What's the worst that can happen?
Almost exactly 10 years ago,
I was sitting in an exam room that was way too cold
waiting to meet my new oncologist.
I was terrified.
Even though my partner at the time
was sitting right by my side,
I felt completely alone.
I had just been diagnosed with breast cancer,
and it seemed at the time
that a single bright spot on a scan of my right lung
meant that the cancer had already spread.
I had metastatic breast cancer.
I had no medical training at this point,
but I knew what it meant if it were true:
incurable breast cancer.
Terminal breast cancer.
I was 27 years old,
had just been accepted to medical school,
and I wondered if I was already at the end of my life.
My new oncologist was not a warm person.
She dealt in simple facts,
as many brilliant physicians do.
"Our body is made up of cells," she started.
I stopped her.
"I'm starting medical school soon.
I know."
Instead of taking this as a signal to go backward, to start again,
she went forward.
She said that I would need to start on chemotherapy
to control the cancer.
She launched into the details of the drug and the side effects
and the schedule.
I reminded her that we hadn't even yet biopsied the bright spot on my lung,
and I asked if she was sure that it was cancer.
I remember viscerally how she seemed almost frustrated with my question.
Perhaps she thought I wasn't following along with her explanations,
or, worse still, I was in denial.
I simply wanted her to understand that, as her patient,
the biopsy was not just a mere formality to prove an already foregone conclusion.
It was a steel needle through skin, muscle and bone
that would deliver a deep piece of me to the surface and answer a question
I wish didn't have to be asked.
Before the biopsy, I could be a 27-year old woman
who might have metastatic breast cancer,
who probably had metastatic breast cancer.
This is a critical distinction,
but it's not one that's emphasized in the most elite oncology training.
Instead, I was dismissed with an appointment to start treatment
in just a few weeks.
So much has happened since that first visit.
Ironically, the biopsy was not just a mere formality.
My former oncologist was right.
It did show cancer,
but it was a totally separate lung cancer,
and as crazy as it sounds,
this was great news.
I did not have metastatic breast cancer,
I had two different cancers,
but both of them were localized,
and so the lung cancer was localized enough
that it could be removed.
And so the onslaught of treatments began with a lung surgery,
continued with chemotherapy,
and ended with a breast surgery just after my 28th birthday.
And then two weeks later,
I started medical school.
My new oncologist,
who deals much more fluidly both with facts and their implications,
very reasonably suggested
that I should defer my acceptance to medical school for a year,
take some time to rest, to recover,
and I trusted her advice.
I felt terrible during the intensive chemotherapy sessions.
And so I wrote to the Dean.
I explained my circumstances,
and a deferral was speedily granted.
But as the chemo fog lifted,
I wondered what I was going to do with a year.
Should I go to the beach?
I wasn't really a beach person.
(Laughter)
And how many years did I have left anyway?
I really wanted to go to medical school.
It seemed like a missing piece of my puzzle.
So instead of going around and around with indecision,
I asked myself, what's the worst that could happen?
Well, I could be too weak or too sick to do the work.
It could be too hard for me emotionally.
I could fail out of medical school.
But then I remembered, that wouldn't be the worst thing that happened to me
even that year.
So why not get started?
Why not continue living the way that I wanted to live?
So I did.
Bald and rail thin,
I put on my best earrings and my favorite dress,
and I started.
I pretended to belong,
and I began to.
There is no way to describe how hard it was.
Some days it felt impossible.
It felt as I was doing things that would never matter in the future.
But every day, I asked myself, are you still enjoying this?
Is this still what you want to be doing?
And every day, the answer was yes,
sometimes a very qualified yes,
but a yes.
And then, just as I was getting comfortable
and feeling like I might not necessarily fail out of medical school,
I received even more devastating news.
I learned that I had a mutation in a gene called TP53, or P53 for short.