Grandma's Marathon: Cloquet's Jim Hagerl, diagnosed with Stage 4 brain cancer, finds comfort in running
Upon registering for Grandma's Marathon last October, Jim Hagerl braced for a fight.
His opponent was supposed to be the clock.
It turned out to be cancer.
Brain cancer, in fact. Stage 4.
Qualifying for the Boston Marathon was shoved to the backburner by glioblastoma multiforme (GBM). Hagerl received the diagnosis Oct. 26, one day before his 39th birthday. Two weeks earlier, he had completed the Wild Duluth 50K.
"And then 48 hours later I was getting a brain biopsy," the Cloquet resident said by phone Thursday.
Symptoms arose not long after Hagerl made his 26.2-mile debut, at Grandma's last June, covering the course in 3 hours, 24 minutes and 46 seconds — fast for a first-timer, doubly so considering that morning's electrolyte-sapping heat. Later in the summer, he was having difficulty seeing. Hagerl struggled to navigate his favorite running trails without tripping. The cursor on his computer screen was barely visible.
Unconcerned, he visited an optometrist, who recommended Hagerl meet with an ophthalmologist. A magnetic resonance imaging exam followed, in which a "mass" was discovered. Samples from the resulting biopsy were sent to the Mayo Clinic in Rochester, Minn. Tests revealed GBM, a "fast-growing, aggressive type of central nervous system tumor that forms on the supportive tissue of the brain," according to Cancer Treatment Centers of America.
If treated properly, life expectancy is "up to 18 months," Hagerl said.
"Which is absolutely devastating when you're only in your 30s, when you're running marathons," he said. "I just had to refocus and say, 'What am I going to do? I'm going to live every day to its fullest.' "
That timeline, Hagerl notes, is a ballpark estimate. It does not take into account factors such as genetics, age and fitness level. The latter of which is terrific, despite a training schedule that must accommodate Hagerl's monthly chemotherapy sessions. He runs when he can, with wife Jessica Winkels-Hagerl often tracking him on her phone.
Maddeningly, the workouts can be inconsistent — a sub-20-minute 5K one week, 10-minute miles the next — but this is Hagerl's respite.
He will be back at the Grandma's start line Saturday in Two Harbors, about 12 hours after completing the William A. Irvin 5K. Hagerl has scaled back his expectations for the marathon. He's unlikely to approach last year's 3:24:46, but four hours isn't out of the question.
Especially to those who know him.
"I think there's a really good chance he'll come in under four hours," said Jeff Krohn, like Hagerl a member of the Cloquet-based Milltown Milers running club.
Hagerl — "Jimmer" to many — originally is from Brutus, Mich., a map dot in the northern part of the state's Lower Peninsula. He and Winkels-Hagerl moved to Cloquet from Vermont about 10 years ago. He is a program coordinator at Northwood Children's Services in Duluth, and she works in children's mental health.
'You're a shell of yourself'
On Nov. 8, surgeons removed as much of the tumor as was deemed safe. The biggest section they took out was in the occipital lobe, the visual fulcrum. But part of the tumor is located near the thalamus, which — among other functions — relays and scrutinizes sensory information, and surgeons couldn't safely get to it without impairing Hagerl.
Prior to the operation, called a craniotomy, Hagerl's medical team floated the idea of an "awake surgery." Hagerl, heavily sedated, would guide surgeons via feedback as various parts of his brain were stimulated. The way Hagerl explained it, he might have been asked, "Does this make you blind?" If so, surgeons would have backed off.
Ultimately, a traditional craniotomy was performed. About a month later, Hagerl started radiation and chemo simultaneously.
He called it "excruciating" because of the impact it had on his cognitive functioning. For example, he might lose something in the house or forget how to make cereal.
"You're there, you're doing things, but you're a shell of yourself," Hagerl said. "You're kind of angry at yourself because you know what you should be able to do and you're having trouble doing it."
