I review Mrs. Jones’s most recent cat scan- enlarging pulmonary nodules, progressing mediastinal and retroperitoneal adenopathy, worsening liver metastasis- I stop reading and slowly exhale. The cancer continues to spread and we have exhausted all treatment options. I must now face Mrs. Jones and her family. Although some days I struggle less, delivering bad news is never easy.
My courtship with a local oncology clinic began about five years ago. I was a spry new graduate just out of PA school enthusiastic to learn and eager to provide care. Today, just at two months shy of five years, it is my longest relationship to date. Over the years I have had to say goodbye
to many people- more than most people have to do in a lifetime. Unlike some who go into Oncology because they were personally affected by a grandmother with breast cancer or an uncle with colon cancer, Oncology found me.
During my second year of PA school, I had the opportunity to complete a rotation in pediatric hematology/oncology. It was these six weeks that made all the difference. I was intrigued by the complexity of the cases and deeply touched by the level of compassion with which the entire health team practiced. Many of my friends and family frequently ask me, “How can you work in oncology? Don’t you get depressed? You must find it so sad.” I answer back, yes of course there is a lot of sadness in oncology but there is also so much love-more than I ever imagined. The love between a grandfather and his granddaughter, the love between a son and his mother or the bond between a husband and wife. One thing my mentor asks his patients, that I now always ask mine, is how they first met their spouse. As soon as that topic comes up, the walls come right down and the elephant in the room is no more. I have heard all sorts of stories on how couples have met from meeting in bible study to reconnecting at a 25-year high school reunion to lasting first impressions on a blind date.
Many patients tell me how they never expected to get sick and contemplate what they wish they did earlier in their lives. They come to a realization that LIFE IS NOW. They overcome the fear of dying by placing importance on living each day to the fullest. Taking photographs on a wild African animal safari, creating oil paintings depicting a real Brazilian sunset, performing in a jazz band, making hand-crafted stone jewelry, adopting puppies from the local shelter, zip-lining through the rainforests of Costa Rica, and giving a special Sunday sermon- are just a few of the many adventures that my patients have shared with me.
Months after Mrs. Jones’ passing, Mr. Jones came by the clinic with his famous, and my favorite key lime pie. We chit chatted and I thanked him. He gave me a hug and expressed his gratitude for my role in his wife’s care and said, “It takes a special person to do what you do.” I smiled
and gave him a hug. “She was an inspiration to us all,” I replied.
I am taking a hiatus from work not because I do not love what I do, but to make myself full again because that is what it demands. The nature of the work is such. You must first have compassion for yourself before you can take care of others. I thank my patients because they have given me the courage and strength to do so. Two months ago I backpacked through Thailand, immersing myself in the rich Thai culture and meeting so many interesting people along the way. I volunteered at an elephant sanctuary and witnessed firsthand a loving majestic species. During that time, I also discovered a vast new underwater world through scuba diving. Last month while hiking through breathtaking canyons and sandstone formations of Utah, Arizona and Nevada, I experienced truly stunning views and found solitude in nature. Last week, I confronted the inner-workings of the mind and successfully completed my first silent meditation retreat. Today, I explore creative writing and tomorrow, who knows.
With no solid path set in stone and unsure whether I will return to practice or steer toward a new calling, only now do I realize it is OKAY to not know. To move forward you have to let go of your past and embrace change. With change comes reinvention and opportunity. In the distractedness and uncertainty of our lives, find more time for solitude, let go of fear of the unknown, embrace love, and soak in the present. Whatever you do, make sure that your body and mind are working in harmony.
“What you do for yourself, any gesture of kindness, any gesture of gentleness, any gesture of honesty and clear seeing toward yourself, will affect how you experience your world. In fact, it will transform how you experience the world. What you do for yourself, you’re doing for others, and what you do for others, you’re doing for yourself.” –Pema Chodron