Chapter 19: I am the Lucky One

Saturday, February 22nd, 2020: Thoughts on a sunny, perfect morning in Saint Paul, MN

Over the past few years of my career as an internal medicine resident, I have seen hundreds, perhaps thousands, of patients. Every patient’s story sticks with me in some way. Some patients bring me happiness, some sadness, some joy, some guilt. They all teach me as much, if not more, than I can ever hope to teach them.

For those who don’t know me personally, or haven’t know me for long, I grew up with the plan to become a teacher. I worked as a tutor for many years, teaching both local and international students in science, math, and test prep skills (ACT, SAT, yikes remember those days?!). I did this for many years and actually continued to do this all the way through medical school. I loved it.

I majored in genetics and cell biology in college. My initial career plan was to become a professor. Teaching was and still is my passion. In college, I volunteered at a number of hospitals, nursing homes, and clinics. As I saw more medicine and met more patients, however, I quickly learned that the medical field involves tons of teaching. As a physician, I have the unique opportunity to teach patients, students, residents, and myself every single day. Physicians have a rare opportunity to teach not only in classroom settings, but in hands-on “real life” situations. In seeing this, my career goals shifted from that of classroom teaching to medicine. I applied to medical school and, despite hard work and occasional, fleeting feelings of “why the hell did I sign up for this?” I absolutely love my job. After completion of my residency (which is supposed to be this May 2020….we’ll see….), I have already signed on to work as a “chief resident.” This is a role I am very excited for. Essentially, it will allow me to spend a year focusing on refining and improving my teaching skills before working as a hospitalist and, ideally, as a teacher of medical students and resident physicians.

If I lost you in that long, casually-worded resume, the short story is that I love to teach.

Through this blog and all of the amazing, kind comments you have shared with me, I am starting to realize that I have been given a very unique, very incredible gift with this whole cancer thing. Somehow, even though I am taking a small, hopefully temporary pause in working as a physician as I navigate this strange path of brain surgery, recovery, likely repeat brain surgery, another recovery, and possible chemo/radiation, I have been given an opportunity to teach in a completely different and unexpected way. I don’t know that I’m qualified to give any sort of life advice, but when you, my mysterious and wonderful readers, send me words of thanks for “wisdom, advice, inspiration, etc” I am astounded. I am happy. I smile and I think, “My God. Am I teaching? Am I qualified to teach in this way?” I don’t know. But, I’ll pretend I am and continue to share my thoughts with you.

Today I want to share a few stories and a few thoughts that I hope will help anyone who has ever lost someone they love.

Prior to my own diagnosis and transition to being a patient from a physician, I often saw patients who were dying. Young patients, in particular, often affected me deeply as these deaths are always tough to witness. Limiting details for patient privacy, I’ll share a few patient stories that I can never forget.

- 30-year-old man with metastatic lung cancer. He was dying. His hospital room was filled with flowers, photos, and family members at all times. His last wish was for his two golden retrievers to visit him in the hospital. We snuck the dogs in, they snuggled with him, and he died the next morning. All I could think was “This is so unfair. This poor man was so young. He was newly married. Life sucks. He must have been so sad and scared to die.”

- 25-year-old female with liver failure. New diagnosis, horrible prognosis. She needed a new liver and would likely never get one. My thoughts often included “This is so unfair. This poor girl. Life sucks. Why is this happening to her? She must be so sad and so scared to die.”

- 30-year-old man with metastatic melanoma. His hospital room was also filled with flowers, photos, and family members. He was dying, quickly. He knew it and his family knew it. Every time we went into his room I thought, “This is so unfair. Why does this young man have this horrible disease? Life sucks. He must be so sad and scared to die.”

I could go on and on here. I have seen many cases very similar to these three. Unfortunately, illness and death are not uncommon, even in the young.

You might wonder, “Why are you telling me these sad stories and making me cry on Saturday morning?” “Why is this helpful, you jerk?”

Well, I tell you these stories because I realize now, as a patient, that I misinterpreted all of them. I looked at these patients, talked to these patients, and always walked away thinking “They must be so sad, so upset at how unfair life has been to them and so scared to die.” If you have lost a loved one and had these thoughts, I want to reassure you that (at least in my case) these are not the thoughts the patient has at all.

Instead, I think, “I am the lucky one.” Let me explain why.

Ever since my diagnosis, my greatest sadness comes from thinking about the sadness my family and friends will have to experience when I die. I can only imagine and assume that many young patients diagnosed with a terminal illness feel the same way. It’s a terrible thought to imagine my parents, my brother, my friends having to experience intense suffering and heartbreak due to my illness and eventual death.

As the patient, however, I will not have to experience this heartbreak. I will die, yes. But, I will not have to lose someone I love. I will not have to live without my family or friends, but they will have to live without me. (I think. Again, as we’ve been over, who the hell really knows our timeline on this Earth.) The thought of losing someone I love hurts me and scares me much, much more than the thought of dying myself. I get to go out first; I don’t have to live without the people I love. Because of this, I am the lucky one.

Fondly,

Courtney

© CB2020