Ever Widening Concentric Circles

I reached out to some fellow MD cancer survivors and asked how and when they had shared news of their diagnosis.

My favorite answer was this: As ever widening concentric circles.

For me, the innermost circle started where you’d expect: Spouse, my immediate family, my work partners, my close friends, my kids.

My assistant – who is really the one who keeps me professionally on track – was also right in the mix, because patient schedules had to be juggled. I *hate* rescheduling patients and have only done this a few times, ever. I also instructed her that it was ok to say what was going on with me, not only because it is not a shameful secret, but also since I think hearing “She has to reschedule because she has cancer” is an immediate diffuser to negative reactions about a moved appointment.

[Sidenote: I also read something recently in an advice column about a patient whose physician had been on a medical leave of absence, but was now back to practice. The patient was asking the columnist if she should fire the physician due to the unfounded assumption that the physician had either been in some type of substance abuse rehab or a psychiatric facility. Fortunately, the columnist called the letter writer out with a Not-So-Fast-What-Are-You-Thinking response, pointing out things like maternity leave, a broken limb that prevents doing surgery, taking care of an ill family member and yes, cancer, that could temporarily take a physician away from duty. The columnist rightfully upbraided the letter writer, but it left me fearful that without an explanation, patients might make similar assumptions about me. I am still concerned that I may lose some over the uncertainty of what the next several months (? years?) will entail, but I will have to find peace with it.]

My kids were not difficult to tell. I have always been direct with them and this was no exception. As each step rolled out, I told them: I had a test that was not normal, I need to get another test, I am scared about the results, I have cancer, I need to get treatment. Their personalities are very different, but they both basically responded with “Ok.” While I would have been happy to answer any questions, they had few.

One of the last people I reached out to was my Mentor, someone who trained me in residency, helped me get a fellowship, and then hired me when I graduated and was my colleague for eight years. Adding it up, this is someone who has been in my life for nearly 20 years and whose impact has been immeasurable. I knew he would be devastated by the revelation and sharing the news was so emotional that I didn’t trust my voice and sent a text. He responded exactly as I knew he would, with kindness and grace. I think I struggled with telling him because I (accurately) predicted his emotional response would equal mine.

The circle is now very wide. As anyone with a crisis like this could tell you, there is an outpouring of love and support from all directions. Risking the vulnerability is worth it.

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