CHAPTER 16: DECISION REACHED!

The future is no longer a given.

Each time its uncertainty is acknowledged,

my heart speeds up, my breathing rhythm stutters, I gasp for air.

Sudden attacks of panic.

~from One-Hundred Days by: David Biro

Walking through the doors of MDA center was like being at a very busy airport. People were swarming into and out of the building in ridiculous numbers. Outside the doors, they had at least 10 valet attendants parking the cars that lined up the curb. Once inside, we were greeted by a grand lobby with marble floors. Directly in front of us was an information desk, while to the left was a café with a sitting area, as well as, of course, a Starbucks concession. There were people from all nationalities and countries, and we heard so many different languages. We asked for directions to the Lymphoma Center floor-we were told to take elevators B up to the 7^th floor-but only elevators B will lead there; taking any other letter of the alphabet will only get us lost in the maze of this place.

Me and sister followed the signs and made our way to elevator B and up to the 7^th floor we went. We stepped into the Lymphoma Center lobby and soon we made our way to two seats to wait our appointment with Dr. Wizmaster-the Lymphoma specialist. Normally, sitting in Hematology/Oncology waiting rooms, I would be trying to dodge the stares of patients much older than I, who would probably be wondering why such a young person was bald and sitting amongst them, but not this time; I did not feel out of place here. Because this was specifically a Lymphoma Center and not just a general all-inclusive hematology/oncology department there were a number of young-adult patients in the waiting area with me. Lymphoma sadly afflicts a big number of young-adults under 40 years old. My sister and I were eventually called back to a nondescript patient room. First, a sweet young Physician’s Assistant (PA) came into the room. She talked with us and examined me. She told us she would be back momentarily with Dr. Wizmaster.

His arrogance entered the room ahead of him, Dr. Wizmaster-an expert in the Lymphoma field with 30+ years of experience- introduced himself. He first went through his CV verbally with us, just in case we had any doubt who we were addressing. I think I got a chance to ask one question and then for the next 50 minutes sis and I were bombarded with facts and statistics about every study and research done on NHL and specifically DLBCL. I told myself this was great, after all I am a scientist; I came here to hear the facts about the research not to be patted on the shoulder and told “everything will be all right Nancy.” Still though, I searched Dr. Wizmaster’s face and voice for a hint of hope or optimism about my case and…….NOTHING! He sounded like he was talking to someone who had already died. He was gracious enough though at the end to say, “you have 10 min. left of your one hour appointment, do you have any questions?” and then he shut up long enough for me to ask one.

I asked: “my PET scan showed that I’m in remission after the last salvage chemo, do you think I need more rounds of chemotherapy before the stem cell transplant (SCT)? Why do I have to go through the SCT transplant? Maybe I won’t relapse.”

Dr. Wizmaster leaned forward in his stool and looked me straight in the eyes with his empty expression and said, “That is very uncommon. I find it hard to believe that you are in remission after only 3 salvage chemotherapies, and if you are indeed then YOU ARE VERY LUCKY.” He then continued, “You do realize how aggressive DLBCL is? It is one of the WORST types of NHL in terms of aggressiveness and how quickly it progresses. In fact, I think you might need an allogeneic transplant (donor cells) not an autologous one (my own cells).”

At that, the little flickering light of hope in my brain went out. It was as if Dr. Wizmaster took all his research papers with their figures and statistics and hung them over every window of my brain blocking any light from seeping in and creating complete darkness in my small sad brain!

At the end of our appointment I asked them to try and get me an appointment to speak with a SCT doctor. We still had 2 more days in Houston, and I really needed to get the opinion of a transplant specialist, especially since at MC I was told I need an autologous SCT. Dr. Wizmaster said he cannot speak for the Bone Marrow Transplant specialists on whether they would agree that I needed an allogeneic transplant. We were told it would be very difficult to get us in to see someone since it was very last minute but they would try.

Sis and I left MDA that afternoon and I realized once back in the hotel how badly Dr. wizmaster had gotten to me. I was feeling depressed, even though I was joking about it with Sister and laughing about how ridiculous Dr. Wizmaster was. I was thinking about death and dying more than I liked, which is why I really wanted to get that other appointment in hopes that the SCT specialist doctor will restore at least a pea-sized piece of hope to my mind.

The next day we waited all day to hear back from MDA about the appointment but nobody called. I finally called MDA in the evening around 8pm, and I was told I had appointment the next morning with Dr. Albert-the Bone Marrow Transplant specialist.

Dr. Albert was a young-looking handsome hematologist, probably in his late 30s or early 40s. His demeanor and attitude made up for my bad day with Dr. Wizmaster. He was very intelligent and informative but yet also encouraging. He did confirm that I absolutely needed the SCT because my risk of relapse would be very high without it. However, he agreed with MC and Dr. Scotty that at this time I needed the autologous SCT.

Dr. Albert told me that I was the 3^rd medical student he had seen this year alone who was going to have a Stem Cell Transplant.

Dr. Albert: “I don’t know what it is, it’s weird.”

I replied only half-jokingly: “I do, it is medical school. It gives you cancer.”

Dr. Albert: “well who knows? We still don’t know the exact role of stress in cancer.”

So there you have it folks, the cause of my cancer is >>>>> MEDICAL SCHOOL!!!

Sis and I made our way back to Arizona, and the preparation for my autologous stem cell transplant was under way…

And He said to her "Daughter, your faith has made you well;

go in peace and be healed of your affliction

Mark 5:34

NOTE:

I would like to apologize for my long absence from blogging. I started back with my med school in April after a long hiatus, and have been extremely busy trying to get back into the swing of things. I had a lot of stuff to take care of beforehand. I also went on a vacation before I started.

I know being busy should not stand in the way of a writer, and I'm trying not to let it. I do desire, more than anything, to continue writing and sharing my story. However, I know I will always be busy and tired because med school is not an easy feat.

So, I am going to make a promise to myself to write at least one chapter each month. I will try my best to keep that promise!

I appreciate your continued support of my writing and my blog. Please keep coming back, because the story is not over yet...

CHAPTER 15: DECISIONS...DECISIONS

Ok-remission achieved. Next stop: the stem cell transplant (SCT).

But, doubt had already started creeping in; slowly inching its way into my thoughts and making me question the SCT choice. To Dr. Scotty it was not even a question. He was sure that I needed to get the SCT to maintain my remission; he said my chances of relapse are really high if I do not get the SCT. That did not satisfy me. I argued back that he is basing that on statistics of patients who had clear-cut cases of being refractory or relapsed to treatment. After all, the SCT is done for Lymphoma patients only when they don’t respond to the chemo treatment or they relapse after hitting remission. My case was different. Was it really refractory? I questioned. Yes, I did develop new tumors while going through the first chemotherapy treatment, but that was because as it turned out I had a different (or mixed) kind of lymphoma that required a different chemo regimen for me to respond. After we utilized the second chemotherapy regimen, I did achieve remission. My case is clearly an outlier, but they were treating me by the statistics, I kept arguing. Dr. Scotty heard my arguments and acknowledged that my case is different, but they have to go by what is out there, what has been researched and studied, and apply it to my situation even if it might be not exactly the same.

