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He's Having Fun Blasting Away at Lung Cancer With a Five-Foot Rifle

By Ken Wells
September 03, 2014 6:39 PM EDT 46 Comments
Tom Galjour on the weight bench at his apartment in Houma, La.
Photographer: Ken Wells/Bloomberg
Tom Galjour on the weight bench at his apartment in Houma, La.

(Corrects spelling of the word Porsches.)

“Let’s go shoot Savannah,” Tom Galjour says as we bounce along in his vanilla-colored Dodge Ram pickup. He’s at the wheel. We’re on a sleepy blacktop road meandering through a sprawl of sugarcane deep in bayou country outside of Houma, Louisiana, where Galjour lives.

It’s an adventure riding with Tom. An oxygen machine pings from his cluttered back seat, supplying the clear-plastic cannula looped over his head and fixed to his nostrils. He soon trades it for a nebulizer, giving himself a breathing treatment as he steers one-handed.

In case you’re wondering, Savannah isn’t a person. It’s Galjour’s affectionate name for his gun and, well, not just any gun. It’s a single-shot, bolt-action ArmaLite .50-caliber rifle. It weighs 35 pounds and is almost 5 feet long. Equipped with a scope, it shoots a projectile that breaks the sound barrier.

Skilled military snipers have used .50 calibers to pick off enemy combatants from more than a mile and a half away. It can penetrate 6-inch concrete walls, no problem, and pierce light armor. Galjour is supplying these data points with deadpan glee. He paid $4,000 for Savannah back when he had money and every shell he fires costs three bucks, but so what?

“Savannah,” he says, “could stop a gorilla -- not that I’d want to do that.”

Galjour is strictly a target shooter and a good one. He once plunked a golf ball with Savannah at 200 yards.

Cancer Boredom

Tom, 64 years old, loves Savannah and in a way Savannah is returning the love. She provides an element of amusement and purpose in the fight of his life. “It’s boring just having cancer,” says Galjour, a psychologist by training, as he pulls onto a dirt road cutting through the land of a friendly farmer who lets him shoot on his property. “If you can’t have fun while having cancer -- what the hell.”

More than 2 1/2 years ago, Galjour, a chain smoker, was diagnosed with Stage 4 metastatic small-cell lung cancer exacerbated by emphysema. He was given a few months to live at best. Spots peppered his lungs and tumors had spread to a kidney and wrapped around his bronchial tubes like fat strangler vines. An initial round of chemotherapy shrunk the tumors yet left him weak, his immune system compromised.

Walking from the drizzle into an air-conditioned house, he soon developed double pneumonia. He’d wasted to 88 pounds and in October 2012 lay in a Houma hospital at death’s door. Then, Tom simply declined to die. And now, numerous of his friends say, he has a huge grudge against his cancer -- and no plans to give in.

“He decided he would learn all he could about his cancer type and then he would do everything he could to kick its ass,” says Judge Jude Fanguy, who presides over Houma City Court where Galjour once counseled juvenile offenders.

Bayou Friends

Tom and I have known each other since 1968, when we were college classmates back on the bayous. We talked philosophy, played pool, dated Cajun women and drank a river of beer together. We lost touch for a long stretch and then reconnected about four years ago. He has let me inside his battle to beat his disease and I’ve caught up with him less than two weeks after his latest round of chemotherapy and 30 doses of radiation.

Over the course of a week, Galjour’s strategy reveals itself. He supplements his conventional treatment with intense research, healthy eating, a dash of alternative medicine and a physical regimen that would test many healthy men. To that you can add an implacable will, a dry sense of a humor and a small web of friends who share his understanding that a goodly part of the battle against cancer is defeating fear, depression and isolation.

Survival Odds

Only 2 percent of patients diagnosed with his form of cancer survive five years. More than halfway there, he intends to be one of those -- even as he has no illusions about what he’s facing.

