Today a patient of mine is sitting on the wall, the wall the divides the cancer and the non-cancer world.
An abnormal lab result has put him there. He is in the middle, waiting for his fate, the outcome of further investigations, to determine which side he is going to fall on. He is dizzy with stress of not knowing and , I , his doctor can tell which side he is going fall on but I don’t want to accept it.
I know that angst, I know it much too well. I feel it in the pit of my stomach, I breathe it with every “survivor” breath , I connect to it every time I have a weird ache or pain.
I don’t want him to join me in the cancer world. We don’t need another companion. There are too many of us on this side already.13.7 million of us. These transitions need to stop.
Sitting in front of me is someone who has just been given a through-looking glass and he sees a life with cancer that could be his. A window has been opened for him to look at what a life of worry and facing death is like. He looks grim and sad, his shoulders are hunched with the burden.
I am distressed. It’s not fair. But my gut tells me, he is yet another victim of the unfairness that we call “life”.
The cancer world is ready to embrace another recruit.

There is muttering on the cancer side, the knowing nods and the sighs.
An unceremonious welcome awaits him. We can comfort him but never take the worry away.
We have to own our mortality every day. Denial doesn’t live in the cancer world. Its across the wall where we once lived. We left it behind when we fell on this side just as we lost our worry free existence.
Someone that has been handed a worry rolled up in a bundle of ,” We need to do additional testing to determine why its abnormal?”, laced by a lame comment of “It’s going to be OK”.

I know that dishonesty too well. The pat on the shoulder, that comforting look, that supportive comment that is trying to mask the true anxiety of the doctor who already knows that her patient has already been given the passport of the cancer world. I am guilty of that too.
It’s my job as a doctor to shelter my patients from unnecessary worries of false positives and to believe in the best until the biopsy glares in my face and I see the word “malignant”. Till then, my job is to give hope and comfort but quietly brace for the worst, assess in my mind what investigations will be needed, what kind of support will be needed for the patient, how will this patient cope with the diagnosis and so on.

He is sitting in front of me as my heart sinks a little. I remember my time on the wall. The heavy weight of every passing moment and the distressing apprehension. The ebb and flow of hope and tears that spread on that wall. The first introduction to the reality of death and dying casting its shadow on me.

I fell on the cancer side. I hope my dear patient you don’t. I know what it does. I hope you fall back on the other side that has bliss. I hope so, I really hope so.


  1. This is a heartbreakingly, poignant post, both from a doctor’s and patient’s perspective. I fell on the breast cancer side of the wall, unfortunately. Before he ordered the biopsy, my surgeon said, “We don’t know what it is yet.” But I could read his face, and I knew he knew it was cancer.

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