Dear Dr. G.:
It has been 12 years since that day in your office, when you dismissed a pea sized lump in my right breast. Before I spoil what became of that lump, I am going to back track a bit.
I was one of your first patients, when you started your practice in Beverly Hills about 17 years ago. You were eager and excited about helping women through child birth and whatever other issues they presented. You were a fantastic ear and a good doctor.
I left Los Angeles shortly after establishing a rapport with you and returned a few years later, in 2005, because I had gotten engaged to a man who had remained in California. Most of my prior support system was no longer here, I was having some issues with painful sex and I had a lump in my breast. So I made an appointment to see you.
This is a day I will never forget. I walked into your office feeling afraid and alone, really hoping to see the doctor I had known so many years before. But you were not there. Or at least your warmth wasn’t. You treated my visit much like an encounter at a cocktail party, almost looking over my shoulder to see if there was someone better to talk to, even though we were the only two people in the exam room.
I told you about discomfort with sex and you asked me if I really loved my fiancé. When I said I did, you mentioned another patient who had had a similar problem and, it turned out, wasn’t in love with her partner. I then told you about a lump that was concerning. It was small, it was hard, it was nothing you said after kneading around it for a minute. Plus, you said, I was way too young to worry about something like breast cancer. I was 33. After that you rushed through the rest of the exam and had me meet you in your office once I got dressed. This was the fun part. We could shoot the shit and you could introduce me to your next patient who was tangentially related to the entertainment industry. It was amazing how far you had come.
What wasn’t amazing was the way I felt when I walked out of your office. I was confused, insecure and not less anxious than when I had arrived. I can’t fault you for not offering the same kind of support or comfort as our past visits. Your bedside manner had changed. And, in my opinion, not for the better. But that was the doctor you had chosen to become. I can, however, fault you for carelessness. For using your fingers and opinions as a diagnostic test. What would it have hurt to have ordered a mammogram back then?
I went through years hearing your words in my head – that it was nothing – even as the lump grew. I was meek, I was afraid to assert myself and truthfully, I probably didn’t want to know it was something. Until another lump appeared under my arm. That was 5 years later. I was almost 38. And you guessed it, it was cancer. It was in my breast and had spread to my lymph nodes.
I was resentful at you back then but, rather than look backwards, I chose to put one foot in front of the other with chemo and surgery and radiation and surgery again and hormone therapy. Through all of that I learned to be my own advocate, something I didn’t know how to do when I saw you back in 2005. I learned how to do research, get second opinions, ask for tests I thought were necessary even if they weren’t readily recommended. And for all of that I thanked you in a weird way. It was a hard lesson. A terrible lesson but I swore never to put my health and wellbeing squarely in someone else’s hands again.
I was upset that maybe I could have escaped with a lumpectomy and medication instead of the barrage of treatments I had to undergo. But I was willing to let all of that be the past. Until summer of 2015, when the cancer returned: in my bones, my liver and my brain.
So now, Dr. G., I am a stage IV breast cancer patient. Do I know that I wouldn’t have gotten here if you had ordered a mammogram on that day in 2005? No. I know there is no guarantee but my odds would have been better. My chances of living a cancer free life would have been much higher. So I am writing this letter to let you know this.
The lesser part of me wishes you would stop practicing. The lesser part of me is calling you out on your arrogance and ignorance. I sent a lot of patients your way, most of who ultimately left you because of their own experiences with you. Some of those experiences were fatal. The lesser part of me feels better for pointing that out.
The better part of me wishes you well. It hopes that you move forward more responsibly. That you take my story and the story of others you have affected to become a better doctor. You are in a position of power and I hope you recognize that. Not just with your ability to diagnose and write prescriptions but with your words as an expert and someone people look to and trust.
I do hope that somehow this reaches you. I hope that you think of me every time someone comes in with a breast abnormality and every time you write a prescription for a mammogram. I also hope you are writing those often. That very small action, that scribble on a pad of paper could have changed the trajectory of my life. While I missed out on that opportunity, please do give that to the women who come to you for guidance and care. You can’t do anything to make this right, but that would surely help.
All the best.
I’ve taken a mini hiatus from blog writing and social media for two reasons. One, treatment struck again. But two, mostly because I was angry and reacting to my situation.
For treatment, I went through some more rounds of radiation. I also had a scan and found out I have a new lesion in my skull. The good news is that my organs are still cancer free. But really, fuck good news. Or at least, that’s how I’ve been feeling.
The only thing worse than being angry and not being able to get out of that tornado is not wanting to. I found myself holding onto anger like a life preserver that, in the end, only promised to drown me or, at least, make me miserable.
Stage IV cancer is the embodiment of powerlessness. From new mets to hair loss to runaway side effects from treatment. The only control I have is with my attitude or how I choose to come to the world. For the past month I chose anger as the emotion to tether me to a sense of purpose in an otherwise meaningless landscape.
Of course, anger as an anchor into anything worthwhile is an illusion. I knew that when I was in it but it was the only thing that made me feel powerful in the moment.
I don’t recommend staying there too long because, from that place, people get pushed away and internalization of that emotion can lead to depression and inactivity: all things that stand in the way of tapping into real life purpose.
I will thank anger for showing up though. It was a shitty crutch (that I’m sure will be back at some point). But it was one that gave me perspective about my relationship to this emotion. My reasons for holding on to it when I do. Now, being mostly on the other side, I am reminded that things always move and change. I am also grateful to have had access to this feeling, because it is entirely human and part of this crazy life experience. It means I’m still alive.
I try to focus on gratitude for every day I get to experience, for the massive amounts of love in my life, for having options outside of just fading away from this disease. But right now I’m angry. Angry and depleted.
The darkest thing I can admit during times like these is that there are moments I have fantasies of being killed by a stray bullet or an intruder. Of course, I don’t really wish for that but it feels just as senseless and quicker than whatever I am going through.
I’m heading into another round of chemo tomorrow and every fiber of my being is resistant. It’s difficult to undergo what seems like barbaric measures to rid myself of this disease without any guarantee regarding its efficacy. The last chemo cocktail I was on seemed to only give me a host of uncomfortable side effects without de-bulking my bone mets. In fact there was a slight progression. Although who’s to say it didn’t keep the cancer from spreading to my lymph nodes or organs. I choose to believe it did something since the thought of getting knocked down for no reason is unbearable.
The truth is I’m resigned to a roller coaster life – hopefully wth some large breaks from treatment in between – but the acceptance of it doesn’t make it any easier or less exhausting. I see people expire from this disease on a regular basis and it’s been a challenge for me to remember that, while we are on similar paths, theirs are not mine. So matching up their diagnosis dates with mine and comparing their treatment paths with what I’ve gone through, gets me no closer to figuring out when my last breath will be.
So I put this post here to remind myself to stay moment-based. To say I will forge ahead. I will continue to find joy in my days. I will focus on love and life experiences and self expression. I will try to trust this process and during the moments I don’t, I will let myself cry and be afraid, knowing that that too will pass.