“You want an analogy?” Galjour says. “I wake up every day in the ring with a 6-foot-4, 240-pound heavyweight. I can’t afford to miss many licks -- he’ll take me out.”

Tom brakes the Dodge under the sprawling, moss-draped branches of a handsome live oak tree. We have a target to take out.

He slides from the truck and peers across a fallow field, pointing to the trunk of a previously scouted dead tree more than a quarter mile away. “I’ll shoot first and you can use my shot as your target,” he says.

Savannah, which he keeps in a sturdy black metal case padded with egg-crate foam rubber, requires some assembly. It’s mid-afternoon, 85 degrees, breezy, the air a swamp of humidity. Tom, separated from his oxygen, coughs sporadically as he works but his breathing is fine. During what he calls his “bad breathing days” he sometimes gasps for breath so loudly that he could be mistaken for a bear grunting in the woods.

Hot Rifle

Savannah takes his mind off of such things. “I take care of you now, don’t I baby?” he says as he snaps the rifle together.

I’m expected to fire, too, and Tom is giving me some pointers. “We’ll be shooting from a prone position,” he says. “Pull her up hard on your shoulder. The kick’s not worse than a 12-gauge shotgun. But Savannah has no safety. Once she’s hot, she’s hot.”

He hands me some black padded ear muffs.

“I’ll send the first one,” he says. “When it hits, the tree should shake.”

Tom, reversing his purple Louisiana State University baseball cap, lies flat on an army-green mat he’s spread out on the grassy apron of the field. He clanks in a 6-inch brass-jacketed shell, covering his head under a sniper’s shawl to block out distractions.

Savannah Explodes

He’s under there for a long time, siting in, still as the day moon when Savannah explodes, belching a tongue of fire.

Even with ear protection, I’m not prepared for the shock wave that follows. I jump, almost dropping the camera I’m holding. I notice leaves in the oak above me are quivering. A few flutter down to the ground.

The target tree, had it not been dead, would certainly be dead now. It’s shaking like Elvis’s hip.

Tom nods in satisfaction.

I grew up hunting with shotguns and small-caliber rifles near these very same fields. Still, I suddenly have doubts about firing Savannah –- she’s a beast.

Am I going to back out now? Of course not -- Tom would never let me hear the end of it.

I find myself down on the mat, peering through the scope. I eject Tom’s shell and put in mine, slapping the bolt shut. Savannah’s armed and there’s no turning back now.

Big Blast

I scope out where his bullet hit. I’m a tad nervous but I take a deep breath and try my best to pull the trigger nice and slow.

“Kaboom!”

The blast rattles my brain.

I’m thinking: “Did I just fire a cannon?”

The recoil sends the scope to nick me above the right eye, drawing blood. I don’t care. The tree, 8 inches in diameter, is shaking again.

Tom hands me a tissue he’s fetched from the truck. I stanch my wound as Tom goes to Savannah and peers through the scope. “Damn, you hit it right above where I hit it,” he tells me.

He’s elated. Galjour likes it when his friends do well.

In the truck returning to Houma, Tom says, “Did you notice that my breathing was better when I was shooting -- I didn’t need oxygen?”

A couple of days back, Tom had schooled me on an important fact. Fighting cancer requires celebrating the small victories. They supply oxygen for the elixir called optimism.

“Yeah,” I tell him. “I noticed. That’s big.”

A Determined Killer

Lung cancer is a determined killer. Almost a quarter of a million new cases are diagnosed annually in the U.S. and about 159,000 Americans will die this year.

Ted Owens, an oil company logistics wrangler who thinks of Galjour as his brother, remembers the day it almost took Tom.

“He called me to drive him to the hospital. When I saw him he was blue, his fingertips were blue,” says Owens. “He was gasping for breath like a fish. Air starvation like nothing I’d ever seen. It was painful to watch. I thought it would be the last day I would see him.”

