Cancer, My Husband’s Doctor, and Catherine Deneuve
It was not until shortly after my husband, Josh, died in the summer of 2021 that I learned his oncologist, Dr. Gabriel Sara, was starring in a film opposite the legendary French actress Catherine Deneuve.
I was at the kitchen table, alone. The phone rang, and it was Dr. Sara extending condolences. As we spoke, he told me that he was sorry he had not been in town for Josh’s death; he had been cast in a movie as a cancer doctor. In the days before my husband died, Dr. Sara had been at the Cannes Film Festival, in a tuxedo, with Ms. Deneuve and the rest of the cast, basking in an eight-minute standing ovation for “Peaceful,” a movie about a young man who comes to terms with his terminal cancer by facing up to some of his regrets in life and standing up to his loving but domineering mother, played by Ms. Deneuve.
I could still hear the exhilaration of that reception at Cannes in his voice. I felt like laughing. Telling me about it was tactless, yet I didn’t hold it against him. His professional mask was slipping, and I was intrigued by what was underneath.
Death is funny that way. There are some moments that make you laugh because they are so out of place that you don’t know what else to do. Like when my cousin Tommy took a picture of his father’s corpse on his death bed because he could hear his mother in his head saying, “Get a picture, get a picture” at important family events. Or when the undertaker and his assistant carried away the body of my husband, wrapped in a flowered sheet that I had taken with me to college.
Every day, people ask me how I’m holding up, and it is hard to know how to answer. “Up and down,” I usually say, to be diplomatic. If I were to be more honest, or more precise, I would say: functional in the daylight, terrified at night. It’s almost primal.
Recently, Dr. Sara reached out to me by email, this time to invite me to a screening of the movie at the French Institute Alliance Francaise.
I agreed to his invitation with some trepidation. Why would I want to subject myself to a movie about cancer? Then I thought, maybe seeing my experience reflected on the big screen, graced by a famous actress like Ms. Deneuve, would help me find some kind of message in my husband’s unexpected death. Here, maybe, was a chance to go back to the beginning and relive that time with Dr. Sara through the movie — to figure out how to emerge from the darkness as I watched his character counsel a fictional patient with terminal cancer.
It would be sort of a do-over, I imagined, but this time I could concentrate on distancing myself from the pain of death, recapturing the joy of life and moving on. Perhaps I would finally be able to just say “Doing well!”
If nothing else, it would be a night out.
My husband, Josh Barbanel, learned he had colon cancer in February 2020, just as the pandemic was hitting. For a while we saw a lot of Dr. Sara, a compact, balding man with a brush mustache, what sounded to me like a French accent layered over an Arabic one, and a focused gaze.
New Developments in Cancer Research
Progress in the field. In recent years, advancements in research have changed the way cancer is treated. Here are some recent updates:
Uterine cancer. Women who use chemical hair straighteners frequently could have a higher risk of developing uterine cancer than women who have never used the products, according to new findings from a national study that has followed nearly 34,000 U.S. women for more than a decade.
Breast cancer. A new study suggests surgery may not always be necessary for all breast cancer patients. A small early-stage clinical trial found that a carefully selected group of patients who responded remarkably well to chemotherapy could skip surgery altogether.
Cancer vaccines. For a long time, the promise of cancer vaccines that would protect healthy people at high risk of cancer has only dangled in front of researchers. Now, though, encouraging animal data and preliminary studies in human patients are making some doctors feel optimistic.
Rectal cancer. A small trial that saw 18 rectal cancer patients taking the same drug, dostarlimab, appears to have produced an astonishing result: The cancer vanished in every single participant. Experts believe that this study is the first in history to have achieved such results.
Josh was a reporter, like me, and a man of many hobbies. Over the years, he taught himself statistics, HTML coding, bicycle building, woodworking, sailing and bread baking. For a while, he was reading my college calculus textbook (a required course) in bed at night. He was also the household handyman and could fix anything that needed fixing.
When Josh found out he had cancer, he tackled it as if it were another project, plotting the tumor markers on a graph as Dr. Sara gave us the numbers to keep track of whether the cancer was waxing or waning. Until just months before his death, he continued to work. He rode his bike, switching to an e-bike when he was too weak for his fixed-gear track bike. And he continued to sail a one-man laser in Jamaica Bay, rarely telling anyone that he was sick.