I wrestled with the idea of just going through with the SCT, but I was not comfortable with that decision yet. However, I would be ok with the decision once I got further confirmation of its necessity. I needed to seek a second opinion from a big cancer research center. I told Dr. Scotty that and he replied with “yes, go get that second opinion. At this point it would make me feel better too.” Poor Dr. Scotty, he has to put up with my questioning of every little step in my treatment-I had a feeling that I am probably his most difficult patient! I told him I wanted to go to the cancer center in Texas (MDA). He said it should not be a problem, and he will try to get me an appointment as soon as possible, so that we can go ahead with the transplant without much delay.

I wanted to be at peace with whatever decision I made, and I did not want to be influenced by the voices in my surroundings. I was the one who was going to have to live with the consequences of whatever choice I go with, so I should be the one to have the final say. I did seek advice from my most trusted sources-mainly my dad. He is always so rational and logical that it is hard not to seek his wisdom during difficult times. I made up my mind that if the 2^nd opinion confirmed that I needed the SCT then I would go ahead with it without further doubt. However, I dreaded to think about what would happen if MDA differed in view from Dr. Scotty and MC. Then I would really be confused!

After a few phone calls and information transmission between MC and MDA, I got an appointment that was less than two weeks away with a doctor at their Lymphoma Center. I immediately made the arrangements for me and my sister for our trip to Houston, Texas. For some odd reason I was excited. I know I was still celebrating my remission, but there was still a lot that lay ahead of me and I knew that. Yet, I was excited I think because I felt like I was doing the right thing, and I would be content with the decision I would be making as a result of it.

Flying to Houston was a scary experience. I have never been one to fear flying or airplanes. However, this time it was different. I was immunocompromised in a tiny plane full of people with too many germs and too little ventilation. I had not travelled by air since my counts had been low. Needless to say I got a little claustrophobic and was counting the seconds until we landed. And praying that I did not catch anyone’s bug!

We landed in Houston, and I was fine.

We checked into our hotel, and waited for morning to arrive to go to our appointment at the MDA Lymphoma Center...

CHAPTER 14: EMOTIONAL INCONTINENCE

You are, after all, what you think.

Your emotions are the slaves to your thoughts,

and you are the slave to your emotions

~From Eat, Pray, Love by: Elizabeth Gilbert

Life is perplexing…one minute it gets so rough and has us asking for an end to it. The next minute, something good happens and you see us begging for another chance at it, for a few more days, for a few more birthday celebrations! During the hardest times of this journey, when I was so sick I could not even think; so drugged and my brain so fuzzy that I could not even recall events or conversations that have taken place-it was during those time that I wished for an end to it all no matter what that meant. I wished that if I was going to be cured that it would be soon. But, if it was not in the cards for me to recover then I wanted the misery to end (no don’t worry, I’m not suicidal, I’m just a cancer patient.) However, one piece of good news and we have a glimpse at the beauty of life. We quickly change our minds apologizing to the powers out there, asking them for forgiveness for even thinking such morbid thoughts. I believe most people having to deal with mortality on a long-term basis, due to an illness or some other cause, experience such paradoxical feelings. After hearing about the optimistic results in September, I got encouraged. I knew that I was not yet done with treatment and that there was a lot that still lay ahead, but at least now I had some hope-I could go to those treatments and face them with resilience knowing that victory was possible and not just an abstract concept.

My strength and hope was further restored in October after another batch of satisfactory results put me and the people I love on an all-time high! Dr. Scotty planned to administer a 4^th round of RICE chemotherapy before having my body scanned again; however, I really wanted the scan done after the 3^rd chemo round. I had no desire to wait another month before finding out whether the treatment was effective or not. My reasoning was as follows: if the RICE had stopped working and the tumors did not shrink from their previous size then there was no point in putting myself through another round of the same chemo, and it would be wise to consider changing the drug regimen. On the other hand, if-although that was a big IF and not really anticipated by either Dr. Scotty or me-the tumors were completely gone then we can argue on whether or not I needed another round of chemo at all. The only scenario that I could see myself getting round #4 of the salvage chemotherapy was if the tumors had continually shrunk since the last scan but were not completely gone; in that case, RICE would have shown to be effective and another round of it might prove to be exactly what was needed. Thus, upon my insistence and request, I was scheduled for another PET scan on the morning of October 13^th, 2009.

Now let me diverge a bit from the topic to tell you a little about those pesky PET scans. They are not painful or invasive or even scary like MRIs, but they can drive a patient mad. Why, you ask? Well, because when you are a patient with a serious illness, like say cancer, and you know your whole future and well being depends on what this little scan is going to show/not show, then you really do not want to be left alone with your thoughts. Unfortunately, that is exactly what happens the day of the scan. You see, 45-60 minutes before the PET scan is performed, the patient is instructed to sit quietly with minimal movement on a recliner in a small quiet room with dimmed lights. There is of course a reason behind doing this other than the emotional torture of the patient. That reason goes back to how PET scans work. The scan looks for any metabolic activity, and having the patient rest quietly for a period of time would minimize/eliminate false positive results that can be caused by metabolic activity in active muscles. The point is to calm the muscles down so they do not light up and show activity on the scan-that includes all muscles including those around the jaw that can be activated by talking, so talking is not permitted either. A normal PET scan would not light up anywhere except for the area of the heart, because the heart is a muscle that has constant activity that should not be stopped. If, however, a person has cancer or another active condition such as an infection for example, then the affected spots in the body would light up. After the allotted rest time is over, the patient is taken to lie down on the PET machine table and the actual head-to-pelvis scan takes about 20-30 minutes. Anyhow, I found out that the “rest time” was no rest at all-mentally speaking. If I just sat there quietly and did nothing, then my brain would wander to dangerous places that I did not want to visit especially not on scan day! So I had to actively think about other things the entire time to keep my brain from going astray. I had to make up “happy thoughts” or think of completely unimportant things like how nice/rude the PET tech is or even the weather! Yes, those 45 minutes lasted forever, and I would always be so delighted when the door to that little prison would open and light would enter the room-it meant that “rest time” was up. Music would be a great distraction in this situation, but first time I had a PET scan, the tech told me IPODs were not allowed…say whaaat? It’s not like my brain is not going to be active just because I am not listening to music, in fact the music will actually calm it down more. Plus, there was music playing on the overhead speakers-bad music, but music nonetheless. Anyways, as I found out at another scan a few months later that was just a picky mean tech; IPODs did not violate PET scan rules and their use was perfectly permissible.