So did the doctors at Houma’s Leonard J. Chabert Medical Center. “He has hours, maybe days but certainly not weeks,” an attending physician told Owens. As his condition worsened, the protocol was pretty straightforward -- a one-way trip to hospice eased by a generous prescription of morphine. “Give him all he wants,” the doctor said.

A hospice counselor was on standby and a priest had come and gone.

‘It’s Time’

Holly Smith Galjour, Tom’s ex-wife, remembers a call from Owens saying, “You better come, too -- it’s time.” And in the background, she heard Galjour, rousing himself from the edge of one of the darkest places he’d ever been, saying, “Time? Time for what?”

Though he was drifting in and out of consciousness, Galjour remembers that moment as one of molten anger as he ripped away the monitors that corralled his arms to the hospital bed and demanded to be sent home. “This is bulls--t!” he thundered as nurses came running.

Galjour refused hospice. He went home with Owens, who nursed him as best he could. Tom remained weak, emaciated, and semi-conscious for several days. He wouldn’t take the morphine except for now and then to dab a little on the tip of his tongue. Owens still doubted he would make it.

Human Suffering

“He was in so much grief that at one point I wished he would die,” says Owens. “I know that sounds horrible but I just didn’t want him to have to go through any more. I’ve never seen a human being suffer so.”

Then one day, maybe two weeks past his hospital discharge, with Owens at his bedside, Tom arched his eyebrows and said, “Hand me my guitar.”

“I couldn’t believe it,” recalls the 49-year-old Owens. “He said, ‘Screw this, I’m just not ready to go today.’ He said ‘Help me up.’ I could tell he even looked perkier.”

And now? “It’s hard to believe,” says Owens.

He laughs. “The guys at the office will ask, ‘How’s your friend who has cancer?’ And I have to say, ‘Actually, I don’t see him that much. He’s out and about, running around or visiting his girlfriend.’”

Almost daily since recovering from the initial shock of his diagnosis, Tom spends some time on the Internet seeking insight into his disease. Like many cancer patients, he’s aware that each day he survives could bring medical advances that help his chances of surviving even longer. Beneath those bleak lung cancer statistics lie what cancer experts see as promising developments.

Genomic Science

Researchers have been using the science of genomics to chart mutations tied to tumor growth in the most common form of lung cancer, known as adenocarcinoma, and a rarer type, called squamous cell. The goal is to deploy existing drugs or develop new ones, called targeted therapies, capable of shrinking or killing tumors by turning off the growth-signaling mechanisms that are stuck in the on position. To date, the work has identified 18 key mutations in adenocarcinoma tumors and 11 such mutations in squamous cell.

Lung cancer specialists have also begun to show increased interest in what are called “exceptional responders” who stage radical comebacks against lethal cancers, particularly those who achieve remission when taking drugs that don’t work for the vast majority of patients.

Cancer Survivors

World-class cancer centers such as Memorial Sloan-Kettering Cancer Center in New York and the Dana-Farber Cancer Institute in Boston have begun to process the genomes of these survivors, hoping to learn whether they possess gene variations that can help others by leading to new treatments, better targeted therapies or the revival of drugs once deemed failures. A survey of U.S. clinical trials shows that one in 10 patients respond well to experimental medicines that end up being rejected for approval by regulators, according to the National Cancer Institute.

Galjour’s small-cell variety is the most aggressive of all lung cancers, accounting for 10 to 15 percent of diagnoses and thus far the least studied in terms of its genetic profile. The explanation, says Dr. Bruce Johnson, a small-cell specialist at Harvard University-affiliated Dana-Farber, is that small-cell presents a slighter research pool and a dearth of actual tissue to analyze for genomic studies because most small-cell biopsies are done quickly using endoscopes that pinch off a tiny bit of tumor.

What research has been done so far shows small-cell has a complicated genome whose mutations are “heterogeneous and myriad” and more challenging to crack than the less complex non-small-cell varieties, says Johnson.

