“Wouldn’t it suck if you made it all the way through residency and then got cancer at the end?” my buddy Ron, a fellow medical student, and master of dark comedy, joked. I winced at the thought. God has a funny way of foreshadowing.
Three-quarters of the way through pathology residency I noticed my feet were starting to itch, especially at night. It was a deep itch. I scratched so hard it bled. I thought I hope I don’t have Hodgkin’s, and then put it out of my mind. I had a pile of cases waiting for me in surgical pathology.
Four months and 20 pounds-lost later, I could barely stand up long enough to put on mascara in the morning without needing to sit down for a break. Still, I kept working. The nighttime cough was getting worse, and I was growing tired of sleeping on beach towels after soaking the sheets. At urgent care, I was diagnosed with bronchitis and allergies. A chest X-ray would have revealed a mediastinal mass the size of a lemon, if one had been done.
Sitting in a hematology conference, I scratched my neck and felt a hard lump: a supraclavicular lump. Those are never good. I thought of cancer, probably metastatic lung. I flashed back to my itchy feet months earlier. Hodgkin’s? God, please. A strange mix of relief and dread washed over me.
After conference, I headed straight to the head of cytopathology.
“Could you please needle my neck mass, because I’m pretty sure I have cancer.”
He smirked doubtfully. Then he felt the hard mass sitting atop my clavicle. Concern replaced the smirk. He and another faculty member did a few passes with the fine needle. Ten minutes and a Diff-Quik stain later, he lowered his gaze from the microscope, his eyes full of pity and spoke, “You need to be staged.”
There is nothing like sitting at a double-headed microscope and staring Reed-Sternberg cells, your own cancerous cells, in the face. How could my body betray me like this?
I stumbled home to break down in private. My wedding was in 6 weeks. I told my fiancé. In the midst of my hysteria, he grasped my shoulders and stared intently into my eyes, his voice low and steady, and promised, “You will get into remission, and we will have our wedding this same time next year.” I tried to believe him, as much as I could.
The next day instead of meeting with a caterer, I met with an oncologist and the general surgeon who would excise the supraclavicular lymph node. Less than a week later, my diagnosis of Hodgkin lymphoma-nodular sclerosing subtype was confirmed. A flurry of tests including a PET scan, pulmonary function tests, an echocardiogram, and one painful bone marrow biopsy declared me stage 3B. I was urged to begin chemotherapy immediately.
For six months, I lived in two-week cycles. I got a great wig, named her Janet, and continued working. Work was the safe place where the intrusive thoughts of what might happen if I didn’t respond to chemotherapy stayed away. I looked reasonably well. I like to think that aside from my wig, which was a Catherine Zeta-Jones inspired bob, one would never know I was sick. A stranger stopped me in the mall and demanded to know my hairstylist.
At the end of twelve treatments, I had a PET scan to see if I’d made it into remission. I was awarded the magic letters: NED, or no evidence of disease. It should have been a happy time. It wasn’t unhappy. It was nothing. There were no guarantees that I wouldn’t relapse and have my life shattered again.
Relapse was all I could think about. For months, I couldn’t drive by the oncology infusion center without waves of nausea crashing over me. The mental trauma seemed to have infected my cells like a virus.
I had anxiety and a lot of trouble sleeping. I failed the boards. I desperately wanted to get back to normal. But I didn’t know what normal was anymore. Looking back, I wanted to pretend that my little cancer was but a blip on the radar. It would not derail my plans. It was over and done. Except it wasn’t.
I saw a psychiatrist. He listened patiently. After a few sessions, he directed, “You’re going to have to be a little Pollyanna about this. Humans are not made to walk around contemplating their mortality all the time.” It clicked. I needed to hear that.
With a lot of reassurance from my fiancé, he and I moved forward with our wedding plans. True to his word, we married nearly a year to the day of our canceled wedding. A professional hairstylist piled my short hair on top of my head making it look like the long, thick hair I had the year before. An air of triumph ruled the day.
Fast forward nine years and two children later. When I think back on that terrifying year, there is a psychological scar, but no active trauma. It either moved out of my cells, or I moved on. Either way, it’s gone.
The thing that remains is gratitude. My friend Ron was right: It did suck to have cancer at the end of residency. But cancer also transformed me into a more clear-eyed and mindful person. And for that evolution, I am forever grateful.
Collin O’Hara is a pathologist.
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