The Elephant in the Room is Cancer. Tea is the Relief Conversation Provides.

My Cancer Sabbatical

by AnonymousOctober 15, 2019View more posts from Anonymous

Last October, I realized I needed a new bag for work. The leather was worn from being squeezed into clinic drawers. The fastenings had broken from trying to squash too many snacks in. And the handles were frayed from the weight of the daily paraphernalia that accompanies working in a hospital. But, like many other thirty-somethings these days, I had no time to shop for a new bag.

I was focused on a critical point in my career (as a doctor, I was due to take my last set of exams before finishing my training). Working long hours, I shoe-horned studying, exercise and socializing into any spare time I had. I think most people my age experience this – the perpetual exhaustion of getting on top of life, whilst trying to make the most of it. I’m not saying that’s a bad thing – I found my job really fulfilling, I loved getting outside, hiking and running, and when I had time off I made the most of it with some fantastic trips around the world. Spending a whole day chilling on the sofa and watching Netflix was an alien concept to me.

So if I had no time to shop, I certainly had no time to be ill.

But as October turned to November and my bag began to get saggy, so did I. I couldn’t run as fast as I could before. I was really tired and pale. “Modern living!” I convinced myself as I hit the snooze button again. My appetite started to wane and I became inexplicably emotional at home.

But still I powered on: working, studying, dragging myself out of bed in the middle of the night to see patients on-call, planning a weekend away with friends.

In true millennial-workaholic form, I waited until my first day off in two weeks to collapse on my kitchen floor. I went to the emergency department where blood tests diagnosed me with Acute Myeloid Leukaemia.

A hematologist came and told me I needed transferring to another hospital urgently to start treatment that night: the same hospital I had been working in the day before. Soon, I was having my first blood transfusion of many, spiking my first fever of many, and consuming a cocktail of antibiotics and chemotherapy in an isolation cubicle.

In the space of 24 hours, I had transformed from a doctor to a patient, healthy to seriously unwell, a 100 mile-per-hour lifestyle to one stuck in a bed attached to a drip in my own hospital.

At first, I could not accept that this huge pause button had been dropped in the middle of my life. This was not me! I didn’t lounge around all day, I had stuff to do!

The morning following my admission was a flurry of activity as I phoned work and handed over the details of some patients that I had been planning on following up. I emailed the rota co-coordinator about finding a replacement for me; I was worried the hospital would struggle to cover my shifts over Christmas and New Year.

Then I busied myself with the practicalities of life in hospital: making lists of things I needed, internet shopping for pajamas and researching what hat to wear when I went bald.

I had my first round of chemotherapy and then had to stay in hospital whilst my very low blood counts recovered – four weeks in total. I was visited by a hair salon and selected a short wig as I thought it more practical for my job than long hair. I postponed my exam to July, reasoning if I was recovering from treatment I would have plenty of time to catch up on studying. I even contacted colleagues about potential projects I could do from afar.

My sole focus was getting back to work – sure, I would have to extend my training, but with a few papers under my belt and a bit of a break my career would be relatively unscathed.

I also thought a lot about my life after my treatment had finished. I remember the glee I felt when I found a sports bra at an absolute bargain from one of my favorite websites, purchasing it in anticipation of when I inevitably began running again. I fantasized about where in the world I would travel next.

My husband and I joked that my colleagues would have to let me have Christmas off the following year, seeing as I was spending this one in hospital.

After a two week break at home I was admitted for my second cycle – another four week stay.

I remained upbeat, reading some medical texts and working on my laptop in the mornings. But at the end of this came a bombshell: although the chemotherapy had worked quite well, there was still evidence of leukemia showing up in my tests.

I would need further chemotherapy and a stem cell transplant.

Immediately my thoughts turned to work. I knew from my research that it would take a year of recovery to return to such a physical job. Then came the second blow: the realization that my immune system would be wiped clean – all the immunity I had built up over thirty-odd years, all the vaccinations I’d had would be gone. It would be two years until my immune system was mature enough to handle all the vaccinations I needed to be allowed to work in a hospital.

By the time I was admitted for my third cycle, I was getting really low. I felt that all the things that gave me my identity were slipping away, especially my career. I had been working towards being a doctor since I was fourteen. Years of exams, late nights and studying had made me who I was. I reluctantly took my name off the medical register and explained to the various organizations involved in my training that I would not be returning to medicine any time soon.

I also knew that, with a full-intensity stem cell transplant, there was a high chance of long-term chronic fatigue – I might not ever be able to get back to where I was. My blood counts did not recover after my third cycle and I had to stay in hospital until my fourth cycle and transplant. Weeks turned to months and I couldn’t conceive of life outside my cubicle – I couldn’t imagine regaining a life worth living. The last few days before I was discharged were full of apprehension of what I would be with my new, naive bone marrow, weakened, wasting muscles and fog of chemo-brain.

When I finally got home, however, something in my medication-addled psyche seemed to switch. Yes, I could barely climb the stairs, I had a sack-full of medications and my taste buds were still rebelling against the poison they had been bathed in, but I realized I had started laughing at things again. Within a few days I was singing along to the radio and venturing round the block. Friends rallied round (I had banned them from visiting in hospital to decrease my risk of infection) and I realized I was enjoying myself.

Around 90 days after my transplant I came to the realization: life is pretty good right now.

My diet is restricted but I have the time to adapt, sourcing my favorite ingredients and cooking from scratch or going out to some great restaurants. I have to avoid crowded places, in case of infection, but it’s actually quite fun to go to the cinema on a Monday morning and have the whole place to yourself. I might not be able to go to my favorite bar on a Saturday night, but I can go in the afternoon and read a book with a coffee.

I make plans to see my friends and family without having to consult a rota or coordinate the complicated logistics of shift-swapping. The other day I binge-watched a whole series of Stranger Things in a day. When it comes to sleep I am living the Millennial Dream: as much as I want, when I want, without feeling guilty.

For me, nothing can replace the job satisfaction I got from my career and it is difficult to imagine my long term future outside of the medical profession. But I am gaining fulfillment from helping others – whether it’s marshaling my local 5 km run, running a charity bake-sale or even just supporting my husband with a hearty home-cooked dinner when he gets home from work (small compensation for the months he spent eating at the hospital canteen but a reminder of how far I’ve come since he was effectively my carer). It’s lovely to be able to spend quality time together; before I got ill we were often ships passing in the night with two high-pressure careers.

I am enjoying reading things that aren’t published in a medical journal, and exploring my possibilities outside of medicine whilst figuring out how to keep my foot in the door (i.e. regular meet-ups with my work friends to hear about interesting cases, hospital politics and of course, gossip).

I am now 120 days post transplant and life is good. Yes, it’s not 100 miles-per-hour any more, and for the first time in my life I have no idea what comes next. But rather than my life disintegrating around me, it has stabilized into a sort of pleasant limbo. I still have to spend at least one morning a week in clinic and weather the anxiety that comes with every blood test and bone marrow biopsy.

However, I am embracing my cancer sabbatical and all the silver linings that come with it, finding out a change of pace isn’t so bad.

Last week, I found my old work bag. Rifling through its contents was like delving back into my old life. Scraps of paper with scribbled notes and anatomy diagrams, out-of-date cereal bars, spare hairbands, and an emergency tampon hoard, all useless to me now. It was hard to throw it away but I got my husband to get rid of it for me.

Next I stored my many sets of pajamas in a cupboard, with the industrial tubs of moisturizer and antibacterial wipes I got in hospital. Slowly but surely, I am eking out a new identity, one that does not depend on my profession or diagnosis.

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