Sabrina Slade is a medical student in the Class of 2019 at Queen's University
Let me preface this by saying I am the kind of person who uses sarcasm and humour as a form of coping, and these opinions are my own.
You I have cancer.
A phrase I never could have dreamt would come out of my mouth, yet something I see or speak about almost every day in my so far short-lived medical career.
It’s the last week of June; I’ve just started my internal medicine rotation in Toronto and am rushing to get ready as I have slept through all seven of my alarms. I glance at my phone, noticing three missed calls and a voicemail with a little urgent symbol beside it. It’s my family doctor’s office; I listen to the voicemail half-heartedly as I struggle to pull on my nylons. She says something about biopsy results, and the words “neoplasia” and “urgent referral” stop me cold. I shimmy over to my phone, my nylons awkwardly half on, and hit replay.
I didn’t hear it wrong.
I replay the message about ten more times before I realise I need to call her back to agree to this referral.
Let’s take a step back:
I’m 26 — sliding into the home stretch of medical school, juggling research and my part time job as a spin instructor, and trying to maintain my personal life, exercise routine, and healthy eating all while beginning a rotation in a very unfamiliar city with even more unfamiliar faces. Needless to say, I felt like all of this went up in flames very quickly with this new information, and not because of the current heatwave.
When you learn how to break bad news in medical school, they tell you to go slow: Go ten times slower than you think necessary. At this point in my education, I like to consider myself a person with some medical knowledge (though this knowledge is quite minimal, as I have been quickly learning on my internal medicine block). However, it took me about 30 minutes to process what had just happened; I then Googled “can biopsies be a lie” word for word, listened to “Anonymous” on Yahoo Answers, texted my preceptor that I had food poisoning, and cried myself into a nap.
After calling my parents and some of my close friends for advice — as well as exclaiming to my body, “I fed you veggies and coffee; how could you betray me?” — I decided the best course of action would be to ignore the burning trash fire that my life quickly was seeming to become throughout the Canada Day long weekend and deal with it on Tuesday.
Well, let me tell you — that weekend ended with a bang, because I woke up to a fit of extreme abdominal pain in the middle of the night on Tuesday, July 3rd, and walked myself over to the Emergency Department at 4 am.
Gears started moving from there (mostly thanks to my amazing internal medicine supervisor), and here I am nine days later; two days post-lymph node biopsy and anxiously awaiting (my editor kindly told me to pick something less vulgar than my initial phrasing) the results that my oncologist will reveal tomorrow.
Enough about my diagnosis... my purpose in writing this piece is to elicit my feelings; less so as a soon-to-be medical professional and more so as a friend, loved one, and patient. The next little portion of this article is a bit more real, with my three big take-home points from this situation as a learning experience.
Breaking bad news:
When I first learned what was going on, my brain truly did not process what was happening; I had to repeat the voicemail way too many times and, even now, I feel like I’m missing information or dreaming. The best way to describe the whole situation would be à la Charlie Brown with the adults “womping” along in the background coinciding with intermittent intelligible words.
Retrospectively, I have broken bad news more times than I can recall and can guarantee you: having now been on the receiving end, there are many situations where I did a substandard job. Please, for your patients’ sake, really take the time to lay out what you’re going to say, and ensure you repeat it, answer questions, and write it down. This may just be a flicker in time for you, but to them... this is their life moving forward.
When someone tells you they need help, or are “having a rough go,” (even if it is unspecified), that is them asking for support — they need someone to lean on.
This is a good time to ask them what you can do to help, or if they wish to catch up. Although you may not have seen them in months or years, or may not necessarily be that close to them, they must have felt some level of trust to share what’s going on. At the time of my diagnosis, I was in an unfamiliar city where I knew few people; this forced me to take some risks. Reaching out resulted in some shying away while others were beyond amazing.
I reconnected with one friend whom I hadn’t seen in over three years (thanks, Facebook) and just happened to now be living in Toronto. I spent a lot of time with her; sometimes she helped me with meal prep after work, while at other times we simply sat in silence, my head laying on her lap while I sobbed. My friendships with her and others that have grown because of this diagnosis have really helped to pull me through, and for that I am forever grateful.
Put down the phone:
Life is in front of you, not on a screen.
It wasn’t until I faced my diagnosis head-on that I realised what I regretted not doing most, and that was being present and really enjoying life through my own eyes (not others’).
Friday, July 13th: Node biopsies were negative for metastasis. My surgery date is pending.