After Josh received his diagnosis, we had a pretty clear idea that the statistical odds did not give him much time to live — perhaps months, rather than years. But our coping strategy was not to talk about it too much together. In the meantime, the visits to Dr. Sara every couple of weeks were like visits to a psychotherapist, or a fortune teller. He delivered the latest news from the crystal ball of tumor markers. He listened.
Dr. Sara’s demeanor in life, as in the movie, could seem stern. At one of our early appointments he told us that he did not want us consulting Google about Josh’s illness. Another time, he advised Josh to keep his fingernails clean.
But he also had a philosophical, free-spirited bent. He introduced music therapy and performances by professional tango dancers to the chemo suite, for instance, because he wanted his patients to connect with their senses despite their illness.
The first two scenes of the movie capture his oracular quality. Though the lines are scripted, they are based on things the director heard him say. In one scene, a nurse is distraught because a wife had held her husband’s hand for hours, only for him to die when she left the room. “In his final hours, a patient often chooses his time of death and who will be in the room at the same time,” Dr. Sara, as the fictional Dr. Eddé, says. “If he let her go, it’s because he decided to die alone. That was his decision, and it takes nothing away from what her presence did for him until the last ten minutes of his life.”
The main character in the film, Benjamin, played by the French actor Benoit Magimel, is a rakish, sardonic acting teacher with advanced pancreatic cancer. Ms. Deneuve plays his overprotective mother. “Can you cure me?” Benjamin asks. “You’ll never hear me say, ‘I’ll cure your cancer.’ I’d be a liar if I did,” Dr. Edde says. “So whatever the scenario, one day the cancer will prevail. It will overpower us all.”
The insistence that there is no cure sounds harsh. But Dr. Sara believes in being truthful with patients, if they are open to it, so they have a chance to prepare for the end. “With every one of my patients, I try to walk them and their family on that path to get to peace,” Dr. Sara told me. “We are all going to die, but it doesn’t have to be ugly and doesn’t have to destroy those around us.”
Dr. Sara, 68, grew up in an upper middle class family in Beirut. He studied medicine in Beirut and Paris, and arrived, newly married, in the United States in 1980 for postgraduate studies, intending to return home. But Beirut was a war zone, and he had two children. The months became years. He fell into oncology accidentally, when someone else withdrew from a fellowship, and retired from Mt. Sinai West two months ago after 35 years of practicing.
I asked Dr. Sara how he was able to keep working year after year while constantly confronting death.
“Tough doesn’t work for me,” he said. “The way to prevent burnout is to embrace what you’re doing, live with it and tango dance with it. When you dance tango you have to feel the body of the other person, the movement, the emotion.”
Why Think About Death?
We went through my husband’s treatment under pandemic conditions. Because of Covid protocol, I wasn’t allowed to accompany my spouse to doctor appointments without special permission. But we figured out how, in Dr. Sara’s words, to tango.
When I sneaked past the guards, Dr. Sara never said a word about my illicit presence. A few months into treatment, I realized that Josh might not make it to the next spring, when we would normally visit my extended family in Greece. I told Dr. Sara that I would like to take my husband to Greece, because he might not get the chance again. Covid-19 was sweeping across Europe, curfews were being imposed and borders closed. There was no vaccine yet. Dr. Sara did not hesitate. He believed that travel was good for cancer patients, he said. He wrote us a letter “To Whom It May Concern” describing Josh’s disease and course of treatment.
We used my Greek passport to move through the eurozone. Josh and I rowed a tandem kayak on the Aegean because he was too weak to sail, and he lay on the beach, sprawled among the white sand lilies. It was his last trip abroad.
My diary reminds me that while we were there, I asked Josh what he would do differently in life. “Not get cancer,” he said. Something else, not something you can’t control, I said. “Go to law school.” Why? “To make money and do something engaging,” he said. It occurs to me only now that he might have been thinking not of himself but of our son, who was in law school at the time. So those are the thoughts of a dying man. Not so profound, but practical.
As for me, I kept hearing the lyrics to a Simon and Garfunkel song in my head: “So, I’ll continue to continue to pretend, my life will never end, and flowers never bend, with the rainfall.” It was my soundtrack.
