From the Other Side of the Knife

Let me start off by letting you know that I am a doctor, an orthopedic surgeon actually. I was working the long Memorial holiday weekend last year at the hospital taking trauma call and the weekend was super busy with injuries and surgeries.  So when my back started hurting, I just figured I was overdoing it.  Plus, I am getting old at the ripe ole age of 36, so maybe I will have back pain now.

Throughout the weekend though, it kept getting worse despite my best attempts at keeping anti-inflammatories in my system.  I finally broke down on Sunday when I hit the point that I could not stand up straight anymore from the pain that I would go to the Emergency Room.

You must realize, a doctor deciding they need to go to a doctor, this is a big deal.

When I get put into a room in the Emergency Room, I tell the doctor, I just need an MRI of my spine, I am sure I just herniated a disc (after all, I am an orthopedic surgeon, I should know).  Luckily, this emergency medicine doctor went on to get more details and I confessed that I had been having some pain where my ribs meet my chest bone.  No worries though, I have been doing physical therapy for this issue.  He wants to get labs, chest XRay, EKG in addition to the MRI… ok, go big or go home.

Turns out he was on to something, he reports to me that I have anemia, renal failure, high calcium and low platelets.  I say, “But I am on call and I have a patient coming in for surgery”.  To which he quickly replies, “You are getting admitted to the hospital.”

He won, I was admitted to the hospital.

More testing and workup was done.  The next morning, the team comes in to see me and update me on the findings.  I am by myself that morning because my husband is home with our 11 month old son.  Then the doctor hits me with the unthinkable that I didn’t even see coming… You have cancer.

I listen silently in shock as she explains that my blood-work is consistent with multiple myeloma.

My mind races to dig up old med school knowledge: Isn’t that in older people, something about proteins in the urine, and I know that can cause fractures.  As it turns out, I had 3 broken ribs and 2 vertebral fractures in my spine from my Myeloma.

The doctor asks if I have any questions, I can think of everything and nothing all at once.  I say no and they leave.

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Now I have to call and explain this to my husband. I tell him that I have a type of blood cancer but until the oncologist comes later I really don’t know much.  He is coming up to meet me so I quickly turn to Google.  I furiously read through resources and medical journal articles about multiple myeloma.  My main focus is on prognosis, how long am I going to live. I keep seeing 18 months, 2 years, etc…. it is not looking good.

Following my diagnosis, I began getting treatment at a major cancer center and from my first appointment, I was struck by how huge and complex the facility was.  Equipped to handle all types of cancer from diagnostics through treatment, I was amazed and yet saddened.  I had not truly seen firsthand before the burden of cancer on society.  As I meandered through the maze of lab, diagnostic, clinic and treatment appointments, I met many other patients.  I was amazed at some patient’s lack of understanding as to why tests were being done or what the treatment was that they were receiving.  I thought of my patients and families and watching them nod along with me as I explain sometimes complex surgeries and diagnoses.

I wondered, do they too leave my office confused and unclear as to what is going on?  I personally was so grateful many times in my treatment that I had a medical background, understanding the complexities of cancer and its treatments.  I too felt fearful of the unknown, not knowing how a treatment would make me feel or not knowing what would be the next step in my care.

My oncologist gave me a more positive outlook than Dr. Google had provided me. He explained that there are now better treatments with more options and that patients are able to live much longer with myeloma now.

But the reality still was that this cancer is not curable.

So all I can do is fight…. I delve head first into induction chemo followed by conditioning chemo and an autologous stem cell transplant.  I will save the details for another day, but I will tell you, I would not wish this treatment on my worst enemy.

As I return to work, I often think back to that first day that the doctor told ME that I have cancer.  How they left me in shock with so many questions and how I had to explain this all to my family.

Had I done this to my patients?

As a physician, the concept of empathy had always been important to me.  Trying to put myself in the patient’s and family’s shoes and try to do and say anything that would help them.  But you can never really put yourself in someone else’s place and truly understand how they are feeling and what they are thinking.  But the thought of my “abandonment” by my medical team, made me feel that I never wanted my patients to feel that way.

I may likely drive them crazy now asking, “Do you have any questions, anything at all?” “If you think of something later, email or call me.”  I offer, “Is there anyone we need to call so I can explain the diagnosis and plan?”  I can relate to the fear of not knowing what surgery will feel like and what it is like to be lying in the hospital bed feeling so far from where you were just a few days ago.

The perspective I have gained through this process of cancer diagnosis and treatment has forever changed my practice.

As I adjust to my new normal as I call it, of being both a physician and a patient, scurrying from my oncologist appointments to my clinic to see patients.  I hope to continue to use my knowledge from being a patient to become a better physician.  I also hope to use my knowledge as a physician to become an advocate for multiple myeloma and young adult cancer awareness.

Much of my story is yet to be written, I wish you all the best on your journey.

I will leave you with these words from the Hippocratic oath, traditionally taken by physicians as they enter the medical profession, “I will remember that there is art to medicine as well as science, and that warmth, sympathy, and understanding may outweigh the surgeon’s knife or the chemist’s drug.”