“You are not going to die.”
Jana Cranwell has a vivid memory of the day she heard those words.
“I can still hear his voice,” she said of Dr. Harry McCoy, the Blacksburg oncologist who delivered the good news. “I can see his face.”
It was 2012 and Cranwell had just had surgery for breast cancer when she found McCoy.
“One thing I had known about him before I talked to him was that he told the truth,” Cranwell said. “If you were dying in two weeks, he would tell you.”
She first heard of McCoy when he treated her husband’s aunt, who died of terminal cancer. It was McCoy who told her she had only weeks to live.
About three years ago, “I heard him tell my mother. And, I don’t know, there’s no one else I would have wanted to have heard those words from other than him,” Cranwell said. “He’s just such a comfort. He was just, I don’t know, I just love him. When I see him, I want to hug him.”
For Cranwell, she said it came down to caring.
“I’ve been around so many doctors that I just don’t like,” she said. “They may know their stuff, but you know, they’ve got terrible bedside manner. They’re jerks. They’re rude. They talk over you. They don’t listen to what you say.
“And [McCoy] comes in there, and he looks you in the eye,” she said. “He is about 6 inches from your face and talks to you and explains everything. When I see him, I leave thinking that he just truly cares about me.”
Until February, Cranwell saw McCoy every six months. But on her next visit to Blue Ridge Cancer Care in Blacksburg, she won’t see her favorite oncologist.
“I will miss him every time I have to go,” she said.
It was in February, McCoy, a well-known cancer doctor in the region retired from BRCC, where he had worked for more than two decades.
“I always tell my patients, there’s a little voice inside, and you need to listen to it,” McCoy said. “And to my surprise, the voice popped up in my chest one day and said, ‘You know, I think it’s time for you to stop now.’
The doctor double checked.
“Really? You sure?” McCoy asked the voice.
“Yeah,” it said.
On reflection, McCoy decided the voice was right.
Now 64 and for the first time in more than three decades free from carrying a pager, he’s considering what to do next. While he hasn’t ruled out a second act in medicine and will keep his license active, first, he’s going to get to know the family tractor.
His daughter, horse trainer and Spanish teacher Corrine McCoy said she plans to put her dad to work at Meadow Ridge Stables, which she owns and operates with a business partner.
After her father’s years of hard work, Corrine said, “I’m happy for him.”
It’s time, she said, that he was able to do some things other than medicine.
Filling in checkboxes
At BRCC, McCoy was known among the staff for dispensing a daily dose of corny jokes and his reliance on a “huge” jar of M&Ms he often prescribed to staff and patients, practice manager Cathy Alcorn said.
His leaving has left a hole for the staff, she said. “But we’re all happy for him. He definitely took on the role of the leader here. He was always known for coming in really early and staying really late. He was also the last person here at the office, so he put in a lot of hours.”
While there is no replacing McCoy, in the wake of his departure, Alcorn said BRCC is bringing two new oncologists on staff.
For McCoy and his cohort of oncologists, it’s been a revolutionary time in cancer care.
McCoy said he has seen enormous leaps in technology and treatments during his 35 years treating patients. He and his colleagues have gone from having about 30 drugs to treat every kind of cancer to uncounted new therapies, some of which are very effective.
Worldwide, cancer is the second leading cause of death, according to the National Institutes of Health. But since McCoy began his training in the 1980s, rates of cancer mortality have declined significantly for many forms of the disease.
Overall, cancer deaths decreased by 20% from 1980 to 2014, according to NIH.
But other changes have been less positive.
“Given everything that was going on, the way medicine’s practiced …maybe it is the younger doctors’ role,” he said. “They’re okay with spending more time on the computer and doing the checkboxes and doing this stuff that I find menial and not rewarding.
“I like to sit and talk to people and enjoy being with them and getting to know folks,” he said. “But medicine seems to be moving away from that.”
While McCoy used computers in his practice and even treated some patients via telehealth during the pandemic, Cathy Alcorn said “he was best face-to-face with patients … he wanted to sit down right across from them, you know, and examine them and then talk to them.
“And, I always said that if Dr. McCoy walked by a desk and there was a computer on it, that computer would jump off the desk and break,” Alcorn recalled with a laugh.
McCoy’s not alone in his frustrations with computer-assisted doctoring. Dr. Michael Williams, associate director for clinical affairs at the University of Virginia Cancer Center. He teaches medicine at UVa and is lead physician for its oncology service.