Next-Generation Sequencing

Dana-Farber is tackling that issue with new technology, known as next-generation sequencing, that lets them analyze small-cell tumors with as little as 1/200th of a teaspoon of tissue -- so the game of cracking the small-cell code is on. “With small-cell, we are just getting around to the first step of trying to map out” the genomic mutations that in turn could provide targets for drugs, says Johnson, who has authored a number of papers on long-term small cell survivors.

Advances in non-small cell give researchers confidence that the small-cell puzzle is ultimately solvable. Already non-small cell has a half a dozen gene-based therapies, including three in pill form, that can be thrown against it. Many of these have proven highly effective when used in combination with chemotherapy.

For small cell, what’s called combination chemo -- usually two chemotherapy agents given simultaneously -- and radiation are still the go-to treatments. Galjour, who has studied both types assiduously, is keenly aware of the gap. “When I run into people with non-small-cell,” he says one day, “I tell them to take their pills and not to worry so much.”

Pumping Iron

Lacking a pill for small-cell, Tom decided he needed to shore up his conventional treatment with his own unorthodox offensive. That means pumping iron.

“I’ll be honest with you my friend,” Tom tells me. “This one is going to hurt. I don’t know if it’s going to come off -- but I’m going to try.”

Bare-chested, a stars-and-stripes do-rag decorating his head rendered bald by chemo, Galjour is leaning forward on a black padded weight-lifting bench, a study of abject concentration. A yellow and black oximeter, a device that measures his blood oxygen level, decorates Galjour’s left index finger. It’s his constant companion.

Cancer Bills

The bench is in a small room with dim white walls and a beige tile floor cluttered with books, medical charts, unopened gallon jugs of water and paper towels still trapped in plastic wrappers. This is his sanctuary within the cramped rental apartment where he lives alone on Houma’s east side. This is all he can afford.

Cancer has also ravaged his bank account. In better times, Galjour lived in a three-bedroom house in the country on 6 acres. He’s been forced to surrender his therapy practice because of the potential side effects on his mental acuity of chemotherapy and his other drug regimens. At Chabert Medical, an affiliate of the well-regarded Oschner Health System in New Orleans, he’s on a system called Free Care, awaiting a Medicaid designation.

Free Care, which Galjour calls “a lifesaver,” has picked up tens of thousands of dollars of his bills, though he estimates he owes well more than $100,000 in charges racked up before the system kicked in.

240 Pounds

In the solace of his weight room, Tom is able to put such issues aside. He lies back on the bench. Hands spaced wide, he grips the object above him, a barbell on a rack holding an imposing hodgepodge of plate-shaped weights. A slow arc of time flutters by when abruptly he rips the barbell from its rest, straightening his arms and letting the weights dip down before thrusting them back on the rack. This act of clanking violence consumes about five seconds.

He sits up, his faced boiled red by exertion, panting loudly. Recovery is aided by an asthma inhaler, yet it comes with a smile that exudes both serenity and defiance. “Two-hundred-and-forty pounds,” Tom says. “That was easy. I’ll be damned.” This is a step up from 220, which had been his previous post-cancer best.

“Brother,” I tell him. “You’re the Incredible Hulk.”

He smiles and nods. “Now, I’ve got to go for 260,” he says.

Galjour is 5-foot-10. At 150 pounds, he’s gained back most of the weight he’d lost. He sports a swimmer’s legs and a wrestler’s torso. His feat, coming four months short of his 65th birthday, might be considered remarkable for his age and size -- never mind collateral issues.

‘Dread Week’

“Mr. Galjour,” says his oncologist, John Kennedy, “is an unusual character.”

Dr. Kennedy is a lanky man, better than 6-foot-3, with fashionably cropped brown hair and a youthful, almost boyish look. We’re in his utilitarian office on the fourth floor of Chabert Medical for Tom’s regular monthly check up.

