MIAMI COUNTY — In a little brick building on the north end of the county, Piqua Family Practice has operated for many years, serving thousands of residents from throughout the upper Miami Valley area. Despite a roster of physicians that have come and gone, one who has been a steady mainstay at the practice is Dr. Robert C. Landes, MD.
Recently, Dr. Landes announced his retirement from the practice, a decision which came on the heels of an extended medical leave.
“I had decided long ago that family medicine was what I wanted to do,” Landes said. “It was a given fairly early for me.”
Landes grew up in Fairview Park, Ohio, west of Cleveland. He graduated from the University of Cincinnati with a degree in Biology, and was then accepted to The Ohio State University, where he completed medical school.
“I was in the Air Force ROTC program, and they had a scholarship for health professionals. I did my residency in Cleveland, and in 1983, I went into the air force and worked at bases for them for seven years. Essentially, that service paid back my loans.”
Following a two-year stint at a practice in Delaware, Ohio, Dr. Landes came to Piqua Family Practice in August 1992, where he practiced full-time with several doctors until 2016.
According to Landes, his experience in Piqua and Delaware differed greatly from the Cleveland area.
“When I left Cleveland following my residency, it was when University Hospital and Cleveland Clinic really started their push,” Landes said. “There was a cap put on how much medical stuff you could build that expired, and that’s when this explosion happened. From a healthcare standpoint, they were far more aggressive on expanding their systems.
“Throughout the rest of my career, we didn’t face that. Things were status quo for a long time. Our area is filled with creatures of habit. People live here until they die, and the memories are very strong here. In a more changeable environment like Cleveland, people come through to move to different careers, but people stick around here. A more stable environment isn’t right, wrong, or indifferent, but it does make things more consistent.”
Landes said while a family practice was always right for him, it isn’t for many other professionals.
“To get a private practice family physician now is tough to do, because they’re trained more to be part of a corporate setting,” Landes said. “A lot of physicians want a bigger city, or at least think they do. In my more recent years, my wife and Dr. Lorenz’ husband served as our managers. It was helpful that they were there, because we were so proactive.”
During his years as a full-time practitioner, Landes was able to take his skills abroad, attending several medical mission trips to empoverished countries.
Landes expressed a love for the eclectic nature of his patient roster, who came in from counties all over the Miami Valley.
“I’ve always been a newborn-to-death kind of guy,” Landes said. “Having different kinds of people kept it fun. I had great interactions with everybody, but I loved it when I was able to see children. It’s just a whole different interaction with kids. If I could make it so that a child would look at me and smile as they left, I felt like I’d done okay.”
As Landes approached retirement, he and his staff began to shop the practice to local buyers.
“We talked to many hospitals, but most weren’t interested because of our location,” Landes said. “Premier had the best set-up, because they own UVMC, which has been our primary hospital the whole time I’ve been here, so we came around to an agreement.”
Despite a retirement plan being put into place, things shifted for Dr. Landes when in September 2016, he was diagnosed with cancer following a bout of telltale symptoms.
“That summer, I was having trouble with fatigue,” Landes said. “My endurance wasn’t as good. I was taking more naps, and I had to take more breaks than usual. In September we went to Canada, and I started coughing. We went on a fairly level hike and I couldn’t go more than 50 feet without having to stop and catch my breath. I couldn’t keep up with my wife, which is unusual.
“After my sweats started to saturate the bedding, my wife took me in to the emergency room.”
Doctors in Canada checked Landes’ oxygen saturation levels.
“Normally you run in the mid-to-upper 90s, and that’s where I typically ran,” Landes said. “Since I wasn’t at great altitude, I should’ve been there. I was at 86 percent. They did a chest X-ray, which was just flat-out ugly; it had all sorts of junk on it.
“We came back early, and I saw the doctor here. I thought it was an infection; there’s some fungal things around here that can be nasty. He sent me down to get a CT scan and the radiologist quickly called back. You know then that they’re seeing something.
