
Getting my diagnosis of breast cancer in the first week of March 2020 was personally devastating. It also happened to be a professionally overwhelming time for me as an ER physician at the beginning of the COVID-19 pandemic. In fact, one of my first thoughts after my diagnosis was, “What about work?” The fact that considering what would happen to my professional life was high on my mind at a time when I wasn’t sure whether I’d be surviving the year shows how my relationship with my career was at that time.
I even asked myself, “Having cancer is a legitimate reason to step away from work, right?” As ridiculous as this question sounds, I genuinely weighed various answers to this inquiry. You’d think medical professionals would best understand the importance of prioritizing their personal well-being over their work, but we’re not. As purveyors of health, we struggle to identify ourselves as patients. Sickness presenteeism, or working when sick, is ingrained in our medical training and work culture. A whopping 88% of health care professionals across the globe admit to working while sick. I have personally worked through many conditions that I often write work excuse notes for, for my ER patients, including migraine headaches, influenza, GI illness, even while I was 36 weeks pregnant, 6 centimeters dilated, and contracting every 15 minutes.
So when I posed this question to my oncologist and she emphatically, yet simply stated, “Absolutely, yes.” I felt a huge sense of relief. If she said so, then it must be legitimate. Not only did she validate my concerns about working, but firmly stated it wasn’t recommended for me to work. Eventually, this became clearer to me as I started chemotherapy, recognizing the effect it had on my immune system and that being in the ER was risky given my daily exposure to multiple infections, such as COVID-19.
Although I knew why I couldn’t work during treatment, I still felt guilty for not working. Especially, during a time when I watched my colleagues battle the COVID-19 pandemic. Having taken an oath to serve others’ health, it’s confusing and difficult to stop doing so because of your own health. Even though I knew it wasn’t my fault I had cancer, it felt like a personal insult. I often had to remind myself that to best take care of my patients, my health and wellness needed to be optimized. If the roles were reversed, which they were when I became the patient, I wanted my oncologist, who was directing my cancer care and as it felt to me, holding my life in her hands, to be operating at 100% of her professional capacity.
Eventually, I understood that as vital as I felt to the frontline workforce, I was not necessary for my profession to succeed. Although this sounds like a disempowering statement, I found it quite relieving. Was my role as an ER physician important? Yes. Could I have contributed clinically? Yes. Was I required? No. It’s just that simple. There are approximately 60,000 people in our country who can do what I do. I, however, have only one life. The pressure to work was lifted and my absence was acceptable to me.
Having much of my adult life focused on my medical career, with 14 years in training and working as a relatively new attending, I didn’t know what to do with myself when I took medical leave. I was focusing on my cancer treatments, healing, and resting, but I began to question who I was. Being a physician was such a large part of my identity and now it had very little relevance to my life. Cancer doesn’t discriminate and being a physician didn’t portend any direct impact on what cancer was doing within my body. It was an emotionally unsteady time. However, by challenging everything I thought I knew and believed, desired, and feared in life I developed clarity of who I was. I fostered a deeper connection with myself. Although being a physician is an important part of me, it is only one part of my life. There is so much more to being me and living my life.
I returned to work in August of 2021. I joined the workforce restored and refocused on what brought me to medicine in the first place -- improving the lives of patients. I am less afflicted by the other tasks (darn, electronic health records!) that take up my time on shift and have rediscovered the joy in my interactions with patients. Albeit in the ER our encounters can be brief, I more readily sense my patient’s concerns, as well as how to alleviate them, beyond just labs and imaging tests. Connecting with my patients in this way feels mutually healing.
Some of my challenges may seem specific to my work as an ER physician, however the conflicts and insight is relevant to all fields of work. In hindsight, medical leave was the right decision for me and I’m so fortunate to have been able to support myself in doing so. Many people who have been diagnosed with cancer maintain their presence at work. It can be an important way for them to preserve a sense of normalcy. Regardless of what you choose to do, make sure it is a conscious decision with your best interest in mind.
To connect with other breast cancer survivors, join our Breast Cancer Facebook Support Group.
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