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Where My Story Ends and Yours Begins

It was a Thursday morning, my first day on the medical oncology service. I hurriedly gathered my white coat and badge, the block letters “3rd Year Medical Student” unmistakable in fresh ink. Taking a deep breath, I forced myself to look up at the cancer center.

This is going to be difficult, I thought.

Just one year ago, my father was treated at this same center after being diagnosed with stage IV colon cancer. I’d never imagined that the first death I would witness while in medical school would be his.

As I approached the center’s entrance, unwelcome memories of chemo suites, ambulance bays and exam rooms began to surface. Glimpsing myself in the window, I felt the stark contrast between my role here today and my role one year ago. I closed my eyes; my mind screamed the words “colon cancer,” as if all my family’s pain and suffering could be captured in a two-word chief complaint. How would I get through the day? Would I be able to empathize with the patients and their families, or would I be paralyzed by flashbacks of my own loved ones in these same rooms?

Our first patient was a young woman named Viv. I saw the words “colon cancer” next to her name in the chart. My heart sank. Was that how simple the diagnosis had looked next to my dad’s name?

“She has a young son,” my attending told me before we entered Viv’s room. “Quality of life and maintaining grace are her priorities.” I nodded uneasily.

Vibrant, talkative and bubbly, Viv offered us candy that she’d brought just to brighten our day. I hoped fiercely that my attending was bringing her good news.

But no.

Unfortunately, the scans showed that Viv’s cancer had progressed significantly, with growing metastases in her liver and a new lesion in her lung. Upon hearing this, she looked towards her son.

“No more chemo for me, doc,” she said softly.

As my attending gently brought up hospice as an option, I admired his ability to convey compassion while maintaining a professional demeanor.

My mind wandered to my own experience of sitting in that chair. What if Dad’s treatment team had initiated this hard conversation with us? Did we make a mistake in not thinking about hospice and urging him to consider it?

Desperately, I tried to ward off these thoughts.

As Viv expressed her wishes for hospice care, I marveled at her poise, grace, strength and acceptance.

How could someone so young have come to terms with this? I thought. Why isn’t she angry? And why am I? Maybe it’s the injustice of her having to die at such a young age and leave behind her son—and my own anger at the injustice of Dad’s death.

When the visit came to an end, I didn’t want to leave. A part of me knew that I would never see Viv again. The reality of her impending death hung heavy in my heart. If we could just stay here, maybe time would stand still, maybe she could stay on this earth with her son. I looked at the toddler, busy driving his toy truck along the arm of the chair, his youthful innocence a shield against this harsh reality.

I am so sorry….

The last appointment of the day was just as difficult as the first.

It was hard to peel my eyes away from Ms. Kane, a young woman suffering from esophageal cancer. She weighed only eighty-seven pounds and was sitting in a wheelchair, breathing through a tracheostomy tube. Her radiation treatment had caused left-sided torticollis, a drastic, involuntary twisting of the neck, which had led to massive swelling in her left eyelid.

Family members and friends filled the room, wide-eyed, their hopes resting on my attending’s next words. Again, I so wished that we were bringing good news. Sadly, despite numerous rounds of chemotherapy and immunotherapy, Ms. Kane’s disease had progressed. She was too frail for a clinical trial.

When my attending introduced the idea of hospice, I could tell from the blank stares around the room that no one had anticipated this.

I understand, I thought. Somehow, that final piece of bad news hits like a train.

Because the tumor was blocking her trachea, Ms. Kane could communicate only through writing.

“I am not ready to die,” she wrote, tears welling up in her eyes. Her tenacious will to live reminded me of my father’s.

The following week, I rotated through inpatient hospice. Death was an almost tangible presence as we rounded on our patients.

As I’d expected, most patients had cancer. Making enormous efforts to suppress the memories of my dad’s last days, I successfully numbed my emotions until the morning we rounded on a woman dying of metastatic breast cancer. She was fifty-one—my dad’s age when he died.

Standing at the foot of her bed, I finally allowed myself to feel raw emotion. In a daze, I listened as her husband told us about his wife’s adventure-filled life, her wonderful personality, her passion for art. His voice broke whenever he looked at her. I felt an overwhelming urge to ease his grief, to offer him the words that had helped me through, to tell him, “You are not alone.”

Instead, I stood there. Silent. I was bursting to comfort this man, yet I remained speechless, wavering between my urge to share my experience and my wish to fit the norm of staying anonymous—a norm that I had absorbed without wanting to.

I struggled with this for a long time afterwards. Was my silence due to lack of courage, or was it a reflection of Western medical culture? Why didn’t I return to the room to share some of my experiences and offer comfort to the patient and her husband?

Is there a place in the physician’s role for using personal experiences to comfort patients or their families? When is it appropriate to tell our stories, to offer understanding, to embrace someone in solidarity?

My father’s death has changed my view of medicine. I better understand the deep pain felt by families—and I question the need for a demarcation between the personal and the professional. I ask if and when we should bring our own stories into the patient encounter and let ourselves be swayed by our personal experiences.

How can I not be swayed by my own?

