Donning and Doffing – A Doctor's Experience of a Cancer Diagnosis During the Pandemic

If you are going to receive a cancer diagnosis, it is better for it to happen during a pandemic. When your image-guided biopsy takes longer than expected, the nurses will show you the little windowless room down the hall from radiology, where you can attend your virtual Zoom committee meeting scheduled for 11:00 with an ice pack and an Ace bandage (an elastic bandage that restricts blood flow) wrapped around your bruised breast. When they call with the biopsy result the following week, no one will see your expression change as you numbingly search UpToDate (an evidence-based online clinical resource frequently consulted by doctors) for answers while virtual meetings continue in the background.

Virtual Meetings That Can Hide the Change (?) 

During the months of chemotherapy, when food begins to taste like sawdust, you will prefer smoothies (liquid fruit puree) to solid food. There are no more real lunchtime meetings. During the first month, people will not really notice that your face has become thinner and paler. Zoom has a "touch up my appearance" filter. You are glad that this filter hides how fragile your skin has become; the small telangiectasias (dilated capillaries appearing as red spots) sprouting on your cheeks disappear on screen, while penciled-in eyebrows look real. As the weeks pass and hair loss becomes unbearable, do not worry. Everyone is starting to walk around with their new pandemic hair. Colleagues whose hair was once straight and sleek suddenly appear with natural waves. Your new style may be a bald spot at the back of your head. It is a secret between you and the mirror.

When Being Treated and Treating Others Become Entangled

When the oncologist calls during a meeting, remember to turn off your Zoom feature and hide your video, which you can easily do. You will get used to hundreds of patient messages, another overflowing inbox to manage. Health system coronavirus disease (COVID-19) updates will mingle with your patient recommendations, but you will quickly learn which part of you they are intended for. Daily employee health screenings and patient health screenings will become absurd when they ask about all the symptoms you are expected to have during chemotherapy. These include fatigue, nausea, vomiting, diarrhea, and muscle aches, and the answer is always yes, yes, yes, and yes. Does neutropenic fever count? You may need a COVID-19 test until the granulocyte colony-stimulating factor (the injection that raises blood counts) takes effect. Distance will be a blessing, you will see. No unnecessary scrutiny from well-meaning family and friends. No exposure to coughs or colds. Your sinuses have never been so clear.

Awkward Moments

There will be some awkward moments. While being seen at the oncology clinic, you may encounter a trainee who used to be your intern, perhaps now a colleague who says a bright "Hello" before their face falls as they realize you are out of place. The interventional radiologist involved in placing your port may recognize you from the fight against COVID-19. While you are at the chemotherapy center and also in a Zoom meeting, your infusion pump (the machine delivering chemotherapy into a vein) may begin beeping as you speak, an instantly recognizable sound. You are hiding in plain sight.

The Doctor Trained to Be Superhuman

The number of doctors dealing with a serious illness and its treatment while continuing their careers is unknown, and, like many, you may not want to share your story. No doubt about it: doctors are trained to be superhuman. Eight-hour certification examinations and 36-hour shifts prepare you to work even under the most inadequate conditions. Although you have privileged knowledge of navigating the world of urgent care, clinic visits, and emergency departments, you will probably seek advice from friends and colleagues to avoid revealing yourself to a wider group of colleagues. We do not want their sympathy or the inevitable biases about our professional abilities that come with it.

Intertwined Heartaches and Fighting for Better Times

But perhaps when COVID-19 case numbers begin to fall in your city, you feel that months of staying home and careful masking have worked. You will realize there is room for your personal grief amid all the grief of the pandemic. Hiding an illness from someone who is supposed to care about illness is exhausting. You will tell one colleague, then another. You will share with your patients struggling through chemotherapy that you now know what it is like not to feel invincible. Through your days of donning and doffing, you will realize that you can be both a doctor and a cancer patient. You will let those close to you join in your private struggles. Everyone's heartaches around you will become intertwined: protests in the streets, homeschooling, lost jobs, and lost relationships... And every time we say it, if we are lucky, personal protective equipment is no longer something we hide behind, but something worn in solidarity, fighting for better times with everyone around us.

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