Cancer Patient Seeks Caring in Immune System

One day Evan Handler was a 24-year-old understudy in a Broadway hit, a professional actor with a promising career who was poised to embark on the national tour of a Neil Simon play. The next day he was patient number 865770 at Memorial Sloan-Kettering Cancer Center in New York, a terrified and very sick man "thrown into a world I didn't even know existed." During the next three years, Handler said, he became the recipient "of some of the very best and the very worst health care our nation has to offer."

Now 36, Handler has survived acute myelogenous leukemia--twice--as well as several harrowing courses of aggressive chemotherapy with its myriad life-threatening side effects.

In 1988, Handler left Sloan-Kettering, where he was being treated for the second time, and went to Johns Hopkins Hospital in Baltimore. There he received what was then a highly experimental and extremely risky new treatment: an autologous bone-marrow transplant.

The cancer has not returned, and Handler is considered to be cured of a cancer that, when he was diagnosed 12 years ago, was considered incurable.

Since then, Handler has resumed his acting career--he appeared last year in the Mel Gibson movie "Ransom"--and has written a searing, passionate and ironic account of his experiences titled "Time on Fire: My Comedy of Terrors" (Henry Holt, 1996), based on Handler's one-man off-Broadway play of the same name. Its premise, Handler said, is that "the truly horrible and the hysterically funny [can] exist right next to each other."

That was the theme of his 90-minute appearance recently in Washington before an unusual audience: nearly 4,000 physicians and medical practice administrators who attended the Medical Group Management Assn.'s annual convention.

Handler's performance, which received a standing ovation, was a striking departure for a conference that focused on topics such as "positioning," "vertical integration" and "physician extenders"--the new parlance of the business health care has become.

And that, said conference chairwoman Ann C. McFarland, is what made Handler's perspective as a patient advocate necessary.

"We in health care get so wrapped up in making the process work that we forget the recipient--the patient," said McFarland, vice president of a medical practice management company in Los Angeles. "I've been a patient myself for a serious illness, so I can empathize. Too often, we forget the patient, and Evan Handler reminds us of that."