The morning of October 13^th came, and I went through the PET scan routine described above and hours later went back home to patiently (or not-so-patiently) wait for the results. My plan was that I would wait until the end of the work day, if I did not receive a call by that time then I would call the next morning to inquire about the delay. Around 4PM the phone rings…caller ID shows (and loudly announces-since our phone has voice caller ID as well) that the call is from “MC”. I jump out of my chair and run to pick it up, before I do I whisper “oh please God make it NOT be any more bad news!”

“Hello, can I please speak with Nancy?” said the familiar voice on the other end of the line.

“This is she”

“Nancy, this is Angela (the physician assistant-PA) from MC. How are you doing?”

“Well, it depends on what you are going to tell me”

At this, her tone changes immediately to reflect a happier higher-pitched voice, and I could tell then that it was going to be good news. How good though?

Angela continued: “your PET scan from today shows no uptake, which means you have no active cancer”

Oh my God! Am I really hearing those words?! I was not expecting this at all. My hands were visibly shaking and my heart was racing.

“Seriously? It is not showing anything? It is all gone?” I stammered

“yeah the lungs and abdomen are all clear with no activity. I am glad I could deliver good news to you today Nancy.”

Click, the call ends. It sounds more like a dream than reality. I hung up the phone and my mom and sister are standing right there anxiously waiting for me to finish the call, and tell them the news.

“It’s all gone…the scan was clean” I said as tears started streaming down my face uncontrollably.

My sister kneeled down in front of the chair I was occupying hugging me and crying too. She and mom were both screaming “really? Are you serious?”

My mom had the flu the day before so she could not come near me due to my susceptibility to infection because of my low white blood counts. So she kept screaming at me from across the table saying “I want to hug you Nanous!” (one of my many nicknames) “Oh, why did I have to get the flu now?!”

The three of us were crying (tears of joy this time around), smiling, and laughing all at the same time!

“I have to call dad. What time is it there now?” I said. My dad, who was still working overseas, was 10 hours ahead in time, but he would want to hear this sort of good news immediately.

“it’s 2AM” mom said “but it does not matter, let’s call him”

I dialed dad’s number. Man! My hands were still trembling. I did not care that I was going to wake dad up in the middle of the night, and I knew he wouldn’t either. Of course, dad was happily shocked; he too was not expecting this. I mean no one was-Dr. Scotty said it was very unlikely that the tumors would be completely gone with just another round of chemotherapy. It goes to show that science’ and physicians’ knowledge extends only so far. However, because of the nature of their jobs they are sometimes forced to make predictions that they base on numbers and statistics, but in the end they are just that-predictions. Anyhow, the phone call with dad did not last long since he was still in a drowsy sleepy state. The next morning he called us again. He talked to mom and told her that he had woken up thinking it was all a dream, but then he kept thinking to himself ‘it couldn’t be, I distinctly remember talking to them.’ Yet, he still had to call us to confirm that it had all happened!

Next up on the list were my brothers. My 20 year old brother was in Atlanta in college, and he was squealing on the phone like a 13-year-old girl upon hearing of the vanishing of the filthy cancer (he is going to kill me for writing this about him haha). My other brother was at work and he just wanted to skip his shift and come home; I told him that we could celebrate at night when he got back.

Mom got on the phone next and started calling our entire extended family, and let me tell you, we are not a small family! But I cannot blame her; the news was just too good not to share with everyone. In fact, I did the same with my friends; I started texting people and quickly realized a mass email would be much more efficient. Within minutes I was flooded with texts and email replies. I even felt that some of my family and friends were more thrilled at the news than me, if that is at all possible. It is times like these when a person realizes how blessed they are to have such a strong support system. I was grateful to be the bearer of good news for a change.

One of my best friends, MA, called me a few hours later and said: “I just got out of bible study. I was especially praying for you yesterday and today, and when I saw your text I was like ‘ok God, I get it! You answer prayers.’ ”

“MA, I don’t know if I want to cry, laugh, or smile”

MA replied “we can do it all! I learned a term this month in my neurology rotation that can apply to us right now, we are experiencing what is called ‘emotional incontinence’ ”

I could not think of a better way to describe how I was feeling that fall day in October…

The LORD is my light and my salvation;

Whom shall I fear?

The LORD is the defense of my life;

Whom shall I dread?

Psalm 27:1-3

CHAPTER 13: SUNSHINE IN THE MIDST OF CLOUDS

You raise me up, so I can stand on mountains

You raise me up to walk on stormy seas

I am strong when I am on your shoulders

You raise me up to more than I can be

“You raise me up” by: Selah

I was long due for good news and it finally came on 9/10/09. I had a CT scan the previous day, and in the morning I woke up to a call from Dr. Scotty. I held my breath when my caller ID showed “MC” and did not exhale until Dr. Scotty said the words “so good news” pheeeeeeeew! Finally!!!!!!!!!!!!!!!!

I had spent the months of July-September in and out of the hospital. The salvage chemotherapy that I was now receiving was much stronger than the previous chemotherapy I had received; it was also delivered over a course of 4-5 consecutive days rather than in just one day as before. Plus, I lived 30-40 minutes away from MC and hated more than anything to be in a car post-chemo sessions because it would cause me to get carsick and thus more nauseous. So, for all those reasons I chose to receive my salvage chemotherapies as inpatient. My stay in the hospital to receive the chemo got shorter though with each one as the pancreatitis was put under control with the tumor shrinkage. At first, I was given this regiment of chemo in July called R-ESHAP, but nine days after my discharge I was hospitalized again for a pancreatitis recurrence. A CT scan at the time showed that the kidneys and lung tumors had shrunk some but not the pancreas tumor. Yeah I figured since I was lying in a hospital bed with abdominal pain again. Because of that, the doctors decided to switch my chemo regiment to another called R-ICE; they were quickly realizing that I did not want to finish this fun experience without getting a taste of all the chemotherapy regiments available out there-give me more, give me more! We had better luck with R-ICE it seemed. I was discharged from the hospital a week later and 2 ½ weeks had passed without incident. On my follow-up appointment with Dr. Scotty he had scheduled my CT scan and told me he would call me with the results as soon as he found out; he also instructed me that I should relax some and not think too much about it-pssshtt yea as if that was possible.

On 9/9/09 I went in for another CT scan and waited anxiously for the call. I was still in bed the next morning when my cell phone rang and I heard Dr. Scotty’s voice on the other line. He informed me that ALL the tumors have shrunk further this time, and the pancreas one was almost gone. This meant that I was chemo-sensitive to this regiment which was really good news. Dr. Scotty finished telling me about the plan- that we will continue with R-ICE treatment and try to shrink the tumors as much as possible before the stem cell transplant. Then he said to me:

“You don’t sound too happy”

I guess I forgot to show some excitement in my voice. I told him that I was happy and thanked him for calling me so quick. The truth is that I was thankful for this little light in the midst of all the darkness lately, but I still could not get myself too excited about the news. If I learned anything from this experience, it is to always be on the lookout for the worst; I did not want to set myself up for disappointment in case things went south again. So I made myself be thankful and happy about the news but very cautiously…

In Him was life,

and the life was the Light of men.