Galjour is strikingly poised -- most of the time -- about his cancer, yet this appointment has made him jittery. We had visited the emergency room here on a late Sunday morning, two days before, so a nurse could draw blood. He likes to avoid the ER on busy days when germy people are about. Catching somebody’s cold could be a death sentence.

Tom calls these Sundays the portal to “dread week” since the blood work is about spotting markers that could indicate his bronchial tumor is growing again. Momentum is everything and the momentum has been going Tom’s way.

Doctor Decision

He looks forward to seeing Kennedy personally because Kennedy has a laid-back manner and yet Galjour believes the oncologist appreciates what Tom brings to the battle each day. “He has my back. I feel like he has a plan for every eventuality,” Tom says.

Before his last round of treatment, and weeks before I’d decided to write about his illness, Galjour had called me to tell me about Kennedy’s decision, in consultation with a radiologist, to up his radiation doses from 20 to 30.

Tom has an Ivy League IQ and formidable vocabulary. He can talk knowledgeably about stem cell theory. Don’t get him started on particle physics and subatomic convergence. Yet he exudes the swagger of a welder with whom you’d probably not want to tangle, speaks in a roux-thick Cajun accent and drops f-bombs like a rap star. It’s a disconcerting combination.

Mortal Combat

So this is Tom, in the way he is wont to do, paraphrasing to me over the phone Kennedy’s 30-dose approach: “I like this guy’s f_ing attitude. He told me, ‘Tom, you don’t look like a guy who has cancer. You look like a f---ing guy who can take it.’ He talked about my tumor and said, ‘You know, the idea is to kill that son-of-a-b-tch, not just shrink it.’”

Tom paused and then said, “Kill the son of a b---h! Now we’re talking.”

Framed as mortal combat, Tom is all in.

Before we slipped into Kennedy’s office, Galjour had his vitals taken. A nurse was running him through a litany of standard questions.

It was hard not to perk up at one series.

“Are you sexually active?”

“Yes.”

“Men or women?”

Tom rolls his eyes. “Women. Well, woman, singular.”

The nurse smiles. They’ve been through this drill before.

“I hear you’re swimming,” Tom says.

“Yeah,” she says. “I’m trying get in shape, lose my fat butt.”

“Don’t do that for me. I like it,” Tom replies.

This time she rolls her eyes and then laughs.

Blood Work

On this day, Tom’s dread of dread week is for naught.

“Your blood work looks good,” Kennedy tells him as we settle into Tom’s appointment. “There’s nothing there to indicate anything we should be concerned about.”

Galjour is visibly relieved. They talk strategy. Galjour needs to be reunited with his asthma doctor. And sometime in the not-too-distant future, Kennedy will order a PET scan that will be their first look at how the bronchial tumor has fared under the latest bombardment. The trick is to time it for when the radiation will have done all its work.

Tom, thinking the scan was imminent, says he sees the logic in waiting. Whenever it takes place, it will be a big day.

“You know,” he tells Kennedy, switching gears, “I racked 240 this week. I can see doing 260.”

Kennedy, who has a personal stake in the broader fight against cancer -- he’s lost a relative and a close friend to the disease -- nods and smiles. He looks at Galjour and says, “Whatever it is you’re doing, you should keep doing it.”

The Girlfriend

Back in the truck after the appointment, I ask Tom about the girlfriend.

She’s from New Orleans and he sees her now and then. “I go online to a site, Plenty of Fish,” he says. (It’s free.)

He’s upfront about his cancer and it doesn’t appear to be a turnoff -- he could have lots of hook-ups if he wanted them. He himself has a rule. “If I see a widow, I don’t go there. If they were in bad relationship all the bad stuff will come out and if it was a great, loving relationship, there’s no way anything new will ever come close to what they had.”

Later, I ask Kennedy about the role of optimism in cancer treatment in general and Tom’s case in particular. Recent medical research finds little correlation between survival rates and “fighting spirit.” Still, at least one 1999 study of 578 U.K. breast cancer patients indicated that those suffering depression and feelings of hopelessness had higher relapse and death rates than patients who didn’t.

