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Health & wellness

In Practice

A doctor ponders her reaction to a cancer diagnosis

Adapted from the In Practice blog on Boston.com

There’s this weird feeling I get when I hear bad news, or even not-that-bad news, or even the possibility of bad news: a tingling that spreads across my forehead, down my face, into my jaw, and then to my chest, where it settles like a . . . no, not a lump . . . a void. I get the feeling every time I go for my annual mammogram or any other medical test, I wonder how I would react to a bad outcome.

Would I be brave and noble, as so many of my patients are? Or would I be like Woody Allen in the classic scene from “Hannah and Her Sisters,” one of the “weaker ones,” panicked, swallowed up in the void of my own fear?

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At my Literature and Medicine discussion group, I had a chance to reconsider this question. Once a month, nurses, nurse practitioners, administrators, and doctors meet to discuss literature related to a particular medical theme. This month, the theme was cancer, and two of the works we read detailed very different reactions to devastating cancer diagnoses.

Christopher Hitchens, essayist and contrarian, died of esophageal cancer in 2011 at age 62. In 2010, he wrote in Vanity Fair about his reaction to the diagnosis (his essays about this illness appear in a book, Mortality, published shortly before his death). Hitchens, a heavy smoker and drinker of alcohol, wrote with characteristic dry wit of learning that he had the same cancer that had killed his father:

“. . . I can’t see myself smiting my brow with shock or hear myself whining about how it’s all so unfair: I have been taunting the Reaper into taking a free scythe in my direction and have now succumbed to something so predictable and banal that it bores even me.”

We also read Susan Gubar’s Memoir of a Debulked Woman. Gubar, a distinguished literary scholar, was diagnosed with ovarian cancer in 2008. She now blogs about cancer for The New York Times. In her memoir, Gubar describes a strange euphoria that overcame her as she lay on a gurney in a hall, having just been told by a radiologist that the vague digestive symptoms she’d had for months were likely caused by advanced ovarian cancer. Some of this euphoria — which, of course, gave way to despair, anger, and myriad other emotions later — was the scholar’s satisfaction in learning the truth:

“Knowledge clinched or confirmed always feels like a coin falling into the right slot, a ball landing in a basket, a peg knocked into its proper hole. I recognized, I believed, what would kill me. That there is pleasure even in such painful knowledge may seem perverse; however, the mind and spirit are subtle and mobile faculties.”

Roughly one in four of us will face a cancer diagnosis at some point. I’m hoping I’ll bring my better, braver self — not my Woody Allen-ish self. Meanwhile, I look to my patients to show me the way.

Read this blog at Boston.com/InPractice.

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