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A Thankful Retrospective

Thanksgiving has become the season of gratitude, and the practice of tallying the bits of gratitude strewn throughout your life has become a tradition this time of year. Today's check-up with my Medical Oncologist gave me just that; time to pause and take stock in the many things for which I am grateful while awaiting my turn. Despite Covid, I'm thankful my family's health is intact, thankful for the upcoming holiday reprieve to rest and recharge, and for the software engineer at Apple who built the "tomorrow's a holiday, turn your work alarm off" feature. 'After all, it is the little things that add up to a grateful outlook on life. But, I had a "micro" experience today that brought me back to 516 days ago. See, while I was registering at the front desk for my check-up and was filling out the usual Covid questionnaire, the receptionist second-guessed herself and said, "wait, are you a patient or a doctor?" That small moment of confusion may not seem like much to someone else. To me, it felt like a gift, a little nugget for which I could feel gratitude. I could have chosen to see it differently. It's an easy mistake, doctors come in all shapes and sizes, but I didn't because it meant she thought I looked healthy enough to be a doctor. Of course, I had to correct her and let her know that "yes, I am a patient." And 516 days ago and more, I was also a patient.

At that time, I was done with my chemotherapy treatments and had just completed my partial mastectomy surgery. I estimated that I had lost about 60% of my hair from the harsh chemo drugs, although, looking back, it might not have been that high. The cold cap therapy I chose to use during treatments limited balding to behind my ears and around the nape of my neck. My remaining hair was able to cover those areas nicely. What I found peculiar then and now is the misconception that still exists for breast cancer patients and drug-induced alopecia. Cancer therapies have come a long way. They now have an arsenal of drugs to pump into your system, all before introducing any chemo drugs. This pre-drug chemo treatment happens with every infusion visit. These drugs help to keep nausea at a minimum. Sometimes they are more effective than others and work to varying degrees for each person. There are drugs to keep sickness at bay and protect patients from infections and too many others to name here. All combined, these drugs keep the usual side effects under control. That being the case, I, like many others, was able to work during my treatments months. A generation before, treatment meant difficulty maintaining life as it was before a patient's treatment began.

Furthermore, my nurse navigator introduced me to the "Cold Cap" therapy I mentioned earlier. The system uses intensely low temperatures to keep blood flow at your hair follicles to a minimum, preventing hair loss. All of these things combine created what seemed to be an a-typical patient profile. I was able to work and still had hair. I new other patients with a similar experience.

Easter 2019 2 months into treatment. Lots of hidden blading.

Have all of these treatment advances have led to a profile shift of the average chemotherapy patient? Gone are the days when every chemotherapy patient is immediately rendered too sick to work or look so different that their sickness takes over their entire external essence. This new persona doesn't mean you don't feel bad. You do. Your limbs ache, you can't taste anything, and you are often in a drug-induced brain fog. Not to mention the surgery scars and ports you've had implanted can cause continuous pain.

If not for their infusion anchors, you could look around treatment centers and see people who you would not otherwise know were sick. We can gleam multiple insights from this state of affairs. First, I am personally grateful that being able to look and feel even slightly whole during this time gives such great hope. It did for me and so many others, and for that, I feel incredibly grateful. I am so very thankful for medical advances, those who research them, and those that deliver them. Reflection during the holiday season seems like a good reminder of how far we have come as a whole and how far we as a family have come from a personal perspective.

But what I also find striking is how these typical patient profile shifts highlight the tried and true statement, "Don't judge someone until you've walked a mile in their shoes." Cancer and so many other diseases are becoming more challenging to spot. We are in an ever-changing world, and as we evolve and learn more about each other, let's not forget that what we see on the surface can not be mistaken for the complete picture of that person. We are in a phase of great learning. We are learning more about mental health and racism, and my hope this holiday season is that we can learn to turn up our sympathetic and empathetic meters. We can add more empathy and sympathy to our repertoire, acknowledging that such remarkable medical advances continue to make the journey more manageable but less pronounced. Less incapacitating still wholly impactful to one's life.

Thank you to all the fighters out there whose spirit shines bright and spreads inspiration. Thank you to all the thinkers who spend their holidays discovering life-saving therapies. Thank you to all the practitioners who devote their lives to helping others and who deserve daily appreciation. To all of you, I am thankful for you on this Thanksgiving holiday.



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