Chemotherapy, Then the U.S. Championships, for Gabriele Grunewald
Gabriele Grunewald stepped onto the track as the dying light of day yielded to periwinkle evening.
She and her fellow world-class runners walked single file, hair tied in ponytails, to the starting line at the annual Prefontaine Classic, one of track’s premier events. The women were a lithe pack, and it was difficult to pick out Grunewald. I identified her by the purple half-moon scar that stretches across her abdomen.
The runners toed the starting line, the crowd fell silent, a gun sounded and they were off.
Grunewald is not the world’s fastest 1,500-meter runner, although she is competitive and fierce down the stretch. But on this warm May evening, she slipped to the back, her stride choppy. Coming out of the final turn, she scrunched her face and summoned a burst, neck straining and legs pumping. She caught an Australian runner, nipping her competitor by half a second, but finished ninth out of 10.
She came to a stop by a couple of us reporters. Her face broke into a rueful smile. “I was kind of in the race, even if I wasn’t really,” she said. She rolled her eyes at this spin, admitting, “It was borderline embarrassing.”
“It’s just kind of rough. That shadow keeps sneaking in.”
That shadow is long and deep.
Grunewald has a rare metastatic cancer. Nine months ago, surgeons cut a large tumor out of her liver, which left that scar. They have found two new tumors there. Less than two weeks after the Prefontaine, she began daily chemotherapy sessions. This is her fourth bout with cancer. She turns 31 this month.
To receive a serious cancer diagnosis is to feel an overpowering desire to retreat within and to try to block out the chirpings of your mind. Grunewald made the decision to crawl out.
She talks about her disease in the way of a stream tumbling down a mountain. She has a website and a Twitter feed, and she encourages supporters to contribute to research on this cancer.
Candor will not banish fear. But it does give her a sense of agency.
“I’m a young adult with cancer,” Grunewald said. “I don’t always love talking about it. It’s not a made-for-TV movie. It’s real. It’s scary.”
She gives and she receives, and that helps. “I love when people reach out to me, because it helps me get out the door.”
We walked to a tent behind the grandstand. Not so long ago, her life story formed a sweet narrative with a Rocky curlicue.
Grunewald grew up in tiny Perham in Otter Tail County, a three-hour drive northwest of Minneapolis. She rode the bench in basketball. Running, even as temperatures dropped to 10 below and ice formed on her lips, was her freedom.
“Small-town politics could make team sports a headache,” she said. “Running was all about you.”
Grunewald claimed her only state title in her senior year and made the University of Minnesota track team as a walk-on. Her first year, she met a lanky marathon runner. He talked with her, and was so shy she wasn’t sure if he was flirting.
“She was standoffish,” the marathoner recalled. “She will say she pursued me. If so, she did it very indirectly.”
Across endless weeks running 65 miles, Grunewald became a serious contender. As a fifth-year senior in 2009 — she obtained a master’s degree in public policy — she got off to a fast start in the racing circuit. Then she felt a tiny cyst below her left ear. She had it checked out and fielded a call on Good Friday in a hotel lobby in Tempe, Ariz., where she was in a track meet. You have adenoid cystic carcinoma, a rare cancer, the doctor told her.
She felt a flutter of panic. She talked to herself: You’ll be O.K. You’ll be O.K. The next day, her coach suggested she skip the race. She shook her head and ran a personal best of 4 minutes 22 seconds in the 1,500 meters, known as the metric mile.
Just 1,200 cases of this incurable cancer are diagnosed each year. A website dedicated to the disease describes it as following a “relatively indolent but relentless course.” Words catch your attention when you have cancer. “Relentless” stayed with Grunewald. Eighty percent of those who have the cancer make it to five years without recurrence. Then it often returns, commonly in the lungs. Over all, the 15-year survival rate is 40 percent.
Grunewald had surgery and radiation. Strands of her sandy-brown hair fell out, and she got a skin burn. Three months later, she began running, and oddly, her times got better. It seemed that cancer had stripped away the fear of failure that lopes after her like a hound.
“It’s like I lost all excuses for not pushing myself to reach my fullest potential,” Grunewald said.
