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When Doctors Need Doctors: Working Through Lung Cancer

Paul Kalanithi, MD, Neurosurgeon, Stanford University

 

I worked for about a year after my lung cancer diagnosis, finishing my training, operating, and seeing patients a bazillion hours a week. I’ve had to take time off from that for the last couple of months, and as my strength improves, I’ll evaluate how to get back into patient care.

As a doctor, you have the sense that if you were to get a serious disease, you would retire and sit back and spend time with family. That’s the standard narrative that we tell each other. But once it became clear that I wasn’t going to die in the next couple of months, that I would live for at least a few years, I decided to go back to neurology. When I told my colleagues, a number of them asked, “Why don’t you just spend time with your family?” My reaction was, “Why don’t you go spend time with your family? You’re making the decision to do this work because, properly understood, this work is a sacred thing.” I had thought a lot about what I wanted to do with my life, and that didn’t change when I got sick.

As a doctor, you can get some sense of what it’s like to be sick, but until you’ve done it yourself, you don’t really know—it’s like falling in love or having a kid. We don’t appreciate the mounds of paperwork that come with it. And tiny little things: When you get an IV placed, you can actually taste the salt when they start infusing it. They told me that this happens to everybody, but even after 11 years in medicine, I had never known. There’s a whole mess of things like that, little details that you don’t appreciate as a physician.

Unless you’re going to have cancer therapy define your life, you have to start caring about other things. I still maintain hope that I can get back to clinical work and neurosurgery, but I’m fully aware that they will be among the first things to go in terms of what I’m able to do. Surgery is actually hard labor. That led me to consider other possibilities, where you can still be productive even if you’re tired or having back pain or whatnot. One option is getting back into lab-based neuroscience. Another is working on scientific advisory boards for companies. On the less scientific end of things, there’s work in teaching and, of course, writing.

I wrote an Op-Ed for the New York Times discussing my experience, as a doctor, delivering information about diagnoses, and as a patient, receiving my own diagnosis. In particular, the focus was on the seemingly critical question, 'How long do I have left?'—how doctors don't know the answer, and how patients are looking for something more.

It completely surprised me that it resonated with so many people. I still get an email nearly every day from someone with heart disease or depression or another medical illness, saying that it helped clarify his or her own situation. The second, and really pleasing, development was the number of doctors who emailed to say that they planned to give the article to their patients or incorporate it into medical school curricula to help students understand the human impact of disease. That was really touching. I’m currently working on a book proposal about my experience: It’s a larger look at the meaning of being a doctor and the meaning of being a patient, and how those meanings change when you can see from both sides.

After I wrote the piece, I finished residency, but also relapsed and had to go through chemotherapy. I’m more or less recovering from it right now. I had standard chemo for about three months, but unfortunately, I’m one of those people who get every chemo complication, so I was bouncing in and out of the hospital for several months. My daughter was born about two days after I was discharged. She and I have been chilling out at home for the last three and a half months.

I’ve kind of stopped looking at survival curves. They don’t tell you about you—they tell you about the disease population. What’s going to happen to you will fall somewhere within the range. It’s pretty wide.

 

More Doctors' Survival Stories:
Beating Breast Cancer with Help from Beyoncé
A Superhero Surgeon Brought to His Knees
After Dodging a Death Sentence, Looking for a Cure

From Pain, a New Purpose

Getting Back to Life After an Assault

For a Workaholic, the Misery of Bed Rest

Sometimes, It’s Not the Doctor Who Heals

Originally published in the January issue of San Francisco

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