Author: Molly Kochan O
Open letter to the OBGYN who waved off my tiny lump
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.
Honest statement of the day
The Anger Crutch
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.
Honest statement of the day
Reminder to self
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.
Honest statement of the day
My stage IV life
It’s been a while since I’ve posted anything. I was in the hospital for about a week and a half due to complications with the oral chemo drug I was taking.
Doing nothing except healing gave me time to reflect on this stage IV life. I thought I’d share a few of the things I face daily. Most of the below, I don’t share with anyone so many people are unaware of what goes on behind the body scenes.
Of course, not all journeys are the same, but here’s a view into mine with the hope that some of you will relate and, for those of you who are supporting someone with cancer, maybe you’ll get an eye into some of what they are going through.
- Pain and fatigue is a part of my daily life: The intensity of pain and fatigue shifts. Sometimes it’s worse than others. I’ve gotten good at compartmentalizing and shutting out some of the discomfort. I’ve learned to focus on other things to distract my brain. Surprisingly, it’s more difficult to do that with fatigue. There are times, like now, fresh out of the hospital, where I have to lie down for a moment after putting on an article of clothing. Needless to say, it can take me a long time to get out of the house.
- Sometimes the side effects from treatment will set me back as much as any disease progression will: This is why I like supplemental modalities to help quell certain side effects. But there are times my body will react adversely to treatment anyway. And like now, I am still healing and therefore am off treatment all together for at least two weeks. This means the disease may be progressing during this time. A scary prospect I try not to think about.
- Every time there’s a setback, I know something similar is likely to happen again at some point: Lying in the hospital, I typically have thoughts like “what if I don’t leave this time?” Eventually I get to the point where I realize this bump in the road is just part of the bumpy road I’m navigating. The goal then becomes to maximize and multiply the good days.
- I don’t make long term plans anymore: This is not because I think I’m going to be dead next year. But all I have is right now. Long term plans don’t give me hope of survival. In fact, thinking about going to a spa next summer just feels like an alien conversation. What does give me hope is soaking up as much of the moment as I am able. And of course, short terms plans, like I’m going to have a big meal when I get out of the hospital, always work too.
- There are always side effect issues: Some are worse than others, and some I’ve gotten used to ignoring, like the intermittent pain in my neck from bone mets. The funny thing is that as some of the larger effects dissipate or as I get used to them, I start to notice the smaller side effects. Right now I’m dealing with finger tip neuropathy, which is more annoying than anything. And it signals that maybe the other side effects are just not taking such a great toll at the moment.
- I’m not suicidal, but sometimes I think about what it will be like to drop this body: I love life. I love living. I don’t feel like I’ve said my piece yet. But there are times where this journey is so taxing that I imagine transcending this life and what it will be like to move on from all of this. I’m not there yet and I’m hopeful I will get strong, get better and self realize before I say goodbye. But I do wonder about the end an awful lot.
- Friends are great, but so is connecting to people going through the same thing: When I was in the hospital, I had friends visit and bring me things daily. They were all so wonderful and there is only so much they can understand what I’m going through. I’m actually happy about that. I wouldn’t want anyone I love to truly “get” this. I tend to shy away from anything Cancer. Pink, marches, walks, talks…etc. I don’t want to integrate that into my life or identify with it more than I need to. For that reason, I rarely talk to other people going through similar things. However, I’ve been on Twitter for a while and have found the digital support and understanding to be unmatched. So while I was laid up, I wound up connecting with someone who has become a close Twitter friend. We spoke on the phone at length about treatment, side effects, how we navigate loved ones and the public. And while our journeys are not exactly the same, there is a mutual caring and understanding I haven’t found anywhere else.
- It’s become important to me to understand every medication or treatment I’m given: My oncologist is a terrific quarterback. He’s always on top of next steps and responds to emergencies and non-emergencies at lightening speed. However, I have become of the mind that if something were to happen to me while I am “managing” my treatment, I’m ok with that. If something happens because a doctor makes a decision that doesn’t resonate with my body, I don’t think I’d forgive myself. So, when I was in the hospital, they put me on TPN (intravenous nutrition). The drip rate was fairly high and I could feel it was freaking my body out. So I requested they lower the rate, which made the infusion more manageable. I am constantly navigating things this way and have regretted none of my choices, since I’ve built a team I trust and that gives me all the information I request. Plus, everybody’s body is different and, while I may not be an expert in Cancer treatment, I’m an expert in how my body feels.
- The weight loss messes with my body dysmorphia: This may be something unique to my situation as I have never heard anyone else discuss this….I’ve lost a lot of weight since treatment. Currently I’m 5’5″ and 105 pounds, about 6 pounds underweight. I have lost a lot of muscle mass so that it can be difficult to open a car door or a bottle of pills. Part of me is pleased with the thinness and I’ve gotten compliments on the way I look from men to the woman at the imaging place, who always harps on how gorgeously thin I am. The last time I went in, right before my hospital stay, she said “You’re almost a supermodel now.” Definitely messes with my head a bit, since I come from a background where being thin and looks were a huge focus. I am working on shifting my priority to building strength. Because it is only with strength that I’ll be able to handle treatment or fight what I have effectively.
Honest statement of the day
We’re all headed to the same place
I don’t generally get sentimental about death. When someone dies, I see it as their last stop on the train in whatever body they arrived in. And I don’t believe they fully disappear. In fact, I think they reenter a big pool of oneness, that births us all, only to reemerge in myriad ways I won’t even pretend to know.
But this week has been different…
I met a woman at a party a year and a half ago. She was around my age, vibrant, smart, filled with purpose. She and I not only found we had a breast cancer diagnosis in common, but we shared an oncologist.
While I go about this journey quietly, she lived it out loud. But not as a victim. As something of a sherpa to those who would come after her in this dodgy terrain called cancer. And while I find empowerment in silence, she found it in positive broadcasting and even went as far as to make a documentary about her journey. It provided answers she had been looking for and was unable to find at the beginning of her diagnosis.
So we bonded over our commonalities and became Facebook friends, as you do. I never kept in touch and rarely saw her posts. But she was in my peripheral radar. Until this week…when I saw a post announcing she had passed away.
And this time, this death has been so utterly impossible for me to process. It’s not because she was taken by the disease that I have. It’s not because of our similar age or the doctors we shared. But it’s because she was doing and living and looking mighty damn healthy up until the end. Many of her Facebook friends even said they had no idea she was sick again.
So why would that hit a nerve? Well I pride myself in looking healthy and in doing and in living every day to its fullest. And I have believed it to be something of an antidote to this disease. As if living fully will, in part, make the cancer go away. It will signal to the Universe that I’m really ok to stick around for a bit.
But if it didn’t work for her, why will it work for me?
That may sound selfish. It may sound naive – I mean, everyone is different. And as I said in the beginning, we are all headed to the same point. When that will occur, no one knows. But her death strikes a chord of terror. It makes me feel like this thing may very well take me and what if it takes me before I realize myself or do what I feel I am meant to do?
And that’s where this woman’s story is actually an inspiration. AW Gryphon touched oh so many people. She was a light in this world. You didn’t need to talk to her for more than 10 minutes to know that. She said a lot in a short amount of time. She seemed to harness the air around her and fly towards purpose and meaning and authentic messaging that helped droves of people.
So while this death is still a difficult one for me to wrap my head around, I am going to choose to focus more on the life that was realized here. Because that’s worth celebrating.