The Light shines in the darkness,

and the darkness did not comprehend it.

John 1:4-5

CHAPTER 12: FRIENDS-THE WIND BENEATH MY WINGS

When you're down and troubled

and you need a helping hand

and nothing whoa nothing is going right

Close your eyes and think of me

and soon I will be there to brighten up even your darkest nights

You just call out my name

and you know wherever I am

I'll come running oh yeah baby to see you again

Winter, spring, summer, or fall

all you have to do is call

and I'll be there yeah

You've got a friend
“You’ve Got a Friend” by James Taylor

During hard times it becomes apparent which relationships in a person’s life are worthwhile and which ones are just a waste of time. Sometimes it may take something life-changing to truly start appreciating some friendships or start re-evaluating others. I have always been so lucky to be surrounded by people who love me, whether they are family or friends, and I have always appreciated the good relationships in my life. However, this experience with cancer still brought with it a few surprises and still taught me a few lessons. There were the good surprises of getting support from unexpected people; people who were merely acquaintances became close friends during this challenging period in my life. At the same time, there were people whom I thought of as dear friends who ended up disappointing me in a major way. I would like to say that it is ok because I had a big support system and I did not need them. Yet, the truth is, when you care about certain people, even when you don’t need them it still hurts when it turns out that the friendship meant more to you than to them. However, I cannot complain at all because thankfully those “friends” were very few and I was blessed to be showered with support from so many people around me. In fact, even though a big physical distance separated me from almost all my friends, the emotional distance between us was never an issue. They made me feel like they were always there, just a phone call, a text message, or an email away.

During the past year, my closest friends have stayed by my side. I could count on them to meet any of my needs. I came to realize and value the unique abilities of each one of them. There is the friend who never fails to make me laugh no matter how stressed or sad I may be. There is the friend who is always there patiently listening to me vent and complain about how horrible my life has become. There is the friend who oozes endless optimism and encouragement no matter how horrible the news or circumstances may be. There is the friend who sends little cards and presents in the mail all the time, making me feel so important, even though I know first-hand how hectic and busy her life is as a medical student. There is the friend who spends money that is not readily available to fly across the country to come visit me and spend a few days being physically there. I have friends who call all the time even when I continuously fail to answer my phone, leaving me messages telling me they just wanted to hear my voice. I have friends who text-message me almost every day when I am sick or in the hospital to ask how I am doing. I have friends who email/facebook/chat with me regularly because they do not want to burden me by calling. Yes, I am a person who is truly blessed to have experienced the meaning of rare genuine friendship to its fullest. In fact, I am so lucky as to be surrounded by not just one such friend but by many assortments of friends all of whom are thoughtful, caring, and wonderful in their own special ways.

My 25th birthday was only two months after my initial diagnosis with Lymphoma. I was in no mood to celebrate it, especially since I was in the middle of my chemotherapy and nowhere near any of my friends. Little did I know though that my sister, who also happens to be one of my best friends, was secretly planning all kinds of surprises for my birthday. She had contacted my closest friends asking them for their help in making my birthday “special”. The evening of my birthday consisted of eating pizza and a delicious ice-cream cake with my family. Then, I was overwhelmed when I discovered all the wonderful cards and presents my friends had sent that my sister had been hiding from me until that night. Among those, I received the most beautiful hand-made quilt in my favorite colors: pink and purple. Imprinted on it were pictures of me and my best friends with all of their names embroidered around the sides of it. It is seriously by far the best present I have ever received and the closest to my heart. Thanks to my fabulous friends, my 25th birthday turned out to be a very memorable one!

Because of such friends, I try not to think of the few people who failed me during this time in my life. Recently, I read an excellent book titled “Everything Changes: the insider’s guide to cancer in your 20s and 30s” by Kairol Rosenthal. Rosenthal says:

In seven years of living with cancer, I have begun to accept that some people simply do not respond to my experiences in a way that brings me comfort. I’m tired of making psychoanalytic assumptions about why they cannot handle my illness. Instead, when it comes to baring my soul about the crap that cancer is, I have learned through Sheila’s example to rely on the small handful of people in my life who really get me.

This is so true. I could beat myself up trying to think of reasons why certain people were not there for me at such a critical time in my life but what is the point? I am not lacking in support, and thoughts like these will not get me anywhere. Plus, I am facing the biggest battle of my life, and only those who are able to handle standing by me and supporting me are welcome in my world. It may sound selfish that I am not willing to try to understand why certain “friends” did not rise up and fulfill their friendship roles, but I need to think of me right now- I need to be selfish some in order to emotionally make it through this time.

Also, when I had first learned of my cancer diagnosis back in November 2008, I chose to only email a few close friends and share the news with them. A close friend of mine recently inquired about why I wanted to keep things quite for so long when so many people would have wanted to be there and show their support for me. I explained to her my position. I wanted her to understand that people deal with such life-changing news in different ways. It has almost been a year now since my diagnosis, and at this point, I am comfortable and strong enough to share the news with people. Cancer has unfortunately become part of my life-like an uninvited and unwelcomed guest. However, at the time, the news was all too fresh for me. I was distraught and trying to wrap my brain around all the changes taking place in my life. I only wanted support from people whom I knew truly cared about me, and were not just going to offer their support out of pity. I did not need nor want pity from anyone. What I did need were people I knew I could truly count on—to listen, to offer encouragement, and to believe in me even when I did not believe in myself. Personally, I did not want people to offer me their support or friendship just because I was really sick. One young adult cancer patient in Rosenthal’s “Everything Changes” book describes it best when she says:

With all the races, rallies, and walks people assume you want to be celebrated for having survived cancer. No! The last thing I want is people cheering me on because I had a disease that I didn’t want, was miserable getting through, and wish I never had. That should not be my moment of fame.

So, my reasons for keeping my Lymphoma diagnosis quite for so long were not to offend anyone. I just do not want to walk around “celebrating” cancer when it is the last thing on earth that deserves celebration, nor do I want to be remembered for this small chapter in my life. I am the same person now as I was before cancer-I have the same personality, the same outlook on life, and the same habits. There have been some minor changes and I have tweaked some areas in my life, but nothing significant enough that would make people want to be my friends any more or less than they did before the cancer invaded my existence!