Attitude Helps

In the trenches, anecdotally at least, attitude sometimes seems to count a great deal. Kennedy tells the story of one of his own patients who far outlived his early prognosis and whose central trait was his happy, upbeat disposition. He thinks Tom’s attitude, to push and stay engaged in the world and in his treatment, is unquestionably helping him.

“From the start, he’s shown a huge amount of interest in his own case,” says Kennedy, a Louisiana native who studied medicine at LSU’s New Orleans medical campus. “This isn’t a guy who’s just going to lay down and die. His rebound has been remarkable.”

Besides, Kennedy says, no other patients bring him stories of pumping iron, shooting a giant gun and blasting golf balls at 200 yards. “I look forward to more,” he says.

Mules and Psychology

Thomas Alton Galjour was born in 1949 on the banks of Bayou Lafourche in Larose, Louisiana, about 50 miles southwest of New Orleans. He was the only son in a family of three children. His father was a whip-smart, tough-as-nails farmer and his mom a special education teacher.

Tom remembers working cattle, baling hay and hauling feed sacks around the 80 acres of pasture from about the time he could walk. He liked the farm life well enough but it was isolating and his head was always brimming with ideas and questions for which his father had little patience.

Galjour’s smarts allowed him to skip grades in school but they never earned praise from his demanding dad. The Galjour home had plenty of books, trending to the classics. Tom, in a spirit of rebellion, learned vocabulary by sneaking away to a friend’s barn to read his comic book collection.

Galjour graduated from South Lafourche High School, a tough place full of the sons and daughters of shrimp boat captains, fur trappers and oil field roughnecks where formal education wasn’t always life’s highest priority. He enrolled at Nicholls State College (now a university) in Thibodaux, 35 miles from home. Probably not 20 percent of his high school class would go on to college.

College Friends

That’s where we met -- bootstrapping sons in families that had never produced a college graduate. He decided to major in psychology after observing a farm neighbor who had trained his mules to follow instructions in Cajun French. The world of the mind, and its motivations, was as alluring to him as outer space.

In my senior year, I was dating the best friend of the woman who would become Tom’s first wife and we hung out a lot. At Nicholls, Galjour frequented a place called the College Inn, back then known for its cheap alcohol, good live bands and regular fist-fights in the parking lot.

Tom was in a few of those, including one in which a guy about twice his size spiked him on chain link fence, causing Tom, who had been an amateur boxer, to finally get mad and punch the big oaf into a bloody pulp.

Into the Scrum

I wasn’t there but I would never doubt a Galjour fight story. Tom saved my hash at Nicholls. In my only foray into politics, I got elected student body president. A tiny contingent of liberal-leaning kids had put up some anti-Vietnam war posters. A bunch of frat guys and jocks started tearing them down.

I was just trying to mediate and soon found myself surrounded by the sign destroyers, who were not taking kindly to my efforts. I was probably a couple of minutes away from a thrashing when Tom and some of his South Lafourche buddies waded into the scrum and surrounded me.

“Something bad is gonna happen here,” I recall Tom saying, as he pulled back his then long hair, pointed at my antagonists and glared. “And it won’t be to us.”

We were well outnumbered but the mob soon dispersed.

When I ask Tom later if he remembered the episode, he says, “Yeah. I’m pretty sure two of those guys remembered me from the College Inn. That’s why they backed away.”

“Oh, really?” I reply. “I thought it was the crazy-ass look in your eyes.”

Tom is hugely amused by this.

Generous Heart

Galjour got his bachelor’s in psychology in 1971, went to work and in his spare time earned his master’s from Nicholls in 1977. During that time, he did stints as a state child protective services and probation and parole officer before signing on as a public school counselor.

In 1978, after four years in the school system, he went into private practice as a therapist. For a while, he was president of the regional mental health association and recalls once squiring around TV psychologist Joyce Brothers at a convention. He also landed a contract with the City Court of Houma to counsel juvenile offenders.

