San José, Costa Rica, since 1956

Finding Joy: Despite rare cancer diagnoses, U.S. expat couple takes the time to waltz

From the print edition

Six months ago, when the doctor first discovered the tumors, he offered a wager to Bill Fischer. If there was one thing to be sure, these lesions were not related to neuroendocrine cancer.

Fischer should’ve taken the bet. The shock wasn’t that Fischer had cancer – it was that his wife, three years ago had been diagnosed with the same disease. 

The rare cancer affects only 100,000 people a year. The oncologist, Joao Bautista, said the odds of a husband and wife both having neuroendocrine cancer were so small that they were incalculable. 

“Nobody thought cancer was contagious,” Fischer, 71, joked. “But I caught it from her.”

Bonnie Fischer, nearby, laughed at the remark. The Fischers enjoy each other’s sense of humor. Also like any couple, they bicker from time to time; all the same, they would rather not have to deal with neck braces and walkers. The sickness brought drastic changes to their lives in Costa Rica, where they’ve lived for two decades. The two have a caretaker, Dian Lindsey, who drives and cooks for them. But the couple appreciates that they’re in this fight together. 

“I couldn’t have survived if I didn’t have him,” Bonnie, 69, said. “And now I’m taking care of him,” she later added.

Medical Tourism 2

Bill and Bonnie Fischer met in 1986, when both were enrolled as patients at the University of California-Los Angeles in the United States.

Gabe Dinsmoor

The Fischers sat in a room on the second floor of the Costa Rican Oncology Institute in La Uruca, a northwestern district of San José, waiting for an appointment with Bautista. According to the Fischers, their doctor has been a lifesaver for them, but punctuality has never been his specialty. In the waiting room, the couple retold their story.

A different malady first brought them together in 1986. At the time, both were enrolled as patients at the University of California-Los Angeles in the United States   for the skin condition psoriasis. One day, the head nurse at the facility came up to Bill and told him in no uncertain terms that a patient named Bonnie wanted to meet him. 

“The rest was history,” Bill said.

Bill Fischer, a former Columbia Pictures executive, was awestruck by the dynamic woman who owned a jewelry and bead store in Los Angeles, which catered to Hollywood wardrobe designers. 

On one of his visits to her shop, Bill remembers watching his hockey idol, Wayne Gretzky, leave with a small paper bag filled with $18,000 worth of beads. The jewels would adorn the wedding dress of Gretzky’s soon-to-be wife, Janet Jones, at the Canadian equivalent of a royal wedding.

The Fischers had their own wedding five years later in Costa Rica. It was the second marriage for both. They had enjoyed Costa Rica during trips to visit Bonnie’s son, J.J., who worked in the north-central canton of San Carlos teaching English to employees at the luxury volcanic hotsprings resort  Tabacón. When J.J. decided it was time to go back to the United States and attend graduate school, Bill and Bonnie started a new life in Costa Rica. They moved into a two-story house in Rohrmohser, a western San José neighborhood. Bonnie served two terms as president of the Newcomers’ Club in Costa Rica. Bill answered an ad in The Tico Times looking for part-time work at a local Ace Hardware store – in a few months, he became the manager. 

After grad school, J.J. met his future wife, who he married at the Ocotal Beach Resort in the northwestern province of Guanacaste. J.J.’s wife, Zeda, who speaks Urdu, Farsi, Arabic and Hebrew, joined the U.S. Foreign Service, and her language skills took them across the world, including posts in India and Israel. 

Each member of the family carved out a tranquil existence in different countries. Then, the cancer surfaced.

In 2009, Bonnie and Bill vacationed in Israel, visiting J.J. and his wife. Throughout the trip, a pain seemed to be bugging Bonnie’s lower back. She received an MRI. The Israeli doctors found several tumors on her spine. They scheduled an operation for the next day. 

Test results showed Bonnie had neuroendocrine cancer, which produces tumors along the neuroendicrine system, such as the pancreas or spine.

“It was astounding,” Bill said. “I was completely unprepared for it. There was no cancer in her family. And when I was subsequently diagnosed there was no cancer in my family.”

The private insurance the couple had in Costa Rica would cover the majority of costs for treatment at the Mayo Clinic in Jacksonville, Florida. But staying in the U.S. proved too expensive, and the prognosis was grim. They lived out of a Marriott Hotel. And Bonnie continued to receive discouraging news from doctors, who said she would never walk again and would need a catheter the rest of her life. They gave her three years to live.

