courtroom battle. Having the jury come back with a resounding verdict in favor of my client should have been enough to help me overcome the incredible fatigue I had been dealing with throughout the trial. But it didn’t. Within a few weeks, I began experiencing blinding headaches. And even worse, I began mixing up words and numbers and had trouble remembering the stories and jokes I was known for. One doctor told me that I was just experiencing “brain farts” brought on by old age. I was fifty-nine. Gerri knew better and she insisted that I go for a second opinion. That decision helped save my life. In mid-May, I learned that I had Stage IV melanoma which had metastasized into two brain tumors and lymph node involvement. The outlook was pretty grim. In fact, I was told that it was likely that I had three to six months to live.  A challenge any Irishman would leap at!

Q. In the book you speak of “going to battle with a quiver as well stocked with arrows as anyone has a right to hope for.” What did you mean?

A.  BRIAN:  Honestly, I was as blessed as anyone can be in the battle I was facing. Gerri and I chose to fight this with everything we had, and for us, that meant getting the word out to everyone we knew, asking who they knew who might be able to help. Friend after friend reached out to doctors or researchers or anyone in the medical field who might have some thread of information—or better yet, hope we could grab hold of. It was just that type of contact that led us to a brand new, cutting edge dendritic cell vaccine treatment about to begin as a clinical trial at Baylor Medical Center in Dallas, Texas. So, finding something in the medical world to battle the cancer itself was a huge plus in my favor.  I was also very lucky to have good medical insurance that approved the treatments I needed. And just as important, they paid for it! Fighting any serious illness is bad enough, but when you have to go to war against the insurance companies as well, it’s more than most of us can handle. I also had a great circle of friends and the best advocate around, my wife, Gerri. All told, as good as it gets.

Q. It’s clear that your intent is for the book to be not just for those with an illness, but for their advocates. Gerri, can you tell us more about that? What does being an advocate mean to you now? And can you tell us about your Fifty Tips which are scattered throughout the book?

A. GERRI:  When we began the book, it was really just Brian’s story.  But over time, it became clear that our hints on how to do things were an important part of our story. During the calls we received, the questions to me were always along the lines of:  “What did you do?” “Do you have any tips for me?” “Any advice?” At first, I wasn’t even aware that I had become an advocate. I had fallen into that role without thinking about it, but I know that there were critical times throughout Brian’s battle when some of the things I did on his behalf clearly made a difference. I really believe that it’s vital that when the person you love, or the friend you care about, is going through a medical crisis, you simply step up for him or her. Too often, that person doesn’t have the strength to speak up for himself or have the ability to insist on getting a second opinion. Often, they just don’t have the ability to fight for themselves. That’s where the need for an advocate becomes vital.

Laced throughout the narrative of Brian’s story, our book contains information that is meant to help the advocate. The fifty tips deal with things as simple as asking for duplicate copies of MRI or CT scans, or not scheduling surgery during the holidays, to more substantive issues such as pushing the envelope of medical science in seeking out clinical trials or doing your own research into various medical treatments. I also tried to focus on helping the advocate by taking away some of the psychological burden of advocacy—there is no right or wrong way to be an advocate. Just by assuming that mantle of responsibility, an advocate has given the patient an extra edge that might make the difference in achieving the ultimate goal—survival.

Q. Brian, you write of learning to accept help from others, something which as a trial lawyer you’ve usually been the one to give. Was it hard to be on the receiving end when you became ill?

A. BRIAN: It might be difficult to believe this, but it wasn’t hard for me at all. Early on, the brain tumors gave me headaches that were capable of bringing me to my knees. They enveloped me in a kind of fog that didn’t allow me to do much of anything on my own. That was one reason why it was easy for me to have Gerri take over to such a large degree. But something else helped me as well. As a trial lawyer, I had always told my clients that they needed to believe in me and trust my capabilities to get the job done. In return, I told them that I would do all the heavy lifting for them, assume the responsibility and take as much pressure off them as I could. I think that was the template that allowed me to do the same thing now, but in reverse. In effect, I became the client and Gerri became what I had always been: the advocate.

Q. Humor is a theme throughout your book. It may be hard for some people to understand humor in the face of a brain tumor but can you share some examples of how it kept you going?

