A Physician's Journey Through Cancer

Physician Heal Thyself

Before I was diagnosed, I was burnt out. It’s so common in healthcare. Healthcare providers rarely take sick days, may not take all earned vacation leave, and tend to give and not put ourselves first. We signed up for this job to help care for others but somewhere along the way we forget, never learned how to, or were not given permission to care for ourselves. However, being burnt out can happen in any professional field and at home as well.

When I got cancer, I was juggling patient care with being a busy Mom. This idea of a perfectly balanced life is a facade and an unrealistic goal. I had to let go of perfection and free myself from the encumbrance of others expectations. There is only what works for me personally and professionally in that moment in time as every day is a different day new challenges.

Health Care is constantly changing, and there are so many pressures with billing, insurance, pharmacies, staffing, patient needs, and hospital systems. With all these variables to balance and external pressures to address, it can feel like a never ending game of 'whack-a-mole". It is a lot to handle. There's always an apparent crisis, until a true health crisis comes and you realize that your own health is paramount and peace can only be found within.

I count myself as one of the lucky ones with Inflammatory Breast Cancer (IBC). Since I am trained to identify skin conditions, I knew that I either had IBC or mastitis (an infection of the skin common after breast feeding). Some women are treated with antibiotics or misdiagnosed for months. IBC grows very rapidly in weeks to months. My knowledge and medical community got me from first presentation to my provider to chemotherapy in 13 days. That number still gives me goosebumps, and I feel incredibly lucky to be alive and NED (No Evidence of Disease). I wish that turnaround for every person with IBC.

However, it was frightening and harrowing to know what I knew about IBC and cancer treatment. I had learned in my training that IBC was a death sentence. While the statistics aren't great, thankfully those numbers are changing with standardization of care at big centers and improved targeted treatments. I was also petrified of many of the chemotherapeutic agents that I was receiving and the possible painful, debilitating or deadly side effects that I had learned about in medical school. I found myself tapping into my faith and doing it afraid. This was challenging since my background is in science, evidence, and certainties. The truth is that despite all the lifestyle changes I was exploring, I didn't know if the treatments would work. So I controlled what I could control (altering my nutrition, exercise, stress levels, mindset) and relinquishing what I ultimately don't have control over (such as response to treatments and side effects from treatment).

I changed my perspective, unlearned archaic knowledge, and opened my mind to new possibilities. I used the skills and curiosity that brought me to medicine in the first place to explore and fight IBC with every useful tool; traditional medicine of my training and holistic healing that was new to me. My husband is also in healthcare and was my teammate pouring over evidence based medicine research articles as we worked together to optimize my diet, fasting, movement, mindfulness, spirituality, and community to best support me. I found a holistic healing team that worked with me and the traditional treatments I was being given at my cancer center. I became a self-advocate to help steer the where, how, and when of my treatment within the best practices guideline for IBC treatment.

Another layer of challenge is that in healthcare often our identity is tied to our profession. I felt like I needed to be the one with answers. It was incredibly humbling to shift from the provider of knowledge and healing to the patient, and to acknowledge that I was sick and that I didn't have even a fraction of the answers nor the capability to medical treatment myself. I feel immense gratitude for every member of my healthcare team: from the researchers, physicians, nurses, medical assistants, greeters, receptionists, medical students, lab technicians, and janitorial staff that makes the healthcare machine work so that our cancer can be poisoned, cut, and blasted away. Our world went through a lot of stress, and suffered unimaginable loss during the COVD-19 Pandemic, but I hope we gained a greater appreciation for all humans and the role each one of us plays in keeping our world flowing.

I often get the question, "Are you back to work yet?" That can seem very heavy, like there's an expectation to return to the me-before-cancer. I realized that that question isn't about me, but about the person asking the question. It is personally challenging to see a cancer patient before your very eyes dealing with mortality. They want me to be "ok"and to them that means me the way I was before cancer.

However, there is no way to go back to being that pre-cancer-me, for better or worse, and it is normal and healthy to change and grow. We all have an intrinsic value that is greater than our profession. We are first and foremost humans being not doing. It is so important to prioritize ones health first because you cannot pour from an empty cup. Right now I am prioritizing my health, being present for my family, and still helping others as an Inflammatory Breast Cancer advocate and through this website. I still am passionate about the field of dermatology, I’m just taking a break for the moment.

Action Plan

Set Boundaries

Set time boundaries and time limits on social media. Unsubscribe or mute people that are feeding you images of a perfectly curated life. These are unhealthy expectations, and it is unhealthy for you. This is only the highlight reel. Real life is messy!

