The journey began with a trip to the doctor’s office for constant shoulder pain and full-body aches. The first doctor gave me a brochure filled with exercises to strengthen my shoulder. Nevertheless, the pain continued; another doctor suggested that I was stressed. The next doctor blamed the pain on my heavy backpack. Finally, one of the doctors ordered some blood work and saw that my white blood cell count was slightly elevated. The blood work was repeated and showed a persistent leukocytosis. He had no idea why my white blood cell count kept increasing, so I went to a hematologist-oncologist. After blood work, history and physical exam, he came to the conclusion that I was a healthy, young female with nothing overtly wrong with me. He suggested I go to a rheumatologist, who then suggested an MRI of my shoulder.
On February 9, 2016, my father called me while I was at the library. I was in the middle of cramming for an ethics quiz later that day, so I let the call go to voicemail and texted my dad that I didn’t have time to talk. He texted me to call him, saying that it was important. I had a feeling something wasn’t right; I thought that something might have happened to someone in my family. I left the library and called him. He told me that the radiologist saw a shadow in my chest on the MRI, which required further workup.
Two days later, I was diagnosed with stage four Hodgkin’s Lymphoma and told that I would have to undergo 12 rounds of chemotherapy for six months. Two days after that, I started my first round of chemo. After the second round, most of my hair was gone. On July 15, which was originally supposed to be my last day of undergrad, I underwent my twelfth and final round of chemo. At that point I had lost all of my hair and gained a total of forty pounds. When I looked in the mirror, I no longer recognized the person looking back at me.
When I was told I had a mass in my chest, I was shocked. Like most people who are told that they have cancer, I was blindsided. But it was even more shocking because I had been going to multiple doctors over a period of six months complaining of pain in my chest, right arm, and right shoulder. They kept telling me that I was young and healthy — that I was just stressed. But my white blood cell count was consistently elevated. They couldn’t figure out what was going on. It was completely incidental that an MRI of my shoulder revealed what ended up being a huge mass in my chest. The radiologist actually told me with a chuckle right before my tumor biopsy that you did not have to be a doctor to know that something was there that shouldn’t have been.
By the time the doctors caught the tumor, it was 10 by 8 centimeters. The tumor had gotten so big that it was almost completely obstructing my superior vena cava and compressing my right lung. I just thought I had a cough. It had gotten to the point that the cancer had begun to invade my bone marrow, and I had no idea. I just thought I had weird body pain. The doctors didn’t have any idea either.
I haven’t had the best experiences with doctors. Once, my usual oncologist was not available, so I saw another one in the practice. He told me that I could not have my usual round of chemo because my white blood cell count was too low. He told me to go home. We ended up calling my usual oncologist who told us that the other doctor was wrong and to proceed with the usual chemotherapy, which we did. Later, another oncologist told us that it didn’t matter what my white blood cell count was, I was supposed to get my scheduled chemotherapy. Apparently, it’s standard protocol to give chemotherapy regardless of white blood cell count. I do not know how the other doctor did not know this. If I had listened to him and did not receive my scheduled chemotherapy, I don’t know what would have happened.
You can imagine that I don’t have complete faith in doctors, which might sound weird, since I am a third-year medical student. Before my experience as a cancer patient, I essentially viewed doctors as superheroes. They seemed to know so much. Based off of a few symptoms, they could tell you what was wrong and what you should do to get better. But after my experience as a cancer patient, I realize that doctors are not superheroes. They do not always know all the answers, even though they sometimes should.
During my clerkship year I have been able to see the healthcare system through a different point of view: that of the physician. I have met some amazing doctors who have spent time listening to patients and their complaints and made sure that patients understood treatment plans. They seem to understand that many patients are worried when they come into the doctor’s office and want to make sure that they are receiving the correct care.
On the other hand, I have seen physicians get frustrated when patients ask “too many” questions and defensive when patients question their plan. I can see why some physicians become frustrated due to the limited time they’re able to spend with patients, but I have learned that patient education is important not only for the patient, but the doctor as well. It is necessary for the patient to have a complete understanding of their illness and treatment in order to trust the doctor enough to follow the plan.
Someone once told me that I will be a great doctor since I’ve had the experience of being a patient in the health care system. While I think that this experience will help me in my career, I’d like to think that I would have been a great doctor even without going through all that I’ve been through. I don’t think that you have to experience a major medical illness to be a good doctor; most doctors won’t. You just have to listen to your patient.
Don’t dismiss patients’ complaints because they are young and look healthy. Most people who go to the doctor go because they think something is wrong; they know their own bodies better than anyone else. As a physician once told me, listen long enough and the patient will tell you what is wrong with them. I think all physicians-to-be should keep this in mind.