A. BRIAN:  As the Irish often say, “To the world at large, life is serious but not hopeless. To the Irish, life is hopeless but not serious.” Since I interpret hopeless as meaning that we all understand that we’re not going to live forever, this is a philosophy I’ve often lived by and it helped me tremendously when it came to facing a death sentence. Even when I was about to undergo an eight-hour, open craniotomy, which could have left me unable to communicate, I was always able to find a way to use laughter to lighten the situation. I told myself that I was doing this to help Gerri and those around me, but perhaps laughter is just my way of making it through even the darkest times.

Q. One of your doctors, Dr. Maurizio Zanetti, speaks in the book about the crossroads that cancer patients find themselves between despair and hope. You clearly chose hope and backed it up with a deep courage to pursue cutting-edge treatments. Where do you feel that courage comes from?

A.  BRIAN: I’m not sure that the word “courage” applies here.  Choosing between two roads, one of despair and the other of hope is easy. Despair is a one-way road spiraling downward, taking you and those around you, with it. I know that it’s unrealistic to think that choosing hope will guarantee a successful outcome, but choosing that route can sure make your journey an easier one. I think it’s really important for the patient to do the best he can to maintain a positive attitude, not only for himself, but for those around him. I had nothing to lose by choosing to assume a hopeful attitude. And I’m really good at that. When given odds of fifteen to twenty percent that a vaccine would work, I chose to believe that I was going to be in that winning percentage. It may sound crazy or naïve, but it’s true. As to any courage I’ve ever shown, that can probably be traced to growing up in a tough neighborhood in Philadelphia and to one strong, indomitable spirit, my mother.

Q. Your love of Ireland is deep. Can you share a bit about your trips to Ireland and their meaning?

A. BRIAN:  With Gerri’s grandparents from Foynes and mine from Bellmullett, we’ve enjoyed many wonderful trips to Ireland and look forward to many more. But I think my love of Ireland deepened in 1991 when a group of sixteen of us from San Diego, some of us already friends but many just acquaintances, took a trip to the west coast of Ireland. We went there to bury the ashes of two people whose friendship we all shared. Dan and Linda Broderick had been murdered two years before, and we decided to fulfill one of Dan’s long-stated goals, a trip to Ireland. For two weeks, this group traveled together, singing, drinking, laughing, crying and, in all too typical male fashion, mocking each other. John Lynch, one of the founders of The American Ireland Fund, and I spent hours driving together during this trip and formed a strong and lasting friendship.  Close to midnight on our last night in Ireland, our group left a pub in Doolin and walked out to a cliff to bury the ashes of our friends. It was a night I’ll never forget. There was love. There was incredible sadness. We had each lost two good friends, but by the end of those two weeks in Ireland, we had each gained something special. We grew to love one another in a way that was more powerful than sports teammates. We have become known as “The Lads.” In the past ten years, this is a group that has suffered our share of loss and many of us have had tough battles with health problems. But throughout it all, we have held fast for each other. That special trip to Ireland helped us form an unbreakable bond. It formed a band of brothers who stood by my side throughout my battle and helped get me through some tough times. While “The Lads” return to Ireland every three years, I don’t think anything will ever be as special as that first trip together. 

Q. You were honored by The American Ireland Fund in 1999 at the San Diego Gala. What was that experience like?

A. BRIAN:  One of my favorite movies is Waking Ned Devine.  It’s the story of a small town in Ireland where a deceased man is the owner of the winning Irish sweepstakes ticket. You’ll have to see the movie to understand it, but at one point, one of the characters says something along the lines of: “Wouldn’t it be wonderful to attend your own funeral? To hear the things people say about you and to enjoy and relish their thoughts while you were around to hear them.” That’s what it was like for me to be the honoree at the dinner in 1999. It was like being able to attend my own funeral. Beyond the sound of wailing bagpipes and the glitter of gowns and tuxedos, I spent an evening where friends from as far back as high school, to clients I had represented in the past, to lawyers I had fought against in the courtroom came up to me and told me how much I meant to them; how I had affected their lives. They told me that they loved me while I was around to hear it. I had two streams of thought that night. First, was that if I died right then, I would have been okay with it. But the second and much stronger thought was that I needed to stay around long enough to justify all the good things that people were saying about me. I needed to live up to what they had said. That’s the serious side to my answer. On the other hand, another story to emerge from that dinner is that in recent years, some of The Lads have questioned whether or not I really did have Stage IV melanoma. Since the 1999 dinner was the largest we’ve ever had in San Diego, with over 900 in attendance, the Lads tell me they think I made up the report of my imminent demise in a bald-faced attempt to drive up ticket sales! Ah, we Irish do indeed have a wicked sense of humor.

