TRAVERSE CITY — Doug Tesner is not a religious man, but he sunk deeper into a brown chair in his living room and talked about God.
Tesner is mad at God — has been since he lost a wife to cancer. Now Tesner has cancer too. He is pretty sure God isn't listening.
He wonders if anyone will greet him at the gates of heaven.
The pastor lay on a nearby love seat, listening, hands cupped behind his head.
"I'm not sure what's on the other side of that hill," said Tesner, a Record-Eagle photographer since 2004. He was talking about death.
"It's scary, isn't it?" the Rev. Jerry Micketti asked.
"Oh, yeah."
A lifelong smoker, Tesner, 64, has Stage IV cancer that spread from his right lung to his lymph nodes. Within a week of Micketti's recent visit, he went from living room to a private room at Munson Medical Center in Traverse City, forced there because of vomiting and difficulty breathing.
Tesner knows death looms.
On the surface, he is not an emotional person. He's sarcastic. He grumbles and jokes and laughs. Inside, he has a heart like a Care Bear. And he is afraid.
He agreed to allow the Record-Eagle to chronicle his treatment — the good days and bad — to shed light on the illness.
"Maybe people will learn things about me they didn't know before," he said. "I think being able to communicate will help people."
Peggy, his wife of nearly 16 years, said he wanted to do it in part because he is "a newspaper man at heart."
"People don't know about this. They don't know until they go through it what it's like," she said. "In a way, it's his legacy. It's what he can leave behind. It's a way not to be forgotten."
Tesner met Micketti a few months ago while on assignment for the newspaper. They bonded over their shared experiences in the Navy. Tesner said if he ever needed a priest, he wanted Micketti.
The pastor listened as Peggy told him how her husband always referred to death as "a new adventure."
"But I don't know if that's true," Tesner said, crumpling suddenly into tears. Peggy left the sofa and wrapped her arms around him.
Micketti quoted poet Dylan Thomas then and urged Tesner not to go gently into that good night, however far off that may be. Tesner regained his composure. Peggy returned to the sofa.
"That's where I am today, Father," Tesner said.
"Then that's where you are," Micketti said. "Tomorrow's not here yet, and yesterday's done."
The beginning
If this is an adventure, it started on a Friday in February. Tesner attended a Michigan Press Photographers Association conference in East Lansing and began to feel ill.
"He was white as a sheet," Peggy said.
He went to a hospital near Detroit, where the couple was visiting relatives, to be treated for pneumonia. Doctors there found the cancer, a type of non-small cell lung cancer known as adenocarcinoma.
Cancer can look like pneumonia on an X-ray, which is why doctors run additional tests, said Dr. John Gorman, who practices internal medicine and pediatrics in Traverse City.
He first saw Tesner in April and continues to treat him.
Tesner's type is "generally lifestyle- or smoking-associated," Gorman said, and can exist with or without symptoms. If it's caught early, the mass has a better chance of surgical removal. But if it has spread to the lymphatic system, as in Tesner's case, treatment largely focuses on relieving symptoms.
In two months, there were pulmonary tests, CAT scans, a biopsy. Multiple visits to an oncologist, a cardiologist, a radiologist. A stress test. Three stents were inserted into his heart.
By May, Tesner was being prepped for a thoracotomy, an operation that would have removed part of his infected lower right lung.
While her husband was in the operating room, Peggy monitored a status board that routinely was updated to reflect patients' conditions. Tesner's progress was changed to "closing" after roughly 45 minutes.
No, she thought. It was too soon.
"I started to cry because I knew what they had done," said Peggy, a registered nurse. "I knew when they closed him up that fast that they weren't able to do it."
Surgeons quickly realized tumors had spread throughout his right lung and into the lymph nodes, Gorman said, meaning that even if they had removed a lobe, they wouldn't have removed the cancer.
On top of that, fluid was building near Tesner's lungs.
"He would have his own struggles with that much less lung tissue," Gorman said. "If it's not cured, then that's too invasive for him."
When he coughs, Tesner feels pain in his side from the incision. Doctors had to spread his ribs to reach the lung.
Not long after surgery, he asked for his Apple iPhone — he is never far from an electronic gadget — and posted "Doug lives, sort of!!!!!!!!" to his Facebook page.
More people will die from lung cancer than any other type, according to the American Cancer Society. It's also the easiest to prevent.
About 160,000 people die from lung cancer in the United States each year, statistics show. The organization estimates 222,520 people will be diagnosed this year.
From 2002-06, an average of 43 people died of lung cancer each year in Grand Traverse County, according to data from the National Cancer Institute. Elsewhere in the region, annual averages ranged from 10 in Leelanau County to 19 in Antrim County for the same period.
Tesner could live as long as a year, Gorman said, but it's more likely to be less.
"It's poor," Gorman said. "He's got a really practical, fairly positive, bright outlook on the situation."
The day before he was discharged after the curtailed surgery, Tesner had a necessary procedure performed on his lungs to prevent fluid from building. It's painful. Tesner called it "barbaric," even with medication.