Some of Hagerl's cognitive functions have returned, but the vision he lost never will come back. Hagerl, whose reaction time is diminished, no longer drives. He is quick to note the "generosity" of family, friends and coworkers who tag-team his transportation needs, but for a guy described by Krohn as "almost like an Energizer bunny — just constant go, go, go," it's been a substantial adjustment.
Hagerl is learning to live with his new reality. That includes the device he wears on his head for 18 hours a day. Called Optune therapy, it is delivered through adhesive patches, or transducer arrays, which are intended to "slow or stop glioblastoma cancer cells from dividing and may also cause some of them to die," according to the Optune website.
Hagerl is better about listening to his body, a chore for any runner accustomed to ignoring red flags, and he remains upbeat. Over the course of an hour-long conversation, one thing became clear: He is matter-of-fact. This is what he has, and this is what he has to do.
You get the sense that he doesn't spend much time feeling sorry for himself.
"There are ebbs and flows, and there are some days that are easier than others," Winkels-Hagerl, 37, said. "But I think he's always got that focus on getting back to that positive attitude, and kind of facing each challenge as it comes and overcoming obstacles as best he can."
That, said Milltown Milers founder Jeff Leno, comes naturally for Hagerl, a lively storyteller who puts smiles on faces. Hagerl has a way of commanding a room.
"He just has a knack for getting everybody's attention," Leno said. "Everybody wants to be around him.
"He got this diagnosis and we were all crushed, but I think on the surface it probably looked like we were more crushed than Jim was. Jim has stayed really positive throughout this whole journey."
Running for his life
And he has kept running.
After the brain biopsy, after rounds of chemo and when his energy level is hovering near empty, Hagerl slips into his Saucony Triumph shoes and clicks off miles.
"Each surgery, I was out running probably a little sooner than doctors wanted me to," he said.
It was one of his first questions, said Winkels-Hagerl — "When can I run again?" Doctors, both at Essentia Health-St. Mary's Medical Center and the Mayo Clinic, have been understanding and flexible.
Case in point: Last week was supposed to be a chemo week, but Hagerl's doctors made a few adjustments and instead he will start a chemo round directly after Grandma's.
He needs his energy for a total of 29.3 miles.
Before, Hagerl says running was just a hobby. Now, combined with modern medicine, he says it's what is keeping him alive.
"It has been one of the things that help me stay focused on living life," Hagerl said. "Running has been something that I can do through muscle memory or just through the athletic shape that I'm in, and I can do it and feel good about myself, and not focus on the severity of my diagnosis and the shorter life expectancy."
Hagerl admits that, for someone with a Type 'A' personality, cutting short longer workouts based on how he feels is torture. Runners have an inherent belief that only going 10 miles on a day that calls for 12 will hijack all their training.
Hagerl isn't giving up on the Boston Marathon just yet. He ran a half-marathon in Fargo, N.D., last month in a personal-best 1:41:55. For Hagerl, that race hinted at his potential. The fitness remains; he's just seeking more consistency.
And, if ever there was a silver lining to turning 40, it's the fact that by doing so Hagerl's Boston-qualifying standard drops from 3:10 to 3:15.
Blocking out the bad
Hagerl said the GBM diagnosis and the rapid response to tackle it was such a whirlwind that he initially didn't have time for the gravity of the situation to settle in. The low moments eventually arrived, "where it's hard to acknowledge that you have this terminal illness." But Hagerl has proven adept at blocking out the negative and rediscovering the normalcy he so desperately craves.
It isn't easy. In that regard, his wife has been "my saving grace." They are fighting this together.
"It's definitely something that doesn't go away," he said. "You don't get over it and be fine with it. It's something that's on your mind every day at some point. It could be something small, it could be that big-picture concept that bothers me. But it's something that's there every day.
"It's just finding ways to cope with it and finding ways to distract myself so it's not consuming me."
So Hagerl runs.