Since being invited and enthusiastically agreeing to write this piece and speak, my pretty much constant thought has been- “Oh crap, what did I agree to?”. I’ve started and deleted more drafts than I can count, talked through what I wanted to share with friends (and aloud to myself), and had serious regrets about not taking my therapist’s assigned journaling homework more seriously. And although I finished this at the very last minute possible, I did it.
So here I go- my story as a medical professional.
I have never had cancer. But I do have a cancer origin story which has inspired me to work in this field and shaped my practice.
I am a pediatric oncologist by training who specializes in working with teens and young adults. My cancer origin story started as a teenager watching a distant cousin be treated for and ultimately dying from a sarcoma as a teenager. At that point, I already was interested in medicine and pediatrics, but that experience was probably my true entry point into the field of oncology. Enter medical school, when a close family member was diagnosed with testicular cancer in his twenties. I am the only medical doctor in my family, and I was all of a sudden put in a situation where I was interpreting scan and test results, medical literature, and discussing treatment plans. Thankfully, everything went well, but this is when I had my first experience of how even “good” situations and outcomes completely disrupt a life.
Through interactions with patients and further training, I entered a pediatrics residency and then decided to pursue pediatric oncology fellowship. A few months prior to starting my fellowship, another cousin the same age as me was diagnosed with a terminal cancer. In an effort to seek treatment and time, I watched him and his family travel the country searching for clinical trials, seeking all the opinions they could get, and ultimately entering hospice care. I remember every moment of visiting him in the hospital shortly before his death and witnessing and experiencing how grief changes over time.
All of these moments led me to this field, and as a physician who believes in the importance of holistic care, memory making, and honesty, I shape my practice to the best of my knowledge at the time.
Since that time, now in practice, I have had countless patient encounters which have taught me so much. I’d like to share a few lessons with you.
1) There is no such thing as good cancer or bad cancer
Yes, it is true that there are some cancers that are more likely than others to kill you or that treatment for different types of cancer causes different side effects. But, any cancer diagnosis is life altering, and categorizing cancers as “good” or “bad” is dismissive. It can lead to not offering appropriate services or screenings. As a community, we need to stop doing this.
2) Cancer doesn’t discriminate, but healthcare systems do
I’ve had the privilege of caring for patients from every sociodemographic and educational background. It is true that cancer doesn’t discriminate based on wealth or knowledge, but having wealth or knowledge makes seeking and receiving treatment easier. An AYA patient of mine sought care weekly for over two months with an actual bump coming out of her back until she acutely couldn’t walk; it wasn’t until then that her care was escalated to a larger hospital. Working with community partnerships is vital to bring excellent cancer care to patients. Listening to patients and their advocates is the most important part of what I do.
3) There is power in silence
For those who know me, I really like to talk. When I started in this job, I could tolerate maybe three seconds of silence before physically needing to say something. The longer I have worked in this field, the more I have realized that the most poignant questions or comments come from allowing a room to be silent and people to process and sit with their thoughts. Silence has become a superpower that I am still working on.
4) The people make your profession
I truly believe that no one understands this job unless they actually do it. There are very few professions where you tell a previously healthy young person that they have a life altering or life limiting diagnosis. And you walk with that young person through treatment and very much care for them and their families. So I am grateful to work with some of the best humans I have known in my life. My colleague friends now are across the country and available to talk about treatment decisions at any time of day, give suggestions on how to best explain diagnoses and plans to families, and just listen when it’s been a hard week. My work family can tell when I need a coffee or a card or a mid-day dance party better than I sometimes know myself.
5) It is possible to feel extreme sorrow and joy minutes apart
I still remember the first time I was paged that they were ready to celebrate an end of therapy with a patient of mine, while I was sitting with another family who had just lost their child. My pager buzzing in my pocket while a mother was thanking me for the care I provided. In a few minutes, and some stairwell tears, I put on a happy face to join the celebrating teen. I was surprised that it ended up not being a front. It was possible to go from that happiness to sadness in a moment’s notice.
Lastly, I am so grateful to the patients who allow us into your lives every day. The vulnerability that you show while we try to keep our professional face is something I have trouble wrapping my head around. And the gratitude and grace you extend to us in the most difficult circumstances is indescribable.
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I don’t even know what to say besides a giant THANK YOU. It is providers like you that inspire me to be pursue this profession. After my own cancer diagnosis at 31 (I think?) I decided to to go back to school and pursue nursing with an end goal of becoming an Oncology NP. Your words will continue to stay with me.
What a wonderful article. You truly humanized the patient dr experience and I can’t imagine having to walk in your shoes as the medical professional. Going through cancer is tough but we are t always aware of others situations. You see it all and are involved in it and I thank you for your compassion and heart towards your patients because it makes a HUGE difference.