This is the part of the story that seems to get Bill every time he speaks of it. The rest he can tell with his usual stoicism. When he talks about Bonnie’s initial diagnosis, he chokes up. But these are “tears of joy,” he says, because of what happened next. 

After three months in Jacksonville, the Fischers moved back to Costa Rica. Bill and Bonnie frequented private hospitals Clínica Bíblica, CIMA and the Costa Rican Oncology Institute, where the couple’s insurance covered most of the payments. Bonnie’s condition stabilized. Through physical therapy, she learned to walk again. She had the catheter removed. She survived her three-year prognosis and is living well into her fourth year post-diagnosis.

Sandra Moreno, chief chemotherapy nurse at the institute, describes how Bill always dedicated himself to Bonnie. He held her hand and helped her walk to her treatments, never leaving her side.

While never religious before, Bill started praying, never asking anything for himself, only for Bonnie’s well-being. For a little while, the couple felt at ease. However, in January, a routine ultrasound for Bill showed lesions on his liver. The discovery led to the infamous bet with Baptista. 

After a CAT scan, a surgeon removed tumors from Bill’s vertebrae near his neck. He still wears a neck brace, but he’s responded well to chemotherapy. 

Bill tells of the defining moment of their new lives, which happened after Bonnie’s diagnosis. It was a Tuesday evening, and Bill and Bonnie were headed home after an appointment at Baptista’s office. On the highway, a motorcyclist cut in front of them. In an instant, Bill slammed on the brakes. Something went wrong. 

Bill can’t remember exactly what happened next. Either the brakes failed or he

lost control. The car spun around. They faced the oncoming traffic. Bill remembers thinking “this is the end.” Now neither would have to suffer anymore because an oncoming car was going to kill them.

But no crash occurred. Bill realized everything was going to be all right.

The Fischers moved to a one-story home in Trejos Montealegre de Escazú, southwest of the capital, where Bonnie no longer has to navigate the stairs. The couple goes out to lunch three or four times a week. They have dates at favorite restaurants Novillo Allegro and Yorgos. Once a month they indulged in a wine club. 

In the past year, Bill and Bonnie watched Amy marry at the Grand Tara Hotel in Escazú. Bonnie returned earlier this month from visiting J.J. and Zeda in Washington, D.C.

Bill celebrated a birthday two weeks ago with a dinner of oysters and ribs. Bonnie had her own birthday last week.

But the cancer will never go away. Bill’s assessment is honest. They both have stage 4 cancer. It’s an incurable form with so few cases that little data about the illness is available. They will need chemotherapy sessions as long as they live. 

They started another round on Monday. At the Oncology Institute, IV bags dripped chemotherapy drugs into several patients.

In a plain tan shirt, jeans and black shoes, Bill nibbled on Ritz crackers. Next to him, Bonnie indulged in a quarter-pounder from McDonald’s with a side of fries and a Coca-Cola. Her legs are sprawled out on a footrest, her slippers off, revealing cartoon bugs dancing  across her socks. 

Both are bald, although a white bristly beard covers Bill’s face. Bonnie has eight fresh stitches on her scalp due to a fall. Bill had a similar accident several months ago.

“They’re like Siamese twins,” Lindsey said. “Anything that happens to one happens to the other.” 

They talk about how they’d rather be somewhere else. Many of their friends are gone for the summer. A friend from Jacksonville who assisted Bill and Bonnie when they were at the Mayo Clinic, visited last week but returned home on Tuesday morning.

The doctors often check in on the Fischers. And Lindsey, the caretaker, watches over them. To her, she’s tending to two hopeless romantics. 

Last week, Bonnie’s son sent the couple a collection of their favorite songs from the 1950s and ’60s. In their home, the gentle bellow of Louis Armstrong’s “What a Wonderful World” hummed through speakers. 

This was their song, they told Lindsey. The neck brace, the cane – those items no longer mattered. Bill and Bonnie waltzed together in the kitchen.

Bill said when he first learned of the coincidence that he had the same rare cancer as his wife, he never felt woeful. He saw the ailment as a sign to be closer with Bonnie. He knew there was no longer a choice. They would combat this disease literally side by side, experiencing the same irritations and successes together. 

Although not every day would be spent in hospitals hooked up to some machine. Some days all one needed was a dance partner. 

And for that, they had each other too. 

“I accepted it as now we didn’t have to live without each other,” Bill said. “Now we could simply fade away together.”

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