I won’t lie, this year's review has not been one that I’ve been looking forward to writing, but one that I’m sure I’ll appreciate looking back on.

This year, I’m actually avoiding usage of my classic FORD acronym (family, occupation, recreation, dreams), since there’s only one thing that truly stood out this year:

Family

This year was a challenge for the Bean family. On January 5th, my youngest brother, Evan, was diagnosed with Acute Lymphoblastic Leukemia after feeling achy and fatigued throughout December. Blood tests revealed the unimaginable, and within an hour of the results, he was hospitalized for what would be the first of many month-long stays.

January was a whirlwind; we consulted numerous oncologists and hematologists to find the best care team, coordinated work schedules to provide support, moved his belongings out of his East Lansing apartment, and disenrolled him from what was going to be his final semester at Michigan State.

At the same time, my wife Audrey faced severe abdominal and thoracic endometriosis, becoming bedridden. For those unaware, endometriosis occurs when tissue similar to the endometrium (note: NOT endometrial tissue itself) grows outside the uterus and causes adhesions. In her case, lesions affected her bladder, intestines, kidneys, liver, and diaphragm, and led to repeated catamenial pneumothoraces (cyclical collapsed lungs).

We sought consultations at top hospitals like Cleveland Clinic, Mayo Clinic, and the University of Michigan, but faced frustrations. Many surgeons were hesitant due to the complexity of her case; some proposed open surgery or avoiding the liver, which was her most painful area. Finally, in February, we met with a world-leading NYC surgeon specializing in endometriosis & excision. Impressed by his empathy and expertise, we scheduled her surgery for his soonest date (and my birthday): May 15th.

Those four months were among the most difficult of my life. I spent my days working from the University of Michigan Motts Children’s Hospital or caring for Audrey, whose pain remained relentless. Even with maximum doses of NSAIDs and narcotics, she suffered greatly and was often immobile, needing to be carried up and down stairs.

Audrey’s surgery on May 15th went well, although admittedly not exactly as expected. Even with the extent of her images, no one expected the disease to be as progressed as it was. After they were done, Dr. Raccuia, the hepatologist, described it to me as looking “like a bomb went off in there. Like someone sprayed a hose of crap all throughout her abdomen”. As a result, Audrey spent 4 days in the hospital and was discharged (back to the New Jersey Airbnb) on May 19th. I was provided with a thumb drive of Audrey’s surgical footage, and Audrey’s organs were quite literally glued together in so many places that it is no wonder the amount of pain she felt. She often described the pain as “stitching”, as if someone sutured her organs together, and whenever she would bend, lean to the side, or even try and put her arms above her head, she would feel those stitches rip. And she had felt that pain for years as her liver, kidney, and uterus were adhered to surrounding entities.

Unfortunately, on May 21st, we went back to Jersey City Medical Center after Audrey came down with a 101.4 fever. We would come to find out that Audrey had another pneumothorax and required a second chest tube. 4 days later, on May 25th, we planned to be discharged from the hospital, only for Audrey to come down with a 102.7 fever. After days of the hospital physicians looking for the source of infection and Audrey enduring 103+ fevers, 140+ heart rates, and excruciating symptoms, we would find out that she had fallen victim to a liver infection. During the surgery she suffered a hematoma on her liver which was then packed with Surgicel. Fluid collections are a normal expectation with the given result, however these fluid collections can become infected. Unfortunately in Audrey’s case, hers had become infected with an antibiotic resistant bacteria. We would spend the next 10 days in the hospital with a tube draining fluid from her liver and trying a variety of antibiotics, until ultimately being discharged for good from Jersey City Medical Center.

It is truly difficult to capture the strength Audrey has. To feel the debilitating pain she has for years, with no medical professionals believing her, as her organs are twisted and tied together and we pray for relief, requires more strength than I can even imagine. And when she finally catches a glimpse of hope, to then have to spend 17 of the next 20 days in a crummy hospital bed, being poked and prodded every 4 hours, having 2 chest tubes, 1 liver tube, 4 antibiotic trials, dozens of IVs and blood pulls often with no end in sight; I simply cannot overstate how strong she really is. The way she handled the entire situation was incredible and a testament to the strength of the woman I love with my entire existence. She is a warrior.