Many experienced oncologists are moving out of private practice, Williams said, especially as computers have entered the exam room and administrative tasks have ballooned.
“It’s a real distraction from where we want to spend as much time as we can with them [patients],” Williams said. “And I’m hoping that we’ll sort of be able to evolve back to something where there’s a little less intensity in the administrative side of things.”
Williams has especially followed McCoy’s career. Not only has Williams seen some of McCoy’s patients, who came to UVa for clinical trials and specialized treatments, but the men have a long history.
McCoy was one of Williams’ medical students.
“It’s been fun to see a former student who develops into such an outstanding clinician, and just really practices the highest quality hematology-oncology,” Williams said. “Everybody was always just so complimentary of his thoroughness, and just how engaged he was and making sure they were well taken care of.”
The admiration is mutual. McCoy credits his student work with Williams as a profound influence on his career.
“I got to work with him for a month, and at the end of a month, I said, ‘That’s the guy I want to be,’” McCoy recalled. “After working with Mike, he was such an inspiration and such a mentor. I always credited him with putting me on the track.”
Life without a pager
A native of Norfolk, McCoy graduated from the University of Virginia School of Medicine in 1985 and in 1992 completed residencies in internal medicine and hematology-oncology at the University of Florida.
He and his wife, Kate, a physician and Martinsville native then came to Salem for Harry to take a job with LewisGale. In the 1990s, he took over a small Blacksburg oncology practice that was later folded into Blue Ridge Cancer Care.
Kate, who the couple decided would stay home with son, Bo, and daughter, Corinne, told him early on she wasn’t moving again, McCoy said. Blacksburg was it. They’ve been here ever since.
“She’s a large reason I was able to do what I could do. It was because of her, you know, supporting me. I don’t know what I would have done without her,” McCoy said. “She deserves a lot of credit.”
Oncology has a high rate of physician burnout and can be hard on doctors’ families, Williams said. It’s a demanding specialty that requires practitioners to be constantly on call. That can make it hard to relax and enjoy a dinner out or a movie.
“I’ve been a doctor about 35 years. And I was thinking to myself, this is the first time since 1985 I have not been on call,” McCoy said. “What a relief not having a pager.”
But McCoy said he loved his work and misses his patients. What some might think looks from the outside like depressing work, he insists is anything but.
“You know, it doesn’t get more real than dealing with people that have cancer. There’s something about that word that changes your life. You’re not the same person,” he said. “But what I found was, that doesn’t mean it has to be bad. If anything, it’s honest. It’s real. You have intense, really deep conversations with people. And you get to know them, and you develop relationships that are unbelievable.”
A dedicated proponent of palliative care, early in his New River Valley career, McCoy worked in hospice. And over the years, he helped ease the transition for many terminal patients and their families.
“Sometimes I felt like a priest,” McCoy said. “Because people wanted to tell you stuff that they wouldn’t talk to even their family members about. Being that person to be able to help them work through things was so important.
“And, boy, we laugh and joke and just appreciate everything,” he said. “People think it’s depressing. Well, yeah people come to an end, and there’s sadness. But it’s not depressing.”
And, with cancer, pain and discomfort often can be controlled. Studies show that many cancer patients, even those who are terminal report higher quality of life over the course of their illness than some with other chronic diseases.
“We look at people that have, let’s say, emphysema, or chronic heart disease, and we look at their quality-of-life scores, and they’re not high like that because they’re always sick,” McCoy said. “They’re always short of breath, are always having chest pain.”
But cancer can be different, he said. A lot of people do get cured. Then there’s the group for whom treatment keeps the disease in check, and they live their life and do the things they want to do.
Then there are terminal cancers where “we know that the disease is going to take their life … because you can’t stop it. And those groups need more help than anybody, to just support them, to help them get through it, to find whatever peace they need to find and make certain that they’re free of pain and free of suffering,” McCoy said. “That is incredibly rewarding. It’s tiring – on some days.
“But, I tell you, people let you into their lives in ways that I don’t know how to describe sometimes. Some of my best mentors have always been my patients,” he said. “I mean, the people, the patients, they teach me more than anything, to see their resilience, and their ability to ... do things and to get through things.
“It makes you think about life, sometimes about spirituality, about all kinds of things,” he said. “People are much more than we give them credit for sometimes.”