The Race We Already Lost: A Piece of My Mind

Eileen P. Storey, MD 

I remember when we started running. It was a Monday evening. We had just finished dinner, pork chops and pesto, on our back porch as a family of 5. I had reading to do, so I pushed my chair back to get up from the table. Before I had time to stand, your voice cut through the hot, humid July air, interrupting the inevitable laughter of our family dinner and the Bruce Springsteen soundtrack in the background. “I have to tell you all something,” you said. “And it’s not a good thing.” 

You paused. Only for a second or 2, but long enough for me to sift frantically through the things it could be, the people we care about who could be sick. “Maybe someone we know has COVID?” I thought. And then you began, “I.” The screams went off in my head, “No, No, No. Not you. Please not you. Anyone but you.” You were undeterred by my silent screams. You went on to describe the masses they found in your liver. “Masses,” I thought with a sinking feeling as the questions fired through my brain, “How many are there? Are they all in your liver or have they metastasized elsewhere? Did you have a biopsy? What type of cancer is it?” You began to answer my silent questions, “My biopsy is tomorrow. I will then have additional imaging to see if it has spread elsewhere.” You took another deep breath and then you finished me off. “Unfortunately, I am not a surgical candidate.” 

I had just completed a surgical oncology rotation, where I had learned that when it comes to cancer, nothing good ever comes from those 4 words, “Not a surgical candidate.” I looked at you, noting the strength and anguish that balanced out in your expression, and then I looked down because I knew anguish weighed heavily on mine. I pulled my chair closer to the table. I no longer had reading to do. 

I had just started my fourth year of medical school. Just returned to the hospital and in-person clinical medicine that I had yearned for after months of being sidelined by the pandemic. Just decided I would apply to a combined residency in internal medicine and pediatrics, thrilled that I didn’t have to leave behind either field of medicine that I had come to love. Just reached the contentment and balance I had been striving for since before medical school started. The night before you shared your news, I had written down this quote from the novel-based movie, The Perks of Being a Wallflower, which captured the beautiful place I was in at the time, “I can see it. This one moment when you know you’re not a sad story. You are alive. And you stand up and see the lights on the buildings and everything that makes you wonder. And you’re listening to that song on that drive with the people you love most in this world. And in this moment, I swear, we are infinite.”1

How quickly and brutally I remembered we are finite. 

And so, our race began. Our race to share even a single day as Drs Storey. My timeline was fixed with 10 months until graduation; your timeline was uncertain, but everyone, including the renowned oncologists and the reference texts and journal articles I combed through, suggested you had at least a year. Hopefully longer. 

At first, I thought we would easily win the race. You were still working full-time, gardening, decorating our home for holidays, taking photos, making music playlists, sharing wisdom, and going above and beyond for us every single day; you were still you. But then September arrived. You had failed your first immunotherapy regimen, or rather, it had failed you. September turned into October, and now the masses were notably larger on the repeat imaging. Seven months to go. I reassured myself with false hope based on the initial opinions of your oncologists, and I distracted myself with rotations and residency applications. But then you looked sicker. With each passing week, you seemed to age by a year; some days you seemed to age between when I left for the hospital in the morning and returned home in the evening. 

And then there was the Tuesday I came home from taking Step 2 CK (clinical knowledge), the second portion of the US Medical Licensing Examination. Tuesday had always been your late night since you had evening office hours with patients. When I walked in the front door, you were already home. “How was your test?” you asked. “Why are you home?” I replied. You answered first. “My pain was excruciating. I was more of a patient than my patients. I knew they would be better off seeing someone else. Anyone else.” And then you repeated, “How was your test?” 

Your words still hung in the air between us. “Dad, you know I would fail my test if it meant you still got to see your patients, and your patients still got to see you.” 

Your hardened expression relaxed into a soft smile as you replied, “I hope you know how happy I am that you cannot give up your future to preserve mine.” I looked down to hide the tears I knew were coming. That was November, 6 months to go. 

Then it was the middle of December, a week before Christmas, your favorite time of year. You had just completed your first round of chemotherapy. I was starting my winter break. I was worn out after a month of weaving residency interviews in with my clinical rotations, so I joked about sleeping until midafternoon. Instead, I was awakened by my sister just before 7:30 am. She is not in medicine, but her voice radiated concern as she told me, “Dad is having trouble breathing.” I shot out of bed. With a single glance, I knew that you were sick. We knew we had to take you to the hospital. Mom and I left you by the “No Visitors” sign, an excruciating, invisible, COVID-19 barrier at the emergency entrance that kept our family, like too many others, from you during the most harrowing days of our lives. 

And then it was New Year’s Eve, with just under 12 hours remaining in 2020. We got the dreaded call from the ICU telling our family it was time to come to the hospital. And you were gone. Four months left for me to run alone. 

I ran through winter and spring, but I felt stuck. Stuck between the tomorrow I know is coming and the yesterday I never wanted to end. Stuck between the life I must live without you and the life I loved with you. Stuck between how others told me I should feel about graduating from medical school and how I actually felt. Loved and lonely. Proud and pitied. Exhilarated and exhausted. Hopeful and hopeless. Finishing a race we already lost. 

References 

1. Chbosky S.  The Perks of Being a Wallflower. Movie. Lionsgate and Summit Entertainment; 2012. 

To see the full article and comments, click here.  

Full Link: https://jamanetwork.com/journals/jama/fullarticle/2782297