A friend loves at all times,
And a brother is born for adversity
Proverbs 17:17

CHAPTER 11: ANGER GIVING WAY TO FORGIVENESS

Will you think that you’re all alone
When no one’s there to hold your hand?
when all you know seems so far away
And everything is temporary, rest your head
I’m permanent
“Permanent” by David Cook

I struggled for quite some time as feelings of doubt and uncertainty set in. I had asked Dr. Scotty if he could send my pathology slides to the main MC center located in another state to get a 2nd reading on them. He readily did that for me, and the readings came back to confirm that what I had now was non-Hodgkin; but they further added that the original mediastinal mass was also non-Hodgkin’s lymphoma unlike the lymph node which was still read as Hodgkin’s lymphoma. This meant that I had both components of Hodgkin’s and non-Hodgkin’s lymphoma from the beginning. When I asked Dr. Scotty which chemo would I have received had this piece of information been known from the beginning, he said that they would have given me the R-CHOP (used to treat non-Hodgkin) rather than the ABVD regiment that I received. Hmmm, anger and frustration were definitely not easy to get rid of at this point. It did not help when people close to me were upset too about the delayed diagnosis of the non-Hodgkin’s part of my lymphoma. A part of me wanted to be angry forever, and wanted to escape to another center for care with new doctors who were infallible and error-free. But the more rational part of me knew how ridiculous that was; pathologists are humans prone to error like any other; they did not maliciously single out my biopsy slides that day and decide that they were not going to read them fully. Plus, I could tell how frustrated Dr. Scotty was upon getting the new readings; he was doing everything he could to treat me fully to ensure that I was not only treated temporarily but cured indefinitely.

My dad, being the wise man that he is and having the ability of knowing what to say to turn any situation around, sent me an email upon hearing this news titled “can we forgive?” In it he told me how what happened is in the past, and that we as a family should focus our energy now on deciding what the next steps should be. He said forgiving and moving forward will help keep our spirits high and our minds clear so that we can make the right decisions. It was his email that reaffirmed my thoughts about, eh maybe not forgiving quite yet, but definitely trying not to think about what could have been, and concentrating on what should be done.

On the top of my list of what should be done was seeking other opinions. Dr. Scotty was very open to me getting 2nd opinions, and in fact encouraged me to do so. I wanted to travel to another renowned cancer center in Texas to meet oncologists there and get their opinion on what the next steps should be in a case like mine. Dr. Scotty informed me that he could contact an oncologist there and get me an appointment. My main reasoning was to see if their treatment plan matched the plan Dr. Scotty and the other oncologists had for me, and to come back to MC for treatment.

Unfortunately, my body had other plans for me as usual. I had left the hospital on a Monday after the pancreatitis episode, but by Thursday I was back in the hospital again for a recurrence of my pancreatitis. This time, Dr. Scotty really did not want to wait anymore before giving me the salvage chemotherapy. Their plan was to do salvage chemo regiment for two-four rounds, and then go on to a stem cell transplant (which is done to reduce recurrences and increase the chance of a cure.) He convinced me to start the chemotherapy, and said that I could always go to Texas after the first chemotherapy. I was wiped-out after that chemotherapy (salvage treatments are delivered at a higher dose than the initial chemotherapy), and I knew I was too tired to go to Texas. Plus, I was slowly losing interest in going somewhere else; I felt comfortable receiving my care at MC, and I was scared that going somewhere else may end up confusing me further. I was slowly getting my faith back in the plan they had for me…I mean my main concern was always the pathology readings which I already got a second opinion on.

Like a bullet-proof vest, this cancer experience is making me immune to reacting to bad news…the more bad news I receive, the less and less I react to it. Tears have pretty much dried up, and when they do come they are in the form of a major breakdown once in a while. Plus, when you’re sick and nauseous for more than half the hours of the day, you don’t want to waste the rest of the hours crying. Instead, I spent the rest of the time when I wasn’t nauseous either sleeping (because of the beautiful powers of the antiemetic lorazepam) or thinking how awesome it felt to be nausea-free! But, along the way the bullet-free vest allowed some bitterness to leak into my soul, and take residence there for some time. The bitterness was not directed at anyone in particular, it was mostly irritation at this little thing called: my life!

During this time I also went on strike on praying and “connecting” with God. As I told a friend, I was not exactly angry at God. I just felt that maybe what I have been praying for was not God’s plan for me. What if maybe God’s plan for my life was not cure from this disease? Most of the time believers speak of how they don’t always know what God’s plan is, or that His plan may not coincide with their plans. Well, why should it be different in my case? I just got tired of asking for something that may be the wrong thing. But, I wasn’t even praying for strength and peace of mind that I had been praying for before. I just felt numb for a while. And I felt drained. My strike lasted a few weeks until one night I was finally home in my bed about to go to sleep. I was alone, and I found myself having a one-sided teary conversation with God. I asked him to strengthen my faith whatever the outcome of this battle may be. Slowly, I hope that I would be back to asking God again for strength and peace of mind. In the meantime, I am letting those around me take charge of praying for my healing. That is what sitting at home for many months being useless does to a person, it makes one lazy…

Let all bitterness and wrath and anger
and clamor and slander be put away from you,
along with all malice.
Be kind to one another, tender-hearted,
forgiving each other, just as God in Christ also has forgiven you.
Ephesians 4:31-32

CHAPTER 10: UNEXPECTED SURPRISES

How could this happen to me

I've made my mistakes

got nowhere to run

The night goes on as I’m fading away

I'm sick of this life

I just wanna scream

How could this happen to me
“How Could This Happen to Me” by Simple Plan

I watched as the crimson B+ fluid inched its way slowly through the tube to disappear into my veins. Greeeeeat! Now I had to get a blood transfusion because my hemoglobin was low. Was there anything that I was going to skip in this ordeal?! Again, being a med student I always picture the worst case scenario, and in this case it was me getting a severe reaction to the foreign blood I was being given. Ok, so that did not happen, I was fine and my hemoglobin numbers went up, but still I was angry that I needed blood in the first place.

It seemed like lately anger has been the emotion of choice for me…and damn it, I had plenty of reasons to be angry about!

I had finished treatment-eight grueling rounds of chemotherapy followed by 20 days of radiation, and waited 8 weeks to have my body scanned again to see if we had defeated the cancer. The PET/CT scans came back with unfortunate results that I was so not expecting. See, the whole time while waiting for scan results everyone around me was being super-positive, telling me that the scans will come back clean, that I will be cured and live happily ever after. I, however, was definitely not as optimistic; I had doubts that it was all going to be this “easy.” I also wanted to prepare myself mentally for bad news; I couldn’t just keep myself too positive only to be crushed by unpleasant news, I had to keep open the possibility that I could receive bad news that my cancer was still there. Apparently I did not prepare myself adequately, because my imagination did not stretch far enough to hear Dr. Scotty, my oncologist, telling me that the scans came back showing newly lit spots, which meant there were new tumors in my body. His good news for me? The original mediastinal mass had shrunk considerably to almost a negligible size, and the supraclavicular node was not involved anymore. Wow, awesome! I should go celebrate! WTH! My cancer had spread during treatment?! How is that possible? I now had tumors in my right lung, both kidneys, pancreas, and GI lining! I was in shock, so much for preparing myself well. Dr. Scotty, the ever-positive soul, said that these were too many new spots that appeared in such a short period of time, and thus could just be that I have some sort of infection. I informed him that I had no signs or symptoms of infection, but he said some common Arizona fungal infections can be symptomless. Ok, so I could have an infection. For some reason, I just did not buy that this is what I had; in the back of my mind I knew it was still cancer. However, I had to go through the motions of getting blood work done. Also, I got scheduled for a kidney biopsy to determine what these new masses were.