“Tom has a very kind and generous heart,” says Judge Fanguy, who supervised Galjour’s work back then, “but he also slices right through the b.s. He deals with people the way they are, no pretense. He was also willing to try different things because all kids are different.”

Unorthodox Approach

In one case, Galjour, counseling a teen arrested for illegal drug use, suggested, in the presence of the boy’s parents, that he do more drugs. In the outcry that ensued, Tom explained that “you clearly haven’t reached the point yet where it gets scary -- where people are threatening to kill you or extort you because you owe them money for drugs.” The shock got everyone’s attention.

His private clients attest to his lack of orthodoxy. His friend Ted Owens, a three-tour Army marksman who got Tom into target shooting, first met Galjour when he sought counseling for his failed marriage.

“I’d busted up with my first wife and it had torn the guts out of me. I didn’t know a soul in town so I was looking for a counselor,” says Owens, an army-and-oilfield brat who was born in Oklahoma but moved frequently before settling in Houma. On a recommendation of a friend, he went to see Tom, walking in with a hang-dog expression.

Billiards Therapy

Owens stops and gathers himself for a remarkable impression of Galjour’s Cajun accent. “Tom tells me, ‘I can tell you right now, you’re a big boy. And if you’re coming in here looking for a f---ing hug, you’ve come to the wrong place.’” And then he smiled.

Owens still cracks up at the telling of it. “I loved him from that moment on,” says Owens. “We talked and after a while he said, ‘Brother, you don’t need a counselor. You just need time to heal.’”

“You’re going to drive because I’m going to drink,” Tom tells me as he hands me the keys to the Dodge.

It’s late afternoon and we’re heading to the High Tide, a place on Houma’s west side that resides somewhere between dive bar and pool hall, for a meeting of the League of Extraordinary Gentlemen. It’s Tom’s confederacy of billiard playing friends. He swears he started the club long before the movie by that name debuted.

We’re kitted out: Tom’s oxygen bottle, his nebulizer, his Advair inhaler, his albuterol inhaler, his $1,200 Meucci pool cue.

18 Medications

I’ve seen Tom’s list of the 18 medications he’s on, including Vyvanse, a mood and energy elevator, not counting the over-the-counter supplements he takes. But if he wants a beer, which is part of his pool-shooting routine, I’m going to buy it. I’m with Dr. Kennedy. Whatever Tom’s been doing, he should just keep on doing it.

Galjour doesn’t do anything halfway. He’s studied billiards as hard as he’s studied psychology and his cancer. “There are 99 pool shots,” he tells me. “If you learn them all, you can put the ball anywhere you want to. I shoot for the perpendicular bisector of centers of balls that are in clusters and then you can tell where every one of those balls is going. People look and go, ‘Lucky shot’ and I say, ‘It’s not luck.’”

Billiards fills the same social space as Savannah -- it offers camaraderie and cheer and gets Galjour out of his gloomy apartment. “Tom’s a different person at the table,” says his longtime friend David Cannon, who is a member of the Extraordinary Gentlemen and who helps Galjour run errands from time to time.

Marriage Saver

Cannon, 66, now retired and who races old Porsches as a hobby, is another testament to Tom’s power as a counselor. “By the way, he saved my marriage long ago,” Cannon tells me.

In candid moments, Tom will nod toward his doubts and fears -- how could he not? He isn’t conventionally religious but he believes in God and has had a recurring dream -- of a dark, explicitly evil presence trying to claim him and a beneficent presence counseling him to resist. It’s a metaphor for his struggle.

Getting up every day is work. Fatigue is a constant issue. “Mornings are the worst but I only experience fear when I’m alone,” he says. “With my real friends, I can feel myself charging up……I have thought about suicide. But if I even mention that so I can talk about it in relation to what I’m going through, my friends go crazy. It’s like I do not have permission to die. They expect me to beat this…I think it’s reasonable for me to ask them, ’How long do you expect me to beat this?’”