"I'm wondering if there was any morphine in there," he said. "I would highly, highly recommend it instead of waterboarding."
'Some regrets'
Douglas Paul Tesner was born May 21, 1946, in Royal Oak. He grew up in Southfield.
He'd always wanted to be a newspaper photographer. A neighbor taught him the skill as a teenager. It turned out he was good at it, so he signed up for classes at a community college.
"They didn't want me to take them because I was too young," Tesner said. He did anyway.
It was mostly a hobby at first. He postponed the career in 1964, when he dropped out of high school to enlist in the Navy. He served about 22 years as a helicopter mechanic and official Navy photographer.
He was in a couple of helicopter crashes, but he shrugs them off.
"Nothing major," he said. "It can screw your day up, though."
Cigarettes came cheap in the military. In the Navy, he could buy them for "a buck a carton, 10 cents a pack." A smoking culture was pervasive.
Tesner bought his first pack of cigarettes — Newport, he remembers — when he was about 14. It quickly became an addiction.
On average, he smoked more than two packs a day. Marlboro, mostly.
He recently quit for more than a year, replaced cigarettes with Life Savers mints, but Tesner is the first to point out it was too late. He'd tried to stop before, but couldn't.
Gorman said smoking is the probable cause of Tesner's illness.
"I kind of wonder where I'd be right now if I didn't smoke," Tesner said from his hospital bed, an oxygen tube fixed to his nose. "I have some regrets."
What are they?
"That I smoked."
The waiting game
"The hardest part is the waiting," Peggy said prior to a follow-up appointment a few weeks after surgery. "You've got to wait while they schedule this test and schedule that test."
A nurse practitioner was pleased with Tesner's progress, but instructed him to eat more.
Just days earlier, he had gone to Munson's emergency room with nausea and vomiting. The bug also hit Peggy and a home health nurse, but it was hardest on Tesner, whose immune system already was compromised.
"You look a little better," Micketti, the pastor, said at home later that day.
"You should have seen me yesterday," Tesner quipped. "You would have been giving me the last rites."
He told Micketti then that returning to work was at the top of his "bucket list," along with winning a casino jackpot and watching a space shuttle launch from Cape Canaveral, Fla. That might not be possible now.
Tesner began working for newspapers after leaving the Navy. He enrolled in a Syracuse University photojournalism program designed for military service members. Before moving to Traverse City, he photographed for papers near Washington, D.C., and in New Mexico.
His job is to capture life on film. His secret to finding the perfect shot? There isn't one.
"It just strikes me. That's the moment," said Tesner, who enjoys "the instant gratification of seeing what I've done."
He tried to focus on one moment at a time to get through treatment. But waiting for test results or treatment plans isn't easy.
"They don't tell you what your chances are of living or dying," Tesner said. "It's mentally fatiguing.
"It gives you a lot of time to reflect on different things in your life."
Reflect?
"Yeah."
His former wife, Maggie, died of cervical cancer in the 1980s. He told Micketti that was why he was mad at God — she didn't deserve it.
"I know what she said," Tesner said. "The waiting was killing her."
The cancer progresses
Tesner went back to the hospital late June 16 because he was vomiting. He initially was treated for pneumonia, but doctors suspect tumors are the culprit.
The couple thought he might have been ready to go home that weekend, but he still was a patient on the cancer floor this weekend.
"Feels like a year," Tesner mumbled, hoarsely.
He had a persistent, hacking cough that at first devolved into a wheeze. He can talk, but his speech is muffled and often interrupted by a coughing fit. He sleeps with his mouth ajar. Peggy drapes cold washcloths across his forehead.
His mind is sharp, but his body is weak. Tesner hasn't eaten in days — he has dropped weight, about 25 pounds at one point — and it takes two people to move him from his bed to a wheelchair.
He still has his sense of humor. When Gorman stopped by his room, he asked if Tesner needed anything. Tesner asked for a ticket to the Bahamas.
He is in the middle of 10 days of radiation therapy in an effort to shrink a blockage, about 4 centimeters, in his right lower lung, Gorman said.
Outside a simulation room, where Tesner had CAT scans taken the day before his first radiation treatment, Peggy clutched her breakfast — a cup of sausage and cheese. It was a long weekend. She had slept at home, caring for the dog and cat, but spent the prior night at the hospital after Tesner told her he wanted her there.
"He said, 'I just want it to be over,'" Peggy said, her eyes moist. "Because I don't."
Chemotherapy remains an option, but not right now, since Tesner isn't strong enough. Nausea and vomiting also are side effects of treatment.
Cancer itself can kill an appetite, Gorman said.
Tesner wants treatment — "I got to do that. Otherwise, I'm going to die. Quicker." — but is quick to stress that his quality of life is more important.
He already gave hospital staff strict instructions in the event of a crisis: Do not resuscitate.
He wears the three letters — DNR — on a purple band around his wrist.