She became an All-American the next year, turned pro and obtained a shoe sponsor, Brooks, which in women’s track is worth between $30,000 and $50,000. In 2011, she finished in third place nationally in the mile. To the extent that journalists mentioned her cancer, it played as a feel-good tale in her rearview mirror. She never believed that.
“I knew it was there during all those years,” she said. “I kept trying to push it out of my mind. I tried to convince myself: ‘This is not my life.’”
In October 2011, doctors diagnosed thyroid cancer. The good news was that it was a common cancer, as opposed to the deadlier one. Grunewald underwent surgery and doses of radioactive iodine. Running was her daily meditation.
Throughout, she leaned on that marathoner she had met her freshman year, Justin Grunewald. That is not to say that time was easy for the couple.
“I was slightly nuts,” she said. “I kept telling him, ‘I don’t want you to stay with me just because this is a sad story!’”
He kept shaking his head. He was all in. A few years ago, he took an engagement ring to the Prefontaine meet. She had a bad run, so he pocketed the ring and asked her later. She said yes.
Grunewald finished fourth in the 2012 United States trials, narrowly missing a trip to the Olympics in London. In 2014, she had the fastest time among Americans in the 3,000 meters. She kept going to get CT scans of her lungs. Clear, clear, clear.
The 2016 Olympic Trials brought disappointment. Weeks later, Justin gave her a morning hug. He felt a mass.
“Your stomach feels funny,” he told her.
Her head felt as if an alarm had gone off. To have cancer is to live with two neighbors: hypervigilance and denial.
“I had been feeling a weird tingling feeling down there,” she said, “like heartburn in the wrong place.”
Late that night, they drove to an emergency room and got an X-ray. Adenoid cystic carcinoma had crept back into her body, and there was a large lesion on her liver. Surgeons removed half her liver.
She shrugged again, smiled again. “I was hoping it would not come until I was 40. I wanted to get a little more of life in first. I wanted to have children first.”
“It is metastatic, and that is scary,” she said later. “You can’t smile that away.”
Grunewald returned to practice runs last winter. Nothing came easily. She would stop in the middle of a run, spent and shivering, and her husband, who trained with her, would sprint ahead to get their car and drive her home.
Life became more precarious this spring when doctors discovered two new tumors in her liver. She found a doctor at Memorial Sloan Kettering Cancer Center in New York who has made his career out of fighting this disease. The Grunewalds met with him a week before the Prefontaine.
“He doesn’t look at me like I’m a dying person,” she said. “You can tell when doctors look at you like that. I don’t think it’s my situation, and even if it is, it’s not helpful.”
Neither Gabriele or Justin has use for pretend. They know the nature of their enemy. Grunewald will complete her chemotherapy regimens and then perhaps a clinical trial.
“It gives me hope,” she said. “Hey, maybe we can get this under control. And I can turn one year into another and I can have a long life.”
Grunewald is not certain how long her body will accommodate a battle with an aggressive cancer and professional running. She had planned to stop after the Prefontaine for chemotherapy. Instead she has kept running while getting chemo. (A medical waiver from the sport’s governing permitted her to take two steroid pills after surgery.) She hopes to run in the United States Championships late this month in Sacramento, where daytime temperatures can top 100 degrees.
I do a poor job of hiding my surprise. She gives that shrug. “I’m relentless or insane,” she says. “I can’t pretend that I’m fine because I’m not fine, ya know?”
There is silence, and she said: “This is the hardest thing I’ve ever done.”
She excuses herself. She has postrace stretches and a cool-down run. Her husband and I talk as cool fingers of night air descended from Eugene’s hills. He is an internist in his final months of his residency; he knows disease and its paths. He tried to focus on being a husband.
“I’m an emotional guy, and if I dwell on it nothing good happens; I wouldn’t get out of bed,” he says. “I just want to spend every minute of my life with this girl I love so much.”
We shake hands, and he steps around the edge of the tent to find his wife.
I walk down an alley that exits on the far side of the practice field. I look back. It is near midnight, and the sky is backlit by the Milky Way. Across the field, Gabriele and Justin jog together, her ponytail bouncing. They talk and laugh and lean in toward each other, lovers with thoughts for no one else in the world.