Richard Rayner, MD
“Gratitude is not only the greatest of virtues, but the parent of all the others.” – Cicero
Some years the Thanksgiving holiday seems extra special. Such is the case this year for my family and me. Aside from so far avoiding COVID-19 infection, and welcoming in late 2019 and early 2020 two new grandsons into our lives, we also experienced a very scary situation. I’ve debated long as to whether or not to share this story. I’ve decided to in the hope that others will find encouragement and reasons to be thankful.
Every medical student at some point during his schooling feels that he must have some terrible illness, usually one of those just recently introduced in the course work. They say a little knowledge can be dangerous, but as we loaded huge servings of scientific information onto our medical education platters in our first and second years of medical school, it became clear that a ton of knowledge can be catastrophic to the psyche! My fellow classmates and I became convinced that little aches and pains were likely precursors to our imminent demise. Eventually, we all settled down as the flood of information was too great to waste the emotional energy on determining how many of the symptoms of the disease du jour we actually had.
But a physician goes through life with the unusual ability to self-assess constantly. Some become hypochondriacs, over-diagnosing, and self-treating every twinge and ache. Some of us swing entirely to the other extreme and live in a chasm of denial, ignoring the warning signs of bad things brewing. But often the knowledge a doctor possesses plus honest, self-assessment proves helpful.
Who, me?!
Such was the case with me in mid-February, 2020. Just prior to when the creature that has become the COVID-19 pandemic began spreading its tentacles through our country I began to notice obvious blood in my urine, “frank” blood as we like to call it. Twice. No pain, just blood, and a good amount of it, once for less than a day, then again a week later, this time persisting. At that point, my knowledge proved helpful for setting my mind for what I knew even before any testing was going on inside me: bladder cancer. A CAT scan and visit to the urologist confirmed my suspicions a couple of days later. Three days after that, instead of skiing at Alta, I was in the operating room undergoing surgery for the removal of the tumor which was removed in its entirety. Fortunately, it had not spread and the prognosis is excellent.
Still, this experience has afforded me the opportunity to experience several things that awakened my sensitivity to what it means to be a patient, especially one with a serious diagnosis.
Life as a Patient 101
Turns out life on the other side of the exam table is full of surprising experiences. Here are some of mine and my observations:
- The strange position of having the phrase, “I have cancer,” be true of me. Wait, what? Me? The one who promotes and generally follows healthy living practices? Shouldn’t I be exempt from such bad fortune?
- Experiencing surgery and post-operative care involving a very private and vulnerable part of my body, now invaded by all kinds of tubes that the hospital staff needed to “check.” Frequently! There was considerable discomfort involved, and the expected overnight stay grew into four days total.
- Waiting for a pathology report that would determine what the treatment would be, including one possibility being a life-altering surgery. Sometimes a person’s bladder needs to be removed if cancer has invaded the wall of the bladder deeply. Although I knew from the CAT scan results it would likely not be a terminal condition, the pathology report was key to determining future procedures and prognosis. Thankfully my tumor had remained superficial so I required only to be treated with solutions placed directly into the bladder. Not a picnic – more tubes! – but doable.
- The ongoing significant discomfort even after the hospitalization, each trip to the bathroom a painful reminder that I had had a significant problem and an invasive procedure.
- Then there were the administrative annoyances: failure of the specialist’s office to make appointments as promised; COVID delays; incorrect information delaying insurance approvals and thus delaying treatment; staff not reading the chart before addressing me, etc.
The Telling
The effects of this diagnosis on a family are difficult too. Fortunately, I had my wife Leslie to walk through all this with me, and our relationship of 35+ years was a solid shelter of protection in this new storm. However, she had to watch and listen as the details of her loved one’s serious illness were laid out before her. What would it mean for her? For us? Telling my adult children and their spouses was another layer of difficulty. I wanted to care for them even as I was giving them the news about me. Their tears were harder than my own reaction. Having lost our only sister suddenly at age 63 just a few months before, even telling my brother was difficult. After all, with our parents being gone also it meant it was just he and I from our nuclear family, and, although he is 9 years my senior, would I now be the next one to die? Those closest to me outside of my family – my practice partner David, my pastor friends Josh and Steve, other caring friends – received the news with love and concern, but I didn’t enjoy being the one who needed support in the medical realm. I’m the healer, remember?
And where is God in all this? Did this happen while His back was turned? My belief in a sovereign God is steady, deeper even, knowing that His kindness towards me over my lifetime has been great. He is neither absent nor impotent in this. Rather, He is handcrafting the story of my life, and this suffering is a very important tool in His gracious hands. He is using it to create depth of character and give experiential knowledge with which I can more effectively care for others.
Now in the game of cancer experience, I’ve been tossed a softball. There are many who have had the term cancer applied to them and it means a much more significant and deadly challenge. I don’t mean to downplay that reality at all. I feel for them even more so now. It’s the news that everyone dreads. However, that should not be my story if all goes as it typically does. Bladder cancer is annoying in that I will need many follow up procedures, but at the stage that my tumor was at the time of diagnosis, it is not usually terminal. For that I am grateful, and I thank God for His kindness in allowing the early discovery of my condition.
Ch-Ch-Ch-Ch-Changes
What has this whole thing meant for me and my approach to doctoring and life? That will be an ongoing tale. My hope is that I will have more empathy now for those who hear the words “It’s cancer.” applied to their situation. I will increase my efforts to encourage patients to undergo appropriate screenings for early cancer detection. And I hope to be more careful to make sure that my patients with any serious illnesses that require specialist care get what they need in a timely manner. And I will continue to push our practice to remember that while dealing with those who are ill or hurting is routine for us, it’s often a major disruption in the life and family of the one dealing with the pain and suffering. Good healthcare providers not only take care of patients but care for patients.
Thanks
If you’ve read this far, thanks! As I stated above I debated with myself for a long time as to whether it was wise to share such a personal story. I had concerns that once the word got out that I had cancer that the whisper-down-the-lane rumor mill would have me feeble and weak, unable to competently manage patients and that I would be dying any day. You’ve seen that happen! But ultimately I decided that my story might be helpful, especially at a time when there is so much hurt and confusion in the world. I encourage you to pause this November and consider the gifts you have, a note from where they come, and whom you have to thank for them. And express those thanks.
This year I am thankful in newer and deeper ways. I thank God for: a faithful, long-suffering, patient wife who is industrious, kind, and lovely, a real treasure; 2 delightful grandsons; 3 adult sons and 2 daughters-in-law that are leading productive lives; a home church family that cares for me; comforts that make life pleasant; and a cancer diagnosis that seems to be fast becoming a past problem.
Finally let’s consider the words of that great philosopher, Charlie Brown. “What if today, we were just grateful for everything?”
