To Suffer and to Teach

Dear Cancer,

When you entered my life, I couldn’t say your name without bursting into big fat alligator tears. “I have cancer.” I hated the very phrase, as if you were something that belonged to me. When I wanted anything else, but you. Your existence felt foreign, like you were meant for someone else but somehow made your way to me. Your presence interrupted the life I had created for myself—a climbing trip to Las Vegas with friends, a learning experience in Tucson, a retreat before graduation with my co-residents. These are moments I’ll never get back. Instead, you made your presence known, and loudly at that.

You filled every waking hour and took me to places I’d rather not go. Hours in waiting rooms and infusion centers, meeting my surgeon, oncologist, primary care physician, gynecologist, social worker, nurses, techs, and schedulers. But most of all, meeting other patients who also knew you well and fought to rid you from their lives. Your name still fills me with dread, and pain, and an indescribable hurt. You pushed me away from my friends in the most isolating year of my life and took away opportunities for adventure. You stripped me of the familiarity of my body, replacing it with a reflection of a stranger with scars and hollow eyes. You filled my mind with fears of death and the pressure of leading a meaningful life, a crushing guilt to make the most of my one wild and precious life.

But beyond the doctor’s visits, medication side effects, and a roaring fear, I am thankful for the small joys you brought me. Because in this year, I had countless meals with my family and re-imagined what family means to me. I slowed down my life and took note of the wind in my face and the crunch of the fall leaves beneath my feet. I reconnected with art and remembered how nice it felt to exercise the creative muscle in my brain. How joyful it is to put together a puzzle, its pieces interlocking to create something beautiful. How wonderful it is to immerse yourself in a book and live in a distant imagined world. How freeing it is to put pen to paper and watch your thoughts take physical form. These little moments that I had forgotten to make time for in my previously busy life, had the opportunity to spring back again.

In this chapter of my life, gratitude overflowed.

Gratitude for the way my body carries me every day even with you in my life, even after the chemotherapy, surgeries, and radiation I put it through. Gratitude for my little village that would check on me often, connecting me to the outside world, refusing to let me spiral in cancerland with you. Gratitude for all the resilient men and women I’ve met along the way. Gratitude for all the little mundane moments in life, and the big ones too.

Without meaning to, you gave me the lens to see my life in a beautiful way. You gave me an understanding of what it means to be human, to feel so many emotions in such a short period of time. Fear, anxiety, disappointment, confusion, sadness, loneliness, and uncertainty. But also, joy, peace, contentment, relief, and stillness. Almost as if these positive emotions were experienced more fully to the degree that it contrasted with the pain in my life.

Although it was never my choice to have you in my life, you will always be a part of me. Hopefully, as a memory and never as a visitor again.

Today, February 20, 2024, marks one year from my initial diagnosis. I remember it like it was yesterday. It was a holiday, President’s Day. It was a Monday. The weather was nice, sunny, and bright. I had gotten out of work early and was preparing to meet my friends at a café when I received the call from my primary care physician. I walked through the rest of my day in a haze, as if everything was the same. But everything from that moment had changed. And even though it feels like just yesterday, the span of a year has aged me in many ways. Physically, I remain in a chemotherapy-induced menopause and have osteopenia, my bone age is more similar to that of an older adult. Mentally, I feel like I’m still re-calibrating. Like a compass that spins erratically, untethered by its True North. A year out from my initial diagnosis, I’m still trying to piece together my life and figure out how to live as authentically as possible with this chance I have been given.

Most days it feels daunting.

Although my medical chart reads “no evidence of disease” and “pathological complete response,” cancer, your presence still feels close to me. You remain a heaviness in my heart and a constant in my mind. As I think about how I want to re-engage with the world, I’m reminded of my first year as a psychiatry resident. My attending physician was big on understanding the words we use. He taught me that the root word for patient in Latin means “to suffer,” while the root word for doctor in Latin means “to teach.” To be a good doctor then, meant I would spend the next four years learning to be a good teacher. I hoped to not only be empathetic, but also teach my patients what I knew in a way they would understand. I hoped to be a safe space where they could feel seen, heard, and understood. However, it wasn’t until my last year of residency, when I myself became a patient that I truly understood the inverse. To suffer.

To suffer at the hands of uncertainty.

To suffer from cancer.

To suffer from the treatments.

To suffer from loneliness.

To suffer from wondering if I was doing the right things, making the right decisions.

To suffer from having my voice and opinions heard in a busy medical system.

Cancer, when I think about all the ways I’ve suffered with you, I see more clearly what it means to be a patient in a healthcare system that is broken. A healthcare system where access to care and insurance unfortunately is a privilege, not a right. A system backed by short visits and stacks of paperwork, making the human connection between patient and doctor difficult. And although these systemic changes are not something I have control of, there are things that I realize I can control.

I know my own healing process is a long-winding road and it often feels like my career was paused right as it was just getting started. But I wonder if this was the plan all along. If I could somehow channel my own personal experiences with you to better care for patients. When I think back to how overwhelming the initial days are and how treatment and survivorship continue to be difficult in different ways, I am certain that there is a great need for psychological support. It amazes me that of the millions of people who seek cancer care treatment, this is not the standard of care.

For me, this letter serves as a reminder that there were painful moments that brought me to tears, but also beautiful moments that stilled my heart. That these very experiences, both the glimmers and the dark clouds, brought me closer to uncovering what leading a meaningful life looks like. But most importantly, as I look toward the future, I hope that I can find confidence and a place to call my own. This community has a place for me as a patient, but perhaps it can also hold space for me, a psychiatrist, in the future too.

Cancer, I hope my suffering from you is finite, but your teachings infinite.

With love,

Cathleen

This article was featured in the June 2024 Dear Cancer issue of Elephants and Tea Magazine! Click here to read our magazine issues.