Set boundaries around what you are willing to do at your work. If you can, take the time to treat your cancer and heal.

Self-Care is Not Selfish!

Create a self care routine that fits your life right now. I'm not talking about pampering of a spa day (though those experiences are lovely!) or simply attending to the basic necessities of life like washing your hair (although with a newborn or as a busy intern this can feel like a luxury).

Self care is taking take of your mind, body, and soul to give yourself what you need to function. Give yourself 10 minutes in the morning to read, reflect, breathe, pause, stretch, experience nature, move or whatever feels life giving to you.

Be Open to Receive

It is ok and important to ask for help and receive help. Vulnerability is not a sign of weakness, but makes your relationships stronger.

Use online websites to update family members, coordinate rides and household tasks, and create a meal train. Try social media or an online health journal to share updates like Caring Bridge. Lotsa Helping Hands allows you to coordinate rides, meals, household tasks and appointments on a calendar. Meal Train and Take Them a Meal allow you to create an online meal train. Be VERY specific about what your needs are. If you are on a particular diet, say so! People want to help! The wise folks at an organization called Bright Spot Network came up with a fantastic list of ways you can ask people for help for when they say, "How can I help?"

If someone offers help, ask them specifically what they like to do. Create a running list of who volunteered for what position: chauffeur, laundry, meals, babysitting, walks, cleaning, etc.

Get Curious about Holistic Healing

Challenge yourself to try something different that you've never tried nor prescribed before like meditation, affirmations, yoga, massage, Reiki, Qigong, acupuncture, chiropractic or sound healing. Always ask your oncology healthcare team if they are ok with you trying new holistic therapies especially those that physically manipulate your body.

Books for Healthcare PRofessionals

Kitchen Table Wisdom: Stories that Heal by Rachel Naomi Remen. A former pediatrician turned cancer counselor shares a collection of personal, professional, and patient stories about healing. Her stories helped me unlearn some of the teachings of western medicine and allowed me to be human and feel. A story that touched my soul, took my breath away, and stuck with me is that of a young cancer survivor who envisions himself as a cracked vase. He feels the anger at the loss of his leg and being broken, but later he realizes that the crack is what lets the light in.

The Immortal Life of Henrietta Lacks by Rebecca Skloot. This is the true story of a young woman named Henrietta Lacks whose cervical cancer cells were taken without her knowledge. Her cells, or HeLa cells, were the first immortal cells to be grown in culture. HeLa cells became crucial to many medical discoveries of vaccines, cancer, and in vitro fertilization. Through Henrietta's story, Skloot illustrates racial and gender inequality and the dangers of paternalism in medicine. It is a fascinating and eye-opening dive into our history.

The Gifts of Imperfection by Brené Brown. This book shares Brown's 10 guideposts for living life wholeheartedly by embracing our true selves and releasing ourselves from the constraints of expectations and perfection. "Authenticity is the daily practice of letting go of who we think we’re supposed to be and embracing who we are."

Radical Remission: Surviving Cancer Against All Odds by Dr. Kelly Turner. Radical Remission is the product of over 100 interviews of cancer survivors and 1000 case reports of patients who have survived cancer despite the diagnosis of terminal cancer. She discovered 9 commonalities that survivors use to survive despite the odds. She highlights the survivor's stories and provides evidence based research behind why these techniques work. I highly recommend this book for inspiration and for guidance.

The Brain that Changes Itself: Stories of Personal Triumph from the Frontiers of Brain Science by Norman Doidge - This book changed my view of my brain. I was taught that our brains have specific locations for certain senses, motor skills, intellectual actions and that these are static. This book revolutionizes our old thinking that the brain is fixed and unchanging. Elegant experiments and case histories demonstrate how stroke patients regain faculties, the blind "see", phantom limbs fade away, a woman with half a brain rewires itself and how to improve your cognition. This book can be a bit scientific for those without a science background, but it is still accessible for all. The findings presented in the book are empowering especially when you are trying to change your behaviors or learn a new skill. Embrace the possibilities. Your beautiful brain can keep growing and changing with you!

Set Boundaries, Find Peace: A Guide to Reclaiming Yourself by Nedra Glover Tawwab. Counselor and therapist Tawwab defines healthy boundaries and provides accessible ways for us to ask for and achieve healthy boundaries in all aspects of life. Her specific examples and phrases (especially using her narration in the audiobook version) make boundaries setting easier. She also provides relatable and easily digestible tips on her Instagram account.

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