As I was leaving Dr. Scotty’s office I asked him: “if this is cancer, could it be Non-Hodgkin’s Lymphoma since Hodgkin’s Lymphoma does not normally spread in such a manner?”

He replied: “anything is possible, but it is highly unlikely because this is very uncommon.”

I thought to myself ‘I am used to having rare things happen to me’ and left the office feeling numb and…praying big time for an unlikely infection!

I underwent the kidney biopsy on a Friday. A day later I went to the ER with severe abdominal pain. First thing they did was put my pain under control by giving me the wonderful drug Dilaudid-which the inept ER nurse decided to just push it really fast into my IV putting me in a panic for a few seconds as the drug sent my heart racing and made my entire body heavy, but after I got over the initial shock (or “high” as some people call it I guess) I was in bliss-land, pain-free and in a sleepy/loopy state. Then, they did the usual blood work and a CT scan and came back to tell me I had pancreatitis (inflammation of the pancreas). Ok, seriously? Where did that come from? I thought for a second about my Vegas escapade ten days before with my best friend K (since I know as a med student the 2 most common causes of pancreatitis are alcohol and gallstones), but I was no alcoholic damn it! Thankfully, the doctors agreed and quickly ruled out this possibility as well.

Anyways, I ended up being hospitalized for my pancreatitis. The doctors could only guess at what caused it, and the most likely culprit was the tumor sitting there on my pancreas. The only positive experience of that hospitalization was that now I was being seen by the Internal Medicine team as well as the oncology team. The IM team had interns and residents. The interns and residents who came to see me were all nice, cute and obviously smart guys! Yeah, I can enjoy that even when I’m lying in a hospital bed sick; plus they all were conversational when they knew I was a med student (which I don’t tell anyone but apparently it’s written in my chart in the doctors’ notes.)

The kidney biopsy report came back a couple of days later. I had Diffuse Large B-Cell Lymphoma (a very aggressive and fast-growing type of NON-Hodgkin’s Lymphoma). What happened to the Hodgkin’s they told me I had initially back in Nov.? I was being treated at one of the top most-renowned clinics in the world and I get misdiagnosed/not fully diagnosed?

My anger could just no longer be contained…I was ANGRRRRRRRRRRRRRRY!

NOTE: I have not been able to continue writing my story for a while. when I write my chapters I like to profread them and make sure they are well-written, not just vent and be angry. Recent developments have shown that I am not in remission, I will be continuing the misery of going through futher worse treatment. Because I have so much I want to write about of what is happening to me NOW, I am thinking I may skip a few chapters from the past few months and just instead start writing about what is happening now. I do intend to fill in those missing chapters of course, but that will be when I am feeling inspired to write beautifully again. For now, I just want to keep people in the loop of what is going on with me. And my current mood is "damn pissed off!" details will follow as soon as I get over this latest chemo side-effects and I have enough strength to blog again. Thanks for the continued support!

Nancy...

CHAPTER 9: HAIRLESS & DEALING WITH IT

Breast Cancer and Chemotherapy

Took away her crown and glory

She promised God if she was to survive

She would enjoy everyday of her life

On national television

Her diamond eyes are sparkling

Bald headed like a full moon shining

Singing out to the whole wide world like HEY...
I am not my hair

I am not this skin

I am not your expectations no no

I am a soul that lives within

"I am not my hair" by: INDIA.ARIE

“You are going to lose your hair”…these are very difficult words to fathom. It is not like I have not seen pictures or movies of bald cancer patients before, but this was MY hair we were talking about, and my brain did not want to register the fact that it would soon be gone. Plus, I kept trying to convince myself that this should be the least of my worries; that I should not be so superficial and turn my hair loss into major drama. However, I felt like my hair was part of my identity, part of who I was, and that by losing it I would be losing part of myself. It did not help that I thought of my hair as my best physical characteristic-I was going to lose my long thick beautiful hair. I used to always joke about how thick my hair was; I would tell my friends who had thin hair that I could donate some to them since I had enough hair for four people. It seemed that now I was not going to even have enough to cover my own scalp. Life is so weird sometimes.

I was told that the hair loss would start 2 weeks to a month after my first chemotherapy session. I heard of people who shaved their hair so they would not go through the emotions of losing it little by little, and thereby they felt like they still had some control over the situation. I could not do that, I wanted to savor every strand of hair I had left until the very end. What I did do though was cut my mid-back length hair to chin level. I have always been afraid of getting a short haircut, and I thought this was the best time to experiment and try the new bob haircut that was in style. I mean the worst that could happen was that I was going to hate it, which would be easy to fix since I was due to lose the rest of it in a couple of weeks anyways!

I got the haircut, and of course to make matters more difficult, I fell in love with it. A couple of days later, clumps of hair started making their way into my hands, my brush, and ultimately the wastebasket in my sister’s room. Everyone talks about their first shower when the hair starts to go- it really is not fun seeing large amounts of hair coming off your scalp as you shampoo. I did not want to wash my hair anymore, and when I did I would go into my sister’s room alone, shut the door, sit in front of the mirror looking at my reflection, and just cry as more clumps of hair came out. My hair was being found everywhere around the house but the one place where it should be-on top of my head! I would wake up in the mornings with my pillow covered and covered with too many strands of hair; I eventually got tired of cleaning the pillow and just left the hairs alone. The living room rug was littered with strands of blonde-highlights. It seemed like there was no end to my thick hair. I kept my hopes that maybe because it was so thick I would not lose all of it-if I could only hold on to that thin layer left of it I could handle it. I stopped brushing my hair, and tried to not run my fingers through it. By the fourth chemo session, I was left with a very fine layer of hair that exposed various parts of my white scalp, but I still had those strands that I could touch and reassure myself that I was not a bald chick yet. I would wear baseball caps and still look like a normal person with very thin hair (taking the cap off though would show a different story.) Since it was this late into my chemo treatment and those strands of hair that I had left were still fighting and clinging to my scalp with all their might, I just figured this was the end of the hair loss. However, even though it had slowed down a lot-probably because increasingly there was less and less hair to lose, the hair loss had not stopped yet. Creeping up on me slowly, by chemo #8 (the last session) it seemed that that hair strands I had left could be counted on one hand. It was not till then that I held up the scissors and told my sister to cut the chin-level strands to make them short, because now they were only annoying reminders of the long beautiful hair I used to have. Yes, I did not have the courage to shave my head, but sometimes I think maybe these people had it right; maybe things would have been easier if I had not made myself go through that tormenting experience. I know when we think about it, we think it is only hair; but that was one of the most emotional experiences of my life. It was so emotional that even writing about it now (over 3 months after my last chemo session, and after I already have gotten back a good amount of thick short hair) I cannot help but cry and feel depressed.

