A teacher’s troubled road: one man’s battle with Crohn’s disease

Photo by Phil Long

It is 11:15 p.m. Tuesday, Nov. 18, and 25-year-old Neil Smithe is still hunched over his desk, working on the finishing touches for tomorrow’s lesson plan. It is his last week of full immersion at Fraser Wood Elementary, where he has been teaching a grade four class. “The PDP (Professional Development Program) is tough,” he says. “But I can’t slow down. I’ve got this class for one last week. I’ve worked so hard to get here. I just really need to take it home strong.”  A twinge of pain creases the edge of his smile as he talks. He reaches for the small bottle of pills he keeps on his desk, swallows one, and continues working.

Crohn’s disease is an inflammatory disease that can affect a patient’s gastrointestinal tract anywhere from their mouth to their anus. It causes the body’s immune system to target and attack segments of the gastrointestinal tract, resulting in tiredness, weight loss, fever, diarrhea, and severe abdominal pain. Less common symptoms can include arthritis, anemia, open sores and bowel obstructions. These issues are difficult to deal with on their own, but they also hamper a patient’s immune system and increase the possibility of bowel cancer. Though the disease is treatable, there is no cure yet. Crohn’s usually begins to exhibit itself between the ages of 15 to 30.

Smithe was 23 when he began to notice something was wrong.

In 2012, Smithe was almost done a history degree at SFU. He also worked as a lifeguard and swim instructor at the Surrey Sports and Leisure Complex. He was making good grades and was one of the highest requested instructors at his pool. But in early February, he started feeling sick.

“I remember being really confused. I was busy, with school and with work, so I wasn’t working out or eating all that well. But I was losing weight. I was keeping some crazy hours, but they weren’t anything too out of the ordinary. I was tired all the time. People told me I was getting old, or I was burning out at the end of my degree; but something just didn’t feel right.”

I wasn’t myself, but I had no idea what was going on. – Neil Smithe

Smithe’s grades started to slip. It was harder and harder to pay attention in class and, when he got home, he had no energy for homework or studying. It also affected his work. He found it harder to concentrate on guarding the pool and his temper grew shorter. One day, he fell asleep on the Skytrain on his way home from school. He rode the train from one end to the other and back again, missing his shift completely.

“It was embarrassing! And it was frustrating. I wasn’t myself, but I had no idea what was going on. People started to ask me if I was okay.  It’s strange how the people around you can notice you’ve got a problem before you do yourself,” he said.

Smithe barely made it through the spring semester of 2012, scraping by with the worst grades of his university career. His supervisors were getting frustrated with him. Parents were complaining that he was missing so many days of work; their children never knew if they were going to have their normal swim instructor or a substitute. His fatigue was getting worse. In early May, 2012, the pain began.

“The semester was done so I was trying to get back into working out. It started as a dull pain in my abs, but it wouldn’t go away and it took on this radiating quality. It got so bad that I had to stop going to the gym, but the pain didn’t go away. It got worse. Then I started having diarrhea. That one came on quick. Right off the bat it was almost on a daily basis. That was when I really started to feel like something was wrong,” he said.

Smithe finally went to a doctor in late May.

The problem with Crohn’s is it is difficult to properly identify. The most common symptoms can be indicators of anything from a poor diet to irritable bowel syndrome to Behcet’s disease. It is often passed off as a lesser issue at first and is only investigated further after multiple visits and tests. When Smithe’s doctor gave him a clean bill of health, it was standard protocol.

“They told me ‘lots of rest and liquids’ and sent me on my way. That was that. And I was happy with that. That’s exactly what I wanted; a quick and easy fix. That’s what anyone wants to hear from a doctor.”

That was the worst summer of my life. – Neil Smithe

The pain continued and intensified. Smithe knew he was not healthy. By July 2012, he had visited five doctors and specialists in search of answers. He underwent three colonoscopies, by choice. Blood samples were taken and radiological tests were done, but no one could provide him with an answer.

“That was the worst summer of my life. I spent more time in hospitals than at work. Literally. At the end of the summer I had a sit down with my boss. They asked me, ‘Are you ok?’  I said, ‘No.’  They asked me, ‘Do you think you can still work?’  I said, ‘No.’  They shook my hand and told me if I ever need help not to hesitate to ask.”

Smithe quit his job in September 2012, and only took one course at SFU that fall. He devoted himself to finding out what was wrong, to finally getting an answer. He visited three more doctors but none of them could give him anything conclusive. He was angry, confused and battling the early stages of depression when he finally met Dr. Chang.

“Dr. Chang was working out of Royal Columbian at that time. I remember meeting him for the first time and explaining my situation. The first thing he wanted to do was another colonoscopy. I was sceptical. They aren’t pleasant, and they hadn’t given me any answers before. But he said to me, ‘If you let me look in your butt I will tell you what is wrong.’ I kid you not. That caught me off guard, but for whatever reason it made me kind of trust him.”

That question, ‘What’s wrong with me?’, took a year; but the answer is going to take the rest of my life. – Neil Smithe

Dr. Chang performed Neil’s fourth colonoscopy in November 2012, close to a year after Smithe first presented symptoms of Crohn’s. The procedure revealed snake-like ulcers in his bowels, which the doctor diagnosed as Crohn’s disease.

“Honestly, it was a bit of a double-edged sword. It was such a relief to finally understand what I was up against, but Crohn’s is with you for life. This is a huge part of who I am now. What if I pass it down to my kids? That question, ‘What’s wrong with me?’, took a year, but the answer is going to take the rest of my life.”

In November of this year, Smithe is living with his disease. A delicate diet and an army of pills and medication keep him as active as he can be. He finished his history degree in the fall of 2013 and was accepted into the spring 2014 intake of SFU’s PDP program for elementary school teachers. He works covering the reception desk at Cloverdale Arena to pay his bills until he finishes his program and can find a full-time teaching job.

At 11:45 p.m. on Tuesday, Nov. 18, 2014, Smithe finally closes his binder. Inside are the final lesson plans he’ll write for his grade four class and the crafts for the surprise game he has planned for Friday, his last day. He walks to his bathroom, brushes his teeth and swallows the pill he has to take before falling asleep.

“Yeah, it feels like I’ve been through hell,” he said. “And yeah, it’s something I’m going to have to deal with for the rest of my life. But I feel like it’s made me more resilient, you know? I’ve proven that I can get through it, that I can deal with it. And trust me, any of the crap a fourth grader tries to throw my way is just going to pale in comparison.”