Q. Brian, how are you today?

A. BRIAN: All of my follow-up tests continue to show no signs that the cancer has returned. That’s an additional ten years of life during which I have learned to enjoy each and every day. Seven grandchildren I would never have known have become an important part of my life. And I’ve continued to enjoy laughter and the love of friends. I have a fantastic wife who has stood by my side and fought my battles every step of the way. How could I be anything but ABSOLUTELY GREAT?!

Q. How has this whole experience—the good, the bad, the awful—changed your relationship? So many couples don’t seem to have the strength to stay together when things are really bad. Do you have any advice on that point?

A. GERRI: It has often been a struggle. We’ve had to face some seemingly insurmountable odds, but whenever it looked as if we couldn’t meet the challenge, we always came across someone who was having an even more difficult time. That seemed to re-focus us on how blessed we have been. And no matter how difficult it has been, Brian has always kept his wonderful sense of humor, his wit, and his charm. I’ve learned that all too often, patients take out their frustrations on those around them. Brian never did that (okay, maybe once or twice!) and he’s always been wonderful about expressing his appreciation for any efforts I’ve made on his behalf. His Irish spirit continues to soar and that has given me any added strength I’ve needed. Besides, I love him.

A. BRIAN:  As Gerri always says, there is no free lunch. For me that has meant that as a result of radiation damage and post- surgical seizures, I now have aphasia, which makes it a struggle for me to read and which causes me to sometimes mix up words and numbers in crazy ways. This has made it necessary for Gerri to assume more and more responsibilities, to the point that we finally came up with a new division of labor. I’m now in charge of the weather, and she has to do everything else. (As long as we stay in San Diego, I usually hold up my end of the bargain!)  We’ve been through some tough experiences together, and I think it has given us a greater understanding of the need to truly believe in—and live by—those words we all say when we get married: “in sickness and in health.” It helps to keep life in perspective when we turn to each other, as we do each day, and say, “Aren’t we lucky?” Because we both really believe that we are. As to advice for others on how to get through an experience like this, all I can say is: Sorry, she’s unavailable. I’m already married to her.

Q. Why did the two of you write this book?

A.  GERRI:  A few years after Brian’s diagnosis, when it was clear that he had outlived all the dire expectations, friends began contacting us to ask if we would speak to friends of theirs from around the country who were now fighting cancer battles of their own. They wanted to know if we would pass along our story, as well as any hints we had on how we had handled things, and most importantly, give them a reason to hope. Brian and I both spent hours on the phone, trying to pass along any information we had that might be helpful. Soon friends told us that Brian’s story was something that needed to be shared with others.  Cancer had made it necessary for Brian to shut down his law practice, and never one to sit around without a mission to work on, he came up with the idea of writing a book about our experience. Our intention was to self-publish the book, pay for copies of it and take them around to cancer treatment centers and leave them there for cancer patients to read. We had no idea how to go about this, but we knew we had a story of hope against all odds to share. Somehow, the book took on a life of its own, and beyond any expectation on our part, it’s being published!  We are incredibly happy about this, as it will allow our story to reach well beyond where we could have gotten on our own. But we haven’t given up on our original idea. We’re still going to buy copies of the book and give them out to those it might help.

Q. Last question: You love Irish jokes, will you share a favorite?

A. BRIAN: The following was told to me by a good friend who was golfing with his son at one of Ireland’s great courses when they came to a hole where they had to hit over the water. The son asked his caddy for a seven iron. In his wonderful Irish manner and full-on Irish brogue, the caddy replied. 
“Oh now, I don’t believe that a seven will make it.  I think you’re goin’ to need a five iron.” 
“No, give me the seven.” 
“Are you sure now?” 
“Yes, give me the seven.” 
Just as the golfer lined up to hit the ball, the caddy stopped him.  “Wait just a minute.” He came over, knelt down close to the ball and in a great stage whisper said, “Take a deep breath now.”