When Brian Zikmund married Naomi Fisher in 1992, they wrote their own vows in the form of a promise: I promise to share with you in times of joy as in times of trouble. Although the Zikmund-Fishers’ Quaker matchbox marriage has brought much joy, it has also seen its share of trouble.

In 1998, Brian was diagnosed with myelodysplastic syndrome, a form of pre-leukemia that causes bone marrow to function improperly and fail to produce blood cells, especially, in Brian's case, clot-making platelets. To save his life, in 1999 he received a bone marrow transplant from an anonymous donor through the National Marrow Donor Program (www.marrow.org).

When Brian was diagnosed, Naomi was six months pregnant with their now 4-year-old daughter Eve. Over the next year, Brian received regular platelet transfusions drawn from approximately 100 units of blood. A healthy person’s platelet count is between 150,000 and 350,000, but Brian's was 19,000 when he was diagnosed, and it soon dipped below 10,000. The entire family had to relocate for 4 months from Pittsburgh to Seattle for the transplant itself.

To take control of the situation, Brian confronted his uncertain future, which included the possibility of his death.

“I had to face hard questions about my future while still trying to enjoy my daughter. I made videotapes of me for her just in case. I wrote letters to her," he says.

With the success of the transplant, Brian says today he’s 99 percent recovered and off almost all medications. He’ll always have to monitor his blood to watch for a possible relapse, but he has a normal life expectancy.

“I’m not so sure who had the harder task," says Brian, praising his wife on how she handled the situation in Seattle. “I was all drugged up. All I had to do was lie in a bed and get well. We were 2,000 miles from home, living with my parents who came to Seattle to be with me, and we had a toddler."

This fall, Brian will begin a postdoctoral position at the Program for Improving Health Care Decisions, a joint program of the Ann Arbor Veterans Administration Medical Center and the University of Michigan School of Medicine. “I want to use my experience to help communicate complex medical decisions to patients," he says.

Naomi’s Jewish faith helped her through this period. “I had absolute faith that I was not being punished. From Judaism, I’ve learned I have a religious obligation to make the world a better place," says Naomi, who is an elementary school vice principal. Following that belief, Naomi and Brian established the Brian Zikmund-Fisher Fund for DR Typing (www.bzffund.org), which funds a detailed form of tissue typing of potential stem cell donors so that the patient-donor matching process can be quicker and more efficient.

BMT InfoNet (www.bmtinfonet.org), a national marrow transplant support organization, recently published Naomi’s book Across the Chasm: A Caregiver’s Story (BMT InfoNet, 2002). “As we dealt with Brian’s illness, I sent e-mails to all my friends and family. This book is based on those e-mails, showing how our family dealt with Brian’s illness on a day-to-day basis," she says. All book proceeds go to the Brian Zikmund-Fisher Fund and BMT InfoNet.

At their 10-year Swarthmore reunion, the Zikmund-Fishers coordinated a bone marrow registry event on campus and typed 105 people through a simple blood test. “That’s a lot of people," Brian says. “We usually get 30 or 40." They also raised $500 in donations to help cover the cost of the tissue typing.

Dealing with a life-threatening condition gives the Zikmund-Fishers a renewed perspective on what’s important in life.

“Family life matters. Enjoying each day matters. Being locked up in my career doesn’t," Brian says. “My life is not a tragedy. It’s my life. Dealing with this looks absolutely enormous, but you take it day by day. And we deal with it. End of story."

—Audree Penner