Friendship, Challenges, and Cancer – A Doctor's Memories

As Julia and I waited off to the side in the crowded procedure room, she suddenly reached for my hand. I had spent years in operating rooms as a doctor, but I had never held a friend's hand for a reason like this. When the nurses told Julia to lie down on the stretcher, we looked at each other and shared a brief embrace. Even when I could no longer hold her hand, I could not let go of her. As I stroked her hair, I imagined fortune-tellers predicting her future by analyzing the contours of her skull, like the phrenologists of old.

As the breast biopsy needle struck the lump in Julia's breast and took a sample, I realized that I was clenching my teeth and had briefly stopped, unable to move my hands. I remembered a teacher in medical school telling us that cancers often felt like a stone. As the biopsy needle sampled the lump as though a hammer were striking a piece of rock, my instincts as a doctor that the lump was malignant grew stronger. Julia squeezed her eyes shut, and I was paralyzed.

I had never expected to find myself in a situation like this.

For 33 years, I had been a breast cancer doctor. For 33 years, I had helped strangers through this strange land, caring for thousands of women with breast cancer. Women in their 20s, women in their 90s, women who came alone to every appointment, women whose husbands carried their handbags at every visit, women who barely spoke, women who never stopped talking, women awaiting biopsy results while mourning their spouses, women diagnosed days after giving birth… I had never imagined that my dear friend Julia, a 38-year-old mother of two, would be among them. Everything had happened so suddenly.

It is always so sudden. That is one of the things about breast cancer—you feel well, you exercise, and then something appears on a routine mammogram or you feel a small lump, and everything changes in an instant. That morning, I had asked Julia whether she wanted to have lunch. We had worked in the same neighborhood for more than fifteen years—I as an oncologist, she as a rising corporate star. Over the years, we had witnessed every significant moment in each other's lives. Even during our busiest times, when we lost ourselves in the rush of life, we made time to meet twice a month at best. When she did not answer my message, I sent another, but again there was no reply. Two hours later, she stammered that her mammogram had shown suspicious findings. In a whisper, she said, "They're worried. They want a biopsy, today. And my husband is in Atlanta. I don't know what to do." "It's all right," I jumped in. "I'm sure it will be nothing, so let's get it over with as soon as possible. Only a small proportion of breast lumps turn into breast cancer. You'll be fine."

Although I tried not to show it, I was shaken. I returned to my clinic and went straight to Kit, our veteran nurse. "They've found a lump in Julia's breast, and they want an urgent biopsy. On top of everything, her husband is out of town. Isn't that terrible?"

"Then, of course, you'll go and be with her," Kit said. "Call her and tell her you'll be there, and just go without asking anything else."

I did as Kit said, but nothing could have prepared me for that afternoon. At one end of the room was the radiologist, watching the machine intently; at the other was Julia, lying on her back. Beside the bed, with my hands in Julia's hair, I tried to stay strong despite feeling that I might faint. I could not gather my thoughts or grasp how stunned I was. Although I saw four dozen breasts a week, this was an entirely different situation. When I heard the needle touch the tumor, I shuddered and began to pray. Forgotten prayers from my childhood rose in the biopsy room: Please, God, let this be a cyst, a scar, a clot, a blockage; let it be benign. As the machines rumbled, I prayed that the answer would not be cancer, that the stains would not turn blue.

When the procedure was over, the lump was labeled and placed in a packet filled with stain. Julia and I walked to the parking lot, got into our cars, and drove in opposite directions. As a licensed doctor, I had made peace with biological injustice long ago. Trained in the hardest battle zones of cancer clinics, I had thought of myself as someone who was not easily frightened—until, on my way home that day, I pulled over, folded forward until my forehead touched the steering wheel, and burst into tears.

My bad feeling was proving correct. Julia's tumor was malignant and had spread to the nodes. I think about the moment when I touched her hair. We had been friends for 15 years, yet I had never touched her hair before. The hair she would soon lose to chemotherapy… When I returned to my clinic as usual the next day, my interactions with patients had reached an impasse. I struggled to focus on a new patient's treatment plan, unable to stop imagining the physical changes Julia would undergo. Noticing me stumble through my routine questions, Kit had given me stern but concerned looks throughout the day.

As I tried to collect myself in the staff room, I thought about how, from the first days of medical school, I had believed that I must not allow the dramas of my personal life to affect the complex decision-making of my professional life. That was what I had been taught, and I needed to focus. During my internship in the era of incurable AIDS, I had once asked an older doctor, through tears, how he coped with it all. Without hesitation, he said: "At the start of every critical visit, I make a 'Buddhist half-smile'. I turn up the corners of my mouth into a half-smile, then take a deep breath and breathe in everything I have learned and done, everything I have learned from my past patients and teachers. Then I breathe all the way out and go to see my patients."

After watching myself in the staff-room mirror for a while, I felt the silence in the room suffocating me. Before walking out, I paused, remembered my teacher's words, and decided to make my Buddhist half-smile. I took a deep breath and breathed in Julia's hair, our embraces, everything the thousands of patients I had cared for had taught me, medical school, my teacher—all of it. Then I let it out and left the room...

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How oncology patients respond to this article depends on their personal experiences and perceptions. Some readers may find hope and strength in this story, which emphasizes the importance of support from friends and doctors. Others may feel discouraged as they focus on the challenges of illness. Ultimately, Julia's story and her doctor's support can be a beacon of hope for oncology patients. What matters during this process is remembering the support of our loved ones and healthcare professionals. Together, we have a better chance of overcoming difficulties, and patients can feel stronger. On the journey toward recovery, preserving hope and our bonds with loved ones can help us appreciate the value of every moment of life. This story shows oncology patients and their loved ones that, by supporting one another through difficult times, we can move forward with hope.