Cancer isn't fair

Today's guest blogger: Val Jones, MD

Physicians see horrible things, tragic injustices caused by unexpected disease and circumstance. We do what we can to remain compassionate - to be emotionally "present" and yet to keep the professional distance required for our survival and success. It takes courage to set a bone, crack a chest, to do painful procedures to save lives - there must be no hesitation when minutes count.

And I suppose that our saving grace is that the majority of the patients we meet in tragic circumstances are not personally known to us. We appreciate their humanity in a general sense, but are not pierced and incapacitated by a family tie or bond of friendship. We are pained by their suffering - but we can cope.

That is, until we're confronted with a loved one who is thrust into tragedy. Two days ago, a dear friend and former coworker called me to say that she had been diagnosed with colon cancer that had metastasized to her liver. She had just given birth to her first child at age 41. Her only symptom? Post-partum fatigue.

My friend is a health nut and athlete - she has lived the "gold standard" life from a preventive health perspective. I always wanted to be more like her - eating lots of veggies and running regularly. She has been at her target weight all her life, has the occasional glass of wine, and spends much of her free time in community service projects and charity work. She has no history of cancer in her family - they are all hardworking, clean-living types who enjoy long, productive lives.

So when she told me about her advanced disease I almost fell off my chair. How could this happen to her? She is too young! She doesn't fit the right description... Why didn't I catch this sooner? Did she ever give me any hint of a warning symptom?

She told me that after having her baby she just felt really tired and was unable to bounce back as quickly as expected. I was worried about post-partum depression, and she eventually decided to see a family physician about her fatigue. He was unclear as to its root cause, and ordered a broad range of general blood tests - including liver function tests. They turned out to be abnormal, and he inquired as to whether my friend might be a drinker. She denied any such tendencies, so he scheduled an ultrasound. The ultrasonographer noted the appearance of metastatic cancer - she had a CT scan and a colonoscopy to confirm the diagnosis of colon cancer. We were both in shock.

And now as my dear friend faces likely surgeries and chemotherapy, I am witness to her journey - the same one that I've observed in strangers - but this time I have no professional defenses. I will watch as her body is wracked by the disease's treatments, I will understand the individual circumstances behind her bravery, I'll know and feel everything in a personal way that I can't control.

I am about to join the millions of cancer patients and their families on the other side of the examining room. This time I'm not the doctor, I'm the close friend who rages against a disease that is not fair. And I am ready to fight.

Thank you, Dr. Val. Please send an update on your friend soon ...