I was given some wig stores’ information at the hospital before I left. So, I wanted to get that wig as soon as possible thinking I would be wearing it at all times. My sister came with me as we made the trip to a small wig store at the local mall. We knew nothing about wigs, all I knew was that they had ones made of real hair which were more expensive than the synthetic ones, but supposedly better. We walked into the store that was filled with wigs of all kinds, and we wanted to have some fun. However, the lady working there stopped all the fun in 2 minutes, as my sister reached her hand to touch one wig, she half-yelled at her with a thick accent “no touching.” I looked at my sister and we both almost broke out in laughter as we noticed the sign right in front of that particular wig reading “do not touch the wigs.” Then, we asked her for the price range of the wigs and our hopes of having fun were further squashed as she told us that the cheapest wig cost $199. WHAT?!!! No one told me it was going to cost that much money to get a stupid wig! My sis and I saw the perfect wig; it was a little longer than shoulder length, wavy, and light brown-it looked so much like my real hair. As we were admiring it from afar, we asked the “nice” store lady for the price of that one, and she replied “that’s too expensive for you, that one is $400.” ‘God please give me the willpower not to punch this lady in the face!’ I thought to myself. I mean, she was not being insulting because we had told her what we could afford. Yet, this was not a purchase I had ever imagined myself making, and her tone and snippy attitude was not helping. She finally pointed us to the short wigs that were in our price range. I saw one that was medium brown with reddish tones, and a style that looked cute. I asked her if I could try it on. As the lady helped me put it on, my sister fell in love with it immediately. I just felt weird. The wig was nice, it framed my face well, and the color was great. But, what the hell! I was getting a wig?! I was trying on a wig next to an old Asian man who was looking for something to cover his balding head. I was trying on a wig at one of those mall stores with big glass windows where everyone walking by can see in, and I just suddenly felt so self-conscious. I wanted to get that wig and get out of there pronto. The store lady made sure to inform me that all purchases were final, but as she was giving me the receipt she mentioned that some health insurance companies reimburse for at least part of the cost of the wig if it is for medical purposes. Hmmm, at least she was nice enough to tell me that.

I later learned on my own and with experience, that I probably should have not purchased that wig. Yes, it was one of the best that I owned, and it looked natural when I wore it. However, I soon realized that wigs are itchy and uncomfortable. Especially when worn on top of a bald scalp. I was having headaches from the chemo and all the drugs I was on, and having a tight elastic band wrapped around my head was not helping. So I ended up wearing a wig only when I went out in public to places other than the clinic, which was very rare. During the 4 months of chemo, I avoided people, other than my family, like the plague. Not only because I did not want to see anyone in the state I was in, and because my friends were nowhere close to Arizona anyways, but also because of my low white blood cell counts. You see, white blood counts go down tremendously as a side-effect of chemo treatments, sometimes reaching zero. White blood cells fight infections, and I had very few of those around, so any contact with people’s germs or sickness could put me at a risk of a serious infection. In fact, I developed a fever the week after my first chemo session because I did not take this germs thing seriously and ended up being put in the hospital for another five days. They could not find any source of infection to be causing my fever (it was probably viral), but they would not take any chances and they started flooding me with broad-spectrum antibiotics for those days that I was in the hospital. This, in turn, freaked me out because as a medical student I knew how one could develop resistance to antibiotics. I did not want to be given so much antibiotics, so I decided to ban all contacts with people unless absolutely necessary. It was easy to do, since my hospitalization scared my parents more than me, and they turned our living room and the loft where I slept into a sterile environment. They told relatives and friends they could not visit and stay over anymore until I was done with chemo. They stopped kissing me, and they would only hug me when they have showered and washed their hands. One of the couch chairs was designated as “sterile: Nancy area only,” and my mom covered it with a sheet that she washed every few days. Yes I had become bubble girl.

However, as extreme as what we did was, and way beyond the doctors’ recommendations, it worked. I was not hospitalized anymore after that one time, and I completed the rest of my chemotherapy without any complications or infections. On top of that, I did not really mind the not seeing people part, because I did not want anyone to see me in that state and I did not feel very social during chemo.

Anyways, I later searched online and found this wigs website that could help me expand my wig collection for fun without hurting my bank account too much. It was time for me to have some fun with this, and it was also time to give synthetic wigs a chance. I got two more wigs, one that was long brown hair that cost about a fraction of what that mall store wig had cost. The other was a HOT PINK wig that I felt the need to get for no reason at all other than that I wanted it. Yes, you read that right, it was hot pink. My 16-year-old brother thought that I looked like Lady Gaga when I wore it, which he meant as a compliment. I loved that wig. First time I wore it in public was to my last radiation session on May 18th, and the radiation oncology staff loved it. They took pictures and told me it made their day. Some even told me the color looked good on me. Hmmm, I may be dying my new hair hot pink. I have two little cousins here in Arizona (11 and 7 years old), and when I wore the wig to visit them one day, they ran to their room and brought this DVD cover of a kids’ movie (I cannot recall the name) to show me where the star of the movie is wearing the exact same color of my wig in almost the same style, so naturally they thought I was the cool older cousin.

The final wig to add to my collection I acquired for free. It was a pale blonde Merlyn Monroe-style curly wig. It was so cute. I obtained it through a program I attended hosted by the American Cancer Society, called “Look Good, Feel Better.” They had a number of wigs there they were giving out for free, along with the brand-name make-up collection each attendee gets that cosmetic companies donate to this program.

But, since I already mentioned that wigs are not comfortable to wear, I experimented with other modes of covering my balding head. I bought different colored bandanas which became my favorite, because they were comfortable, easy to wear, and light especially for Arizona’s weather. I also had several baseball caps, and a couple of cool stylish hats. Finally, I had long scarves that I tied different ways to make them into some sort of style. I was doing everything in my power not to lose my fashion sense, especially after I was done with chemo and feeling up to going out again.

The hair has grown back. It is still boy-length, but at least I don’t look horrible in it. One advantage that I can see now: I get to experience every possible hair length/style. I still miss my long hair every day. I miss running my fingers through it, I miss having something to brush every morning and night, and yes I even miss flat-ironing and styling it. I miss feeling feminine as my hair strands danced in the wind, and wisps of it brushed over my face. But as one of my close friends told me one time as I was complaining to her over the phone about how slow my hair growth was that she did not care if I was bald for the rest of my life because “bald Nancy is better than no Nancy.” Of course, I laughed at the way she said it with such a passion, but I also understood what she meant. I am surrounded by people who love me, and would rather see me bald every day than not have me around. I know the pain they experience when a thought of not having me around ever crosses their mind. I hate to have caused so much pain to so many around me. So, I am doing my part, and trying to handle my hair drama with grace. Meanwhile, I am hanging on to a phrase another good friend told me when she saw a picture of my current hair-she said “you look hip in this new hair.” That is a lot better than hearing “you look like a boy” which was my fear…so for now, I will accept the fact/fabricated truth/plain lie that I look trendy, and continue praying that the day will come when I have hair long enough to run my fingers through it…

