Force of Nature

Gail Kraemer did what she wanted, how she wanted, when she wanted to do it. In her early years, she traveled through Africa and Mongolia big game hunting. Later in life, she got her pilot’s license and became an avid golfer. Whether she was jet skiing around Tellico Lake or hosting a dinner party, Kraemer was always in charge. She had no time for limits — just adventures. 

When she was diagnosed with breast cancer in 2008, Kraemer immersed herself in the research, learning everything she could about other women’s experiences and how to successfully navigate her own. (She had a lumpectomy and radiation and was cleared after treatment.) When she was diagnosed with bladder cancer in 2017, she tried to take the same approach. But because men are four times more likely to have bladder cancer than women, most of the support focused on men.  

Thanks to Kraemer, that was about to change.  

Steps to support 

She was born in Missouri, grew up in Queens and was living in Long Beach, California, when she met Rich Kraemer through mutual friends. They were both widowed in their first marriages: Her husband died of a heart attack and his wife was killed in an auto accident. They fell in love, got married, and she became a stepmother to Rich Kraemer’s three children, Suzette, Kim and Rick. They lived in Franklin Lakes, New Jersey, moved to Hilton Head, South Carolina, in 2006 and then to a lake house in Vonore, Tennessee, in 2017 to be “close, but not too close,” to Suzette and Kim, who both live in Nashville.  

“Gail went out and bought a jet ski right away,” Suzette said. “She jet skied until the end.”  

 Rich and Gail Kraemer traveled extensively around the world and were in Augusta, Georgia, for the Masters when she experienced tremendous pain that sent them back home after just one day. When she was diagnosed with noninvasive, high-risk bladder cancer, she opted for clinical trials and medication to avoid a cystectomy, or surgery to remove her bladder, but progression of the disease eventually made it necessary.  

 “Gail wanted firsthand perspective from women who’d gone through it, but found that very difficult,” Rich said. “She found women around the country who helped her somewhat, but it was all her own searching, and she felt more information should be available prior to surgery on what to expect and how to handle everything after. She felt very strongly about that and wanted to change it, so she spoke to her doctor.”  

 On matters of her care, Gail Kraemer and Sam S. Chang, MD, Patricia and Rodes Hart Professor of Urologic Surgery, didn’t always agree.  

 “Gail was a force of nature,” Chang said. “We’d get all the information, and she’d make her decision. I’d say, ‘I don’t know if I’d do that,’ and she’d say, ‘It’s my decision.’ I don’t think she really liked me that much in the beginning, but she kept seeing me, and we became very close. After many discussions and treatments, we came to a mutual decision to proceed with bladder removal.”  

 When she approached him after her surgery, saying she wanted to make a difference for female bladder cancer patients, Kraemer and Chang saw eye to eye immediately. 

 “We talked about our research, educational efforts for residents and patients, as well as many other important initiatives that we raise money for, and Gail was clear that she didn’t want to contribute to some fund,” Chang said. “We came up with the idea of funding and formulating a position we called the clinical care coordinator. Not for men or children but solely for women with bladder cancer.” 

 Different from patient navigators at Vanderbilt-Ingram Cancer Center (VICC) who help with scheduling and logistics like lodging and transportation, the clinical care coordinator assists in those tasks and has a thorough knowledge of all aspects of bladder cancer and how it affects women, including clinical trials, treatment evaluation, surgery, side effects, interventional radiology, ostomy care and stoma therapy — and all the questions that come up long after patients have left the doctor’s office.  

 “It’s a pretty all-encompassing position and sounding board,” Chang said. “I want and envision this role to be a model for other cancers at the VICC and across the country for people. That’s ultimately my goal — our goal.”  

‘Just be a friend’ 

Brianne “Bree” Duncan has seen the gamut of the disease process as a research nurse specialist IV for a bladder cancer clinical trial, including one in which Gail participated for two years.  

 “They started as nurse and patient and came to care for each other,” Rich said. “When Dr. Chang suggested Bree be the first person to hold the clinical care coordinator position, Gail was thrilled.”  

 Duncan became the first Gail Kraemer Care Coordinator for Female Bladder Cancer Patients in June 2022, after eight years with Vanderbilt Urology. 

 “Bree is awesome,” Chang said. “There’s a reason why she’s the first one.”  

 Duncan welcomed the opportunity. 

 “After conversations with Gail, Dr. Chang came to me and asked if I would fulfill this role for her. I was so honored to bring to life this idea that Gail had, and to help other women,” Duncan said. “I was also excited to work with her again, but this time on a different level, and to help carry out her wishes. Gail was vibrant, fearless and kind. She had the biggest heart, which continues to be felt and seen with the creation of this position I hold.”  

 In addition to supporting women in every aspect of bladder cancer and removal, Duncan knows how important it is to “just be a friend.” 

 “My goal is always to help make this process easier on these women because I know how scary it must feel,” she said. “I feel like the women have enjoyed having me in their corner — someone they know will always be there to answer their questions or calm their fears. I have received a lot of great feedback from the women who are so thankful that this role I fulfill exists.” 

Leaving a legacy 

Gail and Rich were visiting son Rick in New Jersey in December 2021 when she received word that her cancer had spread. She didn’t want to ruin anyone’s holiday and waited to tell Rich until they returned to Tennessee.  

 She had a radical cystectomy, with a specialized continent urinary diversion at her request — an internal reservoir that she controlled to empty. She left the hospital earlier than she expected. 

 “It didn’t stop her from living. She still played golf, boated, jet skied and entertained,” Suzette said. “Gail had nine lives. She always bounced back.”  

 In July 2022, Gail visited Nashville to go honky-tonking with Suzette, Kim and her sister, Pam, from Arkansas.  

 “She never let cancer define her,” Suzette said. “A lot of people didn’t know how sick Gail was, including myself. It never broke her spirit.” 

 Shortly thereafter, on Aug. 1, Gail was admitted to the hospital following a surgery follow-up appointment. The cancer had spread very quickly to her liver. She died on Aug. 9, 2022.  

 “I had dinner with Gail and Rich, and within three weeks she had passed,” Chang said. “Her disease progression was very, very rapid.” 

 “She was a tremendous fighter,” Rich said. “She had two major surgeries and recovered very quickly from both. When I took her to the hospital that week, I never thought I wouldn’t bring her home. I think she just finally said, ‘I’ve had enough.’” 

 As a tribute to Gail, Rich continued to fund the care coordinator position after her initial gift, ensuring that women with bladder cancer will benefit for years to come.   

“We are collecting data and records to help track and improve and create true touch points with patients. Where do we need more info? Where do we need less? What are the areas of concern? How did this make a difference?” Chang said. “This type of care requires time, support and the right people. It doesn’t make money, but it makes a difference. It takes philanthropy like this to change the process for the better. Gail and Rich’s efforts are making things better for women with cancer.”