I additionally believe a lot of the problems with endometriosis cases (even those not as extreme as Audrey’s) stem from misinformation across both healthcare providers and friends and family. So let’s spread some truth for a bit. Endometriosis is NOT a menstrual disease: there are prepubescent girls who suffer, there are post menopausal women who continue to suffer, and there are women who have had hysterectomies/oophorectomies who continue to suffer. It is NOT the lining of the uterus growing on the ovaries: it is a chronic inflammatory disease, where endometrium-like material grows in problematic locations. These endometriomas can appear in various places, and from them spawn a glue-like tissue that ties everything together (I have screenshots from the surgical footage, if you’re curious what it looks like). This is why choosing a top surgeon is pivotal — if an endometrioma is missed, the disease rapidly returns. Unfortunately, no one knows the true cause of endometriosis, because it is under-researched. This year, $29M will go into endometriosis research, a disease affecting 10-20% of the female population (low end estimate). A comparison point is $2B will go into diabetes research, which impacts 10% of the overall population.

In June, we were grateful to return home, slowly improving and managing to eventually walk up and down the block. Unfortunately, her infection returned, and by the end of June, we found ourselves back in the hospital—this time local. After four days, she had a port placed in her arm, which began 56 consecutive days of daily antibiotic infusions.

Throughout this period, Evan’s repeated chemotherapy rounds proved unsuccessful, and he underwent a bone marrow transplant in August. His transplant was successful, but he suffered many complications as a result. Most significantly, he suffered from Venous Occlusion Disease (VOD), which causes blood vessels in the liver to clot. At its worst, he gained 63lbs of fluid, and with his diaphragm displaced as a result, his lungs were squished to the size of tennis balls. These were terrifying times when the ICU doctors prepared us for the worst. My heart still breaks when I think back to those moments, especially being with my parents in the hospital—my 60-year-old father, with his criminally bad back, sleeping on the floor of the waiting room just to be near his boy, while my mother slept in that same ever-so-comfortable hospital reclining chair.

It was around this time I saw a tweet (sorry, an X?) that resonated with me throughout this period:

Not the most refreshing sentiment, and one that I truly started to live in fear of. Nothing was preventing my life from continuing to spiral downhill (especially with regards to my brother’s/wife’s health), and that had become quite evident.

Audrey had her midline port taken out in September, and we celebrated that with a trip to Italy with 2 of our closest friends. When we returned, we found out my sister-in-law is pregnant with the first "Grandbaby Bean", due in May, and the bigger surprise was discovering Audrey herself was pregnant with our first child. We recently found out it’s a girl, and our excitement knows no limits.

After 11 days Evan made it out of the ICU, and after 60 days straight in the hospital, he returned home in October. We got results that showed the transplant was an overall success, and on the day before Thanksgiving we got news that his last bone marrow biopsy showed no residual cancer. We’re so grateful and truly fortunate.

The trials and tribulations of this year showed us the community we had. I had friends who work brutal and backbreaking manual labor jobs, for little past minimum wage, send us Doordash gift cards. We had friends order cookies from fancy NYC bakeries, and others send us tacos from our favorite taco place in Austin (didn’t even know you could do that!). I had friends in NYC offer to drop me off clothes/food when we were in JCMC for literal weeks on end. Friends would drive from hours away just to join me on hour long runs, and we received just infinite amounts of texts of support from friends throughout the year. Life is all about the community, and I’m thankful for and love all of you.

I doubt there will be a year that I don’t carry some form of this trauma with me. My mom and I have frequently said how we still live in fear of the other shoe dropping, as if there is no other possibility than for something else to go wrong. But the opposite of the tweet (er, X) above is also possible: it’s entirely possible for your life to start going uphill and then simply continue going uphill forever. For all of us, I hope that is the case. Happy New Year my friends, may I see all of you many times and may we have more joyous times than we know what to do with.