“Dr. Donnelly, the pulminologist at Upper Valley, did a pulmonoscopy and found lymphoma. The biopsy showed it. Typically with lymphoma, you can find it in the lymph nodes without having to go into the lungs, but they did. We started chemotherapy about a week later.”
Dr. Landes’ official diagnosis was diffuse poorly differentiated B-cell lymphoma.
“Because it had completely filled my lungs, it was considered Stage 4,” Landes said. “Stage 4 is not good. The risk of recurrence with treatment was still over 50 percent. I went through six rounds of treatment with one doctor using something called mexotrexate, which was meant to prevent brain metastasis from happening. We think the brain was clear at the beginning.
“PET scans use a radioactive sugar isotope to highlight major organs, but it doesn’t show the head very well. PET scans at the end of treatment were clear; we thought we were in good shape, so I went back to work.”
In March 2017, Dr. Landes started back at Piqua Family Practice part-time, until a new health complication arose in June.
“I came into my house, my wife spoke to me, and I just wasn’t there. I don’t remember any of this; I lost a couple of days. It turned out there was something in the brain.
“You have a fluid system in your brain that allows the spinal fluid to flow. If you block it, you have a dam. That’s what I had, and it was causing increased pressure. We knew from that point that primary chemotherapy didn’t do what it was supposed to do. The next step was to go to allogeneic stem cell transplants; we set that up for August.”
Landes detailed the treatments as an arduous and trying process.
“The way it works is kind of like a dialysis, where they hook you up to a fancy doodad and take the stem cells out of the blood stream,” Landes explained. “All the immunities I’d built up were gone. I responded well to the treatment, but by the end, I had new lesions in the brain.”
Landes expressed that in January 2018, his health hit its lowest point.
“All heck broke loose,” Landes exclaimed. “In January, my oxidation was down to 66 percent. The only time I’ve been near that was at 14,000 feet in the Andes. I probably wasn’t thinking straight not wanting to go back to the hospital, but the doctor insisted I did. Doing that saved my life.”
Dr. Landes is now completing a ten-treatment course of whole-brain radiation at the James Cancer Hospital in Columbus.
“Basically, they zap your brain to try and get as much of the disease as they can,” Landes confirmed. “The brain’s the biggest issue. The rest looks pretty good right now.
“There’s so much I don’t know, but obviously there’s a lot I’ve been exposed to and learned. The bigger deal is that I’m still here, I’m still upright, and I still have options. My strength is definitely improving.”
Landes exclaimed that despite the difficulty of the experience, he has received a great lift from his faith and the support of family, friends, and the community.
“This throws me into an area of disability that I never thought I’d be facing,” Landes admitted. “Due to the complications, I’ve definitely gotten into a disability perspective, and that’s hard for me.
“I’ve always been a doer. Not being able to do bugs me. One of the hardest things is walking away and knowing I probably won’t be going back to it.
“However, God’s in control, and turning it over to Him has been important to me. Everyone’s prayers have been a great encouragement. There’s been a lot of support. My patients have been my rock.”
This week will see hallmark occasions for the doctor, as Wednesday, March 14 will bring his birthday, followed by an open house retirement event planned with family, friends, co-workers, and patients from 2-5 p.m. Sunday, March 18 at Upper Valley Community Church, 1400 Siedel Parkway, Piqua. Landes indicated that ahead of the open house, he is juggling feelings of both joy and sadness.
“It truly is both,” Landes said. “The event will give many of my patients a chance for closure. I think that’s important, and it’s something that I know many doctors don’t get with their patients.”
When asked about feelings he wanted to express to the community, Landes immediately went to gratitude.
“Thank you would be a big part of it,” Landes said. “People have allowed me into an intimate part of their life that can be very fragile. Their support has been phenomenal, so I did something okay with that privilege. Being open to change may be tough for a lot of folks, but hopeful we can adapt together. I’m thankful for the opportunities people have given me to touch them, and for them to touch me. It’s not a one-way street.”
Dr. Landes continues to reside in the Miami County area with his wife, Deb.
Reach Cody Willoughby at firstname.lastname@example.org.