Let's Talk About Cancer...

The day I found out that I have cancer, I only intended on telling Dan, partly because I had to go to work and I didn’t have time but mostly because I needed time to process. The next day I told my mom, dad and brothers. My dad is a surgeon and took the news as I expected. He was calm, collected, reassuring. He gave me advice on what I should do next. He has always been the rock in our family. I expected my mom to be emotional and upset. But she took the news better than I thought. She was understanding and encouraging. She then told me about all the things that she was going to send me to help me feel better. The week after, I received huge boxes of organic vitamins and noni juice. She has always been the caretaker of our family.

After I told my immediate family, I knew I had many other people to tell. But how do you tell someone that you have cancer? Do you just say it? Do you lead up to it? Do you have small talk beforehand? I have no idea!! I called a few of my best friends and told them on the phone. Each of them reacted differently. My medical school and residency friends often reacted with medical questions and making sure I was getting all the tests and consults I needed. Some of them got me in touch with their friends who were breast oncologist or surgeons so I could run things by them. The medical discussions were hard because I didn’t know the answers to some of the questions they had yet. Sometimes they brought up topics I hadn’t even thought of and then I freaked out because I didn’t know the answers. Don’t get me wrong, I was grateful they brought things up because otherwise I wouldn’t know! I told a few of my best friends in LA in person over lunch. This was hard because we were in a public place and I started to cry before I could get the words out and then they started to cry because they got scared. It was not ideal but that’s how it happened. By this point in time, I had re-told the story over 10 times. How I felt the lump, how I was diagnosed, how advanced my cancer was, what the next steps will entail. Needless to say, I was exhausted. I was tired of re-living the moment I found out. I was tired of talking about the procedures I will get and the chemo. I was tired of feeling the same feelings over and over again each time. And this is not anyone’s fault. I wanted to tell all these people who are important to me. I wanted them to know. And I wanted them to feel like I answered all their questions to ease their concerns. Heck, if my best friend told me she had cancer, I expect her to tell me everything from the beginning to the end. I expect her to keep me updated with EVERYTHING along the way. So I get it, and I appreciate that so many people care.

In the end I had to send mass texts to groups of friends to let them know about the cancer. I did this with my middle/high school/college friends and my work friends. I ended up emailing most of my co-workers because there was no way I was going to be able to tell 50+ people at work individually. I felt bad that I couldn’t talk to everyone I cared about individually because I think everyone deserves their friend telling them this kind of news in person and a long conversation answering all questions. So if you are reading this, I’m sorry if I couldn’t fulfill this for you. It’s not because you don’t mean a lot to me. I was just damn too tired. So please excuse me. Well, I have cancer, so you have to forgive me!

After the mass texts, people responded in different ways. I got calls, texts, emails, letters, flowers, care packages, meals… you name it, I got it. And for this, I am forever grateful.

I was scared of having to tell my boss. At that time I didn’t know why. It’s not like I could get fired for having cancer. I know my boss. He wouldn’t be mad or upset. So why was I so nervous? To be honest, I think it was because telling work made it official. I was going to need time off to take care of this. I had been in training to become a physician for 13 years. I have been practicing as an attending for 4.5 years. That’s 17.5 years or exactly half of my life dedicated to becoming a physician. And now, for the next many months, that identity was about to be stripped away from me. I felt like I was losing myself. I told my boss over the phone. I tried not to cry but I did. He was supportive and understanding as I expected him to be. He reassured me that my job would be safe and ready to accept me back whenever I was ready. I hung up and cried some more because at that moment, I felt like I was no longer a doctor. I became a patient.

The Five Stages of Grief

It’s real.

Denial:

When I found out about my diagnosis, I was shocked. As I described above, I was upset and shocked but I went to work 2 hours later and worked as if nothing had happened. During that 8 hour shift something happened. I was no longer that worried because, look, I’m totally fine! I might have this lump in my breast but it’s so small… it’s no problem! I’m working and seeing patients like it’s a normal shift. I did procedures, diagnosed patients, called consults, admitted/discharged… I was on the top of my doctoring game. See? Nothing has changed. I bet that tomorrow someone is going to call me and tell me it was a mistake. They mixed up my results with someone else and I actually just have a cyst. “Take motrin for pain and don’t worry about it,” yup, that’s what they’ll say. Yah, I never got that call.

Anger:

“About 1 in 8 U.S. women (about 12%) will develop invasive breast cancer over the course of her lifetime. In 2019, an estimated 268,600 new cases of invasive breast cancer are expected to be diagnosed in women in the U.S.” Why me? Why out of the 155 million women in the U.S., do I have to get breast cancer?! It doesn’t make any sense! I’m still so young. Then, the guilt and anger towards myself set in. Was it because I didn’t exercise routinely? Was it because I ate so much junk food and used the microwave too much? Maybe, but it’s also probably part genetic. It’s my ancestors’ fault! Argh, is it my lifestyle? Everyone knows that shift work and night shifts are detrimental to our health:

“Night shift work was associated with women having an increased risk of breast, skin, and gastrointestinal cancer, according to a meta-analysis published in Cancer Epidemiology, Biomarkers & Prevention, a journal of the American Association for Cancer Research.”

I’m going to have to quit my job!

Bargaining:

Ok, so if I start eating well and exercising more now, maybe it will prevent recurrence or even the spread of my current cancer. Since I received my diagnosis, I started to take vitamins. I also started to try to cut back on sugar and carb intake, although this had been a huge challenge. I love my carbs and it’s my comfort food. With all this depressing news all I want to do is eat donuts, chocolate and pasta. But I am trying to cut back. I’m replacing my sweets with more natural sweets like fruits, fruit shakes, dried fruits, dark chocolate covered dried fruits, etc. I also started to run a mile every other day… but then I had surgery and egg harvesting (more on that later), and port placement, so I had to stop due to pain. But once all the pain goes away I hope to go back to frequent exercise.

Depression:

This is pretty self-explanatory. How can someone with cancer not be at least a bit depressed? The road ahead is going to be hard. This was not in my life plans. My life goals are being derailed because of this stupid cancer. My life will be on pause for at least a year while everyone else’s life will go on and advance accordingly to the next stage. You know in the Mario Cart video game when your opponent give you the baby mushroom so you shrink in size and you’re going at like 1/10 the speed as all the other players? Yah, that’s going to be me… for a whole year. I still cry sometimes. I have good days where I feel hopeful and strong... where I feel like I’m invincible and I can fight this. But I also have bad days where the worse case scenarios enter my mind. The thought of not seeing Landon grow up, graduate, get married. The thought of not going on international trips with Dan or my friends.  The thought of my parents having to go through sadness and grief. The thought of losing my hair, and vomiting from chemo side effects. Yes, and even the thought of dying. It scares the hell out of me. These days I feel depressed and I cry.

Acceptance:

I have breast cancer. There, I said it. Ok, fine, I’m still working on the acceptance part.

To be honest, the stages of grief are not linear. It’s not like one stages happens, it’s over, and you move on to the next stage. It’s more like you go in circles... but in circles that are not in order. So more like figure of eight loops, but then you can go back a stage so more like random squiggly lines. Like the other week, after I had my surgery and I was waiting for my appointment with my oncologist, I secretly had hopes that my oncologist would say that I don’t need chemo because all my cancer was taken out! Talk about denial creeping back in! So, yes, right now my life feels like I’m in a Mario Cart race where my cart is infected by the small mushroom poison going in squiggly lines.