The One Question I Wanted to Ask My Doctor After My Cancer Diagnosis
Over six years ago, I was blindsided by a diagnosis of cancer. I had had no symptoms or problems, nor any expectation that anything was amiss with my body (outside of the usual problems of needing to shed a few pounds and the steady retreat of my hairline). Thus, when a routine physical uncovered that I had an “incurable form of blood cancer” I went into a prolonged state of shock.
Fortunately, I am married to a doctor and, although she is not herself an oncologist, she was sufficiently knowledgeable about my condition to find the right specialist for me to see. At this first appointment with “my oncologist” — a term, by the way, that no one wishes to ever have the need to use — I was so overwhelmed that I barely spoke. But, again, because my wife is a doctor (and probably just a stronger person to boot), I was not required to do much conversing. I mostly sat in a state of silent despair.
Over the following couple of months, my wife and I had similar appointments, both with this oncologist and then a new one. Yet my level of participation was largely confined to merely providing the blood and a vein through which it could be accessed for testing. In some ways, I felt that my presence was really not needed at these sessions at all.
After a few more of these appointments — and yet another new oncologist — I finally had determined I should go alone. My wife had managed a great deal with all of this, and I felt that it was beyond time for me to take some interest in what was happening to me. It was at this point, however, where I had a major internal debate: Do I ask the doctor the one question — really, the only question — that I care about: Will this cancer kill me?
It might strike some as rather delinquent of me to finally, after months of living with a cancer diagnosis, to just then be getting around to asking about its ultimate meaning. And while I don’t disagree that I was certainly tardy, I think I used the excuse of having a wife-doctor as my proxy and spokesperson when discussing matters with my oncologist.
As anyone who has spent much time interacting with doctors can likely attest, physicians are quite well-equipped to deal with life-and-(potential)-death matters even if not particularly adept at contextualizing them. If one asks a doctor, “What should I expect?” or “What happens now?” the patient is quite likely to receive some excellent, detailed and concrete responses. But these replies will tend to focus on the tangible and the known: “We will monitor you at x-month intervals” or “We can treat the symptoms with drug Y” or, best of all, “We can address that issue when — and if — we come to it.” As I said, all very useful, pragmatic pieces of information.
What is of course missing, is the human element to it all. Now, lest one think I am being critical of the concern or empathy expressed by doctors, let me assure you that I intend no such thing. Doctors are trained to deal with the disease or issue at hand, and they must do so. They are not trained, nor should they be, as spiritual counselors. And, realistically, they cannot possibly do the difficult jobs they must if they have to dwell upon the ultimate outcome that is so often unavoidable. Nevertheless, we, as thinking, feeling beings, are not so constrained, particularly when it comes to our own well-being, the apex of which is our own mortality.
The reality is simply that there is no one else to whom to turn for one suffering from cancer. It is the oncologist — the specialist who deals with this terrible disease day in and day out for years — that we as patients must ask this most fundamental of questions. And while I appreciate that many would just as soon not know, I felt that at this point in my involuntary journey with cancer that I needed to know what to expect. I had two children under the age of four, a wife, two living parents, a sibling and, hard though it is for me to believe, even some concerned friends. It would be, in my view — for me — irresponsible to not ask whether any of them could count on me and for how long.
Thus, at this first appointment flying solo, I said to my then-current oncologist, with perhaps the greatest difficulty I had had expressing any interrogatory since asking my date to the 9th grade prom some 25 years earlier, the most blunt and terrifying of questions: “Doctor, will this cancer kill me?”
The doctor, a kind and experienced gentlemen who had undoubtedly been confronted with what has to be the worst part of his job many times before, paused, looked me directly in the eyes and said, without hesitation or hedging, “Yes. This will kill you. I am sorry. I thought you already knew that.”
One could get into a whole thing about why I would ask the question if I already knew the answer. Perhaps he thought I was merely forum- shopping for a better answer — i.e., one less likely to end in my ultimate demise. But it really would not matter. He had said the words I feared most and I had to confront my own mortality in a way that no one really should. Of course, he added, “It’s not as though you will die imminently, but . . . you should not expect to live as long as your grandparents before you did.” (This was rather disappointing as my maternal grandfather died at only 53. Definitely not the “golden years” in Florida that we New Yorkers think is our entitlement upon reaching retirement.)
Upon hearing my oncologist’s response, I was of course crestfallen. Perhaps a better-adjusted person would hear this as a clarion call to live each day to its fullest from now until my too-soon endpoint. But, at the time, I was consumed by the fears and sorrows of what a life truncated in such a manner would mean: Not being there for weddings, for grandchildren, for growing old with my wife and not having the opportunity to complain about how much tougher we had it “back when we were kids.” I was also, to a certain extent, angry that this should be my fate. And I was disappointed — disappointed that the long life we all hope for would not in fact be mine.
As time has passed since this fateful question, I have adjusted to its answer. Although far from a “seize the day” type, I am more appreciative of that which I have now than I ever was. At least sometimes. And while I am far from an optimist, I do continually hope that some cure will be found or new treatment discovered that will make my now-former oncologist’s prediction grossly inaccurate.
In retrospect, I am glad that I asked the question. Hearing the answer was hard — so very hard — but not knowing the answer would not change the outcome. I would like to be able to say that I grew from the experience and thus it was a small victory for me. But with cancer there are very few victories, and I won’t try to manipulate this into one. I will just consider it a step in the process and go on as best I can — for as long as I can.
Getty image via Pornpak Khunatorn.