What I learned about being a patient after finding my own cancer in ultrasound class

When I think of medical students, I think of a cohort of responsible and organized individuals. It takes a lot of dedication to get into a medical program and being on top of things is sort of an unspoken prerequisite. As students, we are constantly being reminded of the patients we are going to care for in the future, and as osteopathic medical students specifically, we are told that we will be responsible for our future patients’ physical, mental and spiritual health. I guess what I’m saying is, I thought I had the whole “responsibility” thing down, or that I was at least becoming responsible by training to be a doctor.

Then I became a cancer patient, and I learned how different chosen responsibility is from illness responsibility.

An unexpected diagnosis

During an ultrasound class in my first year of medical school, I volunteered to be a patient. I was excited to see my thyroid on the little screen and, to be completely honest, I was even more excited when my thyroid looked different from the videos we had to watch before class. My thyroid was special! It had a nodule! Yes, nodules are common, but I got to see mine. How many people get to do that?

I wasn’t concerned because I had learned that most thyroid nodules are benign, and that, even in the worst case, most thyroid cancers have excellent prognoses. At that point in my life, medical school still felt more important than whatever was going on in my thyroid. It seems crazy to say this now, but I truly felt as though my responsibilities lay elsewhere: In my relationships, in my schoolwork and in my dearly protected free time. A year later, a biopsy confirmed that while trying to be a responsible student doctor, I had neglected myself as a patient. My nodules were tumors that had grown in size and number, and my cancer had metastasized.

A shift in perspective

In my experience, being a medical student is nothing compared to being a cancer patient (or any chronically ill patient) in terms of responsibility. One of the first things I learned is how different responsibility tastes when it isn’t a choice. I had chosen to study hard in undergrad. I had chosen to take the MCAT, apply to medical schools and then do my best once accepted to a program. I had made these choices knowing they would be difficult endeavors, but at the end of the day, I would feel proud of myself and know I was working toward something important.

The new responsibilities I faced as a patient were not only unchosen, but completely unanticipated at the time of my diagnosis. Overnight, I had to face the responsibility of answering my phone every time it rang, even if I was in class or an important meeting. Around my study schedule, I became responsible for what I referred to as “self-admin work,” which involved staying on top of numerous appointments, bloodwork intervals and payment plans for my various treatments.

Worst of all, I acquired the dreaded responsibility of following up with my wonderful (albeit extremely busy) doctors each time my insurance denied a time-sensitive pre-authorization. I adopted and adapted to these overwhelming responsibilities with the (arguably) simple goal of being healthy again, as I’m sure many other patients must do.

The daily burden of patient responsibility

During our medical school orientation, a speaker at my school reminded us that “patients are only patients for very brief moments in their lives,” but my patient-ness has spilled all over the rest of my life. I believe this was said to remind us that our patients are human beings and not just puzzles to solve. However, in my opinion, the speaker’s quote doesn’t take chronic illnesses into account.

For me, being a patient has slipped through and invaded moments when I planned on simply being a person. It has changed me forever.

I am a patient, not only when I am at the doctor’s office, but when I am on the phone with insurance during the times I should be studying. I am a patient when I check the mail and see medical bills among newspapers and postcards. I am a patient every time I reassure my friends and family that I am still doing okay, or when fun times feel slightly dampened by my honest answers to “What’s new?”

One of the hardest things for me to come to terms with has been the fact that I will always be a patient. Yes, ideally one day I will be cancer-free, but I will always rely on medications for my body to function properly. I will continue to need blood work, medication titrations and follow-up appointments. I have become a very responsible patient, and I will need to continue to be one for the rest of my life.

I think it will get easier as I continue to grow up and become more used to this new version of myself. I am grateful every day that I am able-bodied and not in pain. I am also relieved to be navigating this disease with no dependents.

Dual responsibilities

My message here is not that patients always need to fend for themselves. In fact, I hope this continues to be less and less true as we grow in our knowledge and compassion as medical professionals. My message is that as health care professionals, I hope we can do our best to understand how much focus, discipline and strength it takes to be a patient. To some of your patients, their health journey may feel as difficult as getting a medical degree, but without the rewarding career that follows.

I hope that both you and I can tuck this perspective into our back pockets and use it to make someone’s life easier in the future. Furthermore, I hope my words and experiences will encourage you, the osteopathic physicians and medical students, to stay on top of your own screenings and check-ups.

It may not always feel like it, but your responsibility as a patient is just as important as your responsibility as a physician.

Related reading:

The gift of time: Reflecting on caring for patients who have cancer

Compassion in medicine: It’s not just the right thing to do—it also makes the most cents