3.6

The CT and blood work that I mentioned in my last post ended up showing essentially no change, which kept limbo-land as the status quo. My two main doctors are on opposite coasts in the best of circumstances, and on opposite sides of the globe quite frequently, and it has been excruciatingly frustrating and frankly dangerous that the lack of a national electronic medical record and the existence of HIPAA legislation prevent my doctors from being able to instantly access my scans from anywhere in the world. Instead, CDs get FedExed, then lost or buried under piles of other mail, then not looked at because it is the weekend, or not until a week later because the recipient is lecturing in Dublin or Chengdu. The anxiety and delay caused by this state of affairs is totally unacceptable.

Three weeks after my scans were done, the team in New York finally looked at them and got back to my doctor in California. To my great relief, they agreed that things looked stable, and that they would proceed to schedule the surgery for June 17th. Since there was no communication about whether or not there needed to be any more chemotherapy between now and then, my subconscious decided that this meant that the answer was "no", and so I proceeded to have a terrifically fun, celebratory long weekend. Alas, I find that I am writing this blog a short night's sleep away from Round 6. I still don't understand why it took so long for this decision to be reached and/or communicated, but it has been very destabilizing. Future doctors of the world, hear me: your patients need you to be focused on the rhythms of their lives. It is the nature of our profession that the rhythms of our lives must be secondary.

Despite finally having a surgery date, there are still many unknowns and what-ifs. If my tumor markers go up despite continued chemo, the surgeons in NY are unlikely to agree to proceed, just like what happened back in March. So then do I wait weeks for them to come up with a new plan? Or do I give up on them entirely, declare their approach proven wrong, write off the collateral damage done by the chemotherapy and the delay, and fly to Indiana, where there is a respected surgeon who is willing to do a different surgery that I am less confident will work?

It is a constant struggle to remain present in the moment, and yet also to remain proactively and effectively engaged.

The mountain of work that I have to get done before beginning 3rd year of medical school looming as large as always, and the time that I have to complete it growing ever shorter with each round of chemo, my anxiety level about being able to pull off this increasingly superhuman feat of concentration under extreme circumstances gradually reached a breaking point. I recently learned from the school administration that I had a third option besides either compromising both my health and my academic performance trying to get it all done while getting cured of cancer, or taking a third entire year off from medical school: I can give myself until January to get well and take all of my exams, and then rejoin at that point. This has been a huge weight off of my shoulders.

It took me a while to realize why I have been so focused on not taking any more time off: In normal everyday life, I know that if I delay doing something once, it is not very likely to happen, and if I delay doing it a second or third time, it usually means that I didn't want to do it in the first place and have been looking for an excuse not to do it at all. I use this self-knowledge to get my otherwise lazy ass out of bed and on to business. While this may be appropriate for goading myself into taking out the garbage or filling out financial aid paperwork, I realized that I was inappropriately applying this logic to this current situation as well. Having already taken so much time off of school, I was giving myself a hard time because I felt like taking any more time to get well was a sign of laziness. Once I realized that this logic was completely inapplicable to the current situation which is quite out of my control, it became much easier to let go, and accept a more sane (and safe) course of action.