Caitlyn Myrdal is a recent graduate of the University of Arizona College of Medicine in Tucson. She is passionate about cutaneous oncology, has published numerous academic works in that field and is interviewing for a residency in dermatology. Outside of medicine, she enjoys photography, travel, hiking, backpacking and listening to new audiobooks. “After my father’s death, I struggled to integrate my own experience and my professional practice. After one particularly difficult clinic day, I returned home and began typing the pages that morphed into this story, my first piece of narrative writing. The process of reflecting helped me to heal in ways I could not have imagined. Since then, I have continued to find meaning through writing and intend to continue throughout my career.”


11 thoughts on “Where My Story Ends and Yours Begins”

  1. Dear Caitlyn,
    Thank-you for your raw writing. What comes to my mind first is that you must be able to share your feelings with some one. If you don’t have have time for loving friends or a partner who can really hear you, a good therapist might help you unload some of the pain. We all feel it when we care for patients, especially when their issue touches a chord in our own experience.
    I think it’s important to learn the line between showing the emotion you are feeling for THEIR pain, and making encounters about your own experience. Once you get that, it won’t be so hard to know what to show/share. There may be times when it’s ok to make it about you, but most often it’s not. This learning comes with experience. Hold on to your sensitivity, your compassion, and your willingness to be real. Maybe start a resident’s group to help others process these feelings and issues. Trust me, you’re not the only one to feel this way and you could help many others maintain their humanity amid the stresses of clinical practice, perhaps especially in these crazy covid times.
    Remember your patients needs your strength and ability to focus on them, as well as your humanity. Crying with a patient is perfectly fine, just like laughing with them is. We are all human….
    When I was a new clinician I’d call my sister at midnight after a long evening shift. She’d listen. I’d feel so much better. She later told me she had trouble falling asleep after hearing all the details I needed to share, bless her!
    I hope this helps….
    I am nearly 70.

  2. Yes, the art of medicine. Learning when to share, how much to share, how even to begin to share without one’s own experiences taking over the interaction. The patient’s needs, what we can offer, how to listen and take care of their needs, when our own heart is breaking inside. Perhaps this is a kernel of the pull on us as caretakers during this time of covid when our hearts are just filling up with experiences and we are trying so hard to focus on the needs in front of us. It’s definitely part of being in medicine, being a person, being human. Constantly caring, continually learning.

  3. Thank you for this story! I find these questions particularly meaningful. “Is there a place in the physician’s role for using personal experiences to comfort patients or their families? When is it appropriate to tell our stories, to offer understanding, to embrace someone in solidarity?”

  4. I am in tears. Hang in there. Hug..cry with patients. It’s allowed. And I am looking forward to welcoming you to the dermatology family. Good luck and godspeed.

  5. Here in India, I know many doctors do share our personal experiences with patients,in the hope that it will ease their pain . Is there any written law which prevents you from doing it in your country ?

  6. You definitely should keep on writing.

    I rarely cry after reading stories on Pulse,
    but I’m crying now

    It may have been the immediacy of your story,
    but also the emotional truth of it.

    It was in no way “artful.”

    As a writer, let me suggest that whenever possible you
    pour your stories out as quickly as you did this one, without stopping to think or re-word.

    Of course the story will then need many, many revisions,
    perhaps over a period of months,
    But if the raw, unedited emotions are there, you have

    Finally, I think the idea of finding a way for doctors
    to share their personal experiences with patients is
    Wonderful and much-needed.

    Doctors have been taught to put up such an emotional
    wall between themselves and their patients ..
    This is very hard for patients ( we feel they don’t care)
    and reading this story, I realize how hard it is for doctors.

    We really need to change the way we train medical students.

    I will always remember when my cataract surgeon told me
    that I had lost all sight in the eye that he had operated on
    2 weeks earlier.

    When he told me, his eyes were brimming over with tears.
    He didn’t say anything.
    He was embarrassed.

    But seeing the tears made me feel better.
    Another human being was breaking the news to me.

    1. Dana Cook Grossman

      Maggie, I started to read your thoughtful and wise comment without noticing your name. Then about halfway through it, something tugged me to scroll back up and check out the commenter’s name. I was not the least bit surprised to see it was you. And I fully agree with your praise for this story’s genuine tone. Beautifully done, Caitlyn AND Maggie!

  7. So very touching, so well written, and thoughtful. I’m very sorry for the loss of your father and very sorry your family had to journey through cancer. Until you’ve traveled such a path you just can’t “get it”. You are guaranteed to come out a different person with a different outlook and understanding. And when you’ve treated patients and walked their journey with them, you will have a better understanding of that perspective also. There will be many varied journeys in your bright future and I feel confident that you will see them through with caring compassion. I wish you all the best.

  8. Henry Schneiderman

    This is a most potent and moving story. I think we can and should share some personal stories with patients and families; the key is to avoid the cold impersonalism that portrays ourselves as different from our patients and their families; but to be selective, wise and never gushing, never telling because we need to, only because and to the degree that our sharing will be of potential use to them. Not an easy call in any case, but as with all facets of interviewing and practice, improveable with immersion, reflection, and using the direct feedback of colleagues, supervisors, and patients and families themselves. One can also, of course, always say, “I have a story of my own about this–would you like to hear it?”

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