When the doctor becomes the breast cancer patient
As a doctor, I’m used to being the one with the answers, the one doing the comforting, the one instilling hope. But as a breast cancer survivor, I also know what it’s like to be on the other side of the equation — to be the one searching for answers, the one in need of comfort, the one desperate for hope.
Let’s go back in time for a moment to April 2014. Only two months shy of completing my first year as an actual attending physician, I felt like I was on top of the world. After 14 years of post-secondary education, all those sleepless nights and exam after exam, I was finally able to independently treat patients. I felt very fortunate to do so.
One day while I was showering, I noticed a lump in my left breast. Being a physician, I knew there were many potential causes. I thought this may be a fibroadenoma or fibrocystic disease, so I logically decided to wait until one menstrual cycle had passed to see if the lump changed.
I remember going through all the differentials in my mind and convincing myself that there is no way this is cancer — I am too young, I have no risk factors, I have no family history. This is most likely benign.
But I knew something was off.
In the months leading up to this point, I had noticed I was requiring more rest than usual, especially on days I would go jogging. I remember mentioning this to my family and friends, who inevitably retorted, “You’re not in your 20s anymore and you work so hard. Of course you’re tired.” This answer seemed logical, so I dismissed my concerns, something I always tell my patients not to do…
I spent the next several weeks examining and re-examining myself. Unfortunately, the lump did not get smaller as might be expected in fibrocystic changes. I began to worry and decided to go see a gynecologist. She examined me and told me it likely was not anything to worry about.
Since I was a physician, she asked me, “What would you like me to do?” I was taken aback by this — I was in her office as a patient, not as a doctor. I was as confused and unsure as anyone would be in this situation…
I was taken aback by this — I was in her office as a patient, not as a doctor. I was as confused and unsure as anyone would be in this situation, but I responded by stating that I would like her to order a diagnostic mammogram and ultrasound, and she obliged. I wanted to get rid of that nagging feeling in the back of my mind that something was wrong. A clear mammogram and ultrasound would do the trick.
I was only 34 at the time, so this was my first mammogram. Most women are recommended to begin yearly mammograms at age 40. The day I went to have my imaging done, I remember going through the motions of changing into a gown and then allowing the technician to physically manipulate my breasts into position. It was not very pleasant to have my breasts squished like a pancake, but my discomfort was quickly overshadowed by the image of my own breast — with a discrete mass.
By this point, I was hoping that I had read the image incorrectly. After all, I am an internist, not a radiologist.
After my imaging was completed, they asked me to enter a private room where the radiologist came to speak with me directly. I remember the look on his face when he took a large, deep breath and started with: “I know you are an internist and…”
I interrupted him, declaring what I had already figured out on my own.
“I know, I already saw the images,” I said.
He proceeded to tell me that my mammogram was a category 4 on the Breast Imaging Reporting and Data System (BI-RADS). This is what physicians use to categorize mammogram results. For reference, a benign or non-cancerous finding is category 1 or 2. Category 4 suggests a suspicious abnormality.
I needed a biopsy ASAP. The biopsy was not very pleasant, but the nurses and physicians made the experience tolerable. It was a reminder to me that as a doctor, I have the power to make a difference in my own patients’ experiences, just as these nurses and doctors did for me. Navigating healthcare isn’t always easy, but the little things go a long way.
Two days later, I was in Cancun with my mother and aunt. This was a trip we had planned beforehand. I refused to cancel my trip only to stay home and anxiously await the results of what I already knew to be true — I had breast cancer. Now, I just needed to know the specifics so I could come to terms with my prognosis and treatment options.
Three days into my trip, I called my gynecologist to get the results. She was very hesitant to discuss the results with me on the phone, but I told her I already knew it was cancer and just needed to know how bad it was. I was with my family and had all the support I needed to handle the news.
Stage II triple positive invasive ductal adenocarcinoma of my left breast.
My gynecologist was as shocked by my cancer diagnosis as I was at first. At only 34 years old, it just hadn’t seemed likely. For the next 18 months, I went from doctor to doctor, chemo treatment to chemo treatment, radiation to radiation, one procedure after another. Looking back, it all seems so daunting now. However, I was fortunate enough to have amazing support — my family, my friends and most surprisingly, my patients.
I continued to work throughout my chemotherapy because I felt better taking care of patients, focusing on improving their health instead of staying home and ruminating on my own nausea or pain. It was the most vulnerable time in my life, and my patients saw me go through it all. Their prayers and support gave me the strength I needed to fight for my life.
Going through all this as a patient has given me a unique perspective of my role as a doctor. I can now relate to patients on a more personal level through the eyes of experience, and I have a greater sense of compassion and empathy for what they are feeling.
Going through all this as a patient has given me a unique perspective of my role as a doctor. I can now relate to patients on a more personal level through the eyes of experience, and I have a greater sense of compassion and empathy for what they are feeling. I know what it feels like to be in that chair and face bad news. I know what it feels like to anxiously wait for test results. I know what it feels like to worry about my future. Now, I try to use those experiences to help my patients cope with their own health struggles.
It has been a little over four years since my diagnosis and today, I feel stronger, healthier and happier than ever. I now consider breast cancer an important part of my story. Facing this battle has shaped who I am as a person and as a physician.
I’ll tell you what I tell my patients: At the end of the day, regardless of what type of health battle we’re facing, keeping a positive mindset and drawing from the support of loved ones is what helps us persevere.
Get your mammogram today. Regular breast screenings are an important part of every woman’s wellness routine.
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