10-Year Survival

And then he tells me the story he’s heard of a man with small-cell lung cancer who lived for 10 years.

“If you do the math on that,” I tell him, “that would take you pretty close to normal life expectancy.” (Tom will soon be 65. Life expectancy for U.S. males is 76.)

“Yeah, it would,” he says.

Tom’s not exaggerating about the number of people who are forbidding him to die. He’s been married five times -- twice to Holly Smith -- and Holly prays for him constantly. Tom helped to raise Smith’s two daughters by another marriage and they all remain on friendly terms. Holly helps Tom sort out his medical records and straightens out his laptop when he can’t get online or open attachments in e-mail.

Holly was present for one of Galjour’s weight-lifting sessions and she told me, “Tom looks better now than when we were married. It’s his gift -- to heal. It’s what the doctors keep telling him. ’We can’t explain how you’ve gotten to where you are.’”

Remarkable Stories

No one in the small-cell cancer battle wants to peddle false hope. Yet there are remarkable stories. Dr. Johnson at Dana-Farber has a small-cell patient cancer free after 23 years. True, he was diagnosed with his cancer confined to his lungs. Yet Johnson has seen quite a few metastatic patients who have lived five to ten years or longer.

We pull into the High Tide parking lot. I carry Tom’s gym bag with his oxygen machine and nebulizer. In the beery dimness, Tom orders a Miller High Life and then goes to plug in his equipment near a pool table close to an electrical socket. He takes a sip of beer and gives himself a breathing treatment.

We shoot alone for a while, the table lit up by a purple Bud Light awning that matches Tom’s purple LSU ball cap and his purple-and-gold LSU Tigers T-shirt. I haven’t played pool in years and Tom is giving me running tips. When he shoots, he’s all business. When he’s not, it’s something else -- he’s relaxed and happy.

Advair Time

At 6 p.m. he stops -- it’s Advair time. The inhaler eases his emphysema and asthma symptoms but at a cost. He takes a big puff and goes down hard on one knee in a spasm of coughing that lasts so long that I wonder if he’s in trouble. He isn’t. He rises and returns to the table.

Tom plays well and makes one shot that is so outrageous -- the cue ball hopping over another ball, smacking its target into a corner pocket and then reversing like a dervish to a stop in perfect position for the next shot -- that I accuse him of voodoo. The next day, though, all Tom wants to talk about is how well I shot, pointing out my four-ball run.

Before I leave Houma, Tom will rack 260 pounds on the weight bench.

He calls me a week or so later, panting heavily. I wonder if something is terribly wrong.

The Fighter

“No, I’m on my bike.”

“What bike?”

“The white Mongoose I bought at Wal-Mart.” He’s pedaled close to a mile already. He’s counting out his oximeter oxygen-level readings to me. They’re in the high 90s, meaning very close to normal -- hard to reconcile for a guy with lung cancer and emphysema.

“You work hard, brother,” I tell him.

“Yeah, I know.”

I later figure out that it was another form of training. Tom has a daughter, Gabrielle Galjour, from his third marriage. She’s 25 and living with a family in Arkansas. She’d been expecting a baby, Tom’s first grandson, and he was born Shelby Broyles on Aug. 15.

Tom, after refilling his oxygen bottles, hopped in the Dodge and made the drive alone. He texted me a picture of him holding the baby.

He had shared an earlier e-mail from Gabby, as he calls her, that further explains his determination. “No one can beat this but you can Dad,” she said. “You’re a fighter like nobody I know, come on, fight. Please.”

Tom says, “It doesn’t give me much choice, does it?”

To contact the reporter on this story: Ken Wells in New York at kwells8@bloomberg.net

To contact the editors responsible for this story: Elyse Tanouye at etanouye@bloomberg.net John Brecher, Angela Zimm

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