God is faithful and will not let you be tried beyond your strength;

but with the trial he will also provide a way out,

so that you may be able to bear it

1 Corinthians 10:13

CHAPTER 8: POWER OF HUMAN KINDNESS

You’ll never know the way it tears me up inside to see you
I wish that I could tell you something
to take it all away
Sometimes I wish I could save you
And there’re so many things that I want you to know
I won’t give up till it’s over
If it takes you forever I want you to know
“Save You” by Simple Plan

I had requested from my family that I be the one to call my dad, who was working overseas, to tell him about the new developments. My rationalization was that it would somewhat be reassuring to him if he heard my voice, and knew that I was not in critical condition or on my deathbed. You know how parents are, you tell them you have the flu and they think they should fly across the country to make sure you are ok. So imagine if you had to tell them over the phone, with an ocean separating you, that you had cancer. It was not something I was looking forward to doing, but I knew I had to do it. I was the best one in my family anyways who could keep a composed tone at this point, and not break down crying over the phone. I absolutely could not do this to my dad; I had to keep strong until he made it home. I knew he would be extremely worried, and he didn’t need me to add to his anxiety. I had discussed it with mom and decided we should postpone telling dad until after we had a definite diagnosis. My dad would call me regularly when I was in Florida to check on me. So for the few days that I was home, but he did not know, he would call me on my cell phone and I would talk to him pretending I was still in Florida; then he would call mom or my sister and they would pretend everything was fine as well. I hated lying to dad like this, but it was for his best interest at that point. There was no need to preoccupy him, if it turned out that I had something benign and easily treatable. After all, we were all still praying that it would be benign.

I cannot recall exactly who called who that Thursday, the day of my first chemo, and I don’t remember the details of our conversation. Somehow I had found the strength to blurt everything out to him. I felt like pieces of my heart were tearing off as I told daddy the news. I could not bear what I was doing to him emotionally, and I felt so guilty for making him go through that. Yes, I knew that it was not in my hand to change the situation; I did not will this sickness on myself or my family. Yet, I still could not escape the feeling of guilt. Perhaps, it was this guilt-along with my love for my family- that helped keep me strong in times when they needed me to be so. Somehow, somewhere along this journey of life, we suddenly find ourselves worrying about our parents just like they’ve always worried about us, and I had hit that point a few years ago. I remember talking to one of my best friends one day a couple of years back about how it scared me that my parents were actually aging, but I suppose that is all a part of it. The role of who worries about who slowly reverses, until one day we understand (never fully of course-until we have children of our own) how our parents feel every time they sense one of their offspring in trouble or facing some sort of life crisis.

As I had anticipated, dad did not take the news very well. I asked him if he could come home for some time off, and he said he will inform his employer that it is a family emergency, and work it out with the Red Cross so they can send him home immediately. He was going to send me the details to give to the Red Cross people when I called them. I hung up the phone feeling more miserable than ever; I was relieved that I had finally told dad, but I would not stop worrying about him until he arrived home safely. I started having those painful thoughts of “what if something happens to him before he gets here?” even though my dad is in perfectly good health (thank God!) To make matters worse, I had one of my uncles, who was also working overseas where my dad was, call after he heard the news. He semi-yelled at me for telling dad myself; according to him, I should have told him first so he could go and break the news more gently to my dad face-to-face. I personally did not believe this news could be made gentle, it was harsh information to break to anyone especially parents, and I did it the way I thought was best.

While I was at the hospital that week, I had the privilege of being looked after by a truly amazing doctor-Dr. Angel. I have seen very few like her; she was a hospitalist (an internal medicine doctor who cares for hospitalized patients only). She was the exact embodiment of what a doctor should be like-caring, full of sincere compassion, encouraging, never in a rush, and always willing to sit down and listen (even when I was not very willing to talk). As silly as it sounds, I wished that she could be every specialist I needed to see during this time; I wished she could oversee my care. Unfortunately, with her being a hospitalist, our doctor-patient relationship ended when I left the hospital. She made me wonder what extraordinary new doctors society would have if the preceptors who trained us possessed half of Dr. Angel’s qualities as a doctor.

One day, before we had the definite diagnosis from the biopsy, Dr. Angel was in my room explaining the next steps in my treatment plan, and responding to my questions. She was sitting on a chair that she had pulled close to my hospital bed (she ALWAYS followed the rule we are taught in medical school, but few doctors follow in real life because of their rush to get in and out of patients’ rooms, and that is: always make sure to be on eye-level or lower with the patient, never talk to the patient while towering over them because it makes patients feel more intimidated.) After we finished discussing my care, she leaned forward in her chair and placed her hand lightly on my arm and said:

“My dear, I must say you are being awfully calm about all of this.”

To which I replied: “yeah, I am just trying to stay rational so I can make informed decisions and understand everything”

To be honest, I could not explain why or how I had stayed calm so far. I had barely cried since hearing the news back in Florida considering the enormity of the situation.

Later that day, my sister was with me in my hospital room and I just started crying. I felt sad, and I just could not hold it inside anymore. I suppose being confined to a hospital room adds to one’s depression. During this time, a nurse had come in to check on something. As she saw me in that state she quietly left the room generously allowing me some privacy as my sister attempted to comfort me. She came back afterwards, and as she was checking on my IVs and such, she said:

“Dr. Angel will be here to check on you later. She had wanted to come in earlier but I had told her ‘now may not be the best time’ and told her you were crying. She just replied ‘good I had been waiting for that’”

the sweet nurse smiled at this, and I smiled back. I suppose Dr. Angel, being the marvelous doctor that she was, also knew of the therapeutic power of tears, and was glad I was getting to that point-the point beyond the numbness and shock of a situation.

After my conversation with my dad, I had told Dr. Angel that I may need her to tell the Red Cross people about my condition so they can work on expediting my dad’s trip home. She asked if I had the local Red Cross phone number; I did not but I was planning on looking it up later. She left and came back shortly after, with the number of the local Red Cross written on a piece of paper. She had taken out of her precious time to look it up for me, or had asked someone else equally busy to look it up; either way it was a very kind gesture. She dialed their number while still in my room, and within minutes she had explained the situation to them and took care of everything for me. She handed me the phone, and I gave my dad’s information to the Red Cross lady, who then reassured me that they will be working on this case immediately, and my dad’s employer should hear from them within hours.

Wow! It is amazing when small humane acts like that restore someone’s faith in the human race. Dr. Angel had not only restored my faith in human kindness, but also in the medical profession. I wanted to be like her! I wanted to be such a doctor, who through small every day deeds can make a huge difference in the patients’ lives. I will forever be indebted to her for showing me that one can be such a doctor, despite the challenges that he/she may face because of this messed-up healthcare system.

Two days later, dad was on his way home. I had been discharged from the hospital, and was anxiously awaiting his arrival…

Do nothing out of selfishness or out of vainglory;
Rather, humbly regard others as more important than yourselves,
each looking out not for his own interests,
but also everyone for those of others.
Phillippians 2:3-4