Dr. Paul Weiden on 20 years of cancer care in Southeast Alaska

This is Tongass Voices, a series from KTOO sharing weekly perspectives from the homelands of the Áak’w Kwáan and beyond.

Oncologist Dr. Paul Weiden has been treating patients with cancer in Southeast Alaska for 23 years. Now, he’s retiring at 83.

For the past two decades, he would travel to Juneau monthly to see patients who might have otherwise flown to Seattle to see a specialist. He also provided remote care for patients in other Southeast communities.

Although he’s seen treatment access improve over the years, he says there are still gaps.

Listen:

This transcript has been lightly edited for clarity.

Paul Weiden: I’m Paul Weiden. I’m a physician, a medical oncologist, hematologist, and I have come to Juneau monthly to see folks up here since November of 2001.

In the 20 years prior to that, I was at Virginia Mason, and we saw a lot of patients who came from Southeast Alaska – particularly Juneau – to Seattle, particularly to Virginia Mason for care for cancer. So the folks that bothered me most were the patients at the end of life who had been treated up here and would come down to see if there was anything more that could be done.

And they’d come with the patient and the family, often spending their last resources — monetary resources, energy resources, psychological resources — to come down, and almost always for me to say, you know, “You’ve had pretty good treatment up there in Juneau or Wrangell or wherever you were, and there’s really nothing more that could or should be done.”

So when I left Virginia Mason, I said, you know, “I don’t need to have those folks come down here, I can go up there.”

If I have a patient in Sitka or Wrangell or Skagway, or whatever, we do telemedicine, unless they need to come to Juneau for the radiology facilities that are here.

There are more towns in Southeast Alaska now that are able to do that, but it stretches their resources, because not so much the administration of the chemotherapy. That’s not so hard, but it’s the complications of the chemotherapy that occur unexpectedly between the times a patient gets chemotherapy, and that’s a lot of responsibility for somebody, and let’s say in Skagway or Wrangell or Petersburg, where there are limited resources, so that that is still a tension.

But on the other hand, I think that problem is better solved by us here in Juneau being the center hub than trying to do it when I was practicing in Seattle, I didn’t really understand where the hell Skagway was in relation to Juneau.

So now I have a pretty good understanding of where everything is, and can work with the patient and the family and whatever local medical facility is in that town to see what’s reasonable to do. You know, you also understand that a patient from Skagway can get to Juneau pretty reliably in the summer, but come winter, and, you know, it’s a little dicey.

As I say, it’s rare that a patient really needs to, let’s say, get the hell out of town to get good care. And there are two or three patients over these 20 years that I really struggled to get out of town today, and not only get out of town, but to go somewhere where they would be taken care of that night.

And there are at least two that come to mind who, if you know, I hadn’t seen them on the day that I saw them and made the diagnosis and understood the situation, if they’d called the University of Washington or Virginia Mason and said, “I’m sick,” they’d get appointment for two weeks later, or even a week later, they’d be dead. That’s rare. I mean, it’s good television drama, but it’s actually very rare, and I can think of two in 20 years for that.

Now, I’ve probably forgotten two, but it’s not 10s or 20s, it’s single digits of patients where that kind of encounter is a difference between life and death. And if I go back to like the 30, 40 years before 2000, there are also two or three patients in my career where I can think, on this day, I made the difference between life and death. It’s rare, but it is, you know, extraordinarily exciting and rewarding.

Friends and colleagues will celebrate Dr. Weiden’s retirement Thursday at 5 p.m. at Amalga Distillery.