Human Connections

It was a long day of precepting in resident clinic that ended in a trip to radiology, a late after-hours appointment I had rescheduled a few times because—as we all know—doctors sometimes make the worst patients.

It was my first mammogram. I was only 38 after all, 2 years before I was even supposed to begin routine breast cancer screening. As a med-peds primary care physician, I had reviewed the screening guidelines countless times with my internal medicine residents in clinic. I had talked with my pediatrics residents about how breastfeeding reduces the risk of breast cancer. But I could no longer ignore the abnormal area I felt in my breast. As I sat in the cold waiting room, I did not realize at the time that it would also be my last mammogram.

I could tell by the way the radiology tech was carefully taking measurements and staring diligently at the screen that it was abnormal. She apologized. “I'm sorry,” she said. “If this was earlier in the day, I could have one of the radiologists look at it right now but it's after 5pm.”

So I went home and waited for the next day.

Almost at 9am on the dot, I received a call from one of the radiology nurses. “Multiple irregular masses...” The next 2 weeks were filled with additional imaging, including a diagnostic mammogram, targeted ultrasound, and breast MRI, followed by stereotactic and ultrasound guided biopsies. Eventually this all led to a diagnosis of invasive ductal carcinoma of the breast.

I felt paralyzed.

How could this be? I looked up survival rates depending on the stage of disease. I calculated how old my kids would be if I lived another 3 years, 5 years, 10 years, or 30 years. I asked my husband radiologist to show my imaging to his colleagues.

The plan was mastectomy in a few weeks. And I opted for bilateral.

My colleagues were amazingly supportive and immediately said I should do telemedicine in the weeks leading up to my surgery. They didn't want me to risk getting COVID-19 while seeing patients and then postponing surgery.

This also meant that I fell off the face of the earth. I didn't see my residents anymore. Were they wondering where I was? My colleagues were all aware of what was going on, but I had felt uncertain about whether I would share the news with my residents. About one week before my surgery, I crafted an email to let them know why I had disappeared. I shared my diagnosis, the plan for my treatment, and that I was feeling OK and hoped to return as soon as I could, maybe even before the end of the academic year in time to see our postgraduate year 3 residents graduate.

I did not expect the overwhelming emails and texts that I received.

I received well wishes, thoughts, and prayers. I received offers for babysitting and homework help for my kids. They shared stories of their own personal or family struggles with illness. They encouraged me to ask for help and even taught me ways to do it. “People around you truly want to help (and I think people feel good when they get to do something) so ask for specific things,” one of my residents wrote. I read and reread this message a few times. So, I started asking for help: “Can you pick up some groceries?” “Could you give me a ride to my doctor's appointment?”

It was pure, unadulterated kindness. And it truly got me through a period of anxiety, worry, and stress.

A few of my pediatrics residents organized a day when the residents, faculty, and staff dressed in pink, and they sent me a picture to show support. I cried when I saw that picture, and it always stayed close to me throughout my surgery, treatment, and recovery.

They offered me hope.

I also developed a new level of trust in the residents: not only that they would take good care of my patients while I was gone, but that they would also take good care of me. It was residents who ran to my bedside when a rapid response was called after I had a syncopal episode a few hours postoperative. When I came to, it was a surgery resident who was standing over my bedside squeezing a bag of normal saline to get more fluids into me with my blood pressure of 73/34. It was an internal medicine resident, someone I'd precepted, who saw me in the ER for shortness of breath, a few days after surgery. I trusted them wholeheartedly.

In our day-to-day moments teaching residents, we talk about how we impact them: the medical skills we teach them, the educational milestones we help them achieve, and even the career mentoring and life advice we may give them. But what has become clear from my health journey is that residents teach me in ways I may not even realize. I have learned that the teaching moments we share together mean so much more than simply medical education. They are opportunities to form truly meaningful human connections.

And for that, I am forever grateful.