Josh failed one course of chemo and began a more targeted one. His graphs showed his tumor markers improving, fluctuating, and then getting decisively worse. Dr. Sara advised him several times, in somber tones, to put his affairs in order. My husband did not react, and I did not push it. Why make him think about death? I was, I guess, in denial.
In the spring of 2021, he had an emergency hospitalization for a bowel obstruction and was not allowed to eat solid food. “Saturday, 5/15,” I scribbled in my notebook. “Strawberry Jell-O, 100 cal, ginger ale, 70 cal, apple juice, Seltzer.” A palliative care doctor came to his bedside, as if smelling death. “You’re going to just let him starve?” I asked. She nodded, yes. My notes say that on 5/27, he was getting “Haldol, Famotidine, Dexamethasone, Morphine.”
But his will to live was strong, and he wanted to eat. The hospital let me take him home with a nasogastric tube coming out of his nose, draining into a bottle. As we were leaving, a young nurse said offhandedly, “See you next time.” No you won’t, I thought to myself, resolving never to return. Josh was in good spirits. It was warm out. He could sit in the backyard with me and our children.
The physician who cared for my husband at the hospital called to ask how he was doing. How long could my husband keep that drainage tube in his nose, I asked. In this country, the doctor said, the rule was about three weeks, after which we would have to return to the hospital to replace it. But in India, doctors would leave it in for three or four months, the doctor said. We’re going with the Indian method, I replied.
But we didn’t need to. His bowel obstruction magically disappeared, and the visiting nurse came right over and removed the nasal tube. He could eat again.
At first, Josh seemed so well that I began planning to return to work from a short leave. Then suddenly, every day brought a new physical breakdown, and he went from walking on his own to using a cane. A cane became a portable wheelchair, then a big wheelchair, then a hoist.
My husband died at home in mid-July, a half-hour after I had left his side to get some sleep. Our son was with him. As Dr. Sara observes in the movie, the timing did not seem accidental.
A Folder Marked ‘Home’
Dr. Sara is a movie buff, which is how he met the director of “Peaceful,” Emmanuelle Bercot. One night in 2016, Dr. Sara and his wife, Nada, went to a French movie at Lincoln Center, “Standing Tall,” that Ms. Bercot had directed. “It’s about a runaway kid, who was struggling to keep his dignity,” Dr. Sara recalled, just as his cancer patients struggled to keep theirs.
After the Q. and A., he and his wife pushed their way through the crowd to get to Ms. Bercot, and he remembers saying something like, “Madame, are you interested to go in the trenches of cancer?” Soon they were exchanging emails, and Dr. Sara was showing Ms. Bercot around the hospital.
“Catherine Deneuve, the first thing she said was ‘Who is going to play the doctor?’” Ms. Bercot said. To Ms. Bercot, no one but Dr. Sara seemed right for the part.
Dr. Sara appears in more scenes than any other actor, Ms. Bercot said.
“He is the main actor and the lead actor of the film,” she said. “He had more days of shooting than Catherine Deneuve or Benoit Magimel.”
“Peaceful” premiered in the United States on Oct. 28, and will play on Saturday afternoon at the New Plaza Cinema in New York City, with a Q. and A. by Dr. Sara.
My husband was not the type of person who liked to be told what to do. Like Mr. Magimel’s character in the movie, he was resistant to authority.
“Josh at the beginning made us maybe think he did not realize what was going on, or he did not accept the truth,” Dr. Sara told me. “But deep down, I think he was getting it without any question, and that was his way of coping with it, maybe making us believe he didn’t get it.”
After Josh died, I found a series of letters he had written to me in a shared computer folder marked “Home.” They were instructions for how to do things I had never done. How to program the thermostat. How to pay insurance, and haggle over the annual increases, even though it probably would not do any good. How to make the arrangements for his funeral. Recommendations on engravers for his gravestone. In those difficult months, I would have been lost without those instructions.
Until I saw the movie, I had forgotten about Dr. Sara’s admonition to my husband to put his affairs in order. Watching my husband’s doctor onscreen didn’t turn out to be a do-over, or a salve. You don’t get to do-over death. But I was reminded of what we had in Dr. Sara. Now I saw that Dr. Sara might have been responsible for these letters. My husband had been paying attention after all, and this was his gift to me.