Our Shared Journey

Editor’s Note: This piece was awarded an honorable mention in the Pulse writing contest, “On Being Different.”

It took a terrifying and life-changing experience of being different for me to realize a fundamental truth: I’m the same as everyone else.

This truth has redefined my goals and reshaped the way I practice medicine.

At age twenty-nine, during my third and final year of internal-medicine residency, I received a diagnosis of a rare and malignant brain cancer called anaplastic astrocytoma. Quite suddenly, I was different.

I was different from the healthy version of myself I’d thought I was. I was different from my residency peers; I was different from my friends and family. I was a different kind of physician—one who is also a patient. I was also a different kind of patient—one with a rare diagnosis and limited treatment options.

My original diagnosis came about in an unusual way. During year three of my residency, I spent a month in Thailand on a global-health elective. It was there that I started to notice strange symptoms and ended up diagnosing myself with a brain tumor. (The entire bizarre ordeal is described in my memoir, Difficult Gifts.)

My rotation ended abruptly with my being admitted to a hospital to a hospital in Thailand so that the doctors could stabilize my seizures and cerebral edema.

Suddenly, I was a patient. I was a patient in a foreign country, unable to speak the primary language; a patient in the room where I was supposed to be a physician. My experiences as a patient taught me much more than a medical residency or textbook ever could about what it truly means to be sick, and to feel different and alone.

Being a patient is terrifying. You are clad in a thin gown that strips you of your individuality and dignity, attached to constantly beeping monitors and given little information about your situation. Your provider, whom you’ve likely just met, tells you the worst news of your life, then moves on before you can formulate the right questions.

In this setting, my medical background helped tremendously. Alone in the hospital in Thailand for three days, I knew what to expect. I understood what the beeping machines were monitoring, and I knew not to fear when brushing my hair resulted in a horrifying telemetry pattern. I knew that providers would stop by at random times and spend a handful of minutes with me, so I prepared questions in advance. Not everyone knows these things, nor should they be expected to.

This experience showed me that feeling different can mean feeling alone, disempowered and scared. 

Returning home to Minnesota, I underwent two craniotomies and months of radiation and chemotherapy. Fortunately, I was able to finish my residency, complete a year as chief resident and start my career—first in primary care, now as a hospitalist. I’m incredibly lucky that my illness did not leave me with physical or neurological deficits that would limit my ability to practice medicine.

Throughout the past three years, not a day has gone by when I haven’t thought about the fact that I have cancer. Although it’s currently stable, my illness is considered incurable, and I will live with this constant reminder of “different” forever.

Despite moments of fear, sadness and self-pity, I have come to see my diagnosis as a gift: a difficult and unwanted gift, but one with the unexpected power to change me, motivate me, inspire me and teach me. Cancer has been the most beautiful, life-changing gift I’ve ever received.

My illness’s unsubtle reminders of humanity, physical limitation and mortality exert a constant gravitational pull on my ego. Rather than seeing myself as a person in a position of power, as an infallible healer or as a highly educated provider with the right answers, I see myself as a person like everyone else—someone who faces emotional and physical challenges, who is imperfect, impermanent and mortal. Someone who knows what it’s like to feel different, and who understands how isolating that can be.

Outside of my work at the hospital, I spend my time as a writer and speaker. I’m passionate about raising awareness for brain cancer, patient advocacy and invisible illness. Although my own diagnosis is rare, I’ve come to see that my lived experience with hardship is not.

We all experience difficult and unexpected situations. We all face moments of uncertainty, fear, sadness and frustration. Whether it’s physical illness, mental illness, socioeconomic instability, intellectual disability, bias in any of its forms or one of the many other unforeseen events that can impact our lives, we all experience challenges. I’ve learned that sharing our stories honestly and vulnerably is a powerful way to decrease our sense of isolation and find strength in community. Through sharing our differences, we find similarities.

When I began my career in hospital medicine, I decided that I would share my experiences with my patients if I believed that it might be helpful to our relationship. As a physician, I’d been trained to compartmentalize, to separate Courtney the person from Courtney the physician, but after my own experiences, I started to wonder if this was the right thing to do. Sometimes it is; but I believe that, in holding ourselves separate and concealing our shared experience from our patients, we often rob ourselves, and them, of the most important healing tool we have.

The first time I told a patient I had cancer, I was terrified. For days, devastated by a recent cancer diagnosis, he’d lain tearfully in his hospital bed with the lights dimmed. On our last day together, I asked if I could tell him something personal.

“I have cancer as well,” I said. “I remember the experience you’re going through—receiving a terrible diagnosis, feeling alone and afraid about living a different life than I’d imagined.”

He nodded encouragingly.

“I can’t say it’s easy,” I continued, “but know that you are not alone. As different as you may feel, we’re all facing something we never expected to face. Have hope that you can still live a wonderful life, even if it’s different than what you imagined.”

He jumped out of bed and hugged me.

“Thank you, doctor!” he exclaimed. “If you can get through it, I can too.”

Instantly my misgivings vanished, and I knew that sharing what makes me “different” was better than any medication I could prescribe.

I feel different, but I am not. I am human. I am mortal. I am suffering, and I need help. I have moments of loneliness and fear. I also have moments of hope and acceptance. I cherish my differences and use them to write and speak about our shared humanity: What makes us different also makes us similar.

Being different holds within it the potential to heal, and I embrace it with every part of my being.