I screen patients for skin cancer on a regular basis, and one of my research interests is to find new biomarkers of cancer prognosis – to be able to separate out cancers that won’t actually do someone any harm versus cancers that could very well spread, grow unchecked and uncontrolled, and potentially end a life. I know that cancer treatments have advanced beyond my imagination in recent years, with new, newer, and newest treatments showing survival curves and waterfall plots that would have been science fiction even 15 years ago. Even so, when I found a lump at the edge of my right breast, when I had my initial mammogram and ultrasound, when I was told that the chance of breast cancer was greater than 75 percent – I was scared. I cried. I lost all logic. While it had been easy to get to the appointment because it was in the same building as where I work every day, I found it almost impossible to walk back to my office. I needed to share my fear first. I didn’t want to scare my family, who lives across the country from me. I was hoping to unburden myself by burdening my physician husband, but he was in an operating room himself. I ended up calling a friend who got her own cancer diagnosis several years ago. She said (among other things), “Oh, shit.” Thankfully, she gave me space to breathe. It’s been a wild ride in the last two weeks – I am grateful for the care that has been extended to me. I have been comforted by kind words, warm smiles, and, strangely, a sense of belonging. When I met my oncologist, she explained all the necessary medical steps carefully and conscientiously and commented somewhat off-hand, “Us moms, we have to stick together.” I felt a sense of community with her, she was a doctor, and “well,” I was a patient and “sick”; together making sense of this breast cancer diagnosis and journey. I hope that every patient can feel this welcome. I hope to extend this sense of togetherness to every single one of my patients so that all doctors can create this same sense of belonging with their patients; in the room, the clinic, and the wider health care space. I’ve been feeling burnout at various times during this worldwide pandemic, oftentimes from stressors at home as a parent of a teen and preteen. It has not helped that work has at times felt impossible in a medical culture of overwork that has been only exacerbated by the Great Resignation and COVID-19. I have, at times, lost faith in the health care system, in doctoring, and in myself. The diagnosis of breast cancer, of any cancer, of any potentially terminal illness, is scary. It can feel bitter. The sweetness of it lies in feeling cared for, wholly and completely, by my doctors and technicians, and clinical staff. I have a necessary renewed belief in the role of great health care. There is an unexpected succor in slowing down, having my hand held, and feeling my own tears and those of others. Despite my optimism, I can still have bursts of completely irrational fear. When I went to vote in the mid-term elections, my voter registration had somehow fallen off the permanent list. The volunteer staff needed to write my name down in a special list of walk-in voters. And they were going to use a red pen. I recoiled and could not control my superstition. My mother had always told me that it is bad luck to have your name written in red ink; I asked them to please write my name in another color because I had just gotten a diagnosis of cancer. I started crying and walked out when they told me it was a rule – red pen or nothing. The supervisor, a breast cancer survivor for more than three decades, followed me, hugged me, and walked me back in. They wrote my name in pencil, and I voted. I feel ashamed as I write this, embarrassed of my superstition, my tears, and my lapse of courage. I write it anyway. I savor the experience because of the bitterness of it, the unexpectedness of it, the irrationality that overcame me at the moment – and the corollary sweetness of a stranger’s embrace, blessing, and grace. There is a peculiar wonder in this cancer diagnosis, a discovery of a community of individuals living with cancer, an inescapable belonging to this life of sweet bitter, for which I have a greater appreciation. Perhaps paradoxically, there is much to celebrate. It is a crucial reminder to me, as a doctor, to realize that the journey of illness can be as important as the cure. Source
