2021

In late fall of 2020, rumors were buzzing around the hospital where I worked about a possible retirement buyout package. My supervisor and I sat in our large conference room discussing what we had heard. I said, “If the offer is decent, I will probably accept the package. I don’t want to work until I’m carried off the unit on a stretcher.” Then, with my usual humor, I chuckled and added, “I tried that once and it didn’t turn out so good.”

Years ago, on my first rotation as a third-year medical student, I received a dreaded phone call. My father had arrived home late one night after work. As he entered the house, he tumbled down the stairs. His physician, worried that my dad had suffered a mini-stroke, ordered an ultrasound of the carotid arteries in the neck.

Most people aren’t aware of a cancer that is ruthless above the rest. This cancer lasts a lifetime and never fully remits.

I first became aware that I was susceptible as a child. I was on an examining table and our pediatrician asked my mother to step outside the room. I then heard him berating her: “This child is sunburned! How could you! You know you have genetic skin cancer!”

She was my head nurse on a treatment unit for psychiatric patients. In the course of our work we became as close as sisters. When she developed breast cancer with heavy spread into the lymph nodes, I was devastated but not surprised. She lit one cigarette from the last one throughout those days before smoking was banned.

I knew it was coming.

After my morning walk, I sat down and ran my fingers through my hair, and ended up with a handful. Right on schedule, Day 14 following my first chemo treatment for stage lll inflammatory breast cancer.

Taking what remained of my shoulder-length hair and cutting off what I could with a pair of scissors, I noticed how much I looked like my dad, now that my features, rather than my hair, took center stage. Then my husband shaved off what remained as I sat on an overturned Home Depot bucket in our backyard.

Every second Wednesday of the month we met on Zoom, five of my medical colleagues and I, for more than a year. We started off sharing fun facts. She spoke of her bike rides—how fast she could go, how beautiful the fall leaves were, how fresh the forest air smelled, how spring brought a veil of green.

We also discussed the differences between a doctor’s approach and a scientist’s approach to teaching students and residents in a hospital setting. We provoked each other. We enjoyed the intellectual challenge that faced us—the puzzle of creating a sound medical education research design.

Her breath rasped, heavy, traveling all the way from an ICU in India to my ear pressed to the phone in Yonkers, New York. My mom’s best friend, her cousin, was dying far away from me. She had been like a mom to me.

Her sister had put the phone to her ear so that I could speak to her. She was unconscious for the most part, her body ravaged with cancer, her systems shutting down, one by one.

Keep a green tree in your heart and a singing bird will come. –Chinese Proverb

Spring folds into summer like origami. My vegetable garden thrives. Potted flowers stretch toward the sun. Wildflowers, I seeded in March, burst forth in a colorful display that attracts bees. The yard hums with activity.

All this appreciation for the beauty of the natural world is tempered by my health. I have a blood cancer, multiple myeloma. The disease environment in which I live comes with complications. Some days I am awkward and self conscious as an adolescent. My skin mottles in ugly blotches, my GI tract turns somersaults, or worse, freezes solid. My body cannot be trusted. I sulk and just want to be alone.

I receive treatments aimed at reducing the damage caused by this incurable malignancy. Each month a six-hour infusion of a monoclonal antibody and immunoglobulins tamp down the damage. At home, I take low dose oral chemo along with steroids. I am alive and I am healthy… after a fashion.

I’ve come to accept my illness as part of the overall order. It is not an anomaly, a mistake, or a bad break. It is here to stay. For me,

The words I heard most often from my mother are, “It’s not what you get in life, it’s how you handle what you get.” These words have shaped my life and become the essence of what I believe.

My mother faced so many challenges in her life: the birth of a severely autistic child in the era of blaming mothers for that diagnosis; breast cancer resulting in a mastectomy; a wayward husband and divorce; a serious hand injury following an automobile accident. But somehow she managed to keep her jealousy of others at bay and appreciate her own joys in life.

At first I applied her maxim to relatively minor disappointments, like not making the cheerleading squad or a disappointing test grade. Over time I came to face my own serious challenges in my life: diagnosis with breast cancer twice and endometrial cancer once; major surgeries, radiation and chemotherapy; significant developmental issues with one child and serious health concerns with the other. Through it all, my mother’s words have guided and shaped me.

My experiences have also led me to develop a personal corollary to my mother’s belief. I now believe that, while others can support us in meeting the

It’s 1971 and we are in a green-tinted hospital waiting room, half-sterile, half-filled with sawhorses, wood planks, a drill, sitting in attached sickness-colored plastic chairs. My aunt–my father’s sister, whose ability to exclude herself from experiences by analyzing everyone else has diminished during this mutual terror–is at my right. Her long and elegant fingers cover my own. My younger sister, then brother, mother and older sister are to my left. We wait. It is the eternity of waiting for bad news while hoping for good.

The surgeon enters, scrubs matching walls. He lifts a hand and motions my mother to come to him. My mother grabs my older sister’s hand and moves with the surgeon behind a five-foot high flimsy room divider. Maybe it’s ten feet away from us. Maybe the surgeon really thinks it’s a separate room, closed off ceiling to floor, wall to wall. Asshole, I think to myself. My rage replaces the nausea of waiting. We are invisible to him.

The surgeon’s hand reaches up and pulls off his surgical cap. He’s bald. He’s stooping. He speaks as if we can’t hear. “Your husband has a tumor on his pancreas as big as a grapefruit. It’s inoperable and incurable.”

My

I considered the idea of survival only when I found out, postsurgery, that the cancer had spread to my lymph nodes. I wondered what would have happened had I waited any longer, had I ignored going to the hospital to follow up about the lump on my breast.

“I am grateful for witnessing your courage, your strength is inspiring, your wisdom is eternal, and you are not alone”: These words, written on a paper heart with irises around it, sit on my desk. I feel fortunate to be a behavioral health clinician, providing therapy to patients with cancer who are undergoing radiation at Stanford’s Cancer Center.