Patient and physician navigate the world of cancer

David Kram and Tim Haarmann

There are some days you remember with absolute clarity. For 14-year-old Tim Haarmann and David Kram, M.D., that day is Monday, July 8, 2013. It was Dr. Kram’s first day in Doernbecher’s fellowship training program for physicians specializing in childhood cancers. It was the day Tim learned the cause of his fatigue, frequent nosebleeds and bruises. The path ahead was unclear, but they would travel it together. 


When life changes in an instant 

Tim started feeling tired around Memorial Day. He was getting nosebleeds that lasted for hours and unexplained bruises that wouldn’t heal. Tim’s mother, Susan, looked up his symptoms on the Internet: leukemia. They made an appointment with Tim’s pediatrician for the next day, hoping he would tell them it wasn’t cancer. “Once you say the word, you can’t ignore it,” said Susan. 

“That Monday was pretty crazy,” recalled Tim. “In 12 hours I went from a normal summer, playing video games, whatever, to having everything totally change.” 

Blood tests confirmed that Tim did, in fact, have leukemia—a rare and aggressive form of the disease called acute myeloid leukemia. Dr. Kram and Linda Stork, M.D, head of Doernbecher’s Pediatric Hematology/Oncology division, went to Tim’s room to talk with the family. 

“When they gave us the news,” said Susan, “I remember looking up and seeing tears in Dr. Kram’s eyes and thinking, he gets it. I felt like he understood that there was more than the medical aspect to how this was going to impact our family.” 
Three days after being diagnosed, Tim started his first round of chemotherapy. 

A team of caregivers 

While Dr. Kram was the central figure throughout Tim’s treatment, an extensive support team was involved in every aspect of his care. A social worker helped the Haarmanns find the words to tell friends and family about Tim’s disease. Doernbecher volunteers came to Tim’s room almost daily, offering conversation or a game of cards. Food service staff offered to make Tim’s favorite meals when he insisted he wasn’t hungry. 

It was clear to me that Dr. Kram was sharing information with the whole team so that everyone could care for Tim,” said Susan. 

Between that July day and Christmas, Tim went through four rounds of chemotherapy, each treatment followed by days or weeks resting at home. He spent 130 days in the hospital. He missed his first semester as a freshman at Jesuit High School in Portland but he began his second term with his leukemia in complete remission. 

Fellowship prepares future leaders 

Dr. Kram’s fellowship, funded by Kiwanis Doernbecher Children’s Cancer Program, requires that he spend one year overseeing the clinical team in the 21-bed pediatric oncology unit, while also caring for patients and rotating through other specialty clinics. He’ll spend the next two years in the research lab, conducting experiments on cancer cells and testing drug therapies, as well as continuing to see patients. “This field is moving so very, very quickly, so a goal of the fellowship is to train us to help push the field forward, and that happens through research,” Kram said. 


As the Haarmanns learned to navigate the world of cancer, so did Dr. Kram. The opportunity to apply every aspect of his training to Tim’s care is a lasting gift. “They’re a family who is really invested in things bigger than themselves,” Kram said, “and they were invested in being part of my education, too.” Tim is just glad to feel like a regular teenager again, playing sports and kidding around with friends. “I don’t take things so seriously now. I’ve seen how bad things can get, so the little things don’t faze me.” 

The family’s gratitude is immeasurable, according to Susan. “The care we received at Doernbecher saved our son’s life,” Susan said. “We feel extremely grateful to have such a quality children’s hospital in our backyard. We want this here for anyone who needs it.”